Cardiovascular computed tomography : technical developments and clinical applications

Chapter 1 reviews technical developments of cardiac CT and current status, recommendations and future perspective of various clinical cardiac CT applications. In chapter 2, the eff ect of dose reduction on diagnostic performance in CT coronary angiography is assessed. Chapter 3 evaluates the eff ect of thin-slice image reconstructions on coronary artery calcium measurements. In chapter 4, the assessment of Agatston scores using coronary CT angiography is studied. Chapter 5 evaluates the predictive value of CT-derived RV/LV ratios and cardiac biomarkers for short term clinical outcome in patients with suspected acute PE. In chapter 6, the incremental value of ventricular function with ECG-synchronized cardiac CT over standard pulmonary CTA-derived RV/LV ratios for predicting clinical outcome in patients with suspected acute PE is discussed. Chapter 7 studies the influence of timing of NT-pro-BNP sampling for predicting adverse clinical outcome.Hartstichting Stichting IMAGOUBL - phd migration 201

Improving communication and practical skills in working with inpatients who self-harm: a pre-test/post-test study of the effects of a training programme

BACKGROUND: Differing perspectives of self-harm may result in a struggle between patients and treatment staff. As a consequence, both sides have difficulty communicating effectively about the underlying problems and feelings surrounding self-harm. Between 2009 and 2011, a programme was developed and implemented to train mental health care staff (nurses, social workers, psychologists, psychiatrists, and occupational therapists) in how to communicate effectively with and care for patients who self-harm. An art exhibition focusing on self-harm supported the programme. Lay experts in self-harm, i.e. people who currently harm themselves, or who have harmed themselves in the past and have the skills to disseminate their knowledge and experience, played an important role throughout the programme. METHODS: Paired sample t-tests were conducted to measure the effects of the training programme using the Attitude Towards Deliberate Self-Harm Questionnaire, the Self-Perceived Efficacy in Dealing with Self-Harm Questionnaire, and the Patient Contact Questionnaire. Effect sizes were calculated using r. Participants evaluated the training programme with the help of a survey. The questionnaires used in the survey were analysed descriptively. RESULTS: Of the 281 persons who followed the training programme, 178 completed the questionnaires. The results show a significant increase in the total scores of the three questionnaires, with large to moderate effect sizes. Respondents were positive about the training, especially about the role of the lay expert. CONCLUSION: A specialised training programme in how to care for patients who self-harm can result in a more positive attitude towards self-harm patients, an improved self-efficacy in caring for patients who self-harm, and a greater closeness with the patients. The deployment of lay experts is essential here

The impact of mobile phone use on where we look and how we walk when negotiating floor based obstacles

Pedestrians regularly engage with their mobile phone whilst walking. The current study investigated how mobile phone use affects where people look (visual search behaviour) and how they negotiate a floor based hazard placed along the walking path. Whilst wearing a mobile eye tracker and motion analysis sensors, participants walked up to and negotiated a surface height change whilst writing a text, reading a text, talking on the phone, or without a phone. Differences in gait and visual search behaviour were found when using a mobile phone compared to when not using a phone. Using a phone resulted in looking less frequently and for less time at the surface height change, which led to adaptations in gait by negotiating it in a manner consistent with adopting an increasingly cautious stepping strategy. When using a mobile phone, writing a text whilst walking resulted in the greatest adaptions in gait and visual search behaviour compared to reading a text and talking on a mobile phone. Findings indicate that mobile phone users were able to adapt their visual search behaviour and gait to incorporate mobile phone use in a safe manner when negotiating floor based obstacles

Female brain size affects the assessment of male attractiveness during mate choice

Mate choice decisions are central in sexual selection theory aimed to understand how sexual traits evolve and their role in evolutionary diversification. We test the hypothesis that brain size and cognitive ability are important for accurate assessment of partner quality and that variation in brain size and cognitive ability underlies variation in mate choice. We compared sexual preference in guppy female lines selected for divergence in relative brain size, which we have previously shown to have substantial differences in cognitive ability. In a dichotomous choice test, large-brained and wild-type females showed strong preference for males with color traits that predict attractiveness in this species. In contrast, small-brained females showed no preference for males with these traits. In-depth analysis of optomotor response to color cues and gene expression of key opsins in the eye revealed that the observed differences were not due to differences in visual perception of color, indicating that differences in the ability to process indicators of attractiveness are responsible. We thus provide the first experimental support that individual variation in brain size affects mate choice decisions and conclude that differences in cognitive ability may be an important underlying mechanism behind variation in female mate choice

Spin Excitations and Sum Rules in the Heisenberg Antiferromagnet

Various bounds for the energy of collective excitations in the Heisenberg antiferromagnet are presented and discussed using the formalism of sum rules. We show that the Feynman approximation significantly overestimates (by about 30\% in the $S={1\over2}$ square lattice) the spin velocity due to the non negligible contribution of multi magnons to the energy weighted sum rule. We also discuss a different, Goldstone type bound depending explicitly on the order parameter (staggered magnetization). This bound is shown to be proportional to the dispersion of classical spin wave theory with a q-independent normalization factor. Rigorous bounds for the excitation energies in the anisotropic Heisenberg model are also presented.Comment: 26 pages, Plain TeX including 1 PostScript figure, UTF-307-10/9

Talking quiescence: a rigorous theory that supports parallel composition, action hiding and determinisation

The notion of quiescence - the absence of outputs - is vital in both behavioural modelling and testing theory. Although the need for quiescence was already recognised in the 90s, it has only been treated as a second-class citizen thus far. This paper moves quiescence into the foreground and introduces the notion of quiescent transition systems (QTSs): an extension of regular input-output transition systems (IOTSs) in which quiescence is represented explicitly, via quiescent transitions. Four carefully crafted rules on the use of quiescent transitions ensure that our QTSs naturally capture quiescent behaviour. We present the building blocks for a comprehensive theory on QTSs supporting parallel composition, action hiding and determinisation. In particular, we prove that these operations preserve all the aforementioned rules. Additionally, we provide a way to transform existing IOTSs into QTSs, allowing even IOTSs as input that already contain some quiescent transitions. As an important application, we show how our QTS framework simplifies the fundamental model-based testing theory formalised around ioco.Comment: In Proceedings MBT 2012, arXiv:1202.582

Awareness and practice of patient's rights law in Lithuania

BACKGROUND: Patient's rights law is intended to secure good medical practice, but it can also serve to improve understanding between patients and medical staff if both were aware of their rights. METHODS: Awareness and practice of the new patient's rights law in Lithuanian health care institutions was explored through a survey of 255 medical staff and 451 patients in the four Kaunas city medical units in 2002. Participation rates were 74% and 66%, respectively. RESULTS: Majority of the medical staff (85%) and little over one half of the patients (56%) had heard or read about the Law on Patient's Rights (p < 0.001). Only 50% of professionals compared to 69% of patients thought information for patients about diagnosis, treatment results and alternative treatments is necessary (p < 0.001). A clear discrepancy was indicated between physicians informing the patients (80% – 98% of physicians) and patients actually knowing (37% – 54%) their treatment prognosis, disease complications or possible alternative treatment methods. CONCLUSION: These results suggest a need for awareness-raising among patients to improve the practical implementation of the Patient's Rights Law in Lithuania

Quantized vortices and collective oscillations of a trapped Bose condensed gas

Using a sum rule approach we calculate the frequency shifts of the quadrupole oscillations of a harmonically trapped Bose gas due to the presence of a quantized vortex. Analytic results are obtained for positive scattering lengths and large N where the shift relative to excitations of opposite angular momentum is found to be proportional to the quantum circulation of the vortex and to decrease as N^{-2/5}. Results are also given for smaller values of N covering the transition between the ideal gas and the Thomas-Fermi limit. For negative scattering lengths we predict a macroscopic instability of the vortex. The splitting of the collective frequencies in toroidal configurations is also discussed.Comment: Rextex, 4 pages, 1 postscript figur