367 research outputs found
Sensorische Anwendungen der kalorimetrischen Detektion mit enzymatischer Erkennung
Am Institut fĂŒr Physikalische Chemie der TU Bergakademie Freiberg wurden auf der Grundlage integrierter Schaltkreise im batch-mode und flow-mode arbeitende WĂ€rmeflusskalorimeter (IC-Kalorimeter) entwickelt. Der Miniaturisierungsgrad dieser kalorimetrischen Systeme erlaubt verschiedenste Sensoranwendungen. Der vorliegende Beitrag soll die Möglichkeiten der Kombination des universell anwendbaren kalorimetrischen Messprinzips mit der hohen SpezifitĂ€t der enzymatischen Katalyse zeigen. So können kalorimetrische Untersuchungen enzymatisch katalysierter Reaktionen unter analytischen Gesichtspunkten wie der Konzentrationsbestimmung von Substraten fĂŒr die klinische Diagnostik oder die Ăberwachung biotechnologischer Prozesse eingesetzt werden.
Andererseits wird die Ermittlung kinetischer Parameter aus kalorimetrischen Messkurven mit dem Ziel der Bestimmung von EnzymaktivitÀten und zur Quantifizierung von Inhibitoren verfolgt
The Caldas Novas dome, central Brazil : structural evolution and implications for the evolution of the Neoproterozoic Brasilia belt
The Caldas Novas dome (Goiaas state, central Brazil) lies in the southern segment of the Neoproterozoic Brasilia belt (center of the Tocantins Province) between the Goias magmatic arc and the margin of the ancient Sao Francisco plate. The core of the dome comprises rocks of the Meso-Neoproterozoic
Paranoa group (passive margin psamitic-pelitic sediments and subgreenschist
facies) covered by a nappe of the Neoproterozoic Araxa group (backarc basin
pelitic-psamitic sediments and volcanics of greenschist facies, bitotite zone).
Hot underground waters that emerge along fractures in the Paranoa quartzite
and wells in the Araxa schist have made the Caldas Novas dome an international tourist attraction. A recent detailed structural analysis demonstrates that the dome area was affected by a DâDâ Brasiliano cycle
progressive deformation in the â 750-600 Ma interval (published U-Pb and Sm-Nd data). During event Dâ, a pervasive layer- parallel foliation developed coeval the regional metamorphism. Event Dâ (intense Fâ isoclinal folding) was responsible for the emplacement of the nappe. Dâ and Dâ record a regime of
simple shear (top-to-SE relative regional movement) due to a WNW-ESE subhorizontal compression (a1). Event Dâ records a WSW-ENE compression, during which the dome rose as a large-scale Fâ fold, possibly associated with a duplex structure at depth. During the domeâs uplift, the layers slid back and
down in all directions, giving way to gravity-slide folds and an extensional
crenulation cleavage. A set of brittle fractures and quartz veins constitutes the
record of a late-stage Dâ event important for understanding the thermal water reservoir
Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality â a retrospective study from a Swiss university hospital
AIMS OF THE STUDY
While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent problems currently avoid the ER.
METHODS
Electronic health records from the ER of a large Swiss university hospital were extracted for three periods: first, the awareness phase (ap) from the publication of the national governmentâs initiative âHow to protect ourselvesâ on 1 March 2020 to the lockdown of the country on 16 March; second, the mitigation phase (mp) from 16â30 March; finally, patients presenting in March 2019 were used as a control group. We compared parameters including a critical illness as the discharge diagnosis (e.g., myocardial infarction, stroke, sepsis and ER death) using logistic and linear regression, as well as 15-day bootstrapped means and 95% confidence intervals for the control group.
RESULTS
In the three periods, a total of 7143 patients were treated. We found a 24.9% (42.5%) significant decline in the number of patients presenting during the ap (mp). Patients presenting during the mp were more likely to be critically ill. There was an increase of 233% and 367% (ap and mp, respectively) of ER deaths (none related to COVID-19) compared to the control period. Apart from polytrauma (increase of 5% in the mp), all other critical illnesses as discharge diagnosis showed a lower incidence in descriptive analysis. Significantly more patients died in the ER in both the ap and mp.
CONCLUSIONS
Barriers to seeking emergency care during COVID-19 pandemic may lead to higher morbidity and mortality. Healthcare authorities and hospitals must ensure low barriers to treatment and business as usual for all patients
Data Service Cards - A supporting tool for Data-Driven Business
In the future, every successful company must have a clear idea of what data means to it. The necessary transformation to a data-driven company places high demands on companies and challenges management, organization and individual employees. In order to generate concrete added value from data, the collaboration of different disciplines e.g. data scientists, domain experts and business people is necessary. So far few tools are available which facilitate the creativity and co-creation process amongst teams with different backgrounds. The goal of this paper is to design and develop a hands-on and easy to use card-based tool for the generation of data service ideas that supports the required interdisciplinary cooperation. By using a Design Science Research approach we analysed 122 data service ideas and developed an innovation tool consisting of 38 cards. The first evaluation results show that the developed Data Service Cards are both perceived as helpful and easy to use
Effects of interacting with a large language model compared with a human coach on the clinical diagnostic process and outcomes among fourth-year medical students: study protocol for a prospective, randomised experiment using patient vignettes.
INTRODUCTION
Versatile large language models (LLMs) have the potential to augment diagnostic decision-making by assisting diagnosticians, thanks to their ability to engage in open-ended, natural conversations and their comprehensive knowledge access. Yet the novelty of LLMs in diagnostic decision-making introduces uncertainties regarding their impact. Clinicians unfamiliar with the use of LLMs in their professional context may rely on general attitudes towards LLMs more broadly, potentially hindering thoughtful use and critical evaluation of their input, leading to either over-reliance and lack of critical thinking or an unwillingness to use LLMs as diagnostic aids. To address these concerns, this study examines the influence on the diagnostic process and outcomes of interacting with an LLM compared with a human coach, and of prior training vs no training for interacting with either of these 'coaches'. Our findings aim to illuminate the potential benefits and risks of employing artificial intelligence (AI) in diagnostic decision-making.
METHODS AND ANALYSIS
We are conducting a prospective, randomised experiment with N=158 fourth-year medical students from Charité Medical School, Berlin, Germany. Participants are asked to diagnose patient vignettes after being assigned to either a human coach or ChatGPT and after either training or no training (both between-subject factors). We are specifically collecting data on the effects of using either of these 'coaches' and of additional training on information search, number of hypotheses entertained, diagnostic accuracy and confidence. Statistical methods will include linear mixed effects models. Exploratory analyses of the interaction patterns and attitudes towards AI will also generate more generalisable knowledge about the role of AI in medicine.
ETHICS AND DISSEMINATION
The Bern Cantonal Ethics Committee considered the study exempt from full ethical review (BASEC No: Req-2023-01396). All methods will be conducted in accordance with relevant guidelines and regulations. Participation is voluntary and informed consent will be obtained. Results will be published in peer-reviewed scientific medical journals. Authorship will be determined according to the International Committee of Medical Journal Editors guidelines
Best practice for arm recovery post stroke: an international application
Objective: To develop an evidence-based application (âappâ) for post-stroke upper extremity rehabilitation that can be used globally by therapists. Participants: Twenty-three experienced neurorehabilitation therapists, applied scientists and physicians, and 10 consultants dedicated to the provision of best practice to stroke survivors. Design: This team evaluated the evidence to support the timely and appropriate provision of interventions and the most defensible outcome measures during a 4-year voluntary information gathering and assimilation effort, as a basis for the sequencing of an algorithm informed by the data and directed by changes in impairment and chronicity. Outcome measures: The primary outcome was the formulation of a testable app that will be available for minimal user cost. The app is for a smartphone, and the comments of a focus group (audience at a World Confederation for Physical Therapy 2015 presentation, approximate n = 175) during a 30-minute âQuestions and Answersâ session were assessed. Results: Analysis of documented, extensive input offered by the audience indicated a highly favourable disposition towards this novel tool, with provision of concrete suggestions prior to launching the final version. Suggestions centred on: inclusion of instructions; visuals and demonstrations; monitoring of adverse responses; availability of updates; autonomous use by patients; and potential to characterise practice. Conclusions: A simple, user-friendly app for decision making in the treatment of upper extremity impairments following stroke is feasible and welcomed
Is language an issue? Accuracy of the German computerized diagnostic decision support system ISABEL and cross-validation with the English counterpart.
OBJECTIVES
Existing computerized diagnostic decision support tools (CDDS) accurately return possible differential diagnoses (DDx) based on the clinical information provided. The German versions of the CDDS tools for clinicians (Isabel Pro) and patients (Isabel Symptom Checker) from ISABEL Healthcare have not been validated yet.
METHODS
We entered clinical features of 50 patient vignettes taken from an emergency medical text book and 50 real cases with a confirmed diagnosis derived from the electronic health record (EHR) of a large academic Swiss emergency room into the German versions of Isabel Pro and Isabel Symptom Checker. We analysed the proportion of DDx lists that included the correct diagnosis.
RESULTS
Isabel Pro and Symptom Checker provided the correct diagnosis in 82 and 71âŻ% of the cases, respectively. Overall, the correct diagnosis was ranked in 71âŻ, 61 and 37âŻ% of the cases within the top 20, 10 and 3 of the provided DDx when using Isabel Pro. In general, accuracy was higher with vignettes than ED cases, i.e. listed the correct diagnosis more often (non-significant) and ranked the diagnosis significantly more often within the top 20, 10 and 3. On average, 38 ± 4.5 DDx were provided by Isabel Pro and Symptom Checker.
CONCLUSIONS
The German versions of Isabel achieved a somewhat lower accuracy compared to previous studies of the English version. The accuracy decreases substantially when the position in the suggested DDx list is taken into account. Whether Isabel Pro is accurate enough to improve diagnostic quality in clinical ED routine needs further investigation
âThe Neuroscience of ResponsibilityââWorkshop Report
This is a report on the 3-day workshop âThe Neuroscience of Responsibilityâ that was held in the Philosophy Department at Delft University of Technology in The Netherlands during February 11thâ13th, 2010. The workshop had 25 participants from The Netherlands, Germany, Italy, UK, USA, Canada and Australia, with expertise in philosophy, neuroscience, psychology, psychiatry and law. Its aim was to identify current trends in neurolaw research related specifically to the topic of responsibility, and to foster international collaborative research on this topic. The workshop agenda was constructed by the participants at the start of each day by surveying the topics of greatest interest and relevance to participants. In what follows, we summarize (1) the questions which participants identified as most important for future research in this field, (2) the most prominent themes that emerged from the discussions, and (3) the two main international collaborative research project plans that came out of this meeting
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