Clinical impact of blood cultures taken in the emergency department

OBJECTIVES: (1) To establish the proportion of blood cultures that yield a positive microbiological culture. (2) To determine what proportion of blood cultures taken in the emergency department impact on patient management. (3) To develop guidelines for the appropriate ordering of blood cultures from patients in the emergency department (ED). METHODS: Retrospective review of all blood cultures taken in the ED of a metropolitan teaching hospital between 26 September 1995 and 30 June 1996. RESULTS: One thousand and sixty two blood cultures were taken from patients in the ED during the study period. Ninety two (9%) returned a positive microbiological culture. Of these, 52 (5%) were "true" positives and 18 (1.6%) resulted in changes in management. CONCLUSIONS: Blood cultures taken in the ED rarely yield positive cultures. Only 1.6% of blood cultures taken in the ED impact on management of patients. Simple strategies could reduce the number of blood cultures ordered with little prospect of patient compromise.     

Differences between completers and early dropouts from 2 HIV intervention trials: a health belief approach to understanding prevention program attrition

OBJECTIVES: The purpose of this study was to identify factors predicting program attrition among participants in human immunodeficiency virus (HIV) risk reduction trials. METHODS: Participants were gay/bisexual men and severely mentally ill adults recruited to take part in HIV risk reduction small-group interventions. Program completers were compared with participants who were assessed at baseline but then failed to attend any sessions. The health belief model provided a framework for selection of possible predictors of program attrition. RESULTS: Younger age was associated with early dropout in both samples. Other predictors among gay/bisexual men included involvement in an exclusive sexual relationship, minority ethnicity, injection drug use, and higher perceived severity of AIDS. Severely mentally ill dropouts were less knowledgeable about safer sex methods and more likely to hold positive outcome expectancies for condom use. CONCLUSIONS: Evaluation of intervention effectiveness among vulnerable population segments is threatened if there is selective attrition. Better methods are needed to attract and maintain participation in HIV prevention programs. Alternatively, wider application of "intention to treat" analysis of intervention outcomes is recommended to minimize selection bias due to program dropout.     

Traffic of dynamin within individual Drosophila synaptic boutons relative to compartment-specific markers

Presynaptic terminals contain several specialized compartments, which have been described by electron microscopy. We show in an identified Drosophila neuromuscular synapse that several of these compartments-synaptic vesicle clusters, presynaptic plasma membrane, presynaptic cytosol, and axonal cytoskeleton-labeled by specific reagents may be resolved from one another by laser scanning confocal microscopy. Using a panel of compartment-specific markers and Drosophila shibire(ts1) mutants to trap an intermediate stage in synaptic vesicle recycling, we have examined the localization and redistribution of dynamin within single synaptic varicosities at the larval neuromuscular junction. Our results suggest that dynamin is not a freely diffusible molecule in resting nerve terminals; rather, it appears localized to synaptic sites by association with yet uncharacterized presynaptic components. In shi(ts1) nerve terminals depleted of synaptic vesicles, dynamin is quantitatively redistributed to the plasma membrane. It is not, however, distributed uniformly over presynaptic plasmalemma; instead, fluorescence images show "hot spots" of dynamin on the plasma membrane of vesicle-depleted nerve terminals. We suggest that these dynamin-rich domains may mark the active zones for synaptic vesicle endocytosis first described at the frog neuromuscular junction.     

Natural perspective projections for head-mounted displays

The display units integrated in today's head-mounted displays (HMDs) provide only a limited field of view (FOV) to the virtual world. In order to present an undistorted view to the virtual environment (VE), the perspective projection used to render the VE has to be adjusted to the limitations caused by the HMD characteristics. In particular, the geometric field of view (GFOV), which defines the virtual aperture angle used for rendering of the 3D scene, is set up according to the display field of view (DFOV). A discrepancy between these two fields of view distorts the geometry of the VE in a way that either minifies or magnifies the imagery displayed to the user. It has been shown that this distortion has the potential to affect a user's perception of the virtual space, sense of presence, and performance on visual search tasks. In this paper, we analyze the user's perception of a VE displayed in a HMD, which is rendered with different GFOVs. We introduce a psychophysical calibration method to determine the HMD's actual field of view, which may vary from the nominal values specified by the manufacturer. Furthermore, we conducted two experiments to identify perspective projections for HMDs, which are identified as natural by subjects--even if these perspectives deviate from the perspectives that are inherently defined by the DFOV. In the first experiment, subjects had to adjust the GFOV for a rendered virtual laboratory such that their perception of the virtual replica matched the perception of the real laboratory, which they saw before the virtual one. In the second experiment, we displayed the same virtual laboratory, but restricted the viewing condition in the real world to simulate the limited viewing condition in a HMD environment. We found that subjects evaluate a GFOV as natural when it is larger than the actual DFOV of the HMD--in some cases up to 50 percent--even when subjects viewed the real space with a limited field of view.     

Developing Oregon’s renewable energy portfolio using fuzzy goal programming model

Renewable energy continues to be a hot topic in the United States affecting security and sustainability. A model to create renewable energy portfolio is established using guidelines drawn by Oregon’s Renewable Portfolio Standard (RPS) legislation with the objective of responding to a 25% of the state electricity demand by renewable resources in 2025. The fuzzy goal programming model is adaptable to accommodate changes in energy costs and future advances in technology maturity. It can also take into consideration the preferences of policy-makers and stakeholders. This model can help to reveal the costs and benefits of complex decisions regarding renewable energy.     

Sources and nature of secondary school teachers’ education in computer-related ergonomics

Teachers’ knowledge of computer-related ergonomics in education will have an effect on the learning process and the work practices of their students. However little is known about teacher education in this area. The study aimed to investigate the sources and nature of secondary school teachers’ education about computer-related ergonomics. It also investigated the use of computers by secondary school children. The study included all secondary schools in the Republic of Ireland. The findings suggest that computers are widely available and are used frequently by students and teachers. However, there is evidence that teachers are not receiving information on computer-related ergonomics. Teachers were generally dissatisfied with this and would welcome information on the subject. The study discusses the implications of the findings and makes recommendations to meet the needs of the teachers.     

Local influence in estimating equations

Local influence diagnostics based on estimating equations as the role of a gradient vector derived from any fit function are developed for repeated measures regression analysis. Our proposal generalizes tools used in other studies ( [Cook, 1986] and [Cadigan and Farrell, 2002]), considering herein local influence diagnostics for a statistical model where estimation involves an estimating equation in which all observations are not necessarily independent of each other. Moreover, the measures of local influence are illustrated with some simulated data sets to assess influential observations. Applications using real data are presented.     

Interactive visualization and analysis of transitional flow

A stand-alone visualization application has been developed by a multi-disciplinary, collaborative team with the sole purpose of creating an interactive exploration environment allowing turbulent flow researchers to experiment and validate hypotheses using visualization. This system has specific optimizations made in data management, caching computations, and visualization allowing for the interactive exploration of datasets on the order of 1TB in size. Using this application, the user (co-author Calo) is able to interactively visualize and analyze all regions of a transitional flow volume, including the laminar, transitional and fully turbulent regions. The underlying goal of the visualizations produced from these transitional flow simulations is to localize turbulent spots in the laminar region of the boundary layer, determine under which conditions they form, and follow their evolution. The initiation of turbulent spots, which ultimately lead to full turbulence, was located via a proposed feature detection condition and verified by experimental results. The conditions under which these turbulent spots form and coalesce are validated and presented.