inPractice: a practical nursing package for clinical decisions

This paper examines the recent development of a computer-assisted learning program-in Practice-at the School of Health Science, in the University of Wales Swansea. The project, which began in 2001, was developed in close collaboration with The Meningitis Trust, the aim being to produce a software package to increase nursing students knowledge of meningitis-related illnesses, and to enhance their decision-making and problem-solving skills by using lifelike scenarios. It incorporates two multimedia meningitis modules incorporating the use of text, film, and sound, in which students are presented with information about the illness (symptoms, treatment etc.), and are required to use their knowledge to make decisions at various key points. A general discussion of decision-making theories and CAL design principles is presented, which has provided a foundation for the main design aspects of the package. This is followed by an outline of how the program was created to promote students application of knowledge and their decision-making and problem-solving skills. Results from an evaluation questionnaire are presented. Consideration is also given as to how the program can be extended

Bilateral bone marrow edema syndrome of the humeral head mimicking avascular necrosis: a case report

Abstract Background Bone marrow edema syndrome (BMES), previously referred to as transient osteoporosis, is an uncommon and underdiagnosed self-limiting condition typically affecting the weight-bearing joints of the hip and lower limb. Its occurrence in upper limb or non-weight bearing joints is particularly rare. Case presentation We report the case of an otherwise healthy 42-year-old man who gradually developed severe and disabling left shoulder pain over the course of 6 months. Nine months after onset, he presented clinically with bilateral involvement and radiologically (magnetic resonance imaging, MRI) with diffuse BME associated with a subchondral insufficiency fracture, suggestive of proximal humeral avascular necrosis. Clinical evidence of subacromial shoulder impingement and MRI findings of bilateral subchondral bursitis and tenosynovitis with effusion of the biceps tendons likely resulted from primary BME, as musculoskeletal sonography confirmed the absence of rotator cuff tears. Repeated MRI findings at 2, 12, and 18 months documented near complete resolution of both edema and fracture, consistent with BMES of the proximal humerus. During this time, the patient reported a gradual improvement in both pain symptoms and range of motion. The clinical picture of insidious shoulder pain, exacerbated by activity and improved by load relief, in the absence of predisposing factors for osteonecrosis or antecedent trauma in patients of middle age, should indicate the possibility of the diagnosis of BMES. Conclusions This unprecedented report documents a rare case of bilateral BMES of the humeral head mimicking avascular necrosis. The correct diagnosis of BMES within an atypical anatomical location avoids invasive measures in the affected bone. The misdiagnosis of secondary BME and idiopathic osteonecrosis can be avoided by recognizing the characteristics of BME and subchondral fractures of the humeral head in the absence of rotator cuff tears, as well as their evolution on serial MRI

A Geometric Perspective on Sparse Filtrations

We present a geometric perspective on sparse filtrations used in topological data analysis. This new perspective leads to much simpler proofs, while also being more general, applying equally to Rips filtrations and Cech filtrations for any convex metric. We also give an algorithm for finding the simplices in such a filtration and prove that the vertex removal can be implemented as a sequence of elementary edge collapses

Seeded and unseeded high order parametric down conversion

Spontaneous parametric down conversion (SPDC) has been one of the foremost tools in quantum optics for over five decades. Over that time it has been used to demonstrate some of the curious features that arise from quantum mechanics. Despite the success of SPDC, its higher-order analogues have never been observed, even though it has been suggested that they generate far more unique and exotic states than SPDC. An example of this is the emergence of non-Gaussian states without the need for post-selection. Here we calculate the expected rate of emission for nth-order SPDC with and without external stimulation (seeding). Focusing primarily on third-order parametric down-conversion (TOPDC), we estimate the photon detection rates in a rutile crystal, for both the unseeded and seeded regimes.Comment: 11 pages, 6 figure

Multifunction MMIC For Miniaturized Solid State Switch Matrix

This paper describes a new multifunction MMIC expressly designed for a reconfiguration matrix equipment.This MMIC has been developed using a standard PHEMT process and includes two switches,a totally switchable-off amplifier and a temperature compensation circuit.The complete circuit has also been designed to interface a standard CMOS control level. Performed simulations and obtained results demonstrate the effectiveness of this approach in reaching compactness and reliability of satellite equipment

Transverse Entanglement of Biphotons

We measure the transverse entanglement of photon pairs on their propagation from the near to the far field of spontaneous parametric downconversion (SPDC). The Fedorov ratio, depending on the widths of conditional and unconditional intensity measurements, is shown to be only able to characterize entanglement in the near and far field zones of the source. Therefore we also follow a different approach. By evaluating the first-order coherence of a subsystem of the state we can quantify its entanglement. Unlike previous measurements, which determine the Fedorov ratio via intensity correlations, our setup is sensitive to both phase and modulus of the biphoton state and thus always grants experimental access to the full transverse entanglement of the SPDC state. It is shown theoretically that this scheme represents a direct measurement of the Schmidt number.Comment: 11 pages, 6 figure

Misophonia:current perspectives

Misophonia is characterized by a negative reaction to a sound with a specific pattern and meaning to a given individual. In this paper, we review the clinical features of this relatively common yet underinvestigated condition, with focus on co-occurring neurodevelopmental disorders. Currently available data on the putative pathophysiology of the condition can inform our understanding and guide the diagnostic process and treatment approach. Tinnitus retraining therapy and cognitive behavior therapy have been proposed as the most effective treatment strategies for reducing symptoms; however, current treatment algorithms should be validated in large population studies. At the present stage, competing paradigms see misophonia as a physiological state potentially inducible in any subject, an idiopathic condition (which can present with comorbid psychiatric disorders), or a symptomatic manifestation of an underlying psychiatric disorder. Agreement on the use of standardized diagnostic criteria would be an important step forward in terms of both clinical practice and scientific inquiry. Areas for future research include phenomenology, epidemiology, modulating factors, neurophysiological underpinnings, and treatment trials