Interaction Effects of Combinations of Relevance and Execution Style.docx
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InteractionEffectsofCombinationsofRelevanceandExecutionStyle
Objectives
Thisstudyassessedthediagnosticperformanceofcoronarycomputedtomographyangiography(CTA)forthedetectionandexclusionofsignificantcoronaryarterystenosisasremotelyinterpretedonamobilehandhelddevicewithdedicatedmedicalimagingsoftware.
Background
Recentadvancesintechnologynowpermitremoteinterpretationofmedicalimagingstudiesonmobilehandhelddevices,althoughthediagnosticperformanceofthisapproachisunknown.
Methods
Weevaluated102patientswithstablechestpainandboth64-detectorrowcoronaryCTAandquantitativeinvasivecoronaryangiography.ThediagnosticperformanceofremotecoronaryCTAinterpretationwasassessedusingamobilehandhelddeviceandemployingdedicatedsoftware.ThecoronaryCTAstudieswereexaminedinanintent-to-diagnosemannerforthepresenceorabsenceofcoronaryarterystenosis≥50%onaper-arteryandper-patientlevel;resultswerecomparedwithquantitativeinvasivecoronaryangiography.TwoblindedimagersindependentlyinterpretedcoronaryCTAstudies,withathirdimagerachievingconsensusfordiscordance.CoronaryCTAswerere-interpretedinrandomordertodetermineinterobserveragreement.Finally,coronaryCTAswereevaluatedonadedicated3-dimensionalimagingworkstation;resultswerecomparedtomobilehandhelddevicefindingsforintertechnologyagreement.
Results
Theprevalenceofsignificantcoronaryarterystenosiswas25%(26of102)attheper-patientleveland10%(40of405)attheper-arterylevel.Per-patientandper-arterysensitivity,specificity,andpositiveandnegativepredictivevalueswere:
100%(26of26),78%(59of76),60%(26of43),and100%(59of59),respectively;and95%(38of40),85%(310of365),41%(38of93),and99%(310of312),respectively.Attheper-arterylevel,interobserver,intraobserver,andintertechnologyagreementwas0.74,0.89,and0.75,respectively(p<0.01forall).
Conclusions
TheinterpretationofcoronaryCTAusingamobilehandhelddevicewithdedicatedsoftwareformedicalimageevaluationpossesseshighdiagnosticaccuracyfordetectionandexclusionofsignificantcoronarystenosis.
Dialecticalbehaviortherapy(DBT)hasreceivedstrongempiricalsupportandispracticedwidelyasatreatmentforborderlinepersonalitydisorder(BPD)andBPDwithcomorbidsubstanceusedisorders(BPD-SUD).TherapeuticsuccessinDBTrequiresthatindividualsgeneralizenewlyacquiredskillstotheirnaturalenvironment.However,therehavebeenonlyalimitednumberofoptionsavailabletoachievethisend.TheprimarygoalofthisresearchwastodevelopandtestthefeasibilityoftheDBTCoach,asoftwareapplicationforasmartphone,designedspecificallytoenhancegeneralizationofaspecificDBTskill(oppositeaction)amongindividualswithBPD-SUD.Weconductedaquasiexperimentalstudyinwhich22individualswhowereenrolledinDBTtreatmentprogramsreceivedasmartphonewiththeDBTCoachfor10to14daysandwereinstructedtouseitasneeded.ParticipantsusedtheDBTCoachanaverageofnearly15timesandgavehighratingsofhelpfulnessandusability.Resultsindicatethatbothemotionintensityandurgestousesubstancessignificantlydecreasedwithineachcoachingsession.Furthermore,overthetrialperiod,participantsreportedadecreaseindepressionandgeneraldistress.Mobiletechnologyofferinginvivoskillscoachingmaybeausefultoolforreducingurgestousesubstancesandengageinothermaladaptivebehaviorbydirectlyteachingandcoachinginalternative,adaptivecopingbehavior.
Advancesininformationtechnologyhavemadethethermalmanagementoftelecommunicationequipmentsmorechallengingoverthepastseveralyears.Asadvancesarebeingmadetheelectricalenergyconsumptionoftelecommunicationequipmentsiseverincreasingandtherebyincreasingitsdissipationrate.Inadditionsuchsheltersareinstalledinremoteareas,socoolingoftelecomsheltersbecomesagreatchallengeforthermalengineers.Afieldstudyrevealedconventionalcoolingsystemsarenotsoeffectiveintermsofenergyconsumptionandintheabsenceofpowergrid,sheltersinstalledinsuchareasrequireadditionalcapitalcosttoprovidepowerforcoolingsystem.Anewpassivecoolingsystemincorporatingphasechangematerial(PCM)andtwo-phaseclosedthermosyphon(TPCT)heatexchangershasbeendevelopedandexperimentedtoprovidethermalmanagementfortelecommunicationequipmentshousedintelecomshelters.Thenewlydevelopedthermalsystemabsorbstheequipmentdissipatedheatduringthehottestpartoftheday,storesitaslatentheatandreleasesitthroughthermosyphonsduringthenighttotheambient.
Totestthefeasibilityofshortmessageservice(SMS)usagebetweentheclinicvisitsandtoevaluateitseffectonglycemiccontrolinuncontrolledtype2DiabetesMellitus(DM)subjects.
Researchdesignandmethods
34caseswithtype2Diabeteswerefollowedafterfulfillingtheinclusioncriteria.Theinterventionalgroup(n=12)hadthesameconventionalapproachofthecontrolgroupbuthadtwomobilenumbers(physiciananddiabeticeducator)providedfortheSMSsupportuntiltheirnextvisitin3months.Bothgroupsofage,BMIandthepre-studyA1cwerecomparable.
Results
BothgroupshadasignificantreductionintheirA1ccomparedtotheirbaselinevisit.However,theinterventionalgrouphadsignificantlygreaterreductioninA1c(p=0.001),1.16%lowerthancontrols.Theservicewashighlysatisfactorytothegroup.
Conclusion
TheresultsindicateeffectivenessinloweringA1candacceptancebythepatients.Furtherresearchandlarge-scalestudiesareneeded.
ThetraditionalRandomDigitDialingmethod(list-assistedRDDusingaframeoflandlinephonenumbers)isclearlyunderthreat.Thedifficultyandcostsofcompletingtelephonesurveyshaveincreasedduetorisingratesofrefusalandnon-contact.Thecompletenessofcoverageoflist-assistedRDDsampleshasdiminishedduetotheproliferationofcell-phoneonlyhouseholds.Theabilityoflist-assistedRDDtocaptureyoung,mobile,unmarried,andminorityhouseholdsisthusdiminishingaswell.Increasingly,surveyresearchershavebeenaddingacellphonecomponenttotheirsamplingframesfortelephonesurveys,despitetheincreasedcostsandotherissuesassociatedwithRDDcallingofcellphones.
RecentresearchbyGuterbock,Oldendick,andothershasexploredtheextenttowhich“electronicwhitepages”(EWP)samplesreallydifferfromRDDsamples.Oldendicketal.andGuterbock,DiopandHolianhaveemphasizedthatminorityhouseholdsareseriouslyunderrepresentedinEWPsamples.Nevertheless,EWPsampleshavedistinctadvantageswheneverasurveyisaimedatarestrictedgeographicarea.
ThispaperconsidersthefeasibilityofcombiningEWPsampleswithcell-phoneRDD,eliminatingtheordinaryRDDcomponentfromthesamplingframe.Weanalyzethecomponentsofthetelephonepopulation,showingthattheproposedmethodwouldfailtocoveronlyonesegmentofthetelephonepopulation:
unlistedlandlinehouseholdsthathavenocellphone.Weanalyzedatafromthe2006NationalHealthInterviewStudytoestimatethesizeofthissegment,itsdemographicprofile,thedegreetowhichselecteddemographicandhealthbehaviorcharacteristicsaredifferentfromthoseinthesegmentsthatthissamplingstrategywouldcapture,andwhatbiasesarepresentinthevarioussamplingframesofinterest.TrenddatafromtheNHISareusedtoassesshowthesebiasesarechanging.AsimplecostcomparisonismadeamongtheRDD,RDD+cellandEWP+cellframes.Theproposedalternative“EWP+cell”samplingframeprovidesrelativelysmallbiascomparedtoRDD+cellatcostscomparabletoRDD-onlydesigns.TheportionofthetelephoneuniversethatisexcludedintheEWP+celldesignisgettingsmallerallthetime,thereforeitsbiasrelativetotheRDD+celldesignisdecreasingovertime.Overall,theEWP+celldesignseemstobeausefulalternative.
rapidgrowthofe-commercehasconfrontedbothenterprisesandconsumerswithanewsituation.Whereascompaniesarefindingithardertosurvive,consumersareunabletoeffectivelyselecttheproductsthatreallytomeettheirneeds.ToreducetheproductoverloadofInternetshoppers,avarietyofrecommendationtechniquesthattrackpreviousactionsofgroupsofconsumerstomakepersonalizedrecommendationshavebeendevelopedandapplied.Currentpersonalizedrecommendationsystemssufferfromtheneedtoanalyzelargesetsofconsumerdata,ordatafornumerousconsumers.However,evenwithinasinglegroup,consumerpreferencesmaydiffer,andindividualpreferencesmayalsochangewithcircumstances.Additionally,theconsumerproductknowledgeinfluencestheirbrowsingactions.ToorientWeb-visitorsonhowtobecomeconsumers,asalesman-likerecommendationtechnologywasdevelopedbasedonvisitorproductpreferenceindex,whichcomprisesoftheirproductknowledgeandbrowsingactionsinscene.Aprototypesystemforusewithhigh-technologyproduct,3Gphones,wasdevelopedtotesttheeffectivenessoftherecommendationtechnology.Throughatestof250objectives,theresultsshowthattherecommendationdeviationlevelcanbereducedto0.49,andexactfitwithvisitorfavorproductscanreach60.8%,showingthattheproposedmodelcanachieverecommendationeffectiveness.
Distinctivehumanattributesuchasage,sex,andculturalbackgroundpostedmuchoftheproblemsintheunderstandingofgraphicrepresentation.Thisresearchattemptstousepictorialiconincellphoneasacasestudytorevealtheageandculturalbiasbetweenagegroups.Mostofthemareabletooperateonlythebasicfeatu