PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “reflection”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources

The neural correlates of direct and reflected self-knowledge.

Socrates said that in order to lead a balanced life one must, "know thyself." In two fMRI experiments, the present study examined the mechanisms mediating two ways in which the self can be known: through direct appraisals (i.e., an individual's own self-beliefs) and reflected appraisals (i.e., an individual's perception of how others view him or her). Experiment 1 examined the common and distinct neural bases of direct appraisals of the self, close others, and normative judgments of trait desirability. All three judgment types activated medial prefrontal cortex (MPFC) to a similar degree. Experiment 2 examined the common and distinct neural bases of (1) direct appraisals of self, a close other or a non-close other, and (2) reflected appraisals made from the perspective of a close or a non-close other. Consistent with Experiment 1, all judgment types activated MPFC. Direct appraisals of the self as compared to others more strongly recruited MPFC and right rostrolateral PFC. Direct appraisals as compared to reflected appraisals recruited regions associated with a first-person perspective (posterior cingulate), whereas reflected as compared to direct appraisals recruited regions associated with emotion and memory (insula, orbitofrontal, and temporal cortex). These results support models suggesting that MPFC mediates meta-cognitive processes that may be recruited for direct and reflected self appraisals depending upon the demands of a specific task.

Adult↗

Spectral and directional reflectance of the fovea in diabetes mellitus: photoreceptor integrity, macular pigment and lens.

Our aim was to assess the integrity of the photoreceptors in the fovea, and to measure the optical density of the macular pigment and the eye lens in patients with diabetes mellitus, and to compare the results with those of a group of healthy subjects. The directional and spectral properties of the light reflected from a 1.9 deg field centered on the fovea were measured simultaneously, in a single one second flash, with the Foveal Reflection Analyzer. The directional characteristics, i.e., the optical Stiles-Crawford effect, provided information on the integrity of the foveal photoreceptors. Model analysis of the spectral reflectance yielded optical densities of the macular pigment and the lens. The amplitude of the directional reflectance in diabetic eyes was significantly lower compared to controls (P<0.001). This indicates that the integrity of the photoreceptors in the fovea was altered in diabetics. Surprisingly, the directionality (a measure for the peakedness) was similar in diabetics and controls (P=0.3). The density of macular pigment was not different from that in controls (P=0.3). The optical density of the lens increased with age in both groups, but the rate of increase was larger in the diabetics (P<0.05). Possibly, the lens optical density increasing at a higher rate with age reflects changes preceding cataract formation.

Adult↗

Clinical applications of fundus reflection densitometry.

Fundus reflection densitometry or retinal densitometry is a non-invasive technique to examine the visual photopigment kinetics in living eyes. The technique is based on the comparison of the reflected light from the fundus in a fully light adapted eye (when all visual photopigment has been bleached) with the reflected light following complete dark adaptation (when the retina contains its maximum amount of visual photopigment). The technique provides a measure of the density of visual photopigment, its time constant of regeneration, its distribution and spectral characteristics if measured at a series of wavelengths. Fundus reflection densitometry in the human eye was introduced 40 years ago. Presently, it is the only available technique from which direct and objective insight can be obtained into visual photopigment. This knowledge is particularly relevant in eyes where abnormalities of photoreceptor function are suspected. This paper summarizes the current knowledge of fundus reflection densitometry in the diseased and in the aging human retina, gathered over the last 30 years. Considerable improvements of the instrument for clinical purposes have been obtained, and are also discussed.

Aging↗

Spectroscopic measurement of diffuse reflectance for enhanced detection of bladder carcinoma.

OBJECTIVES: To assess the diagnostic potential of diffuse reflectance spectroscopy for the detection of bladder carcinoma during cystoscopy. Our hypothesis is that neovasculature in neoplastic (dysplastic and malignant) regions will lead to a blood absorption "signature" that is different from that of normal tissue. METHODS: Diffuse reflectance measurements have been performed in 14 patients undergoing mucosal biopsies or transurethral resection of a bladder tumor. A quartz optical fiber was advanced through the working channel of a cystoscope and placed in gentle contact with the bladder surface. A standard cystoscopy xenon light source was used for illumination and the reflectance spectra were recorded using an optical multichannel analyzer (OMA) system. From the spectra, the relative concentrations of hemoglobin (Hb), oxyhemoglobin (HbO2), oxygen saturation (HbO2%), and the total amount of blood (arbitrary units) were calculated to assess their usefulness in differentiating between neoplastic and benign bladder areas. RESULTS: The spectra of 26 bladder areas (9 malignant areas including 4 carcinomata in situ, 2 dysplastic lesions, and 15 benign areas) have been analyzed. Only the total amount of blood was a useful parameter for the differentiation between neoplastic and benign bladder areas. The sensitivity, specificity, and positive and negative predictive values of this method for neoplastic tissue were found to be 91%, 60%, 63%, and 90%, respectively. CONCLUSIONS: The measurement of diffuse reflectance is a fast, simple, and noninvasive method which allows in vivo determination of bladder blood perfusion. The total blood concentration was increased in neoplastic bladder tissue, making it a tool for tissue diagnosis. The relatively low specificity is a result of inflammatory areas also exhibiting an increased total blood concentration. This pilot study encourages further studies to assess the usefulness of reflectance measurements for enhanced detection of bladder cancer.

Aged↗

Reflection photoelasticity: a new method for studies of clinical mechanics in prosthetic dentistry.

OBJECTIVES: This research was conducted to demonstrate the effectiveness of reflective photoelasticity as an in vivo technique for monitoring the strain/stress distribution in prosthetic devices during function. METHODS: Seven subjects were selected for this study and divided into three groups according to the design of the prostheses. The buccal surfaces of the experimental prostheses were coated with a birefringent resin 2mm thick. Using a reflection polariscope, fringe patterns were documented on video tape during standardized in vivo loadings. Strain and stress levels (gamma(max) and tau(max)) were calculated from isochromatic fringe order determinations. The intra-observer variability in counting fringe orders and the accuracy level of reflective photoelasticity as compared to strain gauge results were also studied. The strain results of in vivo loading of the prostheses were analyzed with ANOVA and Scheffés tests. The intra-observer variability was analyzed with the Friedman nonparametric test. Comparisons of photoelastic data and strain gauges were tested with Pearson's correlation. RESULTS: Coated areas accessible to normally incident light, produced comprehensive maps of strain distribution. Significant differences were found in the in vivo gamma(max) values for the prostheses designs (p<0.05). The test for intra-observer variability showed that no significant differences occurred in counting fringe orders. Strain values obtained with reflective photoelasticity showed a high correlation r=0.98 and 0.99) with values obtained at the same areas using strain gauges. SIGNIFICANCE: Reflective photoelasticity is a valid, reliable and accurate technique to be used for in vivo studies on the biomechanical behavior of prosthetic devices.

Aged↗

The nurse teacher's role in the promotion of reflective practice.

The art of reflection is seen as a key process in bringing together practice and knowledge in nursing. More specifically, reflection addresses the artistic elements of nursing care delivery. It thus appears a useful skill for pre-registration students to begin developing. However, research suggests that students under the age of 25 may lack both the cognitive readiness and the experience necessary for mature critical reflection. Teachers must therefore examine whether the reflective strategies and models that they present meet these students educational needs. It is postulated that simple models have a greater chance of success than those that are complex and demand a high time commitment. One such model for reflective journal writing is suggested.

Adult↗

Reflection and learning in student nurses.

One aim of the reforms in nurse education is to produce reflective practitioners. The researcher teaches in a diploma programme and decided to see if there was any evidence that students, one year into a Common Foundation Programme, were developing reflective skills or if they were learning through reflection. Students in this study value reflection as a means of learning and it seems that reflection has led to behaviour change, problem-solving and personal and professional awareness as well as improved patient care. They value debriefing following experience and there is evidence that they would benefit from training in mental previewing techniques prior to embarking on new experience.

Education, Nursing, Baccalaureate↗

Physical correlates of the ultrasonic reflectivity of lipid dispersions suitable as diagnostic contrast agents.

The objective of this study was to determine the physical basis of ultrasound (US) reflectivity of echogenic lipid dispersions. These dispersions were made using a process previously described involving sonication of the lipid in water, addition of mannitol, freezing, lyophilization and rehydration. The component lipids were egg phosphatidylcholine, dipalmitoylphosphatidylethanolamine, dipalmitoylphosphatidylglycerol and cholesterol in a molar ratio of 69:8:8:15. Ultrasound reflectivity, as assessed with a 20-MHz intravascular US catheter and analyzed using computer-assisted videodensitometry, was found to be sensitive to variations in ambient pressure; echogenicity was greatly reduced by exposure to 0.5 atm vacuum for 10 s or 1.5 atm pressure for 10 s. Pressure changes of the magnitude that obtain in the arterial circulation had little effect on echogenicity. Vacuum treatment resulted in the release of approximately 100 microL air from a standard preparation of 10 mg lipid in 1 mL. Maximum ultrasonic reflectivity required the presence of 0.1-0.2 mol/L mannitol during the lyophilization step; mere addition of mannitol to the lipid lyophilized in the absence of mannitol produced nonreflective dispersions. Inclusion of sodium phosphate or other electrolytes reduced echogenicity. High echogenicity was associated with the presence of large-volume freeze-dried cakes and fusion of liposomes (which led to a 10 times increase in liposome diameters) during freezing before lyophilization. Lyophilization from water led to liposome fusion, but the cakes were small and US reflectivity was weak. Lyophilization from solutions of cryoprotectants such as trehalose produced large cakes, but little liposome fusion and also led to weak US reflectivity. Filtration through defined pores revealed that approximately 50% of the echogenicity originated from particles smaller than 1 microm and about 2/3 from particles smaller than 3 microm. These results indicate that lyophilization from 0.2 mol/L mannitol solution generates a disrupted array of lipid bilayers that, upon rehydration, fuse and trap small amounts of air distributed among liposome-size particles.

Air Pressure↗

An experimental study of the reflection from spherical and flat ended cylindrical targets suitable for fetal Doppler performance assessment.

The performance of small-diameter targets suitable for use as oscillating targets for testing the sensitivity of Doppler fetal heartbeat detectors has been systematically studied. Experimental results are presented in the 1.6-3.0 MHz frequency range for the plane-wave reflection loss for a total of 16 targets: spherical balls made of stainless steel; hemispherical-ended rods made of PTFE; and flat-ended rods made of stainless steel, PTFE, polycarbonate, and tungsten carbide. Results show that the fine-structure variation of reflection loss with frequency is greatest in the case of spherical ball targets and least for flat-ended targets. It has been shown that, providing care is taken during manufacture, the reflection loss from a flat-ended target can be predicted using a simple theory based on a plane disc reflector. Tungsten carbide targets consisting of a long rod with a diameter of 1.6 mm tapered down to a cylindrical flat end with a diameter of 0.4, 0.5, and 0.6 mm have been shown to provide reflection losses of between 60 and 40 dB, and to have a smooth variation of reflection loss with frequency. They can also be manufactured in a form that allows no significant interference from the supporting structure and, therefore, are ideal targets to meet the requirements of International Electrotechnical Commission 1266:1995.

Doppler Effect↗

Pulmonary artery reflection for differentially diagnosing primary pulmonary hypertension and chronic pulmonary thromboembolism.

OBJECTIVES: The purpose of this investigation was to differentiate chronic pulmonary thromboembolism (CPTE) from primary pulmonary hypertension (PPH) by means of the indexes of pulmonary arterial reflection. BACKGROUND: These differences in the primary lesions would make pulmonary artery reflection occur earlier in CPTE than in PPH. Although the analysis of pulsatility of pulmonary arterial pressure is useful in the differential diagnosis of PPH and CPTE, it is not known whether the analysis of pulmonary artery reflection can differentiate CPTE from PPH. METHODS: Since CPTE predominantly involves the proximal arteries, whereas PPH involve the peripheral arteries, we hypothesized that patients with CPTE have a large augmentation index and a short inflection time. For this study, we enrolled 62 patients who had CPTE (31 patients) and PPH (31 patients). We measured pulmonary arterial pressure using a fluid filled system that included a balloon-tipped flow directed catheter. To quantify the pulmonary artery reflection, we used the augmentation index and inflection time. RESULTS: The augmentation index was markedly higher in CPTE than it was in PPH (27.4% +/- 15.2% [SD] and -25.1% +/- 26.9%, respectively, p < 0.001) and was diagnostic in separating the two groups. Inflection time separated the two groups reasonably well (97 +/- 20 ms and 210 +/- 49 ms, respectively, p < 0.001). CONCLUSIONS: The analysis of pulmonary arterial reflection is useful in the differential diagnosis of CPTE and PPH.

Adult↗

Effect of reflection of arterial pressure on carotid circulation in essential hypertension.

Pressure wave reflection plays a pivotal role in the augmentation of systolic blood pressure. In the present study, the association between reflection of pressure wave and structural and functional alteration, including blood flow, in the common carotid artery was investigated in 70 hospitalized essential hypertensive patients. The reflection of pressure was estimated by the "augmentation index" of the carotid arterial pressure waveform. The carotid augmentation index was significantly related to age (r = 0.36), body height (r = -0.30), intima-media thickening (r = 0.28), number of plaques (r = 0.44), stiffness of the carotid artery (r = 0.38), diastolic carotid flow velocity (r = -0.31), and left ventricular mass index (r = 0.33). Furthermore, the reflection of arterial pressure showed a significant negative correlation with diastolic/systolic ratio of blood flow velocity in the carotid artery (r = -0.41, P = .0005). Stepwise regression analysis revealed that age and left ventricular mass index were independent determinants for the carotid augmentation index. These findings indicate that the reflection of arterial pressure is related to morphological and functional alterations of the carotid artery, including a relative reduction of diastolic blood flow.

Adult↗

Reflective practice: a guide.

Reflective practice is an important concept to the development of nursing as a profession. Nurses need to become reflective practitioners, especially within the current changeable climate. Many practitioners however, find reflective practice confusing and feel unsure how to proceed. This paper attempts to remove some of the mystery surrounding this issue. The skills needed for reflection are identified from a review of the literature. These include self-awareness, critical analysis, synthesis and evaluation. A suggested activity for developing reflective skills is provided as well as a format for keeping a learning diary.

Clinical Competence↗

Fluorescent strip-lights as a source of error in tissue reflectance spectroscopy.

Tissue reflectance spectroscopy is a widely used technique for measuring the blood content of the skin. Fluorescent strip-lighting of a type in widespread use (Osram L36 W/23 Gelbweiss-white) is a potential source of misleading artefacts in tissue reflectance spectroscopy. The fluorescent light signal has successive peaks and troughs in the 520-580 nm range which closely emulate the inverse of the reflected signal of white light modulated by blood. The presence of fluorescent light in the reflected signal cancels some of the blood signature. Conversely, the presence of fluorescent light in the white reference augments the true blood reflected signal. The marked similarity of the resultant artefact blood spectrum to the true blood spectrum is a hazard, as the presence of the artefact may go undetected.

Algorithms↗

Fundus reflectance--historical and present ideas.

In 1851 Helmholtz introduced the ophthalmoscope. The instrument allowed the observation of light reflected at the fundus. The development of this device was one of the major advancements in ophthalmology. Yet ophthalmoscopy allows only qualitative observation of the eye. Since 1950 attempts were made to address the challenging, quantitative assessment of the amount of light reflected by the fundus. At first, only comparative measurements were possible, applied in the study of macular and visual pigments. With improvements in light detecting techniques, and with the advent of microprocessors, the measurement of spectral and spatial distribution of the reflectance became feasible. This led to the development of models that explained the observed wavelength dependence and the directional behavior of light reflected from the fovea. The models allowed a quantitative assessment of many parameters on absorption and reflection by structures in the human eye. This paper provides a review of both the experimental and theoretical progress, and summarizes the results of fundamental and clinical research using fundus reflectometry.

Diagnostic Techniques, Ophthalmological↗

Proteins at air-water interfaces studied using external reflection circular dichroism.

In this report we describe the first attempts to record external reflection circular dichroism (ERCD) spectra of beta-lactoglobulin solutions. It is shown that the accumulated proteins at and near the air-water interface can be detected using ERCD and that the signals obtained contain information on the conformational properties and concentration of the proteins residing at the interface. The local protein concentration and its conformation are in full agreement with previous observations using external reflection infrared spectroscopy. The ERCD signals are dominated by linear dichroism (LD) due to non-ideal behavior of the instrumental optics, but can be explained for using the theoretical description of chiral reflection. This allows the analysis of ERCD spectra of protein solutions. The measured ERCD signals are described accurately in the region between 190 and 220 nm, but poor resemblance is obtained at higher wavelengths. We are however confident that improvement of experimental conditions and theoretical description will allow that in the near future, external reflection circular dichroism (CD) can be a valuable tool that complements the application of external reflection infrared spectroscopy to study interfacial systems.

Circular Dichroism↗

Photophysics on surfaces: determination of absolute fluorescence quantum yields from reflectance spectra.

A method for the calculation of absolute fluorescence quantum yields for dyes attached to solid particles based on reflectance measurements is reported. The same procedure allows calculation of true reflectance spectra (free of fluorescence) for highly fluorescent materials as well. Samples ofcresyl violet were immobilized by adsorption on microgranular cellulose in the concentration range 4.5 x 10(-9) to 3.8 x 10(-6) mol g(-1). Diffuse and total reflectance spectra were recorded with and without insertion of an optical absorption filter between the output of the integrating sphere of a reflectance spectrometer and the photodetector in order to block fluorescence partially. From these data, the relative emission spectrum of the dye, the filter transmission spectrum, and the detector sensitivity, true reflectances and absolute fluorescence quantum yields were recovered. Observed fluorescence quantum yields, affected by dye aggregation and inner filter effects, were concentration and wavelength dependent, ranging approximately between 0.1 and 0.6. The analysis of remission function spectra showed that dye aggregation is negligible up to a concentration of 1.41 x 10(-7) mol g(-1). Fluorescence data were corrected for reemission and reabsorption using a suitable model [Lagorio, M. G.; Dicelio, L. E.; Litter, M. I.; San Roman, E. J. Chem. Soc., Faraday Trans. 1998, 94, 419]. Application of this model to samples showing no aggregation yielded a wavelength-independent true fluorescence quantum yield of 0.60 +/- 0.05, similar to values found in solution. The usage of cresyl violet as a reference for the evaluation of fluorescence quantum yields for weakly fluorescing samples in the solid phase is discussed.

Journal Article↗

From "The ethical treatment of patients in a persistent vegetative state" to a philosophical reflection on contemporary medicine.

The reflections put forward in this text concern the clinical and practical difficulties posed by the existence of patients in PVS, and the essential ethical issues raised, combining these ethical questions with practical and theoretical experience. Section 1 presents the methodology of the ethical reflection as we see it. Section 2 describes the clinical condition of patients in PVS. Section 3 develops the ethical difficulties relative to PVS from the French point of view. Section 4 illustrates the relevance of debating the ethical significance of such problematic situations, whilst defending a practical position based on a philosophical conviction. Section 5 points out the limits of ethical reflection in a biomedical context, and calls for reflection closer to the source of the problems described. For a comprehensive appraisal of biomedical rationality, the final section suggests combining the bioethical debates with traditional philosophical ethical reflection so as to get a clearer understanding of the real, if limited, relevance of these debates.

Advisory Committees↗

Validation of reflectance pulse oximetry: an evaluation of a new sensor in piglets.

OBJECTIVE: A new reflectance pulse oximetry sensor, developed for intrapartum estimation of arterial oxygen saturation (SaO2), was calibrated and evaluated. The sensor contains two light emitting diodes of 735 and 890 nm, and a photodetector at a distance of 14 mm from both light emitting diodes. METHODS: In seven Yorkshire/Hampshire piglets, the reflectance sensor (Nellcor Puritan Bennett Inc.) was calibrated using blood sample SaO2 values. The resulting calibration line was evaluated in four Dutch piglets, by comparing pulse oximetry saturation readings (SpO2) with blood sample and intravascular fiberoptic oximetry SaO2 values. Several reflectance sensors were fixed on each animal. Desaturation levels were obtained by changing the gas mixture of oxygen/ nitrous oxide via a tracheal catheter. RESULTS: In the Yorkshire/ Hampshire piglets, the standard deviation of difference (SpO2-SaO2) was 4.7% (n = 364), over an SaO2 range of 17% to 100%. In the Dutch piglets, the mean difference (SpO2-SaO2) was -1.6% and the standard deviation of difference was 5.4%, over the same SaO2 range (n = 254). Comparisons of continuous recordings of reflectance SpO2 and fiberoptic SaO2 revealed variation in individual regression lines. CONCLUSIONS: This new 735/890 nm reflectance sensor demonstrates acceptable accuracy in piglets. A further evaluation during labor should assess its feasibility for fetal surveillance.

Animals↗