Optimizing the spatial pattern of networks for monitoring radioactive releases

This study presents a method to optimize the sampling design of environmental monitoring networks in a multi-objective setting. We optimize the permanent network of radiation monitoring stations in the Netherlands and parts of Germany as an example. The optimization method proposed combines minimization of prediction error under routine conditions with maximizing calamity detection capability in emergency cases. To calculate calamity detection capability, an atmospheric dispersion model was used to simulate potentially harmful radioactive releases. For each candidate monitoring network, we determined if the releases were detected within one, two and three hours. Four types of accidents were simulated: small and large nuclear power plant accidents, deliberate radioactive releases using explosive devices, and accidents involving the transport of radioactive materials. Spatial simulated annealing (SSA) was used to search for the optimal monitoring design. SSA was implemented by iteratively moving stations around and accepting all designs that improved a weighted sum of average spatial prediction error and calamity detection capability. Designs that worsened the multi-objective criterion were accepted with a certain probability, which decreased to zero as iterations proceeded. Results were promising and the method should prove useful for assessing the efficacy of environmental monitoring networks designed to monitor both routine and emergency conditions in other applications as well.     

Therapist-aided exposure for women with lifelong vaginismus: A replicated single-case design.

Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other object. Lifelong vaginismus occurs when a woman has never been able to have intercourse. A replicated single-case A-B-phase design was used to investigate the effectiveness of therapist-aided exposure for lifelong vaginismus. A baseline period (Phase A) was contrasted with exposure + follow-up (Phase B), using random switching between phases. The main outcome measure (intercourse ability) was assessed daily for 24 weeks. Ten women participated. The exposure consisted of a maximum of three 2-hr sessions during 1 week at a university hospital. The participant performed vaginal penetration exercises on herself, in the presence of a female therapist. Two follow-up sessions were scheduled over a 5-week period. Nine of the 10 participants reported having intercourse after treatment, and in 5 of the 9, intercourse was possible within the 1st week of treatment. The results remained at 1-year follow-up. Furthermore, exposure was successful in decreasing fear and negative penetration beliefs posttreatment and at 3-month and 1-year follow-ups. Therapist-aided exposure appears to be an effective treatment for lifelong vaginismus. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A smartphone attachment for remote ophthalmic slit lamp examinations

Microsystem Technologies - A low-cost, self-imaging smartphone attachment has been developed for remote slit lamp examination of the human eye. The device is designed with off-the-shelf optical...     

Cognitive-behavioral therapy for women with lifelong vaginismus: A randomized waiting-list controlled trial of efficacy.

Women with lifelong vaginismus (N = 117) were randomly assigned to cognitive-behavioral group therapy, cognitive-behavioral bibliotherapy, or a waiting list. Manualized treatment comprised sexual education, relaxation exercises, gradual exposure, cognitive therapy, and sensate focus therapy. Group therapy consisted of ten 2-hr sessions with 6 to 9 participants per group. Assistance with minimal-contact bibliotherapy consisted of 6 biweekly, 15-min telephone contacts. Twenty-one percent of the participants left the study before posttreatment assessment. Intent-to-treat analysis revealed that successful intercourse at posttreatment was reported by 14% of the treated participants compared with none of the participants in the control condition. At the 12-month follow-up 21% of the group therapy participants and 15% of the bibliotherapy participants, respectively, reported successful intercourse. Cognitive-behavioral treatment of lifelong vaginismus was thus found to be efficacious, but the small effect size of the treatment warrants future efforts to improve the treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Proposed standardization of Neisseria meningitidis PorA variable-region typing nomenclature

Neisseria meningitidis isolates are conventionally classified by serosubtyping, which characterizes the reactivities of the PorA outer membrane protein variable-region (VR) epitopes with monoclonal antibodies (MAbs). A newer method (PorA VR typing) uses predicted amino acid sequences derived from DNA sequence analysis. The resulting classification schemes are not standardized, offering conflicting and sometimes irreconcilable data from the two methods. In this paper, we propose a standardization of the PorA VR typing nomenclature that incorporates serologic information from traditional PorA serosubtyping with molecular data from predicted VR sequences. We performed a comprehensive literature and database search, generating a collection of strains and DNA sequences that reflects the diversity within PorA that exists to date. We have arranged this information in a comprehensive logical model that includes both serosubtype and PorA VR type assignments. Our data demonstrate that the current panel of serosubtype-defining MAbs underestimates PorA VR variability by at least 50%. Our proposal for VR typing is informative because amino acid sequence and serologic information, when serosubtype-defining MAbs are available, can be deduced simultaneously from the PorA VR designation. This scheme will be useful in future classification and applied epidemiologic studies of N. meningitidis, being a systematic way of selecting PorA vaccine candidates and analyzing vaccine coverage and failure.     

A surgical technique for posterior lamellar keratoplasty

PURPOSE: To design a surgical technique for transplantation of posterior corneal tissue, while leaving the recipient anterior cornea intact. METHODS: In human cadaver eyes, and in a cat and monkey model, recipient eyes had an 8.0-mm limbal incision made with a diamond blade set to 50% of central pachymetry. A stromal pocket was created across the cornea, and a 6.0-mm diameter posterior lamellar disc was excised. A donor posterior disc was implanted into the recipient opening, and the limbal incision was sutured. The procedure was evaluated with keratometry, biomicroscopy, endothelial (supra)vital staining, and light microscopy. RESULTS: In human cadaver eyes, post-operative astigmatism averaged 1.2 D (SD, +/- 0.6 D). Posterior transplants showed an intact endothelial cell layer with 1.0% (SD, +/- 1.2%) of cell death. In the animals, six (75%) eyes had clear transplants 2 weeks after surgery; one of these eyes later developed an allograft rejection. Two (25%) eyes showed corneal decompensation, because of inverted implantation of the donor disc. Microscopy showed minimal scarring at the donor-to-host interface and a normal wound-healing response at the posterior stromal wound edges. CONCLUSION: In experimental models, posterior lamellar keratoplasty can be performed through a limbal incision and a mid-stromal pocket. The procedure may be a potential alternative in the surgical management of corneal endothelial disorders.     

Topography following keratoplasty in cats is not representative of that in humans

The excurrent duct system of the rat submandibular gland consists of a number of distinct segments. Using the direction of salivary flow as a reference point, these segments are, in order, intercalated duct, granular convoluted tubule, striated duct, excretory duct, main excretory duct (MED), and salivary bladder (which is an expanded portion of the MED). Because these ducts (with the exception of the MED and the salivary bladder) are encased in secretory endpieces, they are difficult to locate and to observe by scanning electron microscopy. A simple method has been devised to rid the gland of these obscuring endpieces so that the detailed architecture of the duct system can be examined. Rat submandibular glands were fixed initially by vascular perfusion with half-strength Karnovsky's fixative. The connective tissue capsule was removed from extirpated glands and the glands remained in fixative for varying lengths of time. For our purposes, a 30-minute immersion in the aldehyde mixture was optimum. After the sublingual gland was removed, the submandibular gland was softly struck with forceps having rounded tips, then shaken in fixative or buffer. The tissue that remained was postfixed in osmium tetroxide. This method results in the complete divestment of nonductular parenchyma from the rat submandibular gland, leaving the duct system clean and ready for microscopic examination.     

Learning histories as an ethnographic method for designing teamwork in healthcare

ABSTRACT

Designing for teamwork in healthcare requires a thorough understanding of the working context and routines of the different user groups involved. This paper presents a design project in the context of child oncology in which we demonstrate the use of a newly developed ethnographic method for design research called the learning history method. The results of this design research project demonstrate that the method provides the designer with a clear path to gather in-depth insights into the needs and wishes of different users and their interactions, while maintaining flexibility in execution. Moreover, the results also show that the proposed tangible outcomes of each design research step focuses high-quality feedback loops between the designer and the different users.     

Location Optimization of Road Weather Information System (RWIS) Network Considering the Needs of Winter Road Maintenance and the Traveling Public

This study presents an innovative approach to the planning of a critical highway sensor infrastructure ‐ road weather information system (RWIS). The problem is formulated to minimize the spatially averaged kriging variance of hazardous road surface conditions while maximizing the coverage of accident‐prone areas. This optimization framework takes explicit account of the value of information from an RWIS network, providing the potential to enhance the overall efficacy of winter maintenance operations and the safety of the travelers. Spatial simulated annealing is used to solve the resulting optimization problem and its performance is demonstrated using a real‐world case study from Minnesota, United States. The case study illustrates the distinct features of the proposed model, assesses the effectiveness of the current location setting, and recommends additional stations locations. The findings of our study suggest that the proposed model could become a valuable decision‐support tool for planning a new RWIS network and evaluating the performance of alternative RWIS expansion plans.