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Within rheumatoid arthritis (RA) patients treated with intravenous tocilizumab (IV-TCZ), it is unclear if power Doppler ultrasonography (PDUS) can predict future clinical response. This study sought to determine if baseline PDUS or its early changes can predict 12-week and 24-week disease activity outcomes, and quantify the need for dose escalation (4 to 8 mg/kg). Fifty-four RA patients starting IV-TCZ were evaluated at baseline, 4, 6, 12, 16, and 24 weeks using 34-joint PDUS (US34-PDUS), clinical disease activity index (CDAI), 28-joint disease activity score using erythrocyte sedimentation rate (DAS28-ESR), ACR 20/50/70, health assessment questionnaire-disability index (HAQ-DI), and PDUS 20/50/70, a novel measure. Logistic regression models evaluated the predictive utility of US34-PDUS of DAS28-ESR response after adjusting for covariates. Ninety-four percent of patients required dose escalation to 8 mg/kg. US34-PDUS, CDAI, and DAS28-ESR improved significantly over 24 weeks (p

Musculoskeletal ultrasound quantifies the total synovial inflammatory burden in rheumatoid arthritis (RA) but is time consuming when scanning numerous joints. This study evaluated a novel patient-centered method for constructing a longitudinal ultrasound score in RA patients. Fifty-four RA patients starting intravenous tocilizumab were evaluated with power Doppler ultrasound (PDUS) of 34 joints and DAS28-ESR was assessed at baseline and weeks 4, 12, 16, and 24. The sentinel joint score (SJS) was derived from the reduced subset of joints with PDUS ≥ 1 at baseline. Total PDUS (tPDUS) score and US7 were also calculated. Changes in tPDUS and SJS were correlated. Effect sizes were calculated for tPDUS, SJS, and US7. The proportion of “flipped” joints without baseline PDUS signal that later developed PDUS signal was estimated. At baseline, 1236/1829 joints scanned (67.5%) did not have PDUS signal. The proportion of “flipped” joints at 24 weeks was 5.6% for ≥ 1, 2.9% for ≥ 2, and 1.0% for = 3 PD. tPDUS and SJS scores were highly correlated (r = 0.91 to 0.97). Overall the effect sizes for tPDUS, SJS, and US7 increased over 24 weeks, where SJS was the highest (SJS 1.00 4-week, 1.07 12-week, 1.26 24-week) and tPDUS and US7 were comparable (tPDUS 0.32 4-week, 0.52 12-week, 0.84 24-week; US7 0.23 4-week, 0.52 12-week, 0.74 24-week). In RA patients starting a biologic, scanning only joints with baseline PDUS signal can substantially reduce the number of joints requiring follow-up scanning by 67.5% and improves feasibility. “Flipped” joints are infrequently seen after starting therapy. ClinicalTrials.gov NCT01717859

ObjectivesIn lupus nephritis the pathological diagnosis from tissue retrieved during kidney biopsy drives treatment and management. Despite recent approval of new drugs, complete remission rates remain well under aspirational levels, necessitating identification of new therapeutic targets by greater dissection of the pathways to tissue inflammation and injury. This study assessed the safety of kidney biopsies in patients with SLE enrolled in the Accelerating Medicines Partnership, a consortium formed to molecularly deconstruct nephritis.Methods475 patients with SLE across 15 clinical sites in the USA consented to obtain tissue for research purposes during a clinically indicated kidney biopsy. Adverse events (AEs) were documented for 30 days following the procedure and were determined to be related or unrelated by all site investigators. Serious AEs were defined according to the National Institutes of Health reporting guidelines.Results34 patients (7.2%) experienced a procedure-related AE: 30 with haematoma, 2 with jets, 1 with pain and 1 with an arteriovenous fistula. Eighteen (3.8%) experienced a serious AE requiring hospitalisation; four patients (0.8%) required a blood transfusion related to the kidney biopsy. At one site where the number of cores retrieved during the biopsy was recorded, the mean was 3.4 for those who experienced a related AE (n=9) and 3.07 for those who did not experience any AE (n=140). All related AEs resolved.ConclusionsProcurement of research tissue should be considered feasible, accompanied by a complication risk likely no greater than that incurred for standard clinical purposes. In the quest for targeted treatments personalised based on molecular findings, enhanced diagnostics beyond histology will likely be required.

We present a novel approach for RANSAC-based computation of the fundamental matrix based on epipolar homography decomposition. We analyze the geometrical meaning of the decomposition-based representation and show that it directly induces a consecutive sampling strategy of two independent sets of correspondences. We show that our method guarantees a minimal number of evaluated hypotheses with respect to current minimal approaches, on the condition that there are four correspondences on an image line. We validate our approach on real-world image pairs, providing fast and accurate results.

We address the problem of epipolar geometry using the motion of silhouettes. Such methods match epipolar lines or frontier points across views, which are then used as the set of putative correspondences. We introduce an approach that improves by two orders of magnitude the performance over state-of-the-art methods, by significantly reducing the number of outliers in the putative matching. We model the frontier points' correspondence problem as constrained flow optimization, requiring small differences between their coordinates over consecutive frames. Our approach is formulated as a Linear Integer Program and we show that due to the nature of our problem, it can be solved efficiently in an iterative manner. Our method was validated on four standard datasets providing accurate calibrations across very different viewpoints.

BackgroundIt is widely agreed among educational researchers and practitioners that schools with positive climates can effectively mitigate the influence of students’ and schools’ socioeconomic status (SES) on academic achievement. Nevertheless, the exact mechanisms by which this occurs are unclear.ObjectiveThis study aimed to fill that gap, examining student perceptions of school climate, student academic achievement, and student and school SES in Israel to develop a reliable and comprehensive assessment of the role of school climate in the relationship between student and school SES and achievement. Specifically, the study tested whether school climate has an additive contribution to academics beyond students’ and schools’ SES (compensation model), whether the school's SES influences its social climate, which in turn influences academic achievement (mediation model); or whether the relationship between SES and academics changes across schools with different climates (moderation model).Research DesignSecondary analysis of a large-scale, nationally representative sample of fifth- and eighth-grade Hebrew-speaking students in public schools in Israel (N = 53,946).Data AnalysisHierarchical linear modeling (HLM) was used to examine models with variables both on the student and the school levels. Linear regressions were used to examine student level and school level only models.ResultsSchool climate had an additive compensation contribution to academic achievements, both on the student and the school levels. School climate moderated the relationship between students’ SES and academic achievements. However, findings did not support the hypothesis that school climate mediated the relationship between SES background and academic achievement, both at the student and school levels.ConclusionsSchool climate plays an important role in accounting for achievements, beyond students’ and schools’ SES. Results highlight the need to improve school climate, especially in schools serving communities of low SES, to enhance social mobility and equality of opportunity.

The Akko 1 shipwreck was an Egyptian armed vessel, built at the beginning of the 19th century. A wooden saw handle and a box containing iron nails and two split pins were discovered towards the stern. Given their function, location and context, these were part of the ship's carpenter's tools and accessories. A methodology was developed for conducting systematic metallurgical analysis in order to understand the manufacturing process of the surviving ironwork items, as well as to enlarge our knowledge regarding ironworking technologies during the early 19th century. Such methodology may assist in the future understanding of the technological evolution of similar wrought-iron objects. The results demonstrated that the artefacts have a wrought-iron heterogeneous microstructure and were manufactured by hot-working prior to surface hardening by pack carburization.

This article examines the relative impact of internal and external factors on the financial decline of local Arab municipalities in Israel. We employ a unique case study to demonstrate that the negative relationship between local management policies and local financial crises is stronger than any other relationship; in addition, this relationship is expected to hold for other local authorities in Israel and for local authorities in Western countries. The new theoretical approach developed in this study indicates that, with respect to local authorities, the “local management approach” more often explains a financial crisis than other approaches.

Integrative analysis of multiple data types to address complex biomedical questions requires the use of multiple software tools in concert and remains an enormous challenge for most of the biomedical research community. Here we introduce GenomeSpace (http://www.genomespace.org), a cloud-based, cooperative community resource. Seeded as a collaboration of six of the most popular genomics analysis tools, GenomeSpace now supports the streamlined interaction of 20 bioinformatics tools and data resources. To facilitate the ability of non-programming users’ to leverage GenomeSpace in integrative analysis, it offers a growing set of ‘recipes’, short workflows involving a few tools and steps to guide investigators through high utility analysis tasks.

Background Clinical swollen joint examination of the obese rheumatoid arthritis (RA) patient can be difficult. Musculoskeletal Ultrasound (MSUS) has higher sensitivity than physical examination for swollen joints (SJ). The purpose of this study was to determine the joint-specific association between power Doppler (PDUS) and clinical SJ in RA across body mass index (BMI) categories. Methods Cross-sectional clinical and laboratory data were collected on 43 RA patients. PDUS was performed on 9 joints (wrist, metacarpalphalangeal 2–5, proximal interphalgeal 2/3 and metatarsalphalangeal 2/5). DAS28 and clinical disease activity index (CDAI) were calculated. Patients were categorized by BMI: 30. Demographic and clinical characteristics were compared across BMI groups with Kruskal-Wallis test and chi-square tests. Joint-level associations between PDUS and clinically SJ were evaluated with mixed effects logistic regression models. Results While demographics and clinically-determined disease activity were similar among BMI groups, PDUS scores significantly differed (p = 0.02). Using PDUS activity as the reference standard for synovitis and clinically SJ as the test, the positive predictive value of SJ was significantly lower in higher BMI groups (0.71 in BMI

PURPOSE Steroids are often used as medical therapy for active thyroid eye disease (TED). While high-dose steroids have been shown to be effective in reducing the severity of TED symptoms, the side effects of steroids can be severe. As the pathogenesis of TED is thought to involve the upregulation of proinflammatory cytokines, including tumor necrosis factor-α (TNF-α), it has been postulated that anti-TNF agents may be used as steroid-sparing agents in the treatment of TED. This retrospective study was conducted to examine the efficacy of adalimumab, a subcutaneously administered TNF-α antagonist, in treating the inflammatory symptoms of active TED. METHODS All patients in the inflammatory phase of TED who were treated with adalimumab at the Jules Stein Eye Institute over a 2-year period were reviewed. Data concerning visual acuity, optic nerve function, extraocular motility restriction, binocular visual fields, and proptosis were extracted from patient charts. Clinical photographs from baseline and 3-month follow-up visits were reviewed by masked orbital specialists. Each photograph was graded on the severity of conjunctival injection, chemosis, eyelid erythema, and eyelid edema on a scale from 1 to 4. An inflammatory score was calculated as the sum of these 4 elements. Groups were compared using paired t tests. RESULTS Six of 10 patients showed a decrease in inflammatory score while on adalimumab, whereas 3 showed an increase and 1 stayed the same. One patient experienced a significant complication (hospital admission for sepsis). Eight patients received concomitant tapering steroids during the first 6 weeks of therapy as the adalimumab reached maximum efficacy. When data from all 10 subjects were analyzed together, there was no significant change in inflammatory index after 3 months of treatment with adalimumab. However, when the 5 patients with a high baseline inflammatory index (>4) were considered separately, there was a significant improvement (mean decrease of 5.2±2.7; p

PURPOSE To evaluate the efficacy of topical apraclonidine in reducing pain and subconjunctival hemorrhage (SCH) after intravitreal injections (IViT). METHODS A prospective, randomized, double-blinded study. Thirty-nine patients were examined twice, at each monthly IViT of 1.25 mg/0.05 mL bevacizumab. Patients were randomly assigned to receive either topical apraclonidine 0.5% or placebo to the treated eye, 30 minutes before the first IViT. At their second IViT, the intervention was switched. Thirty minutes after the injection, SCH size was measured by a slit lamp, and pain was assessed by the numerical rating scale (NRS-11). RESULTS Mean pain score was 1.69 (SD ±1.44) in the apraclonidine group and 3.28 (SD ±2.27) in the control group (P < 0.001). Phakic patients had a greater pain reduction after topical apraclonidine (P < 0.001). Subconjunctival hemorrhage incidence was 41% in the apraclonidine group and 51.3% in the control group (P = 0.503). Mean SCH size was 1.71 mm (SD ±5.83) in the apraclonidine group and 3.25 mm (SD ±6.41) in the control group (P = 0.253). After topical apraclonidine, there was a smaller reduction in SCH size in patients with choroidal neovascularization or hypertension (P = 0.003 and 0.044, respectively), and a greater reduction in phakic patients (P = 0.048). CONCLUSION Topical apraclonidine 0.5%, administered 30 minutes before IViT, significantly decreased pain by a factor of 1.94. It did not decrease the incidence or size of SCH in the entire cohort, but only in several subpopulations.

We report the case of a 36-year-old man with a recent diagnosis of gout, who presents with a fullness behind his right knee that fluctuates in size with time. An ultrasound revealed a Baker cyst that contained both large and punctate internal hyperechoic foci. Cyst aspiration revealed negatively birefringent crystals, which were consistent with gout.

This association of poverty with progress is the great enigma of our times. It is the central fact from which springs industrial, social, and political difficulties that perplex the world, and with which statesmanship and philanthropy and education grapple in vain. From it come the clouds that overhang the future of the most progressive and self-reliant nations. It is the riddle which the Sphinx of Fate puts to our civilization, and which not to answer is to be destroyed. So long as all the increased wealth which modern progress brings goes but to build up great fortunes, to increase luxury and make sharper the contrast between the House of Have and the House of Want, progress is not real and cannot be permanent. – Henry George , Progress and Poverty, 1879 In this era of globalization – where international financial markets affect developed and developing countries alike, and where financial flows as well as economic crises spread across borders and oceans with remarkable ease – the role of multilateral financial institutions in the international financial scheme is crucial. These public institutions, designed by politicians and economists to navigate the labyrinth of economic, social, and political development, possess the potential to be central players in the long-term planning involved in healing poverty-plagued regions and advancing their economies. This formidable task offers the invaluable payoff of furthering global economic and financial stability and improving human welfare. Consequently, the issues of aid and development that are related to globalization have been at the center of academic debates. Multilateral financial institutions, designed to implement global financial policies, have been an integral part of these debates and have come under increasing scrutiny. Critics vary from those who believe that these institutions do more harm than good by contributing to the “moral hazard” problem and should therefore not exist, to those who believe that they can play an important role in development, but need to be reformed (Stiglitz, 2002, and Sachs, 2005). But even if one begins in the second, more positive, camp, there is still substantial disagreement as to how these institutions should function so that they can be both constructive and efficient. Much of this controversy stems from limited knowledge about how multilateral financial institutions work and what they are designed to do.

Computing the epipolar geometry between cameras with very different viewpoints is often problematic as matching points are hard to find. In these cases, it has been proposed to use information from dynamic objects in the scene for suggesting point and line correspondences. We propose a speed up of about two orders of magnitude, as well as an increase in robustness and accuracy, to methods computing epipolar geometry from dynamic silhouettes. This improvement is based on a new temporal signature: motion barcode for lines. Motion barcode is a binary temporal sequence for lines, indicating for each frame the existence of at least one foreground pixel on that line. The motion barcodes of two corresponding epipolar lines are very similar, so the search for corresponding epipolar lines can be limited only to lines having similar barcodes. The use of motion barcodes leads to increased speed, accuracy, and robustness in computing the epipolar geometry., Comment: Update metadata

Item does not contain fulltext OBJECTIVE: To assess whether ultrasonography (US) is reliable for the evaluation of inflammatory and structural abnormalities in patients with knee osteoarthritis (OA). METHODS: Thirteen patients with early knee OA were examined by 11 experienced sonographers during 2 days. Dichotomous and semiquantitative scoring was performed on synovitis characteristics in various aspects of the knee joint. Semiquantitative scoring was done of osteophytes at the medial and lateral femorotibial joint space or cartilage damage of the trochlea and on medial meniscal damage bilaterally. Intra- and interobserver reliability were computed by use of unweighted and weighted kappa coefficients. RESULTS: Intra- and interobserver reliability scores were moderate to good for synovitis (mean kappa 0.67 and 0.52, respectively) as well as moderate to good for the global synovitis (0.70 and 0.50, respectively). Mean intra- and interobserver reliability kappa for cartilage damage, medial meniscal damage and osteophytes ranged from fair to good (0.55 and 0.34, 0.75 and 0.56, 0.73 and 0.60, respectively). CONCLUSIONS: Using a standardised protocol, dichotomous and semiquantitative US scoring of pathological changes in knee OA can be reliable.

It is known that epipolar geometry can be computed from three epipolar line correspondences but this computation is rarely used in practice since there are no simple methods to find corresponding lines. Instead, methods for finding corresponding points are widely used. This paper proposes a similarity measure between lines that indicates whether two lines are corresponding epipolar lines and enables finding epipolar line correspondences as needed for the computation of epipolar geometry. A similarity measure between two lines, suitable for video sequences of a dynamic scene, has been previously described. This paper suggests a stereo matching similarity measure suitable for images. It is based on the quality of stereo matching between the two lines, as corresponding epipolar lines yield a good stereo correspondence. Instead of an exhaustive search over all possible pairs of lines, the search space is substantially reduced when two corresponding point pairs are given. We validate the proposed method using real-world images and compare it to state-of-the-art methods. We found this method to be more accurate by a factor of five compared to the standard method using seven corresponding points and comparable to the 8-points algorithm., Comment: ICPR 2016, Cancun, Dec 2016

Computing the epipolar geometry between cameras with very different viewpoints is often very difficult. The appearance of objects can vary greatly, and it is difficult to find corresponding feature points. Prior methods searched for corresponding epipolar lines using points on the convex hull of the silhouette of a single moving object. These methods fail when the scene includes multiple moving objects. This paper extends previous work to scenes having multiple moving objects by using the “Motion Barcodes”, a temporal signature of lines. Corresponding epipolar lines have similar motion barcodes, and candidate pairs of corresponding epipoar lines are found by the similarity of their motion barcodes. As in previous methods we assume that cameras are relatively stationary and that moving objects have already been extracted using background subtraction.

The ability to interactively edit BRDFs in their final placement within a computer graphics scene is vital to making informed choices for material properties. We significantly extend previous work on BRDF editing for static scenes (with fixed lighting and view) by developing a precomputed polynomial representation that enables interactive BRDF editing with global illumination. Unlike previous precomputation-based rendering techniques, the image is not linear in the BRDF when considering interreflections. We introduce a framework for precomputing a multibounce tensor of polynomial coefficients that encapsulates the nonlinear nature of the task. Significant reductions in complexity are achieved by leveraging the low-frequency nature of indirect light. We use a high-quality representation for the BRDFs at the first bounce from the eye and lower-frequency (often diffuse) versions for further bounces. This approximation correctly captures the general global illumination in a scene, including color-bleeding, near-field object reflections, and even caustics. We adapt Monte Carlo path tracing for precomputing the tensor of coefficients for BRDF basis functions. At runtime, the high-dimensional tensors can be reduced to a simple dot product at each pixel for rendering. We present a number of examples of editing BRDFs in complex scenes with interactive feedback rendered with global illumination.

The International Society for Musculoskeletal Imaging in Rheumatology (ISEMIR) was founded in 2005 with the goal of discussing matters related to imaging in rheumatology, particularly, validation, education, and use in both clinical practice and research. The field of musculoskeletal (MSK) imaging is continuously evolving; therefore, education for healthcare providers in this field is of paramount importance. ISEMIR's international faculty and world-renowned experts presented the newest information as it relates to the use of magnetic resonance imaging (MRI) and ultrasound (US) at the 8th annual ISEMIR meeting that took place on April 17-18 in Santa Monica, California. Presentations from the meeting can be viewed at www.isemir.org.

Current systems for editing BRDFs typically allow users to adjust analytic parameters while visualizing the results in a simplified setting (e.g. unshadowed point light). This paper describes a real-time rendering system that enables interactive edits of BRDFs, as rendered in their final placement on objects in a static scene, lit by direct, complex illumination. All-frequency effects (ranging from near-mirror reflections and hard shadows to diffuse shading and soft shadows) are rendered using a precomputation-based approach. Inspired by real-time relighting methods, we create a linear system that fixes lighting and view to allow real-time BRDF manipulation. In order to linearize the image's response to BRDF parameters, we develop an intermediate curve-based representation, which also reduces the rendering and precomputation operations to 1D while maintaining accuracy for a very general class of BRDFs. Our system can be used to edit complex analytic BRDFs (including anisotropic models), as well as measured reflectance data. We improve on the standard precomputed radiance transfer (PRT) rendering computation by introducing an incremental rendering algorithm that takes advantage of frame-to-frame coherence. We show that it is possible to render reference-quality images while only updating 10% of the data at each frame, sustaining frame-rates of 25-30fps.

This paper addresses the problem of efficiently calculating shadows from environment maps in the context of ray tracing. Since accurate rendering of shadows from environment maps requires hundreds of lights, the expensive computation is determining visibility from each pixel to each light direction. We show that coherence in both spatial and angular domains can be used to reduce the number of shadow rays that need to be traced. Specifically, we use a coarse-to-fine evaluation of the image, predicting visibility by reusing visibility calculations from four nearby pixels that have already been evaluated. This simple method allows us to explicitly mark regions of uncertainty in the prediction. By only tracing rays in these and neighboring directions, we are able to reduce the number of shadow rays traced by up to a factor of 20 while maintaining error rates below 0.01%. For many scenes, our algorithm can add shadowing from hundreds of lights at only twice the cost of rendering without shadows. Sample source ...

We introduce a simple and effective method for retrieval of videos showing a specific event, even when the videos of that event were captured from significantly different viewpoints. Appearance-based methods fail in such cases, as appearances change with large changes of viewpoints. Our method is based on a pixel-based feature, “motion barcode”, which records the existence/non-existence of motion as a function of time. While appearance, motion magnitude, and motion direction can vary greatly between disparate viewpoints, the existence of motion is viewpoint invariant. Based on the motion barcode, a similarity measure is developed for videos of the same event taken from very different viewpoints. This measure is robust to occlusions common under different viewpoints, and can be computed efficiently. Event retrieval is demonstrated using challenging videos from stationary and hand held cameras.

The Internet is becoming increasingly influential, but some observers have noted that heavy Internet users seem alienated from normal social contacts and may even cut these off as the Internet becomes the predominate social factor in their lives. Kraut, Patterson, Lundmark, Kiesler, Mukopadhyay, and Scherlis [American Psychologist 53 (1998) 65] carried out a longitudinal study from which they concluded that Internet use leads to loneliness among its users. However, their study did not take into account that the population of Internet users is not uniform and comprises many different personality types. People use the Internet in a variety of ways in keeping with their own personal preference. Therefore, the results of this interaction between personality and Internet use are likely to vary among different individuals and similarly the impact on user well-being will not be uniform. One of the personality characteristics that has been found to influence Internet use is that of extroversion and neuroticism [Hamburger & Ben-Artzi, Computers in Human Behavior 16 (2000) 441]. For this study, 89 participants completed questionnaires pertaining to their own Internet use and feelings of loneliness and extroversion and neuroticism. The results were compared to two models (a) the Kraut et al. (1998) model which argues that Internet use leads to loneliness (b) an alternative model which argues that it is those people who are already lonely who spend time on the Internet. A satisfactory goodness of fit was found for the alternative model. Building on these results, several different directions are suggested for continuing research in this field.

Hearing loss is widespread among the elderly. One of the main obstacles to rehabilitation is identifying individuals with potentially correctable hearing loss. Smartphone-based hearing tests can be administered at home, thus greatly facilitating access to screening. This study evaluates the use of a smartphone application as a screening tool for hearing loss in individuals aged ≥65 years. Twenty-six subjects aged 84.4 ± 6.73 years (mean ± SD) were recruited. Pure-tone audiometry was administered by both a smartphone application (uHear for iPhone, v1.0 Unitron, Canada) and a standard portable audiometer by trained personnel. Participants also completed a questionnaire on their hearing. Pure-tone thresholds were compared between the two testing modalities and correlated with the questionnaire results. The cutoff point for failing screening tests was a pure tone average of 40 dB for the frequencies 250–6,000 Hz. The smartphone application’s pure tone thresholds were higher (poorer hearing) than the audiometric thresholds, with a significant difference in all frequencies but 2,000 Hz. The application and the audiometric values were in agreement for 24 subjects (92 %). The application had a sensitivity of 100 % and specificity of 60 % for screening compared with the audiometer. The questionnaire was significantly less accurate, having assigned a passing score to three participants who failed both the application and audiometric tests. While a smartphone application may not be able to accurately determine the level of hearing impairment, it is useful as a highly accessible portable audiometer substitute for screening for hearing loss in elderly populations.

Videos recorded by wearable egocentric cameras can suffer from quality degradations that cannot always be fixed by current methods. When several wearable video cameras are viewing the same scene, each having highly variable quality, it is possible to combine them into a single high-quality video. Current techniques select for each point in time the highest quality video stream, but the highest quality video may not be relevant. E.g. the best quality video can come from a person that happen to look sideways from the main attraction. We propose the curation of a single video stream from multiple egocentric videos by requiring that the selected video will also view the most interesting region in the scene. Importance of a region is determined by the "wisdom of the crowd", i.e. the number of cameras looking at a region. The resulting video is more interesting and of higher quality than any individual video streams can possibly obtain. Several examples are presented demonstrating the effectiveness of this technique.

The present study involves the development of a new self-report scale for the use of Internet services, and examines its relationship to extraversion and neuroticism. Forty-five males and 27 females, differing in extraversion and neuroticism, rated the frequency with which they use each of 12 main Internet services. An exploratory factor analysis revealed three factors of Internet services: social services; information services; and leisure services. Extraversion and neuroticism showed different patterns of relationships with the factors of the Internet-Services Scale, with different patterns of association for men and women. For men, extraversion was positively related to the use of leisure services and neuroticism was negatively related to information services, whereas for women, extraversion was negatively related and neuroticism positively related to the use of social services. Implications for the study of the psychological influences of the Internet are discussed.

An experiment examined cross-modal interference and congruence in speeded classification: Subjects had to identify compound (visual-auditory) stimuli as either low or high in spatial position (visual judgment) or low or high in pitch (auditory judgment), in 16 conditions, each of which combined one of four possible pairs of tones, varying in frequency difference, with one of four possible pairs of dots, varying in positional difference. Both classification by position and classification by pitch revealed Garner interference (poorer performance than baseline, with orthogonal variation in the irrelevant dimension) and congruence effects (better performance with congruent than with incongruent stimulus combinations), but pitch classification showed more. Furthermore, the size of the pitch difference strongly affected classification by pitch and less strongly affected classification by position, but the size of the position difference affected neither. The findings are consistent with the view that Garner interference and congruence effects are closely related, perhaps arising from a common source, and suggest that the asymmetries could depend in part on the degree of dimensional overlap between stimuli and responses.

BACKGROUND Each year, rheumatology programs across the country teach incoming trainees the skill of arthrocentesis, but the relative effectiveness of various teaching techniques has not been assessed in a systematic way. OBJECTIVES We compared approaches to teaching arthrocentesis using cadavers versus anatomic models. METHODS In a pilot study, new rheumatology fellows (n = 7) from 2 academic institutions were surveyed at 3 points during arthrocentesis training: (1) before assuming patient care; (2) after lecture with handouts, followed by practice either on cadavers (group A) or on synthetic joint models (group B); and (3) 6 weeks into fellowship. Fellows rated their comfort levels for arthrocentesis of specific joints using 9-point Likert scales. Fellows also retrospectively rated the utility of individual teaching modalities in helping them to learn. As a follow-up study, internal medicine residents taking part in a month-long rheumatology rotation were similarly surveyed on their comfort level performing knee and shoulder arthrocentesis before a cadaver teaching laboratory and at the end of their month rotation. RESULTS The initial mean comfort level performing arthrocentesis for all fellows was low (2.01). After the cadaver teaching session, group A fellows experienced an overall comfort level increase of 1.95, with the largest single increase reported for shoulder arthrocentesis (3.86). After the anatomic model teaching session, group B fellows reported a mean comfort increase of 1.29, with the largest increase reported for knee arthrocentesis (3.13). The subsequent study with residents confirmed significant increases in comfort after the cadaver laboratory. When surveyed, the learning experience fellows considered most effective was the opportunity to perform procedures under supervision and guidance, followed by training on cadavers. CONCLUSIONS Although all teaching interventions for trainees learning arthrocentesis were helpful for increasing trainee's comfort with arthrocentesis, the use of cadavers seemed to be superior to synthetic anatomic models or lectures alone. The specific impact of these teaching interventions on actual competence, defined as a performance outcome, deserves additional study.

The anti-nuclear antibody (ANA) test is ordered commonly as a screening test for rheumatic diseases. Although ANA positivity is highly sensitive for certain rheumatic diseases, the presence of ANA is nonspecific and can be associated with numerous nonrheumatic factors, including environmental exposures, malignancies, drugs, and infections. This article describes a practical approach for physicians when evaluating patients using a positive ANA test. In the absence of connective tissue disease symptoms, the ANA test has minimal clinical significance in diagnosing rheumatic diseases. Understanding how to use ANA test results appropriately may reduce unnecessary referrals and costly workups.

Despite a lack of clear recommendations to guide decision-making, reductions in enoxaparin sodium dosage in the elderly and in patients with mild and moderate renal dysfunction are common in patients with acute coronary syndrome.To evaluate whether weight, age and renal function are associated with anti-factor Xa activity and with bleeding in elderly patients treated with enoxaparin sodium.This was a prospective observational study of 156 elderly patients admitted consecutively to a general internal medicine ward with creatinine clearance30 mL/min who were treated with enoxaparin sodium twice daily. Anti-factor Xa activity and bleeding events were documented in all patients. Statistical analyses were conducted to determine the effects of clinical characteristics such as renal dysfunction, age and bodyweight on these parameters.156 patients (60% males, mean age 71.0 +/- 15.98 years) were studied. Therapeutic anti-factor Xa was observed in 85.3% of patients treated with enoxaparin sodium 0.61-0.8 mg/kg/12h, and in 82.6% of patients treated with enoxaparin sodium 0.81-1.1 mg/kg/12h. Minor or major bleeding was observed in 5.8% of patients, and was associated with a lower mean bodyweight (61.89 +/- 13.35 vs 74.30 +/- 13.24 kg for patients with no bleeding; p = 0.014). Bodyweightor =55 kg was associated with bleeding with an odds ratio of 5.63 (95% CI 1.2, 25, p = 0.025).Low bodyweight is associated with a greater risk of bleeding despite a reduction in enoxaparin sodium dose according to weight. This finding supports the possibility that low bodyweight is an independent risk factor for enoxaparin sodium-related bleeding.

Summary Background & aims: Parenteral nutrition (PN) is an important component of the supportive care of children undergoing bone marrow transplantation (BMT). The study aimed to assess short-term safety and metabolic effects of an olive oil-based (OO) lipid emulsion compared with a MCT/LCT (M/L) emulsion in the clinical setting of pediatric BMT. Methods Twenty-eight pediatric BMT patients (age 1–18 years) expected to need PN support for at least 2 weeks, were prospectively enrolled and randomly assigned to receive either OO or M/L lipid emulsions within PN. Clinical and routine laboratory parameters, plasma fatty acids profile, vitamin E and peroxidation status were recorded at baseline and after 14 days of PN. Results No significant differences were found for hematological parameters, liver enzymes, vitamins, plasma peroxidation status, percentage and time to engraftment. Taking into consideration the baseline fatty acids levels, the OO group showed higher oleic acid (p = 0.012), linoleic (p = 0.012) and arachidonic acid (p = 0.002) enrichment but similar eicosapentanoic and docosahexanoic acids levels compared to the M/L group at day 14. Cholesterol levels decreased significantly in the OO group after 14 days on PN (p = 0.017). Conclusions OO lipid emulsion was well tolerated, maintained essential fatty acids and peroxidation status, and generated a favorable plasma lipid profile. In this study short-term use of OO intravenous lipid emulsions was safe in children who needed PN support during BMT.

A GRP-scheme is introduced for the numerical integration of the Euler system of equations of compressible reactive flow in a duct of variable cross section, subject to an external potential. The GRP (generalized Riemann problem) scheme is based on an analytic solution of the GRP at jump discontinuities. It is a second-order scheme generalizing the first-order Godunov scheme, having the property of high resolution of shocks and other discontinuities. Some numerical examples are considered, including an infinite spherical reflected shock, a spherical blast wave and gas collapse under an external potential.

Background MSK-US is widely used for assessing disease severity and response to therapy in RA clinical trials. Although reliability exercises have been published, there is sparse literature on standardizing numerous factors that may affect reliability. Objectives The aim of this study was to optimize MSK-US acquisition and scoring reliability prior to embarking on a multicenter MSK-US based RA study. Methods This two-site MSK-US study evaluated the following joints: bilateral radio-carpal, intercarpal, radioulnar, MCP 1-5, PIP 1-5, knees and MTP 2-5. The reliability among our two main ultrasonographers with >5 years MSK-US experience was assessed in 3 phases (pre-face-to-face [pre-F2F], F2F, and post-F2F). A 1st draft MSK-US RA atlas was utilized as an initial reference for intensive teleconferences, which resulted in a 2nd draft atlas (images refined and scoring rules further delineated). Pre-F2F: The 2 ultrasonographers scored still images of 2 patients independently. Inter-reader reliability was calculated and most discrepant scores discussed. F2F: Each ultrasonographer scanned the same 6 patients independently, and then re-scanned 2 patients. The inter- and intra-reader reliability were calculated, and again discussion of most discrepant scores. Factors affecting discordance were identified and addressed: agreeing on cutoffs for synovitis scores, focal point positioning, positioning of deformed joints, room temperature, layer of gel used, prior familiarity with the machine, and color adjustment for PD to accommodate for color blindness (present is 7% of males and 0.5% in females). The 3rd and final atlas was developed as a reference for the post-F2F; clearly delineated the discrepancies among scores. Post-F2F: Each ultrasonographer rescored 2 patients9 scans acquired during F2F study. The intra- and inter-reader reliability was calculated using percent agreement, weighted-kappa, intraclass correlation coefficient (ICC), and spearman correlation. Results The F2F and post-F2F intra-reader reliability ranged between 79%_94% for exact agreement and 0.64-0.89 spearman correlation. The pre-F2F, F2F, and post-F2F inter-reader reliability ranged from 64-82% for exact agreement, 0.59-0.83 Spearman correlation (Tables 1&2). Inter-reader reliability improved from pre-F2F (64% agreement and 0.77 spearman correlation) to post-F2F (82%agreement and 0.83 spearman correlation). Conclusions Our study highlights the importance of standardizing acquisition of MSK-US in RA clinical trials and provides practical tools to improve reliability. we recommend standardization of acquisition to be pursued, prior to commencement of multicenter MSK-US based RA trials. Disclosure of Interest None declared

The flagellar filament, the bacterial organelle of motility, is the smallest rotary propeller known. It consists of 1), a basal body (part of which is the proton driven rotary motor), 2), a hook (universal joint—allowing for off-axial transmission of rotary motion), and 3), a filament (propeller—a long, rigid, supercoiled helical assembly allowing for the conversion of rotary motion into linear thrust). Helically perturbed (so-called “complex”) filaments have a coarse surface composed of deep grooves and ridges following the three-start helical lines. These surface structures, reminiscent of a turbine or Archimedean screw, originate from symmetry reduction along the six-start helical lines due to dimerization of the flagellin monomers from which the filament self assembles. Using high-resolution electron microscopy and helical image reconstruction methods, we calculated three-dimensional density maps of the complex filament of Rhizobium lupini H13-3 and determined its surface pattern and boundaries. The helical symmetry of the filament allows viewing it as a stack of identical slices spaced axially and rotated by constant increments. Here we use the closed outlines of these slices to explore, in two dimensions, the hydrodynamic effect of the turbine-like boundaries of the flagellar filament. In particular, we try to determine if, and under what conditions, transitions from laminar to turbulent flow (or perturbations of the laminar flow) may occur on or near the surface of the bacterial propeller. To address these questions, we apply the boundary element method in a manner allowing the handling of convoluted boundaries. We tested the method on several simple, well-characterized cylindrical structures before applying it to real, highly convoluted biological surfaces and to simplified mechanical analogs. Our results indicate that under extreme structural and functional conditions, and at low Reynolds numbers, a deviation from laminar flow might occur on the flagellar surface. These transitions, and the conditions enabling them, may affect flagellar polymorphism and the formation and dispersion of flagellar bundles—factors important in the chemotactic response.