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PubMed2004

Learning to optimize speed, accuracy, and energy expenditure: a framework for understanding speed-accuracy relations in goal-directed aiming.

Over the last century, investigators have developed a number of models to explain the relation between speed and accuracy in target-directed manual aiming. The models vary in the extent to which they stress the importance of feedforward processes and the online use of sensory information (see D. Elliott, W. F. Helsen, & R. Chua, 2001, for a recent review). A common feature of those models is that the role of practice in optimizing speed, accuracy, and energy expenditure in goal-directed aiming is either ignored or minimized. The authors present a theoretical framework for understanding speed-accuracy tradeoffs that takes into account the strategic, trial-to-trial behavior of the performer. The strategic behavior enables individuals to maximize movement speed while minimizing error and energy expenditure.

Cognition↗

PubMed1990

Effects of background symmetry on same-different pattern matching: a compromise-criteria account.

Two experiments are reported, which were designed to test predictions of an account of same-different matching that assumes that bilaterally symmetric backgrounds provide extraneous evidence toward same, whereas asymmetric backgrounds provide evidence toward different. When all backgrounds within a block of trials are of the same type, appropriate adjustments of response criteria can be made to accommodate the irrelevant evidence and thus maintain acceptable levels of accuracy. However, when backgrounds of different types are mixed randomly, compromise criteria are adopted. This compromise-criteria account predicts distinctive interaction patterns for reaction times when blocked versus mixed presentations of various background types are compared. The predicted interactions were obtained for asymmetric- and no-noise backgrounds in Experiment 1 and for symmetric-, asymmetric-, and no-noise backgrounds in Experiment 2. The findings support the general view that extraneous display attributes are weighted into the evidence for same and different, with criteria settings used that minimize errors under the noisiest conditions.

Adult↗

PubMed2002

In vivo kinematics of the low contact stress rotating platform total knee.

The Rocky Mountain Musculoskeletal Research Laboratory uses in vivo video fluoroscopy to evaluate kinematics of total knee arthroplasty. This method allows us to evaluate in vivo weight bearing activity for a variety of knee designs, as well as kinematics of the normal knee. Our proprietary method of automated model fitting allows for three-dimensional analysis obtained from two-dimensional fluoroscopic images with minimal error. This article outlines the details of our kinematic analysis of the Low Contact Stress (LCS) Total Knee System (DePuy Orthopaedics lnc, Warsaw, Ind) rotating platform total knee and compares this design with fixed-bearing posterior cruciate-retaining and posterior cruciate-substituting total knee and normal knee kinematics.

Biomechanical Phenomena↗

PubMed2004

[Recessive dystrophic epidermolysis bullosa. Report of one case].

We report a female newborn with a dystrophic epidermolysis bullosa. The diagnosis was made by electron microscopy of a bullous skin lesion. The importance of reaching a specific diagnosis is underscored. Close relatives can therefore be informed and educated about prognosis, etiology and the possibility of having new affected offspring. An accurate diagnosis can be reached through electronic microscopy or modern immunohistochemical techniques. Further complementary information given by conventional histology is required. A complete study is recommended to minimize errors in the intepretation of morphology.

Epidermolysis Bullosa Dystrophica↗

PubMedDate not supplied

Socioeconomics of coding for endocrine services.

OBJECTIVE: To review the current coding systems for procedures and services as well as for diagnoses and to address special issues in endocrine disorders such as diabetes relative to reimbursement. METHODS: A method of coding for services to maximize reimbursement and minimize errors and denials of claims is discussed. Useful checklists and resources are also provided. RESULTS: Medicare policies have become increasingly complex, and continual changes in coverage of medical services and procedures can be confusing. Suggestions are presented for securing timely payment for claims, and thorough documentation is emphasized. "Bundling" of codes by payers, a common practice with new screening software systems, is explained. Strategies are described for negotiating contracts that specify prompt payment periods and include penalties for late payments. CONCLUSION: Awareness of current codes for health care services and diagnoses will facilitate the processing of claims and optimize reimbursements.

Journal Article↗

PubMedDate not supplied

Physiological observation track and trigger system.

A patient observation chart was developed to combine physiological observation charting with the calculation and recording of an early warning score (EWS); this was named the Physiological Observation Track and Trigger System (POTTS). Reference to a table of instructions is no longer needed and the EWS can be calculated with minimal error. Increased frequency and accuracy of EWS recording assist in identifying patients at risk of deterioration and enhance patient safety.

Algorithms↗

PubMed1991

Nursing practice in the next decade: the impact on nursing and pharmacy systems.

Nursing practice in the year 2000 will occur within more regulated health care systems, with a much higher focus on the cost and the quality of the service that is delivered. Patients will have more complex illnesses and treatment regimens that will require that nurses have appropriate levels of education, experience, and clinical specialization. The nursing work force will change in its nature, cost, and composition. Nurses will operate in flatter organizations and within productive multiprofessional and technical work groups that operate as flexible, self-directed teams. New clinical practice models will be operational, and they will be adapted to the unique work and environment of each patient care unit. Practice will be restructured to incorporate clinical and nonclinical support. Work redesign and restructured practice environments will be essential to meeting the requirements for the future. Patients with complicated illnesses will continue to move through hospital systems at high speeds. Treatment regimens will be extremely complex. The requirement will be to emphasize high-quality and affordable care, while minimizing errors and complications. Technology will provide new challenges, new excitement, new dilemmas, and new demands. The ethical dimensions of care will become ever more challenging. The pharmacological aspects of treatment will gain in prominence. Mutual respect and mutual support will be the hallmarks of the nursing and pharmacy interface in the year 2000.

Education, Nursing↗

PubMed1993

Effect of implementing a cancer chemotherapy order form on prescribing habits for parenteral antineoplastics.

Effect of implementing a cancer chemotherapy order form on prescribing habits for parenteral antineoplastics. The purpose of this study was to determine whether the use of a cancer chemotherapy order form improved prescriber inclusion of necessary prescription information to minimize errors for parenteral antineoplastics when compared to orders written on standard treatment-order forms. Standard treatment order forms and the newly developed chemotherapy order forms were examined for differences in completeness of the following 13 prescription components: diagnosis, height, weight, body surface area, start date and time, dosage (e.g., mg/m2), dose (mg), solution diluent (drips only) and volume (drips only), infusion rate (drips only), route (i.e., IV push or IV drip), frequency of administration, and total number of scheduled doses. The results demonstrate a significant improvement in completeness of necessary prescription information when cancer chemotherapy was ordered by physicians using a chemotherapy order form compared to a standard treatment order form. Importantly, the availability of various prescription components such as height, weight, and dosage may be used by the pharmacist to verify physicians' calculations of body surface area and dose and thereby reduce the chance of serious medication dosage errors. An additional benefit of the new form is a reduction in the time pharmacists spend clarifying orders.

Antineoplastic Agents↗

PubMed1994

The Canadian National Calibration Reference Centre for In-Vivo Monitoring: thyroid monitoring. Part III: A basic calibration procedure for thyroid monitoring.

This article is the third of a five-part series covering various aspects of occupational thyroid monitoring. This article introduces the basic concepts required to understand the procedure for determining the counting efficiency of a thyroid detector. The B.R.M.D. thyroid-neck phantom is used as the calibration source. A procedure for personnel monitoring is also discussed and the concept of Minimum Detectable Activity (MDA) is introduced. The last two articles in this series discuss energy calibration, counting system optimization based on a single-channel analyzer and placement error minimization.

Calibration↗

PubMed2001

Optimal nonlinear codes for the perception of natural colours.

We discuss how visual nonlinearity can be optimized for the precise representation of environmental inputs. Such optimization leads to neural signals with a compressively nonlinear input-output function the gradient of which is matched to the cube root of the probability density function (PDF) of the environmental input values (and not to the PDF directly as in histogram equalization). Comparisons between theory and psychophysical and electrophysiological data are roughly consistent with the idea that parvocellular (P) cells are optimized for precision representation of colour: their contrast-response functions span a range appropriately matched to the environmental distribution of natural colours along each dimension of colour space. Thus P cell codes for colour may have been selected to minimize error in the perceptual estimation of stimulus parameters for natural colours. But magnocellular (M) cells have a much stronger than expected saturating nonlinearity; this supports the view that the function of M cells is mainly to detect boundaries rather than to specify contrast or lightness.

Algorithms↗

PubMed2002

Alloreactivity and the predictive value of anti-recipient specific interleukin 2 producing helper T lymphocyte precursor frequencies for alloreactivity after bone marrow transplantation.

Allogeneic bone marrow transplantation (BMT) is a treatment modality with the potential of curing otherwise lethal diseases. The predominant indications for BMT are haematological malignancies. In BMT alloreactivity plays a pivotal role for the outcome. Graft-versus-host disease (GvHD) and graft-versus-leukaemia (GvL) are correlated manifestations of alloreactivity. Severe GvHD is one of the main causes of morbidity and mortality post-BMT. In the absence of GvL the risk of relapse is high. The main effector cells are T lymphocytes. Donor leukocyte infusion (DLI) for treatment of leukaemic relapse after BMT can induce durable remissions. DLI causes GvHD in the majority of the responding patients. However, a GvL effect may be present without evidence of GvHD and vise versa. The importance of alloreactivity for the treatment outcome prompted the interest for a predictive test of alloreactivity. Interleukin 2 (IL-2) producing helper T lymphocyte precursor (HTLp) frequencies determined by limiting dilution analysis (LDA) in the graft-versus-host direction were explored. The HTLp assay was optimized and the sources of error minimized to ensure sensitive and reproducible results. The IL-2 dependent cell line, CTLL-2 was optimized to detect 0.6 pg IL-2. UV-B irradiation of the cells was demonstrated to effectively terminate proliferation of the responder cells and thus allow IL-2 to be detected in the whole culture volume. The design of the assay was explored by Monte Carlo simulations resulting in a design yielding frequencies with a coefficient of variation of 20% in the range of 1:20,000-1:1,000,000. The influence of autoreactivity of the donor and recipient cells was minimized as well as the risk of the stimulator cells producing IL-2. The HTLp frequencies correlated with the degree of human leukocyte antigen (HLA) disparity and the assays were able to detect minor histocompatibility antigen mismatches. The HTLp frequencies of 28 HLA-identical sibling BMT pairs and 20 HLA-matched unrelated and partially HLA-matched related BMT pairs were determined. HTLp frequencies from the HLA-identical sibling BMT pairs had a median of 1:557,362 (range 1:9.511 to < 1:2,500,000). The HTLp frequencies from the HLA-matched unrelated and partially HLA-matched related BMT pairs had a median of 1:88,110 (range 1:4.139-1:736,123). Analysis of the HLA-identical sibling BMT pairs in a high and a low HTLp frequency group above and below 1:500,000 showed a trend towards a higher risk of acute GvHD > or = grade II and a significantly higher risk of chronic GvHD in the high HTLp frequency group. This group had a significantly lower risk of relapse as well as a significantly better overall survival and leukaemia free survival. The HLA-matched unrelated and partially HLA-matched related BMT pairs were split evenly in a high and a low HTLp frequency group above and below 1:90,000. There was a significantly higher risk of acute GvHD > or = grade II and a trend towards a higher treatment related mortality (TRM) in the high HTLp frequency group. There were no differences in chronic GvHD, risk of relapse, overall survival and leukaemia free survival. Analyzing all 48 patients the risk of acute GvHD > or = grade II and TRM was significantly higher with HTLp frequencies > 1:100,000 and there was a trend towards a higher risk of relapse with low HTLp frequencies < 1:400,000. Patients in the intermediate HTLp frequency group 1:100,000-1:400,000 had a trend towards improved survival. The HTLp frequency seems to detect clinically significant differences in alloreactivity, that can be useful in donor selection, graft-engineering, T cell add-back and the pharmacological immunosuppression used after BMT.

Bone Marrow Transplantation↗

PubMedDate not supplied

Posterior mandibular residual ridge resorption in patients with conventional dentures and implant overdentures.

PURPOSE: This study investigated the effects of certain systemic and local factors on resorption of the posterior mandibular residual ridge under conventional dentures and overdentures supported by 2 implants. MATERIALS AND METHODS: Proportional area measurements of the posterior mandible were made on rotational tomograms taken immediately before and 5 years after treatment. The area was bounded by a line joining gonion to the lowest point of the mental foramen and the crest of the residual ridge and was expressed as a proportion of an area that was not dependent on the ridge. The use of proportions rather than actual measurements minimized errors related to magnification and distortion. RESULTS: The estimated average reduction in height was 1.25 mm in 5 years (1.63 mm for conventional denture groups and 0.69 mm for implant overdenture groups, ie, almost 1 mm less in the overdenture group). DISCUSSION AND CONCLUSION: Female gender was a risk factor for greater resorption. Other factors, such as the number of years a patient had been edentulous, initial height of the mandible, and the number of dentures used, failed to show an association with resorption of the residual posterior mandibular ridge, while the statistically significant effect of age was unlikely to be clinically significant.

Adult↗

PubMed2003

Predicting outcome in pediatric near-drowning.

BACKGROUND: Near-drowning is common in children and has a high mortality rate. Some survivors remain in a vegetative state after the accident and are a great burden to their family and society. OBJECTIVES: To find out whether outcomes on near drowning can be reliably identified early in the course of illness. METHOD: Medical records of 72 children admitted to Queen Sirikit National Institute of Child Health, Bangkok, Thailand, for treatment of near drowning from January 1993 to December 2001 were retrospectively studied. Stepwise multivariate discriminant analysis was used to identify the power of variables achieving highest overall accuracy in minimizing errors for predicting poor outcome in intact survivors. RESULTS: The patients were identified into three groups: functionally intact, vegetative and dead groups, it was found that a combination of physical examination in the emergency department (ED), the need for cardiopulmonary (CPR) in the ED, amount of adrenaline given during CPR, and high blood sugar achieved an overall accuracy of 83 per cent. When categorizing patients into good outcome versus poor outcome (the combination of the vegetative and dead group were the poor outcome group). The variables mentioned above achieved an overall accuracy of 98 per cent. Good outcome survivors could be correctly predicted with no error, but error occurred when poor outcome survivors were predicted to be good outcome in 3 per cent. Glasgow coma score > or = 5, the need for CPR in the ED and blood sugar > 300 mg/dl were selected clinical variables found to have optimum predictive abilities with an overall accuracy of 96 per cent, but showed an error of 6 per cent in predicting poor outcome from functional intact survivors (unpredicted good outcome). CONCLUSION: From the present study discrimination analysis cannot accurately separate all intact survivors from the vegetative groups, but can prospectively differentiate unpredicted good outcome from vegetative or dead groups. When using only simple clinical classification systems, unpredicted good outcome patients are detected. Since outcome cannot be accurately predicted in the ED, all near drowning victims should receive vigorous and aggressive treatment in the early course of illness and need close monitoring for respiratory complications and neurological signs.

Adolescent↗

PubMed1981

Left ventricular volumes and ejection fraction derived from apical two-dimensional echocardiography.

Two-dimensional echocardiographic data in orthogonal apical projections were used to calculate left ventricular ejection fraction and volumes in 18 patients, 10 of whom had asynergy. The left ventricular chamber was modeled as a stack of 20 elliptical discs in order to minimize errors associated with assumptions of regular geometry. Calculations were compared to data from biplane angiography and yielded correlation coefficients of 0.91 for ejection fraction and 0.90 for volumes. The technique significantly underestimated volumes; the average ventricular volume was 161 +/- 23 ml from cineangiography and 104 +/- 25 ml from echocardiography (p < 0.001). Since this technique utilizes the most readily obtained echocardiographic views and allows for variations in ventricular architecture, its potential utility in long-term, serial evaluation of cardiac function appears promising.

Journal Article↗

PubMed1992

Leg length discrepancy in total hip arthroplasty.

After conducting a thorough literature review, we realized that no consensus exists regarding the definition of a significant postoperative inequality. Whereas some investigators quantitate the disparity, accepting as much as 2.0 cm or in some cases less, others define a significant disparity as one that promotes adverse functional effects postoperatively. This lack of a consistent definition reflects the wide disparity of opinion regarding the problem of postoperative leg length inequalities in total hip surgery. Although the literature may lack consistency, it does reflect the collective experience of many surgeons and provides valuable insight when approaching the issue of limb lengths in reconstructive surgery of the hip. We offer the following suggestions: 1. Begin with a thorough history and physical examination. Question the patient as to whether he or she actually perceives a leg length inequality. 2. Be aware of apparent leg length discrepancies in patients with hip disease. The perceived limb shortening is usually the result of a fixed adduction contracture with little true shortening. 3. Develop a consistent approach of evaluation preoperatively, intraoperatively, and postoperatively. Employ reliable and convenient clinical measures and radiographic techniques. A method of intraoperative assessment is mandatory. 4. Redundancy in the system helps to minimize error. Good preoperative planning does not supplant the need for intraoperative assessment and vice versa. 5. Address the issue of offset in preoperative planning. Anticipate its misleading effects on intraoperative evaluation. 6. Mention potential inaccuracies regarding limb length reconstruction in total hip surgery as part of a routine preoperative evaluation. Patients' expectations should be high but temporized with realism.

Anthropometry↗

PubMed2005

Long-term personality data collection in support of spaceflight and analogue research.

This is a review of past and present research into personality and performance at the University of Texas (UT) Human Factors Research Project. Specifically, personality trait data collected from astronauts, pilots, Antarctic personnel, and other groups over a 15-yr period is discussed with particular emphasis on research in space and space analogue environments. The UT Human Factors Research Project conducts studies in personality and group dynamics in aviation, space, and medicine. Current studies include personality determinants of professional cultures, team effectiveness in both medicine and aviation, and personality predictors of long-term astronaut performance. The Project also studies the design and effectiveness of behavioral strategies used to minimize error and maximize team performance in safety-critical work settings. A multi-year personality and performance dataset presents many opportunities for research, including long-term and follow-up studies of human performance, analyses of trends in recruiting and attrition, and the ability to adapt research design to operational changes and methodological advances. Special problems posed by such long-duration projects include issues of confidentiality and security, as well as practical limitations imposed by current peer-review and short-term funding practices. Practical considerations for ongoing dataset management include consistency of assessment instruments over time, variations in data acquisition from one year to the next, and dealing with changes in theory and practice that occur over the life of the project. A fundamental change in how research into human performance is funded would be required to ensure the ongoing development of such long-duration research databases.

Adaptation, Psychological↗

PubMedDate not supplied

[Classification of the adolescent EEG by the spectral and segmental characteristics for normals].

The 16-channel EEG records of 45 adolescents with schizophrenia and 39 healthy adolescents were subjected to statistical combinatorial analysis of 160 elementary EEG characteristics (6 spectral and 4 segmental EEG characteristics for a channel). Employing pattern recognition algorithm "Kora-n", a list of 37 combined EEG patterns was compiled. This list characterized with a minimal error the EEG of healthy adolescents in such a way that none of these characters featured the EEG of adolescents with schizophrenia. Analysis of this list of EEG characteristics suggests that the contrast between EEG of healthy and ill adolescents is the sharpest in the F4, Cz, T3 and O1 derivations. Compared to EEG samples of schizophrenic subjects, EEGs of healthy subjects exhibit lower levels of delta and theta activity mainly in the frontal and temporal regions of the cortex and higher level of alpha activity predominantly in the occipital region. Applicability of the list of EEG patterns for diagnostics of schizophrenia-type disorders of adolescents is discussed.

Adolescent↗

PubMed1992

Computer-aided forensic facial reconstruction.

The reconstruction of facial features on the human skull for identification purposes has, in the past, utilized either two-dimensional drafting or three-dimensional sculpting techniques. We have developed two- and three-dimensional computer-aided routines to minimize errors introduced by limits of artistic ability or by inconsistencies in the application of techniques. These routines allow generalized facial features to be manipulated to conform to the size and shape of a specific skull. Subtle alterations of the surface form, texture, and color, based on age, sex, and race, enhance the individuality of the generated facial form.

Adult↗