Correlation between colposcopic impression using Reid’s colposcopic Index and histopathological grading of premalignant lesions of cervix

Background: Cancer cervix is in the top rank of gynecological cancers in the developing countries cervical cancer has a long latent period and can be prevented by simple treatment of cervical intraepithelial neoplasm. The incidence of invasive cancer can be decreased by early detection of preinvasive stage which can be treated at the same sitting, “see & treat approach” strategy. Objectives were to estimate the strength of correlation in detecting preinvasive lesions of cervix between colposcopy and directed biopsy and to correlate various socio-demographic data with cervical pre-invasive and invasive lesion. To compare the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of colposcopy with colposcopic directed biopsy.Methods: On selecting the patients based on the criteria, per speculum examination was done and in the presence of abnormal cervix, advised for PAP smear. Based on PAP smear scaled according to Bethedsa staging, patients were accordingly advised for colposcopy. Reid’s colposcopic index applied and biopsy was taken over the site with highest score and sent for HPE in a labelled bottle with fixative.Results: Colposcopy when compared to histopathology had a sensitivity of 100 %, specificity of 48.3%, with PPV of 22.4 % and NPV of 100 %. The p value was 0.001 suggesting a significant strength of agreement between colposcopic diagnosis using Reid’s index and histopathological diagnosis.Conclusions: Correlation of colposcopic impression with directed biopsy is described as the reference investigation or ‘gold standard’ for the diagnosis of cervical precancerous lesions

Is education a fundamental right? People's lay theories about intellectual potential drive their positions on education

Does every child have a fundamental right to receive a high quality education? We propose that people’s beliefs about whether “nearly everyone” or “only some people” have high intellectual potential drive their positions on education. Three studies found that the more people believed that nearly everyone has high potential, the more they viewed education as a fundamental human right. Further, people who viewed education as a fundamental right, in turn, (1) were more likely to support the institution of free public education; (2) were more concerned upon learning that students in the country were not performing well academically compared to students in peer nations; and (3) were more likely to support redistributing educational funds more equitably across wealthier and poorer school districts. The studies show that people’s beliefs about intellectual potential can influence their positions on education, which can affect the future quality of life for countless students

Choosing one at a time? Presenting options simultaneously helps people make more optimal decisions than presenting options sequentially

This research examines an element of choice architecture that has received little attention—whether options are presented simultaneously or sequentially. Participants were more likely to choose dominating options when the options were presented simultaneously rather than sequentially, both when the dominance relationship was transparent (Experiment 1) and when it was not (Experiments 2–3). Depth of cognitive processing mediated the effect of option presentation on optimal choice (Experiment 4). Memory load was unlikely to be the underlying mechanism, as individual differences in working memory span did not predict optimal choice in the sequential condition (which places a greater memory load; Experiment 5), and manipulations of memory load did not reduce the benefits of simultaneous presentation (Experiments 6a–6c). Instead, participants’ working memory span predicted optimal choice in the simultaneous condition (which allows for more in-depth processing; Experiment 5), and a manipulation of processing load eliminated the benefits of simultaneous presentation (Experiment 7)

Choosing among options presented sequentially versus simultaneously

When choosing among multiple options, people can view the options either one at a time or all together. This article reviews an emerging stream of research that examines the ways in which viewing options sequentially vs. simultaneously influences people’s decisions. Multiple studies support the idea that viewing options simultaneously encourages people to compare the options and to focus on the ways in which the options differ from each other. In contrast, viewing options sequentially encourages people to process each option holistically by comparing the option against previously encountered options or a subjective reference point. Integrating research from judgment and decision making, consumer behavior, experimental economics, and eyewitness identification, we identify ways in which the different processing styles elicited by sequential and simultaneous presentation formats influence people’s judgment and decision making. This issue is particularly important because presenting option either sequentially or simultaneously is a key element of choice architecture

An Empirical Study of Finding Approximate Equilibria in Bimatrix Games

While there have been a number of studies about the efficacy of methods to find exact Nash equilibria in bimatrix games, there has been little empirical work on finding approximate Nash equilibria. Here we provide such a study that compares a number of approximation methods and exact methods. In particular, we explore the trade-off between the quality of approximate equilibrium and the required running time to find one. We found that the existing library GAMUT, which has been the de facto standard that has been used to test exact methods, is insufficient as a test bed for approximation methods since many of its games have pure equilibria or other easy-to-find good approximate equilibria. We extend the breadth and depth of our study by including new interesting families of bimatrix games, and studying bimatrix games upto size $2000 \times 2000$. Finally, we provide new close-to-worst-case examples for the best-performing algorithms for finding approximate Nash equilibria

Cardiac Arrest Following Central Neuraxial Block

Central neuraxial blocks (CNB) are used worldwide in anesthesia practice. They are safe, however, not devoid of untoward complications. Cardiac arrest (CA) is one of the major devastating complications. The anesthesiologists are concerned about CA as it can occur unexpectedly and suddenly even in a young ASA grade I patient, undergoing elective surgery, at any time during and after administration of CNB in spite of continuous vigilance. A better understanding of the physiology of CNB, availability of monitoring devices, and safer local anesthetic drugs contribute to reduced mortality, yet cases of CA are reported even recently. These case reports provide information relevant to particular incidents and may be inadequate to provide comprehensive information to explain the overall clinically important aspects related to CA following CNB. This chapter would provide a summary and analysis of the current recommendations about etiology, predisposing factors, preventive measures, and various measures tried for the treatment of cardiac arrest, although the exact etiology and predisposing factors are still not known. The comprehensive information would be helpful for anesthesiologists during day-to-day practice and to increase the safety of patients undergoing CNB. Proper patient selection, pre-/co-loading of fluids, the modifying technique of CNB as per patient’s need, early use of epinephrine during bradycardia refractory to atropine, continuous monitoring, vigilance during intra- and postoperative period would help in prevention, early detection, and prompt treatment of CA. Challenges faced by anesthesiologists during CNB practice and newer modalities used for the treatment of refractory CA are also discussed. The mystery of sudden unexpected CA is yet to be solved and research in this direction is warranted. Electronic medical record keeping and reporting untoward incidence to the national board will also help to improve patient safety in the future

Speeds and arrival times of solar transients approximated by self-similar expanding circular fronts

The NASA STEREO mission opened up the possibility to forecast the arrival times, speeds and directions of solar transients from outside the Sun-Earth line. In particular, we are interested in predicting potentially geo-effective Interplanetary Coronal Mass Ejections (ICMEs) from observations of density structures at large observation angles from the Sun (with the STEREO Heliospheric Imager instrument). We contribute to this endeavor by deriving analytical formulas concerning a geometric correction for the ICME speed and arrival time for the technique introduced by Davies et al. (2012, ApJ, in press) called Self-Similar Expansion Fitting (SSEF). This model assumes that a circle propagates outward, along a plane specified by a position angle (e.g. the ecliptic), with constant angular half width (lambda). This is an extension to earlier, more simple models: Fixed-Phi-Fitting (lambda = 0 degree) and Harmonic Mean Fitting (lambda = 90 degree). This approach has the advantage that it is possible to assess clearly, in contrast to previous models, if a particular location in the heliosphere, such as a planet or spacecraft, might be expected to be hit by the ICME front. Our correction formulas are especially significant for glancing hits, where small differences in the direction greatly influence the expected speeds (up to 100-200 km/s) and arrival times (up to two days later than the apex). For very wide ICMEs (2 lambda > 120 degree), the geometric correction becomes very similar to the one derived by M\"ostl et al. (2011, ApJ, 741, id. 34) for the Harmonic Mean model. These analytic expressions can also be used for empirical or analytical models to predict the 1 AU arrival time of an ICME by correcting for effects of hits by the flank rather than the apex, if the width and direction of the ICME in a plane are known and a circular geometry of the ICME front is assumed.Comment: 15 pages, 5 figures, accepted for publication in "Solar Physics

The Longitudinal Properties of a Solar Energetic Particle Event Investigated Using Modern Solar Imaging

We use combined high-cadence, high-resolution, and multi-point imaging by the Solar-Terrestrial Relations Observatory (STEREO) and the Solar and Heliospheric Observatory to investigate the hour-long eruption of a fast and wide coronal mass ejection (CME) on 2011 March 21 when the twin STEREO spacecraft were located beyond the solar limbs. We analyze the relation between the eruption of the CME, the evolution of an Extreme Ultraviolet (EUV) wave, and the onset of a solar energetic particle (SEP) event measured in situ by the STEREO and near-Earth orbiting spacecraft. Combined ultraviolet and white-light images of the lower corona reveal that in an initial CME lateral "expansion phase," the EUV disturbance tracks the laterally expanding flanks of the CME, both moving parallel to the solar surface with speeds of ~450 km s^(–1). When the lateral expansion of the ejecta ceases, the EUV disturbance carries on propagating parallel to the solar surface but devolves rapidly into a less coherent structure. Multi-point tracking of the CME leading edge and the effects of the launched compression waves (e.g., pushed streamers) give anti-sunward speeds that initially exceed 900 km s^(–1) at all measured position angles. We combine our analysis of ultraviolet and white-light images with a comprehensive study of the velocity dispersion of energetic particles measured in situ by particle detectors located at STEREO-A (STA) and first Lagrange point (L1), to demonstrate that the delayed solar particle release times at STA and L1 are consistent with the time required (30-40 minutes) for the CME to perturb the corona over a wide range of longitudes. This study finds an association between the longitudinal extent of the perturbed corona (in EUV and white light) and the longitudinal extent of the SEP event in the heliosphere