This paper evaluates and maps the quality of life in the Atlanta, Georgia metropolitan area in 2000. Three environmental variables from Landsat TM data, four socioeconomic variables from census data, and a hazard-related variable from toxic release inventory (TRI) database were integrated into a geographic information system (GIS) environment for the quality of life assessment. To solve the incompatibility problem in areal units among different data, the four socioeconomic variables aggregated by zonal units were spatially disaggregated into individual pixels. Principal components analysis (PCA) was employed to integrate and transform environmental, socioeconomic, and hazard-related variables into a resultant quality of life score for each pixel. Results indicate that the highest quality of life score was found around Sandy Springs, Roswell, Alphretta, and the northern parts of Fulton County along Georgia 400 whereas the lowest quality of life score was clustered around Smyma of Cobb County, the inner city of Atlanta, and Hartsfield-Jackson International Airport. The results also reveals that normalized difference vegetation index (NDVI) and relative risk from TRI facilities are two versatile indicators of environmental and socioeconomic quality of an urban area in the United States.
Eun, Sang Jun;Lee, Jin-Seok;Kim, Yoon;Jung, Koo Young;Park, Sue Kyung;Lee, Jin Yong
Health Policy and Management
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v.23
no.2
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pp.176-187
/
2013
Background: In 2006 Emergency Medical Services Index (EMSI), which summarizes the performance of regional emergency medical services system, was developed. This study assesses the performance of the EMSI to help determine whether EMSI can be used as evaluation tool. Methods: To build a composite score of the EMSI from predefined 24 indicators, 3 normalized values were calculated for each indicator, the normalized values of each indicator were weighted using 4 weighting methods, and the weighted values were aggregated into the final composite score using 2 aggregation schemes. The performance of EMSI was evaluated using 3 criteria: discrimination, construct validity, and sensitivity. Discrimination was the proportion of regions that did not include the overall median rank in the 5th to 95th percentiles rank interval, which was calculated from Monte Carlo simulation. Construct validity was a correlation among the alternative EMSIs. Sensitivity of EMSIs was evaluated by total shift of quartile membership and changes of 5th to 95th percentile intervals. Results: The total discrimination performance of the EMSI was 50.0%. Correlation coefficients between EMSIs using standardized values and those using rescaled values ranged from 0.621 to 0.997. Variation of the quartile membership of regions ranged from 0.0% to 75.0%. The total change in the 5th to 95th percentile intervals ranged from -19 to +17 places. Conclusion: The results suggested that the EMSI could be used as a tool for evaluating quality of regional EMS system and for identifying the areas for quality improvement.
Stereo matching techniques are categorized in two major schemes, local and global matching techniques. In global matching schemes, several investigations are introduced, where cost accumulation is performed in multiple matching lines. In this paper, we introduce a new multi-line stereo matching techniques which expands a conventional single-line matching scheme to multiple one. Matching cost is based on simple normalized cross correlation. We expand the scan-line optimization technique to a multi-line scan-line optimization technique. The proposed technique first generates a reliability image, which is iteratively updated based on the previous reliability measure. After some number of iterations, the reliability image is completed by a hole-filling algorithm. The hole-filling algorithm introduces a disparity score table which records the disparity score of the current pixel. The disparity of an empty pixel is determined by comparing the scores of the neighboring pixels. The proposed technique is tested using the Middlebury and CMU stereo images. The error analysis shows that the proposed matching technique yields better performance than using conventional global matching algorithm.
Computed tomography (CT) images are widely used for the analysis of the temporal evaluation or monitoring of the progression of a disease. The follow-up examinations of CT scan images of the same patient require a 3D registration technique. In this paper, an automatic and robust registration is proposed for the rigid registration of 3D CT images. The proposed method involves two steps. Firstly, the two CT volumes are aligned based on their principal axes, and then, the alignment from the previous step is refined by the optimization of the similarity score of the image's voxel. Normalized cross correlation (NCC) is used as a similarity metric and a downhill simplex method is employed to find out the optimal score. The performance of the algorithm is evaluated on phantom images and knee synthetic CT images. By the extraction of the initial transformation parameters with principal axis of the binary volumes, the searching space to find out the parameters is reduced in the optimization step. Thus, the overall registration time is algorithmically decreased without the deterioration of the accuracy. The preliminary experimental results of the study demonstrate that the proposed method can be applied to rigid registration problems of real patient images.
Dzulkarnain, Ahmad Aidil Arafat;Sani, Maryam Kamilah Ahmad;Rahmat, Sarah;Jusoh, Masnira
Journal of Audiology & Otology
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v.23
no.3
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pp.121-128
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2019
Background and Objectives: There is a scant evidence on the use of simulations in audiology (especially in Malaysia) for case-history taking, although this technique is widely used for training medical and nursing students. Feedback is one of the important components in simulations training; however, it is unknown if feedback by instructors could influence the simulated patient (SP) training outcome for case-history taking among audiology students. Aim of the present study is to determine whether the SP training with feedback in addition to the standard role-play and seminar training is an effective learning tool for audiology case-history taking. Subjects and Methods: Twenty-six second-year undergraduate audiology students participated. A cross-over study design was used. All students initially attended two hours of seminar and role-play sessions. They were then divided into three types of training, 1) SP training (Group A), 2) SP with feedback (Group B), and 3) a non-additional training group (Group C). After two training sessions, the students changed their types of training to, 1) Group A and C: SP training with feedback, and 2) Group B: non-additional training. All the groups were assessed at three points: 1) pre-test, 2) intermediate, and 3) post-test. The normalized median score differences between and within the respective groups were analysed using non-parametric tests at 95% confidence intervals. Results: Groups with additional SP trainings (with and without feedback) showed a significantly higher normalized gain score than no training group (p<0.05). Conclusions: The SP training (with/without feedback) is a beneficial learning tool for history taking to students in audiology major.
Dzulkarnain, Ahmad Aidil Arafat;Sani, Maryam Kamilah Ahmad;Rahmat, Sarah;Jusoh, Masnira
Korean Journal of Audiology
/
v.23
no.3
/
pp.121-128
/
2019
Background and Objectives: There is a scant evidence on the use of simulations in audiology (especially in Malaysia) for case-history taking, although this technique is widely used for training medical and nursing students. Feedback is one of the important components in simulations training; however, it is unknown if feedback by instructors could influence the simulated patient (SP) training outcome for case-history taking among audiology students. Aim of the present study is to determine whether the SP training with feedback in addition to the standard role-play and seminar training is an effective learning tool for audiology case-history taking. Subjects and Methods: Twenty-six second-year undergraduate audiology students participated. A cross-over study design was used. All students initially attended two hours of seminar and role-play sessions. They were then divided into three types of training, 1) SP training (Group A), 2) SP with feedback (Group B), and 3) a non-additional training group (Group C). After two training sessions, the students changed their types of training to, 1) Group A and C: SP training with feedback, and 2) Group B: non-additional training. All the groups were assessed at three points: 1) pre-test, 2) intermediate, and 3) post-test. The normalized median score differences between and within the respective groups were analysed using non-parametric tests at 95% confidence intervals. Results: Groups with additional SP trainings (with and without feedback) showed a significantly higher normalized gain score than no training group (p<0.05). Conclusions: The SP training (with/without feedback) is a beneficial learning tool for history taking to students in audiology major.
Purpose: The purpose of this study was to assess the result of arthroscopic treatment in septic knee arthritis and evaluate the prognostic factor over 50 years old. Materials and Methods: Fifty-two patients were treated by arthroscope for septic knee arthritis from January, 2002 to August, 2005. The mean follow-up period was 27.5months. We assessed Lysholm score as functional result, CRP normalized period as laboratory result, and knee range of motion as clinical result. We evaluated patient's age, underlying disease, causative organism, previous knee status (Kellgren stage), clinical status of septic arthritis (G$\ddot{a}$chter stage) and history of intra-articular injection as prognostic factor. Results: Mean Lysholm score was improved from 40.7 to 67.1. And the mean CRP normalized period was 38.7days. At last follow-up, almost patient (92%) were recovered to prior knee full range of motion and 45 patient (74%) were completely cured by one stage operation. The microorganism isolated were MSSA (n=13), MSSE (n=3), MRSA/MRSE (n=4),no microorganism (n=27) and others (n=5). In Lysholm score, young age (42.8(preop.)$\rightarrow$83.5(postop.)), Kellgren stage 0 ($45.5{\rightarrow}84.2$), G$\ddot{a}$chter stage I ($39.3{\rightarrow}73.1$) and no microorganism (442.1{\rightarrow}72.6$) were more increased than old age (439.3{\rightarrow}61.7$), Kellgren IV ($28.3{\rightarrow}43.7$), G$\ddot{a}$chter stage IV ($40.2{\rightarrow}67.1$) and MRSA/MRSE ($40{\rightarrow}58.75$). In case of old age (42.3days), G$\ddot{a}$chter stage IV (55.5), Kellgren stage IV(43.7), DM patient (42.1) and intra-articular injection history (52.1), the CRP titer normalized period was longer than mean period. MRSA/MRSE(n=3,75%) were not normalized in CRP titer at last follow-up. Conclusion: Arthroscopic treatment of septic knee would be an effective and satisfactory procedure. Age, previous knee status (Kellgren stage), underlying disease (DM), intra-articular injection history, microorganism and Ga¨chter stage effect end result outcome.
Objectives : The study is performed to investigate the influence of psychological stress on neck muscles tone and heart rate variability(HRV). Methods : This study was carried out with the data from stress response index score(SRI), surface electromyography(sEMG) and HRV. First subjects were divided into two group according to the SRI points. Subjects in group A had points of SRI in which lower than 30 points. Subjects in group B had points of SRI in which higher than 30 points. Then we investigated how to difference of the index of sEMG and HRV according to each groups. Results : In this study, the muscle contraction of both upper trapezius muscle in stress group were higher than non-stress group significantly. Complexity, root mean square of successive differences of R-R intervals(RMSSD), standard deviation difference between adjacent normal to normal intervals(SDSD), high frequency oscillation power(Ln(HF)), normalized HF(Norm HF) in stress group were lower than non-stress group significantly and normalized LF(Norm LF) was higher. Conclusions : This results show that the stress was associated with neck muscle condition and autonomic nervous system.
Kim, Daejin;Jo, Sion;Lee, Jae Baek;Jin, Youngho;Jeong, Taeoh;Yoon, Jaechol;Park, Boyoung
Clinical and Experimental Emergency Medicine
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v.5
no.4
/
pp.219-229
/
2018
Objective We compared the predictive value of the National Early Warning Score+Lactate (NEWS+L) score with those of other parameters such as the pre-endoscopic Rockall score (PERS), Glasgow-Blatchford score (GBS), and albumin, international normalized ratio, altered mental status, systolic blood pressure, age older than 65 years score (AIMS65) among patients with upper gastrointestinal bleeding (UGIB). Methods We conducted a retrospective study of patients with UGIB during 2 consecutive years. The primary outcome was the composite of in-hospital death, intensive care unit admission, and the need for ${\geq}5$ packs of red blood cell transfusion within 24 hours. Results Among 530 included patients, the composite outcome occurred in 59 patients (19 inhospital deaths, 13 intensive care unit admissions, and 40 transfusions of ${\geq}5$ packs of red blood cells within 24 hours). The area under the receiver operating characteristic curve of the NEWS+L score for the composite outcome was 0.76 (95% confidence interval, 0.70 to 0.82), which demonstrated a significant difference compared to PERS (0.66, 0.59-0.73, P=0.004), but not to GBS (0.70, 0.64-0.77, P=0.141) and AIMS65 (0.76, 0.70-0.83, P=0.999). The sensitivities of NEWS+L scores of 3 (n=34, 6.4%), 4 (n=92, 17.4%), and 5 (n=171, 32.3%) were 100%, 98.3%, and 96.6%, respectively, while the sensitivity of an AIMS65 score of 0 (n=159, 30.0%) was 91.5%. Conclusion The NEWS+L score showed better discriminative performance than the PERS and comparable discriminative performance to the GBS and AIMS65. The NEWS+L score may be used to identify low-risk patients among patients with UGIB.
Objective : Long-term oral anticoagulation or antiplatelet therapy has been used with increasing frequency in the elderly. These patients are at increased risk of morbidity and mortality from expansion of intracranial hemorrhage. We conducted a single-center retrospective case control study to evaluate risk factors associated with outcomes and to identify the differences in outcome in traumatic brain injury between preinjury anticoagulation use and without anticoagulation. Methods : A retrospective study of patients who underwent craniotomy or craniectomy for acute traumatic cerebral hemorrhage, between January 2005 and December 2014 was performed. Results : A consecutive series of 50 patients were evaluated. The factors significantly differed between the two groups were initial Prothrombin Time-International Normalized Ratio, initial platelet count, initial Glasgow Coma Scale score, and postoperative intracranial bleeding. Mean Glasgow Outcome Scale (GOS) score were similar between the two groups. In the patient with low-energy trauma only, no significant differences in GOS score, postoperative bleeding and many other factors were observed. The contributing factors to postoperative bleeding was preinjury anticoagulation and its adjusted odds ratio was 12 [adjusted odds ratio (OR), 12.242; p=0.0070]. The contributing factors to low GOS scores, which mean unfavorable neurological outcomes, were age (adjusted OR, 1.073; p=0.039) and Rotterdam scale score for CT scans (adjusted OR, 3.123; p=0.0020). Conclusion : Preinjury anticoagulation therapy contributed significantly to the occurrence of postoperative bleeding. However, preinjury anticoagulation therapy in the patients with low-energy trauma did not contribute to the poor clinical outcomes or total hospital stay. Careful attention should be given to older patients and severity of hemorrhage on initial brain CT.
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