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Search Results: 1 - 10 of 193842 matches for " D. Gordon "
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Traumatic Brain Injury and Cerebral Vascular Accident: Application of Rasch Analysis to Examine Differences in Disability and Outcome in Post-Hospital Rehabilitation  [PDF]
Frank D. Lewis, Gordon J. Horn
Open Journal of Statistics (OJS) , 2018, DOI: 10.4236/ojs.2018.84044
Abstract: The purpose of this study was to demonstrate an application of Rasch analysis to identify differences in disability profiles resulting from traumatic brain injury (TBI) and cerebral vascular accident (CVA) and to examine outcome differences between the two groups following post-hospital residential rehabilitation. Participant data were collected from 32 facilities in 16 states. From 2990 neurologically impaired individuals with consecutive admissions from 2011 through 2017, 874 met inclusion criteria: TBI (n = 687) or CVA (n = 187), 18 years or older, minimum length of stay of one month, and maximum chronicity of 1 year. Participants were evaluated at admission and discharge on the Mayo Portland Adaptability Inventory-Version 4 (MPAI-4). Rasch analysis was performed to establish item reliability, construct validity and item difficulty. A Repeated Measures Multivariate Analysis of Covariance (RM MANCOVA) determined group differences and improvement from admission and discharge. Rasch Analysis demonstrated satisfactory construct validity and internal consistency (Person reliability > 0.90, Item reliability > 0.98 for admission and discharge MPAI-4s). Both groups showed significant improvement on the MPAI-4 (p < 0.0005). The TBI group was more impaired on the adjustment scale at both admission and discharge (p < 0.001). Rasch analysis identified two distinct impairment patterns. CVA participants exhibited deficits characteristic of focal impairment while the TBI group presented with deficits reflective of diffuse impairment. Rehabilitation was shown to be beneficial in reducing disability following neurologic injury in both groups. Importantly,
Primary aldosteronism: actual epidemics or false alarm?
Gordon, Richard D.;
Arquivos Brasileiros de Endocrinologia & Metabologia , 2004, DOI: 10.1590/S0004-27302004000500012
Abstract: the prevalence of "primary aldosteronism" (pal) cannot be precisely determined at this time, given 1) lack of a universally accepted definition, and 2) normotensive as well as normokalemic phases in the evolutionary development of a disease eventually characterized by hypertension and hypokalemia. the exception is fully genetically characterised forms such as glucocorticoid-suppressible hyperaldosteronism, the true prevalence of which could be proven today by universal screening using a single blood sample, but this is neither practical nor appropriate. controversy has arisen regarding the rareness, or otherwise, of pal because of 1) rediscovery in the last 12 years of the normokalemic phase described by conn, 2) application of widely available methods for measurement of aldosterone and renin to "screening", 3) variable quality of these methods, and of their application, and 4) lack of the necessary "diagnostic", in addition to "screening", tests in some studies. pal is significantly more common than previously thought, and a very important potentially curable form of hypertension. early diagnosis and specific treatment avoids morbidity. the current focus on increased detection is essential, and will help to resolve the question of prevalence.
Asimovian Adaptive Agents
D. F. Gordon
Computer Science , 2011, DOI: 10.1613/jair.720
Abstract: The goal of this research is to develop agents that are adaptive and predictable and timely. At first blush, these three requirements seem contradictory. For example, adaptation risks introducing undesirable side effects, thereby making agents' behavior less predictable. Furthermore, although formal verification can assist in ensuring behavioral predictability, it is known to be time-consuming. Our solution to the challenge of satisfying all three requirements is the following. Agents have finite-state automaton plans, which are adapted online via evolutionary learning (perturbation) operators. To ensure that critical behavioral constraints are always satisfied, agents' plans are first formally verified. They are then reverified after every adaptation. If reverification concludes that constraints are violated, the plans are repaired. The main objective of this paper is to improve the efficiency of reverification after learning, so that agents have a sufficiently rapid response time. We present two solutions: positive results that certain learning operators are a priori guaranteed to preserve useful classes of behavioral assurance constraints (which implies that no reverification is needed for these operators), and efficient incremental reverification algorithms for those learning operators that have negative a priori results.
Outcomes in Seriously Head-Injured Patients Undergoing Pre-Hospital Tracheal Intubation vs. Emergency Department Tracheal Intubation  [PDF]
John M. Tallon, Gordon Flowerdew, Ronald D. Stewart, George Kovacs
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.42015
Abstract: Background: The optimal treatment of major head injuries in the resuscitative phase of care post-injury has yet to be determined. This study measured the effect on mortality of pre-hospital intubation (PHI) vs. emergency department in tubation (EDI) of patients suffering serious head injury. Methods: In the single emergency medical services system for this Canadian province, we used a population-based trauma database, conventional logistic regression (with and without the use of a propensity score to control for selection effect bias) to evaluate the effect of PHI vs. EDI on in-hospital mortality. Inclusion criteria were age ≥ 16 years, serious head injury (Abbreviated Injury Score ≥ 3, non-penetrating trauma) and resuscitative intubation (PHI or EDI). Results: Over 5 years, 283 patients (2000-2005) met inclusion crite ria. Conventional unconditional logistic regression modelled on mortality with “PHI vs. EDI” as the intervention of interest showed an odds ratio of 2.015 (95% CI 1.062 3.825) for improved survival if these patients were intubated in the emergency department rather than in the pre-hospital phase of care. A propensity score adjustment demonstrated a similar but more conservative point estimate (OR 1.727, 95% CI: 0.993
Impact of Chronicity on Outcomes Following Post-Hospital Residential Brain Injury Rehabilitation: Application of Multivariate Statistics and Rasch Analysis  [PDF]
Frank D. Lewis, Gordon J. Horn, Robert Russell
Open Journal of Statistics (OJS) , 2017, DOI: 10.4236/ojs.2017.72020
Abstract: This study evaluated the impact of chronicity (onset of injury to admission in-terval) on three domains of functional outcomes for a large group of traumatic brain injured (TBI) survivors. Subjects included 528 TBI adults who were treated in post-hospital residential rehabilitation centers. Subjects were assigned to one of three chronicity groups: 1) Early Interval (EI), 2.00 - 8.00 months n = 245, 2) Mid Interval (MI), 8.01 - 24.00 months n = 129, and (3) Late Interval (LI), 24.01 months and greater n = 154. Functional status was assessed with the MPAI-4. RM MANCOVA was applied to evaluate differences among groups from admission to discharge. Rasch analysis demonstrated satisfactory construct validity and internal consistency (Person reliability = 0.90 - 0.94, Item reliability = 0.99) for the admission and discharge MPAI-4s. Controlling for LOS and age, the RM MANCOVA revealed that each chronicity group showed significant improvement in MPAI-4 abilities, adjustment, and participation indices from admission to discharge (p < 0.001). Improvement observed from admission to discharge was the greatest among the EI group (p < 0.001). This study demonstrated the utility of multivariate statistical approaches for understanding the complexities of TBI treatment outcomes. As measured across three domains of functioning, rehabilitation was effective in reducing disability for participants in each chronicity group. Of the three groups, EI participants presented as the most disabled at admission but also made the greatest gains when assessed at discharge.
Year in review 2005: Critical Care – resource management
André Amaral, Gordon D Rubenfeld
Critical Care , 2006, DOI: 10.1186/cc4953
Abstract: During 2005 Critical Care published several original papers dealing with resource management. These papers focused mainly on sepsis and inflammation, with particular interest in the pathogenesis of the syndrome (especially the coagulation cascade and inflammatory aspects), analysis of prognostic indexes and markers, resuscitation and resource use in critical care.The importance of coagulation in sepsis has been the focus of attention by investigators for a few years [1]. Only recently has a compound, activated protein C (aPC), been shown effective and been approved for clinical use [2]. Because other natural anticoagulants have not been shown to be effective [3,4], however, the question remains whether the anticoagulant characteristics of aPC are indeed responsible for the survival benefit, or whether certain anti-inflammatory or fibrinolytic properties may also come into play. This issue was investigated in a small case-control study that could demonstrate a decrease in thrombin generation, as reflected by decreased levels of thrombin-antithrombin and pro-thrombin fragments 1 and 2 after aPC administration [5]. The inflammatory mediators and parameters of fibrinolysis did not change, however, which suggests that the main action of aPC may be anticoagulation, not fibrinolysis or inhibition of inflammation. One must therefore argue not only about the importance of coagulation in sepsis, but also how it is inhibited, because the targets on the coagulation cascade of natural anticoagulants are different: tissue factor pathway inhibitor seems to be an 'all or none' mediator, specifically involved in initiating the coagulation cascade [6]. It would therefore probably be useful if it could be administered before coagulation was initiated.Antithrombin III, on the other hand, works on later events in the cascade [7] and also benefits from specific interactions with endothelial glycosaminoglycans that may already be dysfunctional in sepsis [8]. Another report, however, showe
Asymmetric quark pairing and color neutrality in the Polyakov--Nambu--Jona-Lasinio model of QCD
Powell, Philip D.;Baym, Gordon
High Energy Physics - Phenomenology , 2013,
Abstract: We investigate the effects of confinement and local color neutrality on quark pairing at intermediate chemical potentials in the three flavor Nambu--Jona-Lasinio model with Polyakov loop. While prior studies have indicated the presence of a color-flavor-locked (CFL) phase at low temperatures and intermediate to high chemical potentials, we find that in the absence of a local color neutrality constraint the inclusion of the Polyakov loop gives rise to a new preferred phase in which all quark colors and flavors pair, but with unequal magnitudes. We study this asymmetric color-flavor-locked (ACFL) phase, which exists even for equal mass quarks, by identifying its location in the phase diagram, the order of the associated phase transitions, and its symmetry breaking pattern, which proves to be the intersection of the symmetry groups of the 2SC and CFL phases. We also investigate the effects of the strange quark mass on this new phase and the QCD phase diagram generally. Finally, we analyze the effect of a local color neutrality constraint on the QCD phase diagram and observe that under at least certain conditions it eliminates both the 2SC and ACFL phases by rendering them energetically unfavorable. Thus, we observe the previously proposed low temperature critical point emerge with the associated continuity between hadronic and color superconducting quark matter.
Shakespeare's Rosicrucian Revelations
Helen Heightsman Gordon, Ed. D.
Rose Croix Journal , 2007,
Abstract: Shake-speare’s Sonnets, published in 1609. Assuming that “William Shakespeare” was a pseudonym, the actual author may have been Sir Francis Bacon or Edward De Vere, the 17th Earl of Oxford, both of whom were Rosicrucians and cryptographers. The “initials” under the triangular shapes of the dedication are not those widely presumed to be “T.T.” for Thomas Thorpe, the publisher, but a pair of Greek gammas representing the Masonic symbol “G” and the Pillars of Solomon’s Temple. Encrypted names and mottos in the twenty-eight-word dedication indicate that the sonnets are dedicated to Henry Wriothesley, Third Earl of Southampton. Evidence in the Dedication implies that Henry was the natural son of Edward De Vere, who kept their relationship secret to protect Henry’s privacy and possibly his life, if his enemies suspected he had a claim to the throne of England.___________________________________________________________________________
Declaración de Lisboa: Las relaciones entre las facultades de medicina y los sistemas sanitarios en 2007 Lisbon Declaration on the relationship between Medical Schools and Healthcare Systems in 2007
J. Vi?as Salas,D. Gordon
Educación Médica , 2008,
Abstract:
Evanescent wave diffraction of multi-level atoms
D. Gordon,C. M. Savage
Physics , 1996, DOI: 10.1016/0030-4018(96)00237-4
Abstract: Diffraction of multi-level atoms by an evanescent wave reflective diffraction grating is modeled by numerically solving the time-dependent Schr\"{o}dinger equation. We are able to explain the diffraction observed in experiments with metastable Neon. This is not possible using a two-level atom model. The multi-level model predicts sensitive dependence of diffraction on the laser polarization and on the intensity ratio of incoming and reflected laser beams.
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