Predictive Behavior of a Computational Foot/Ankle Model through Artificial Neural Networks.

Computational models are useful tools to study the biomechanics of human joints. Their predictive performance is heavily dependent on bony anatomy and soft tissue properties. Imaging data provides anatomical requirements while approximate tissue properties are implemented from literature data, when available.

Communication training improves patient-centered provider behavior and screening for soldiers' mental health concerns.

Objective: To evaluate the effectiveness of patient-centered communication training for military providers who conduct post-deployment health screening. The half-day interactive workshop included simulated Soldier patients using video technology.

Methods: Using a quasi-experimental design, all health care providers at four military treatment facilities were recruited for data collection during a four- to nine-day site visit (23 trained providers, 28 providers in the control group, and one provider declined to participate).

Feedback mechanisms of change: How problem alerts reported by youth clients and their caregivers impact clinician-reported session content.

Objective: This study explored how clinician-reported content addressed in treatment sessions was predicted by clinician feedback group and multi-informant cumulative problem alerts that appeared in computerized feedback reports for 299 clients aged 11-18 years receiving home-based community mental health treatment.

Method: Measures included a clinician report of content addressed in sessions and additional measures of treatment progress and process (e.g.

Spleen Segmentation and Assessment in CT Images for Traumatic Abdominal Injuries.

Spleen segmentation is especially challenging as the majority of solid organs in the abdomen region have similar gray level range. Physician analysis of computed tomography (CT) images to assess abdominal trauma could be very time consuming and hence, automating this process can reduce time to treatment. The proposed method presented in this paper is a fully automated and knowledge based technique that employs anatomical information to accurately segment the spleen in CT images.

Overview of depression, post-traumatic stress disorder, and alcohol misuse among active duty service members returning from Iraq and Afghanistan, self-report and diagnosis.

Previous studies have found deployment to combat areas to be associated with an increased risk of post-traumatic stress disorder (PTSD), depression, and alcohol abuse, but many previous studies were limited by samples that were not representative of the deployed military as a whole. This study presents an overview of these three mental health problems associated with deployment among Air Force, Army, Marine Corp, and Navy service members returning from deployment to Iraq and Afghanistan between January 2007 and March 2008. With postdeployment health data on over 50,000 service men and women, including diagnostic information, we were able to estimate prevalence of those who screened positive for risk of each disorder in self-report data at two time points, as well as prevalence of diagnoses received during health care encounters within the military health care system.

An automated dental caries detection and scoring system for optical images of tooth occlusal surface.

Dental caries are one of the most prevalent chronic diseases. The management of dental caries demands detection of carious lesions at early stages. This study aims to design an automated system to detect and score caries lesions based on optical images of the occlusal tooth surface according to the International Caries Detection and Assessment System (ICDAS) guidelines.

Resident and attending physician perception of maladaptive response to stress in residents.

Background: Residency stress has been shown to interfere with resident well-being and patient safety. We developed a survey research study designed to explore factors that may affect perception of a maladaptive response to stress.

Methods: A 16-item survey with 12 Likert-type perception items was designed to determine how often respondents agreed or disagreed with statements regarding the resident on the trigger tape.

A hierarchical method for removal of baseline drift from biomedical signals: application in ECG analysis.

Noise can compromise the extraction of some fundamental and important features from biomedical signals and hence prohibit accurate analysis of these signals. Baseline wander in electrocardiogram (ECG) signals is one such example, which can be caused by factors such as respiration, variations in electrode impedance, and excessive body movements. Unless baseline wander is effectively removed, the accuracy of any feature extracted from the ECG, such as timing and duration of the ST-segment, is compromised.

An automated method for analysis of microcirculation videos for accurate assessment of tissue perfusion.

Background: Imaging of the human microcirculation in real-time has the potential to detect injuries and illnesses that disturb the microcirculation at earlier stages and may improve the efficacy of resuscitation. Despite advanced imaging techniques to monitor the microcirculation, there are currently no tools for the near real-time analysis of the videos produced by these imaging systems. An automated system tool that can extract microvasculature information and monitor changes in tissue perfusion quantitatively might be invaluable as a diagnostic and therapeutic endpoint for resuscitation.

An automated optimal engagement and attention detection system using electrocardiogram.

This research proposes to develop a monitoring system which uses Electrocardiograph (ECG) as a fundamental physiological signal, to analyze and predict the presence or lack of cognitive attention in individuals during a task execution. The primary focus of this study is to identify the correlation between fluctuating level of attention and its implications on the cardiac rhythm recorded in the ECG. Furthermore, Electroencephalograph (EEG) signals are also analyzed and classified for use as a benchmark for comparison with ECG analysis.

Hemorrhage detection and segmentation in traumatic pelvic injuries.

Automated hemorrhage detection and segmentation in traumatic pelvic injuries is vital for fast and accurate treatment decision making. Hemorrhage is the main cause of deaths in patients within first 24 hours after the injury. It is very time consuming for physicians to analyze all Computed Tomography (CT) images manually.

mi-DS: Multiple-Instance Learning Algorithm.

Multiple-instance learning (MIL) is a supervised learning technique that addresses the problem of classifying bags of instances instead of single instances. In this paper, we introduce a rule-based MIL algorithm, called mi-DS, and compare it with 21 existing MIL algorithms on 26 commonly used data sets. The results show that mi-DS performs on par with or better than several well-known algorithms and generates models characterized by balanced values of precision and recall.

Does literacy education improve symptoms of depression and self-efficacy in individuals with low literacy and depressive symptoms? A preliminary investigation.

Background And Objectives: Individuals with low literacy and symptoms of depression have greater improvement of depression symptoms when their treatment includes education to enhance literacy skills. The reason why literacy enhancement helps depression symptoms is unknown, but we hypothesize that it might be due to improved self-efficacy. We studied whether providing literacy education to individuals with both depression symptoms and limited literacy might improve their self-efficacy.

Literacy education as treatment for depression in patients with limited literacy and depression: a randomized controlled trial.

Background: Individuals with limited literacy and those with depression share many characteristics, including low self-esteem, feelings of worthlessness, and shame.

Objective: To determine whether literacy education, provided along with standard depression treatment to adults with depression and limited literacy, would result in greater improvement in depression than would standard depression treatment alone.

Design: Randomized clinical trial with patients assigned either to an intervention group that received standard depression treatment plus literacy education, or a control group that received only standard depression treatment.

Lamellar magnetism in the haematite-ilmenite series as an explanation for strong remanent magnetization.

Magnetic anomalies associated with slowly cooled igneous and metamorphic rocks are commonly attributed to the presence of the mineral magnetite. Although the intermediate members of the ilmenite-haematite mineral series can also carry a strong ferrimagnetic remanence, it is preserved only in rapidly cooled volcanic rocks, where formation of intergrowths of weakly magnetic haematite and paramagnetic ilmenite is suppressed. But the occurrence of unusually large and stable magnetic remanence in rocks containing such intergrowths has been known for decades, and has recently been the subject of intense investigation.

Increased endothelial expression of intercellular adhesion molecule-1 in symptomatic versus asymptomatic human carotid atherosclerotic plaque.

Background And Purpose: The mechanisms that cause carotid atherosclerotic plaque to become symptomatic remain unclear. Evidence suggests that mediators of inflammation are not only instrumental in the formation of plaque but may also be involved in the rapid progression of atheromatous lesions leading to plaque fissuring, endothelial injury, and intraluminal thrombosis. Our goal is to determine whether intercellular adhesion molecule-1 (ICAM-1), a known component of the inflammatory pathway, is preferentially expressed on symptomatic versus asymptomatic carotid plaques.

Magnetic properties experiments on the Mars Pathfinder lander: preliminary results.

Many of the particles currently suspended in the martian atmosphere are magnetic, with an average saturation magnetization of about 4 A. m2/kg (amperes times square meters per kilogram). The particles appear to consist of claylike aggregates stained or cemented with ferric oxide (Fe2O3); at least some of the stain and cement is probably maghemite (gamma-Fe2O3).

Delayed diagnosis of large cerebello-pontine angle tumors, despite hearing conservation training.

Recently, at the National Naval Medical Center in Bethesda, Maryland, we have encountered several patients with large cerebello-pontine angle tumors. All were active duty and had evaded the military's stringent hearing screening program until the tumors were of life-threatening size. Early detection of these tumors can reduce overall morbidity and improve the patient's chances of returning to a normal lifestyle.

Current management of carotid atherosclerosis.

Carotid atherosclerosis affects thousands of individuals each year. A history of transient ischemic attacks should alert the clinician to the possibility of carotid artery disease. Carotid endarterectomy is of proven benefit in both symptomatic and asymptomatic individuals, with angiographically confirmed carotid stenosis of from 70 to 99%, respectively.

Relationship of perfusion pressure and size to risk of hemorrhage from arteriovenous malformations.

The relationship between the size of an arteriovenous malformation (AVM) and its propensity to hemorrhage is unclear. Although nidus volume increases geometrically with respect to AVM diameter, hemorrhages are at least as common, in small AVM's compared to large AVM's. The authors prospectively evaluated 92 AVM's for nidus size, hematoma size, and arterial feeding pressure to determine if these variables influence the tendency to hemorrhage.

Cavernous malformations of the brain stem.

Once they become symptomatic, cavernous malformations of the brain stem appear to cause progressive morbidity from repetitive hemorrhage, and can even be fatal. Twenty-four patients with long-tract and/or cranial nerve findings from their cavernous malformations of the brain stem were seen for initial evaluation or surgical consultation and thereafter received either surgical or continued conservative treatment. The decision to operate was based on the proximity of the cavernous malformation to the pial surface of the brain stem, the patient's neurological status, and the number of symptomatic episodes.

Coagulopathy and warfarin-associated breast necrosis in a patient with a primary brain tumor.

Although the association of coagulopathy and neoplastic disease is well documented, there have been few reports of patients with primary central nervous system tumors who exhibited hypercoagulable states. We report the case of a 58-year-old woman with a recurrent falcine meningioma and repeated episodes of venous thrombosis who developed warfarin-associated breast necrosis on the fifth day of coumadin therapy. Laboratory evaluation at that time demonstrated an elevated prothrombin time and normal activated partial thromboplastin time.

Chronic intrastriatal dopamine infusions in rats with unilateral lesions of the substantia nigra.

This study examined the effects of continuously supplied dopamine delivered directly into the dopamine-deficient striatum. Rats received unilateral lesions of the substantia nigra by stereotaxic administration of 6-hydroxydopamine and were tested for apomorphine-induced rotational behavior and general activity. Osmotic mini-pumps were filled with dopamine in various concentrations, implanted subcutaneously and connected to a cannula implanted directly into the striatum.

Unusual metastasis to the cauda equina: case report.

A case of intradural metastasis from endometrial carcinoma to the cauda equina is presented. The clinical presentation and radiographic findings were misleading and suggested a herniated nucleus pulposus. Findings at operation were most suggestive of an ependymoma, but final pathological diagnosis revealed endometrial carcinoma.

A longitudinal evaluation of thyroid function in critically ill surgical patients.

Thyroid hormone alterations (known as the "sick-euthyroid syndrome") are common following major surgery, but the time course for appearance and recovery from these alterations has not previously been longitudinally studied in a large group of surgical patients. The authors prospectively studied 59 patients undergoing major surgery (coronary artery bypass grafting, pneumonectomy, or subtotal colectomy). Compared with preoperative values, the mean serum T4, T3, free T3, and TSH concentrations decreased significantly (p less than 0.