The New Diagnostic Team

The National Academy of Medicine (NAM) in the recently issued report Improving Diagnosis in Health Care outlined eight major recommendations to improve the quality and safety of diagnosis. The #1 recommendation was to improve teamwork in the diagnostic process. This is a major departure from the classical approach, where the physician is solely responsible for diagnosis. In the new, patient-centric vision, the core team encompasses the patient, the physician and the associated nursing staff, with each playing an active role in the process. The expanded diagnostic team includes pathologists, radiologists, allied health professionals, medical librarians, and others. We review the roles that each of these team members will need to assume, and suggest first steps that each new team member can take to achieve this new dynami

Counting unstained, confluent cells by modified bright-field microscopy

We present a very simple procedure yielding high-contrast images of adherent, confluent cells such as human neuroblastoma (SH-EP) cells by ordinary bright-field microscopy. Cells are illuminated through a color filter and a pinhole aperture placed between the condenser and the cell culture surface. Refraction by each cell body generates a sharp, bright spot when the image is defocused. The technique allows robust, automatic cell counting from a single bright-field image in a wide range of focal positions using free, readily available image-analysis tools. Contrast may be enhanced by swelling cell bodies with a brief incubation in PBS. The procedure was benchmarked against manual and automated counting of fluorescently labeled cell nuclei. Counts from day-old and freshly seeded plates were compared in a range of densities, from sparse to densely overgrown. On average, bright-field images produced the same counts as fluorescence images, with less than 5% error. This method will allow routine cell counting using a plain bright-field microscope without cell-line modification or cell staining

Counting unstained, confluent cells by modified bright-field microscopy

We present a very simple procedure yielding high-contrast images of adherent, confluent cells such as human neuroblastoma (SH-EP) cells by ordinary bright-field microscopy. Cells are illuminated through a color filter and a pinhole aperture placed between the condenser and the cell culture surface. Refraction by each cell body generates a sharp, bright spot when the image is defocused. The technique allows robust, automatic cell counting from a single bright-field image in a wide range of focal positions using free, readily available image-analysis tools. Contrast may be enhanced by swelling cell bodies with a brief incubation in PBS. The procedure was benchmarked against manual and automated counting of fluorescently labeled cell nuclei. Counts from day-old and freshly seeded plates were compared in a range of densities, from sparse to densely overgrown. On average, bright-field images produced the same counts as fluorescence images, with less than 5% error. This method will allow routine cell counting using a plain bright-field microscope without cell-line modification or cell staining

Integrating Watershed Management Across the Urban–Rural Interface: Opportunities for Extension Watershed Programs

Urban–rural partnerships are increasingly viewed as a critical component of efforts to improve water quality at the watershed scale. We present an opportunity for such partnerships, using an off-site best management practice (BMP) program developed between the City of Wichita and agricultural producers in the Little Arkansas River Watershed of south-central Kansas as an example. We highlight the critical role of Extension specialists in developing this and similar programs, the success of which hinges on targeted BMP implementation and relationships with agricultural producers

Improving the analysis of near-infrared spectroscopy data with multivariate classification of hemodynamic patterns: a theoretical formulation and validation

Objective. The statistical analysis of functional near infrared spectroscopy (fNIRS) data based on the general linear model (GLM) is often made difficult by serial correlations, high inter-subject variability of the hemodynamic response, and the presence of motion artifacts. In this work we propose to extract information on the pattern of hemodynamic activations without using any a priori model for the data, by classifying the channels as 'active' or 'not active' with a multivariate classifier based on linear discriminant analysis (LDA). Approach. This work is developed in two steps. First we compared the performance of the two analyses, using a synthetic approach in which simulated hemodynamic activations were combined with either simulated or real resting-state fNIRS data. This procedure allowed for exact quantification of the classification accuracies of GLM and LDA. In the case of real resting-state data, the correlations between classification accuracy and demographic characteristics were investigated by means of a Linear Mixed Model. In the second step, to further characterize the reliability of the newly proposed analysis method, we conducted an experiment in which participants had to perform a simple motor task and data were analyzed with the LDA-based classifier as well as with the standard GLM analysis. Main results. The results of the simulation study show that the LDA-based method achieves higher classification accuracies than the GLM analysis, and that the LDA results are more uniform across different subjects and, in contrast to the accuracies achieved by the GLM analysis, have no significant correlations with any of the demographic characteristics. Findings from the real-data experiment are consistent with the results of the real-plus-simulation study, in that the GLM-analysis results show greater inter-subject variability than do the corresponding LDA results. Significance. The results obtained suggest that the outcome of GLM analysis is highly vulnerable to violations of theoretical assumptions, and that therefore a data-driven approach such as that provided by the proposed LDA-based method is to be favored.EC/H2020/641858/EU/Understanding and predicting developmental language abilities and disorders in multilingual Europe/PREDICTABL

Response of Feedlot Lambs to Chlortetracycline and Sulfamethazine

The objective of this experiment was to test the effects of chlortetracycline and sulfamethazine alone and in combination on feedlot performance and incidence of diseases of lambs weaned at an early age, shipped and finished in drylot with a high-concentrate ration

Frequency and Use of Medications in Horses Racing at Prairie Meadows

An analysis was made of the horses racing at Prairie Meadows race track in Altoona, Iowa during 1993 to determine the number of entries designated as racing under the influence of phenylbutazone (Bute(RX)), furosemide (Lasix(Rx)) or both medications. In a total of 1379 Quarter Horse entries, 5.7 % raced with no medication, 74.9 % raced on phenylbutazone, 0.5 % raced on furosemide, and 18.9 % raced on both phenylbutazone and furosemide. In a total of 3424 Thoroughbred entries, 2.1 % raced under no medication, 43.6 % raced on phenylbutazone, 0.4 % raced on furosemide, and 53.9 % raced on both phenylbutazone and furosemide. Overall, of the 4803 entries, 3.2 % raced with no medication, 52.6 % raced on phenylbutazone, 0.4 % raced on furosemide, and 43.9 % raced on both phenylbutazone and furosemide

The Effect of Furosemide on Arterial Blood Gases and Performance in Quarter Horses Performing a Fatigue Test on a Treadmill

Four Quarter Horses (1 filly age 2, 1 mare age 5 and 2 geldings ages 3 and 4; average weight 539 kg) were used in a 2 x 2 crossover design. The effects of furosemide (Lasix(Rx)) on arterial blood packed ceii voiume (PCV), hemogiobin (Hb), pH, pO2, pCO2, HCO-3 and base excess (BE) were measured. Plasma lactate, heart rate, and fatigue time were determined as indicators of perlormance while the horses performed a fatigue test on a high-speed treadmill. The left carotid artery was surgically elevated subcutaneously to facilitate collection of arterial blood samples. Horses were conditioned for 13 weeks with increasing intensity then randomly assigned furosemide (F) or physiological saline (C) as treatments. Treatments were administered 4 hours prior to the fatigue test in accordance with racing regulations. Arterial blood samples were collected prior to treatment dose, prior to exercise, at the 2nd, 4th, and 6th minute during the fatigue test, at fatigue, and at the 5th, 15th, 30th, and 45th minute post-exercise. Arterial blood samples were analyzed for blood gases, Hb, PCV, and plasma lactate. Heart rate and fatigue time were recorded. No difference between treatments (P \u3e 0.05) was observed for blood gases except for pCO2 at rest, and HCO-3 and BE at the 2 minute collection period. No difference between treatments (P \u3e 0.05) was observed for Hb, PCV, lactate and heart rate except at 15 minutes post-exercise for Hb and PCV, and 45 minutes postexercise for Hb. Fatigue times were 11 min 56 sec ± 5 min 30 sec for F horses and 11 min 35 sec--± 2 min 6 sec for C horses. No difference (P \u3e 0.05) was observed in fatigue time. Based on our data, the trend indicated that all parameters measured returned to pre-exercise levels more rapidly for furosemide treated horses. However, furosemide did not enhance performance