Information search and information distortion in the diagnosis of an ambiguous presentation

Physicians often encounter diagnostic problems with ambiguous and conflicting features. What are they likely to do in such situations? We presented a diagnostic scenario to 84 family physicians and traced their information gathering, diagnoses and management. The scenario contained an ambiguous feature, while the other features supported either a cardiac or a musculoskeletal diagnosis. Due to the risk of death, the cardiac diagnosis should be considered and managed appropriately. Forty-seven participants (56%) gave only a musculoskeletal diagnosis and 45 of them managed the patient inappropriately (sent him home with painkillers). They elicited less information and spent less time on the scenario than those who diagnosed a cardiac cause. No feedback was provided to participants. Stimulated recall with 52 of the physicians revealed differences in the way that the same information was interpreted as a function of the final diagnosis. The musculoskeletal group denigrated important cues, making them coherent with their representation of a pulled muscle, whilst the cardiac group saw them as evidence for a cardiac problem. Most physicians indicated that they were fairly or very certain about their diagnosis. The observed behaviours can be described as coherencebased reasoning, whereby an emerging judgment influences the evaluation of incoming information, so that confident judgments can be achieved even with ambiguous, uncertain and conflicting information. The role of coherence-based reasoning in medical diagnosis and diagnostic error needs to be systematically examined

The adequacy of the present practice in dynamic aggregated modelling of wind farm systems

Large offshore wind farms are usually composed of several hundred individual wind turbines, each turbine having its own complex set of dynamics. The analysis of the dynamic interaction between wind turbine generators (WTG), interconnecting ac cables, and voltage source converter (VSC) based High Voltage DC (HVDC) system is difficult because of the complexity and the scale of the entire system. The detailed modelling and modal analysis of a representative wind farm system reveal the presence of several critical resonant modes within the system. Several of these modes have frequencies close to harmonics of the power system frequency with poor damping. From a computational perspective the aggregation of the physical model is necessary in order to reduce the degree of complexity to a practical level. This paper focuses on the present practices of the aggregation of the WTGs and the collection system, and their influence on the damping and frequency characteristics of the critical oscillatory modes. The effect of aggregation on the critical modes are discussed using modal analysis and dynamic simulation. The adequacy of aggregation method is discussed

Coherent states for compact Lie groups and their large-N limits

The first two parts of this article surveys results related to the heat-kernel coherent states for a compact Lie group K. I begin by reviewing the definition of the coherent states, their resolution of the identity, and the associated Segal-Bargmann transform. I then describe related results including connections to geometric quantization and (1+1)-dimensional Yang--Mills theory, the associated coherent states on spheres, and applications to quantum gravity. The third part of this article summarizes recent work of mine with Driver and Kemp on the large-N limit of the Segal--Bargmann transform for the unitary group U(N). A key result is the identification of the leading-order large-N behavior of the Laplacian on "trace polynomials."Comment: Submitted to the proceeding of the CIRM conference, "Coherent states and their applications: A contemporary panorama.

The impact of the ATLAS zero-lepton, jets and missing momentum search on a CMSSM fit

Recent ATLAS data significantly extend the exclusion limits for supersymmetric particles. We examine the impact of such data on global fits of the constrained minimal supersymmetric standard model (CMSSM) to indirect and cosmological data. We calculate the likelihood map of the ATLAS search, taking into account systematic errors on the signal and on the background. We validate our calculation against the ATLAS determinaton of 95% confidence level exclusion contours. A previous CMSSM global fit is then re-weighted by the likelihood map, which takes a bite at the high probability density region of the global fit, pushing scalar and gaugino masses up.Comment: 16 pages, 7 figures. v2 has bigger figures and fixed typos. v3 has clarified explanation of our handling of signal systematic

Conceptual modelling: Towards detecting modelling errors in engineering applications

Rapid advancements of modern technologies put high demands on mathematical modelling of engineering systems. Typically, systems are no longer “simple” objects, but rather coupled systems involving multiphysics phenomena, the modelling of which involves coupling of models that describe different phenomena. After constructing a mathematical model, it is essential to analyse the correctness of the coupled models and to detect modelling errors compromising the final modelling result. Broadly, there are two classes of modelling errors: (a) errors related to abstract modelling, eg, conceptual errors concerning the coherence of a model as a whole and (b) errors related to concrete modelling or instance modelling, eg, questions of approximation quality and implementation. Instance modelling errors, on the one hand, are relatively well understood. Abstract modelling errors, on the other, are not appropriately addressed by modern modelling methodologies. The aim of this paper is to initiate a discussion on abstract approaches and their usability for mathematical modelling of engineering systems with the goal of making it possible to catch conceptual modelling errors early and automatically by computer assistant tools. To that end, we argue that it is necessary to identify and employ suitable mathematical abstractions to capture an accurate conceptual description of the process of modelling engineering systems

End-to-End Learning of Video Super-Resolution with Motion Compensation

Learning approaches have shown great success in the task of super-resolving an image given a low resolution input. Video super-resolution aims for exploiting additionally the information from multiple images. Typically, the images are related via optical flow and consecutive image warping. In this paper, we provide an end-to-end video super-resolution network that, in contrast to previous works, includes the estimation of optical flow in the overall network architecture. We analyze the usage of optical flow for video super-resolution and find that common off-the-shelf image warping does not allow video super-resolution to benefit much from optical flow. We rather propose an operation for motion compensation that performs warping from low to high resolution directly. We show that with this network configuration, video super-resolution can benefit from optical flow and we obtain state-of-the-art results on the popular test sets. We also show that the processing of whole images rather than independent patches is responsible for a large increase in accuracy.Comment: Accepted to GCPR201

Use of Video Games in Patients\u27 Self-management of Pain: A Feasibility Study

Background: Pain affects more than 75 million Americans and is the primary reason people seek medical attention. Pain is a common cause of disability and diminished quality of life. While anecdotal evidence exists regarding nurses’ use of distraction therapy activities in pain management, little empirical research data is available. Purpose: To examine the effects of video game use (VGU) on pain perception, pain interference perception and perceived self-efficacy in pain management in adult inpatients. Conceptual Model: The conceptual model is based on Self-efficacy Theory (Bandura, 1995). The antecedents of the concept of distraction therapy with use of VGs in patients’ self-management of pain, is pain itself. The defining attributes are mastery and control, social observations, positive appraisals, and social supportive relationships. The consequences are self-efficacy in non-pharmacological strategies in pain management and behavioral analgesia. Aims: 1) Describe the demographic variables (age, gender, race/ethnicity, educational level, admitting diagnosis, day of hospitalization, and length of stay); pain location, analgesia variables; VG variables, and total time researcher engaged with subjects of the sample, 2) Describe self-efficacy and pain interference perception following video game distraction therapy (VGDT), 3) Compare changes in pain perception prior to and following VGDT, and 4) Identify factors that predict changes in pain perception following VGDT. This feasibility study utilized a purposive sample of 30 hospitalized adults in a neuro trauma progressive care unit, and an orthopedic acute care unit. Findings: Subjects’ age ranged from 19-79 years, M = 41.47 ± 17.52, with 22 males (73.3%) and eight females (26.6%). Total time researcher was engaged with study subjects ranged from 35 – 90 minutes (M = 63.03 ± 13.10). Pre pain perception M = 4.93 ± 2.49, and post pain perception M = 3.17 ± 2.2, a 36% decreased following VGDT. Self-efficacy perception following VGDT mean score was high (M = 6.97 ± 2.30) overall. There were no predictor variables identified

Gene Therapy for Primary Immunodeficiency

Over the past 3 decades, there has been significant progress in refining gene therapy technologies and procedures. Transduction of hematopoietic stem cells ex vivo using lentiviral vectors can now create a highly effective therapeutic product, capable of reconstituting many different immune system dysfunctions when reinfused into patients. Here, we review the key developments in the gene therapy landscape for primary immune deficiency, from an experimental therapy where clinical efficacy was marred by adverse events, to a commercialized product with enhanced safety and efficacy. We also discuss progress being made in preclinical studies for challenging disease targets and emerging gene editing technologies that are showing promising results, particularly for conditions where gene regulation is important for efficacy

The Turkey Ig-like receptor family: identification, expression and function.

The chicken leukocyte receptor complex located on microchromosome 31 encodes the chicken Ig-like receptors (CHIR), a vastly expanded gene family which can be further divided into three subgroups: activating CHIR-A, bifunctional CHIR-AB and inhibitory CHIR-B. Here, we investigated the presence of CHIR homologues in other bird species. The available genome databases of turkey, duck and zebra finch were screened with different strategies including BLAST searches employing various CHIR sequences, and keyword searches. We could not identify CHIR homologues in the distantly related zebra finch and duck, however, several partial and complete sequences of CHIR homologues were identified on chromosome 3 of the turkey genome. They were designated as turkey Ig-like receptors (TILR). Using cDNA derived from turkey blood and spleen RNA, six full length TILR could be amplified and further divided according to the typical sequence features into one activating TILR-A, one inhibitory TILR-B and four bifunctional TILR-AB. Since the TILR-AB sequences all displayed the critical residues shown to be involved in binding to IgY, we next confirmed the IgY binding using a soluble TILR-AB1-huIg fusion protein. This fusion protein reacted with IgY derived from various gallinaceous birds, but not with IgY from other bird species. Finally, we tested various mab directed against CHIR for their crossreactivity with either turkey or duck leukocytes. Whereas no staining was detectable with duck cells, the CHIR-AB1 specific mab 8D12 and the CHIR-A2 specific mab 13E2 both reacted with a leukocyte subpopulation that was further identified as thrombocytes by double immunofluorescence employing B-cell, T-cell and thrombocyte specific reagents. In summary, although the turkey harbors similar LRC genes as the chicken, their distribution seems to be distinct with predominance on thrombocytes rather than lymphocytes

Series voltage regulator for radial DC-microgrid

The concept of a novel series voltage regulator (SVR) for controlling the dc-bus voltage of a radial dc microgrid is presented in this paper. The proposed SVR uses a dual-active-bridge dc-dc converter followed by a full-bridge dc-dc converter. It injects dynamic voltage in series with the dc grid to compensate resistive drop over the network. As a result, the voltage level at the different points of the grid becomes independent of load variation and stays within the specified limit. Note that the required power rating of the SVR is very low (say 2.7%) compared to the load demand considering 5% voltage regulation. In this paper, the voltage regulator is connected at the midpoint of the grid, but it may be connected in some other locations to get optimal rating of the same. The proposed configuration is simulated in MATLAB/SIMULINK at a 380-V level to check the dynamic performance under various operating conditions. A scaled-down version (at 30-V level) of the proposed system is developed in the laboratory to experimentally validate the concept. The results show the effectiveness of such a voltage regulator for the radial dc microgrid, especially under critical load condition