Asynchronous video-otoscopy with a telehealth facilitator

Objective: The study investigated whether video-otoscopic images taken by a telehealth clinic facilitator are sufficient for accurate asynchronous diagnosis by an otolaryngologist within a heterogeneous population. Subjects and Methods: A within-subject comparative design was used with 61 adults recruited from patients of a primary healthcare clinic. The telehealth clinic facilitator had no formal healthcare training. On-site otoscopic examination performed by the otolaryngologist was considered the gold standard diagnosis. A single video-otoscopic image was recorded by the otolaryngologist and facilitator from each ear, and the images were uploaded to a secure server. Images were assigned random numbers by another investigator, and 6 weeks later the otolaryngologist accessed the server, rated each image, and made a diagnosis without participant demographic or medical history. Results: A greater percentage of images acquired by the otolaryngologist (83.6%) were graded as acceptable and excellent, compared with images recorded by the facilitator (75.4%). Diagnosis could not be made from 10.0% of the video-otoscopic images recorded by the facilitator compared with 4.2% taken by the otolaryngologist. A moderate concordance was measured between asynchronous diagnosis made from video-otoscopic images acquired by the otolaryngologist and facilitator (kappa = 0.596). The sensitivity for video-otoscopic images acquired by the otolaryngologist and the facilitator was 0.80 and 0.91, respectively. Specificity for images acquired by the otolaryngologist and the facilitator was 0.85 and 0.89, respectively, with a diagnostic odds ratio of 41.0 using images acquired by the otolaryngologist and 46.0 using images acquired by the facilitator. Conclusions: A trained telehealth facilitator can provide a platform for asynchronous diagnosis of otological status using video-otoscopy in underserved primary healthcare settings

Uncertain inference using interval probability theory

AbstractThe use of interval probability theory (IPT) for uncertain inference is demonstrated. The general inference rule adopted is the theorem of total probability. This enables information on the relevance of the elements of the power set of evidence to be combined with the measures of the support for and dependence between each item of evidence. The approach recognises the importance of the structure of inference problems and yet is an open world theory in which the domain need not be completely specified in order to obtain meaningful inferences. IPT is used to manipulate conflicting evidence and to merge evidence on the dependability of a process with the data handled by that process. Uncertain inference using IPT is compared with Bayesian inference

The right face at the wrong place: How motor intentions can override outcome monitoring

The concept of intentions is often taken for granted in the cognitive and neural sciences, and comparing outcomes with internal goals is seen as critical for our sense of agency. We created an experiment where participants decided which face they preferred, and we either created outcome errors by covertly switch- ing the position of the chosen face or induced motor errors by deviating the mouse cursor, or we did both at the same time. In the final case, participants experienced a motor error, but the outcome ended up cor- rect. The result showed that when they received the right face, but at the wrong place, participants re- jected the outcome they actually wanted in a majority of the trials. Thus, contrary to common belief, higher-order outcomes do not always regulate our actions. Instead, motor ‘‘wrongness’’ might sometimes override goal ‘‘rightness’’ and lead us to reject the outcome we actually want

Evolution of the Starspots in V478 Lyrae from 1980 to 1988

Differential UBV photometry of V478 Lyrae from 1980 to 1988 is given and analyzed as 22 separate light curves, each spanning an average of a dozen rotation cycles. It is shown that spots on V478 Lyr appear to have lifetimes on the order of several months to a year. The amplitude of the light loss produced by a spot can change by a factor of 2 within 20 days. In the only four determinate cases, a spot came into existence at one of the two conjunctions, that is, in the middle of the hemisphere facing (or opposing) the companion star. This finding provides additional support for the picture of a four-sector longitudinal structure, aligned with the major axis of the binary, which determines where magnetically active regions develop