Binary Definition Research Articles

Drug-coated balloons in treatment of in-stent restenosis: a meta-analysis of randomised controlled trials

BackgroundDrug-coated balloons (DCBs) have been developed for the percutaneous treatment of coronary artery disease. An initial focus has been the management of in-stent restenosis (ISR) but randomised controlled trials (RCTs) have been small and powered only for angiographic endpoints.ObjectiveThe aim of the work was to assess the clinical and angiographic outcomes of patients treated for ISR with DCB versus control (balloon angioplasty or drug-eluting stents) by a meta-analysis of RCTs.MethodsA comprehensive search was performed of RCTs where patients with ISR were randomly assigned to either DCB or alternative coronary intervention. Outcome measurements were death, myocardial infarction (MI), target lesion revascularisation (TLR), binary definition of restenosis and in-lesion late luminal loss (LLL).ResultsFour studies were identified that fulfilled the inclusion criteria. Pooled odds ratios (ORs) were calculated for patients treated for ISR (n = 399). Mean follow-up duration was 14.5 months. DCBs were associated with lower rates of TLR [8.8 vs. 29.7 % OR (95 % confidence interval, CI) 0.20 (0.11–0.36), p < 0.0001], binary restenosis [10.3 vs. 41.3 % OR (95 % CI) 0.13 (0.07–0.24), p < 0.00001] and MI [0.5 vs. 3.8 %, OR (95 % CI) 0.21 (0.04–1.00), p = 0.05]. No significant heterogeneity was identified.ConclusionDrug-coated balloons appear to be effective versus control in reducing TLR and possibly MI versus balloon angioplasty or drug-eluting stents in the management of ISR.

A comparison of udder health trait definitions in German Holstein dairy cattle based on mastitis treatment data

Udder diseases are a major problem in dairy cattle herds. Apart from the improvement of hygiene and food quality, udder health can be improved by genetic selection. This study used disease treatment data of 29,698 Holstein cows from 21 German contract testing herds to evaluate different trait definitions with respect to variance components, breeding values, and genetic correlations to somatic cell score (SCS) and milk yield. Considering the first 305 days of a lactation, four traits were defined: a binary trait, the number of udder health treatments (TRS), the number of sickness periods (NUMS) and the days a cow was considered to be sick. Additionally the number of treatments and the number of sickness periods defined from the treatments were analyzed based on a model with an underlying Poisson distribution. Results from analyses with single and multiple trait sire and animal models showed low heritabilities, ranging from 0.05 to 0.13. The genetic correlation of 305 day average somatic cell score with all disease treatment traits defined in this study was high but differed clearly from one. Genetic correlations with 305 day milk yield were unfavorable and remarkably higher than genetic correlations of SCS with milk yield. Reliabilities of estimated breeding values (EBV) were the highest for NUMS. Spearman correlations of EBV for binary and linear trait definitions differed considerably from unity. Correlations of EBV between the disease treatment traits defined in this study and SCS were similar to genetic correlations. An exception was found for the correlation between EBV of TRS and SCS (0.46) which was remarkably lower than the corresponding genetic correlation. In summary, this study demonstrates the differences between various disease treatment traits as well as the benefits of using a more precise trait definition instead of the binary option. Despite the lower heritabilities, the discrepancy between the correlations of disease treatment traits and SCS to milk yield showed the necessity to include disease treatment traits, i.e. case data on mastitis, into breeding objectives and selection indices.

“Same, same but different”: The dangers of binary definitions of dis/ability in the neoliberal marketplace of early childhood education and care

Introduction In this paper I aim to highlight issues, consider dangers and recognise challenges for adults who are involved in ECEC and the inclusion of children with disabilities. Drawing on my own and others' recent research, I examine the current ECEC environment in Aotearoa/New Zealand and explore the relationship between several key interconnected influences on inclusion. My position is one of commitment to the human rights of all children. I contend that all children, regardless of ability, have the right to be with and learn alongside their peers. Central to my stance is the view that differences in ability are part of the uniqueness of the human condition. Therefore, I consider it to be critically important to challenge beliefs and practices that contravene the rights of disabled people to be included in, and belong to, a community. What worries me most is an apparent renaissance of deficit views of disability since the introduction of privatisation in the ECEC sector. Deficit views of disability draw on simplistic binary comparisons between disability and ability. My concern is that, in recent years we have inadvertently been moving away from previous--and in my view, better informed--attempts to respect and include all children in our ECEC centres. As a heuristic to draw the reader's attention to the abled versus disabled binary, in this paper I have at pertinent points inserted a forward stroke or virgule into the word disability (i.e., dis/ability). This separation of dis and ability aims to show how our, perhaps unintentional, labelling and understanding of ability plays a role in the way we treat both abled and disabled children. As Anderson and Merrell (2001) state, the notions of disability and ability imply and construct each other. The virgule insertion here acts as an alert, drawing our attention to the fact that when disability and ability are viewed as binary partners a person with disability may cease to be viewed as a competent individual and instead the differences between abled and disabled are foregrounded. Several writers have explored disability as socially constructed (Barton, 1996; Fulcher, 1999; Oliver, 1996). This view is adopted in much of Aotearoa/New Zealand's disability legislation and policy as this quote from the New Zealand Disability Strategy (Ministry of Health, 2001) demonstrates: Disability is not something individuals have. What individuals have are impairments. They may be physical, sensory, neurological, psychiatric, intellectual or other impairments. Disability is the process which happens when one group of people creates barriers by designing a world only for their way of living, taking no account of the impairments other people have. (p. 7) This paper offers a particular perspective about the role the current market-orientated ECEC environment may be playing in the construction of young children with disability. This perspective is based in part on what I have observed over the last three decades of my own involvement in the ECEC sector. I also draw on early evidence from a research project I am currently undertaking that attempts to address these concerns by examining the current complexities and tensions surrounding inclusion from the perspectives of teachers, owners and families/whanau in the marketplace environment of the long-day ECEC sector. Long-day ECEC services are those open for the hours of an adult's typical working day, usually 7.30 am to 6.00 pm. I have worked as a kindergarten teacher, been the owner of a long-day ECEC centre and in recent years a researcher/ lecturer in ECEC. I have practised under multiple educational and ECEC sector reforms designed to support children with disabilities. These range from the introduction of special needs units, partial integration of groups from special education facilities, part-time supported inclusion of individual children and, most recently, initiatives to support full inclusion of all children. …

Economic Liberalization and Rising College Premiums in Mexico: A Reinterpretation

Summary Mexico’s college premium rose in the 1990s. Studies employing structural decomposition analyses treat the college premium as the relative price of “skilled” to “unskilled” workers. They find that reallocations of labor across industries and occupations cannot account for rising college premiums, and often attribute them to widely observed trade-induced increases in skills demand within the manufacturing sector. In contrast, using a reduced-form decomposition that moves beyond a binary definition of skill and allows for inter-occupation wage differentials, we show that employment shifts across occupations and industries can account for the increase in the college premium. We link the rising premium, and differences in its trajectory by gender and cohort, to the growth of specific professions that produce services, not manufactured goods.

Indigenous Qualitative Inquiry

Five centuries after the first arrival of European settlers in what they called the Americas, indigenous peoples and ways of knowing continue to be largely represented and reified by Western scholars and epistemologies. We argue here that, even within Qualitative Inquiry and its critical paradigms and theories, indigenous bodies and narratives continue to be relatively scarce as our interpretive communities attempt to advance decolonizing knowledge production, pedagogy, and praxis. In this article, we argue that this persistent segregation is related to an academic structure that continues to privilege Western paradigms (e.g., theoretical sophistication over visceral knowledge of oppression) and ways of knowing (e.g., reductionist binary definitions of indigeneity still too obsessed with authenticity). The center-piece of our article and critique is an email exchange between the authors about ontological, epistemological, and ethical issues of indigenous qualitative inquiry over the period of one year. We attempt to use our exchange as an instantiation—a textual, intellectual, and emotional performance—of ontological questions on indigenous qualitative inquiry: Who is indigenous? Are there common grounds among indigenous peoples of the earth? And if so, can we find more effective ways to gather in these common grounds in the 21st century? We conclude by offering our own suggestions toward decolonizing imaginations and praxis.

Metabolic Syndrome Derived from Principal Component Analysis and Incident Cardiovascular Events: The Multi Ethnic Study of Atherosclerosis (MESA) and Health, Aging, and Body Composition (Health ABC)

Background. The NCEP metabolic syndrome (MetS) is a combination of dichotomized interrelated risk factors from predominantly Caucasian populations. We propose a continuous MetS score based on principal component analysis (PCA) of the same risk factors in a multiethnic cohort and compare prediction of incident CVD events with NCEP MetS definition. Additionally, we replicated these analyses in the Health, Aging, and Body composition (Health ABC) study cohort. Methods and Results. We performed PCA of the MetS elements (waist circumference, HDL, TG, fasting blood glucose, SBP, and DBP) in 2610 Caucasian Americans, 801 Chinese Americans, 1875 African Americans, and 1494 Hispanic Americans in the multiethnic study of atherosclerosis (MESA) cohort. We selected the first principal component as a continuous MetS score (MetS-PC). Cox proportional hazards models were used to examine the association between MetS-PC and 5.5 years of CVD events (n = 377) adjusting for age, gender, race, smoking and LDL-C, overall and by ethnicity. To facilitate comparison of MetS-PC with the binary NCEP definition, a MetS-PC cut point was chosen to yield the same 37% prevalence of MetS as the NCEP definition (37%) in the MESA cohort. Hazard ratio (HR) for CVD events were estimated using the NCEP and Mets-PC-derived binary definitions. In Cox proportional models, the HR (95% CI) for CVD events for 1-SD (standard deviation) of MetS-PC was 1.71 (1.54–1.90) (P < 0.0001) overall after adjusting for potential confounders, and for each ethnicity, HRs were: Caucasian, 1.64 (1.39–1.94), Chinese, 1.39 (1.06–1.83), African, 1.67 (1.37–2.02), and Hispanic, 2.10 (1.66-2.65). Finally, when binary definitions were compared, HR for CVD events was 2.34 (1.91–2.87) for MetS-PC versus 1.79 (1.46–2.20) for NCEP MetS. In the Health ABC cohort, in a fully adjusted model, MetS-PC per 1-SD (Health ABC) remained associated with CVD events (HR = 1.21, 95%CI 1.12–1.32) overall, and for each ethnicity, Caucasian (HR = 1.24, 95%CI 1.12–1.39) and African Americans (HR = 1.16, 95%CI 1.01–1.32). Finally, when using a binary definition of MetS-PC (cut point 0.505) designed to match the NCEP definition in terms of prevalence in the Health ABC cohort (35%), the fully adjusted HR for CVD events was 1.39, 95%CI 1.17–1.64 compared with 1.46, 95%CI 1.23–1.72 using the NCEP definition. Conclusion. MetS-PC is a continuous measure of metabolic syndrome and was a better predictor of CVD events overall and in individual ethnicities. Additionally, a binary MetS-PC definition was better than the NCEP MetS definition in predicting incident CVD events in the MESA cohort, but this superiority was not evident in the Health ABC cohort.

Study of Amended Reports to Evaluate and Improve Surgical Pathology Processes

: Amended surgical pathology reports record defects in the process of transforming tissue specimens into diagnostic information. : Systematic study of amended reports tests 2 hypotheses: (a) that tracking amendment frequencies and the distribution of amendment types reveals relevant aspects of quality in surgical pathology's daily transformation of specimens into diagnoses and (b) that such tracking measures the effect, or lack of effect, of efforts to improve surgical pathology processes. : We applied a binary definition of altered reports as either amendments or addenda and a taxonomy of defects that caused amendments as misidentifications, specimen defects, misinterpretations, and report defects. During the introduction of a LEAN process improvement approach-the Henry Ford Productions System-we followed trends in amendment rates and defect fractions to (a) evaluate specific interventions, (b) sort case-by-case root causes of misidentifications, specimen defects, and misinterpretations, and (c) audit the ongoing accuracy of the classification of changed reports. LEAN is the management and production system of the Toyota Motor Corporation that promotes continuous improvement; it considers wasted resources expended for purposes other than creating value for end customers and targets such expenditures for elimination. : Introduction of real-time editing of amendments saw annual amendment rates increase from 4.8/1000 to 10.1/1000 and then decrease in an incremental manner to 5.6/1000 as Henry Ford Productions System-specific interventions were introduced. Before introduction of HFPS interventions, about a fifth of the amendments were due to misidentifications, a 10th were due to specimen defects, a quarter due to misinterpretation, and almost half were due to report defects. During the period of the initial application of HFPS, the fraction of amendments due to misidentifications decreased as those due to report defects increased, in a statistically linked manner. As HFPS interventions took hold, misidentifications fell from 16% to 9%, specimen defect rates remained variable, ranging between 2% and 11%, and misinterpretations fell from 18% to 3%. Reciprocally, report defects rose from 64% to 83% of all amendment-causing defects. A case-by-case study of misidentifications, specimen defects, and misinterpretations found that (a) intervention at the specimen collection level had disappointingly little effect on patient misidentifications; (b) standardization of specimen accession and gross examination reduced only specimen defects surrounding ancillary testing; but (c) a double review of breast and prostate cases was associated with drastically reduced misinterpretation defects. Finally, audit of both amendments and addenda demonstrated that 10% of the so-called addenda actually qualified as amendments. : Monitored by the consistent taxonomy, rates of amended reports first rose, then fell. Examining specific defect categories provided information for evaluating specific LEAN interventions. Tracking the downward trend of amendment rates seemed to document the overall success of surgical pathology quality improvement efforts. Process improvements modestly decreased fractions of misidentifications and markedly decreased misinterpretation fractions. Classification integrity requires real time, independent editing of both amendments (changed reports) and addenda (addition to reports).

African American Jewish Women—Life beyond the Hyphen

African American Jewish Women—Life Beyond the Hyphen Yavilah McCoy (bio) and Miri Hunter Haruach (bio) As two diverse Jewish Women of Color, what does it mean for us to live "gracefully" across binary definitions that can be drawn in our communities around race, gender and culture? Miri: For me, this question is about moving through life as my full self and enjoying and observing how my own reality influences others perceptions and ideas of who I am. It's about how I work with this condition as a reality. Inevitably, not looking like the stereotypical Ashkenazi Jew, I turn heads when I walk into a room, especially a synagogue. That's the beginning of any educational process: being in the room as yourself. I think this raises questions because the reflection, and I think we all look for our reflections in our community, the reflection looks different, but is the same. So by default, I educate people in the Jewish world on how to work with what they see in me as reflecting a non-stereotypical Jew. What does it means to be Jewish in the first place? This is about my ability to question how we arrived at [End Page 182] the assumptions we carry around about what Jewish looks like. It's about quiet or subtle education. I don't walk around saying, "Look at me, I am moving in grace as my whole self." I just do it. My educational tool is a mirror. The questions that I am asked (Are you Jewish? Are your parents Jewish? How long have you been Jewish?), I repeat back to the questioner. "Well, of course I'm Jewish," they reply, usually somewhat aghast that I would ask. It's odd too, because I have found that other converts with white skin don't get asked to verify their Jewish identity. Grace is also being aware that I live in America and that putting individuals in boxes, categorizing each other, is a way of life; in some ways it's a safety net. I believe we need to let go of the net. Yavilah: Yes, for me it's about the choices I make each day to both know myself and reveal myself in layers. Depending on the people or situations I encounter, I find "grace" in giving myself permission to be one thing at a time with people, knowing that I am much, much more but have all the time in the world to reveal that in a relationship. Resisting the urgency that often underlies questions people seem to need to ask me at first glance, like "How are you Jewish?" helps me to see my experience in the Jewish world as benign as opposed to a proving ground. "Grace" for me is about being both patient and present with myself and others as I discern what it will take in a person or an environment to allow me to feel safe enough to share more than what lies on the surface. It's about being pleased as I experience others' differences from what I am familiar with. It's in taking time to gauge to what extent I will feel empowered or disempowered by the situations I enter and the relationships I choose to form. I find Grace in being courageous enough to choose myself first, as a priority, when I enter environments where my race, gender, or culture has not yet had the opportunity to be celebrated or valued. I find Grace in using the arts as a tool and container that has the capacity to hold all of me while the people around me pick and choose what they can handle. I find Grace when I can enjoy being "other" than the normative experience because I am valued as a contribution to the betterment of a whole. Sometimes, it's difficult for me to hit up against cultures in people and organizations that manifest like walls—impermeable walls where difference feels like a reason to stay out and not engage. Grace, for me, comes when I can approach these encounters, with compassion and love instead of anger. When I am able to reach deep within me...

Preoperative Diagnosis and Early Complications in Thoracolumbar Spine Surgery

Prospective observational cohort study. To determine the incidence of early complications with thoracolumbar spine surgery and its correlation with preoperative diagnosis. The reported incidence of early complications associated with thoracolumbar surgery is highly variable. Varying definitions of what constitutes a "complication" and varying study methodologies make evaluation and comparison of the literature difficult. No large study has investigated the effect of preoperative diagnosis and patient comorbidities on early postoperative complications in thoracolumbar surgery. One-hundred twenty-eight consecutive patients who underwent thoracolumbar surgery by the neurosurgical service at the Thomas Jefferson University Hospital were prospectively entered into a central database from May to December 2008. An earlier-described, binary definition of major and minor complication was used. Data on preoperative diagnosis, comorbidities, body mass index, surgical procedure, length of stay (LOS), and early complication was examined using χ and time-to-discharge survival analysis. The overall complication incidence was 59.4%, with a minor complication incidence of 52.3% and a major complication incidence of 24.2%. The highest incidences of complications occurred in patients with the diagnosis of infection and tumor, where incidence exceeded 70%; this difference did not achieve statistical significance. The overall median LOS was 7 days; LOS was longer in patients with traumatic pathology (17 d) and patients with neoplastic pathology (14 d) (P<0.05). A higher incidence of complications than earlier studies was noted. A trend toward higher complication incidence in patients with infectious or neoplastic disease was observed. The severity of patient pathology, the broader definitions of complication used, and the elimination of recall bias by the use of a prospective study design accounts for the higher incidence of complications reported in this series. However, a large, prospective study using clear definitions is needed to elucidate the true incidence of early complications in thoracolumbar surgery.

Defining “Complications” in Spine Surgery

Survey of neurosurgical and orthopedic spine surgeons. To define the "complications of spinal surgery," we surveyed a large group of practicing spine surgeons to establish a preliminary definition of perioperative complications. Although the risk of complications following spinal procedures plays an important role in determining the appropriateness of surgical intervention, there is little consensus among spine surgeons regarding the definition of complications in spine surgery. The relevance of medical complications is also not clearly defined. We surveyed a cohort of practicing spine surgeons via email and a commercially maintained website. Surgeons were presented with various complication scenarios, and asked to assess the presence or absence of a complication, as well as complication severity, with responses limited to "major complication" and "minor complication/adverse event." The survey was sent to approximately 2000 practicing surgeons; complete responses were received from 229, giving a response rate of 11.4%. Orthopedic surgeons comprised the majority of respondents (73%); most surgeons reported being in practice for greater than 5 years (83%). Greater than 75% of surgeons agreed on complication presence or absence in 10 of 11 scenarios assessed (91%, P<0.05). Consensus (≥70% agreement, P<0.05) as to type of complication was found in 7 of 11 scenarios presented (64%). Events deemed major complications involved either severe medical adverse events with permanent sequela or events requiring return to the operating room. Surgeons consistently considered medical adverse events, whether or not directly related to surgery, relevant to complication assessment. We present a practical binary definition of complications in spine surgery based upon a survey of over 200 practicing spine surgeons. Further work is required in critically assessing spine surgery complications.

Caryophyllales: a key group for understanding wood anatomy character states and their evolution

Definitions of character states in woods are softer than generally assumed, and more complex for workers to interpret. Only by a constant effort to transcend the limitations of glossaries can a more than partial understanding of wood anatomy and its evolution be achieved. The need for such an effort is most evident in a major group with sufficient wood diversity to demonstrate numerous problems in wood anatomical features. Caryophyllales s.l., with approximately 12 000 species, are such a group. Paradoxically, Caryophyllales offer many more interpretive problems than other ‘typically woody’ eudicot clades of comparable size: a wider range of wood structural patterns is represented in the order. An account of character expression diversity is presented for major wood characters of Caryophyllales. These characters include successive cambia (more extensively represented in Caryophyllales than elsewhere in angiosperms); vessel element perforation plates (non-bordered and bordered, with and without constrictions); lateral wall pitting of vessels (notably pseudoscalariform patterns); vesturing and sculpturing on vessel walls; grouping of vessels; nature of tracheids and fibre-tracheids, storying in libriform fibres, types of axial parenchyma, ray anatomy and shifts in ray ontogeny; juvenilism in rays; raylessness; occurrence of idioblasts; occurrence of a new cell type (ancistrocladan cells); correlations of raylessness with scattered bundle occurrence and other anatomical discoveries newly described and/or understood through the use of scanning electron microscopy and light microscopy. This study goes beyond summarizing or reportage and attempts interpretations in terms of shifts in degrees of juvenilism, diversification in habit, ecological occupancy strategies (with special attention to succulence) and phylogenetic change. Phylogenetic change in wood anatomy is held to be best interpreted when accompanied by an understanding of wood ontogeny, species ecology, species habit and taxonomic context. Wood anatomy of Caryophyllales demonstrates problems inherent in binary character definitions, mapping of morphological characters onto DNA-based trees and attempts to analyse wood structure without taking into account ecological and habital features. The difficulties of bridging wood anatomy with physiology and ecology are briefly reviewed. © 2010 The Linnean Society of London, Botanical Journal of the Linnean Society, 2010, 164, 342–393.

MOBI: a web server to define and visualize structural mobility in NMR protein ensembles

MOBI is a web server for the identification of structurally mobile regions in NMR protein ensembles. It provides a binary mobility definition that is analogous to the commonly used definition of intrinsic disorder in X-ray crystallographic structures. At least three different use cases can be envisaged: (i) visualization of NMR mobility for structural analysis; (ii) definition of regions for reliable comparative modelling in protein structure prediction and (iii) definition of mobility in analogy to intrinsic disorder. MOBI uses structural superposition and local conformational differences to derive a robust binary mobility definition that is in excellent agreement with the manually curated definition used in the CASP8 experiment for intrinsic disorder in NMR structure. The output includes mobility-coloured PDB files, mobility plots and a FASTA formatted sequence file summarizing the mobility results. The MOBI server and supplementary methods are available for non-commercial use at URL: http://protein.bio.unipd.it/mobi/.

Rising College Premiums in Mexico: How Important is Trade?

Mexico’s college premium rose in the 1990s. Studies employing structural decomposition analyses treat the college premium as the relative price of “skilled” to “unskilled” workers. They find that reallocations of labor across industries and occupations cannot account for rising college premiums, and often attribute them to widely observed trade-induced increases in skills demand within the manufacturing sector. In contrast, using a reduced-form decomposition that moves beyond a binary definition of skill and allows for inter-occupation wage differentials, we show that employment shifts across occupations and industries can account for the increase in the college premium. We link the rising premium, and differences in its trajectory by gender and cohort, to the growth of specific professions that produce services, not manufactured goods.

Security on Fragile and Semi-fragile Watermarks Authentication

ABSTRACT Digital image manipulation software is now readily available on personal computers. It is therefore very simple to tamper with any image and make it available to others. Ensuring digital image security has therefore become a major issue. Watermarking has become a popular technique for copyright enforcement and image The aim of this paper is to present an overview of some possible attacks which may cause harm the present watermarking techniques. Here we have identified the attacks which frequently attacks some very well known fragile and semifragile watermarking techniques.. General Terms Security, Watermarking and Authentication. Keywords Attack, image authentication, watermark, fragile, semi-fragile, security, private key, public key. attack threats. We have specially fo 1. INTRODUCTION In today's world, digital images and video are gradually replacing their classical analog counterparts. This is quite understandable because digital format is easy to edit, modify, and exploit. Digital images and videos can be readily shared via computer networks and conveniently processed for queries in databases. Also, digital storage does not age or degrade with usage. On the other hand, thanks to powerful editing programs, it is very easy even for an amateur to maliciously modify digital media and create perfect forgeries. It is usually much more complicated to tamper with analog tapes and images. Tools that help us establish the authenticity and integrity of digital media are thus essential and can prove vital whenever questions are raised about the origin of an image and its content. In the past few years, many new techniques and concepts based on data hiding or steganography have been introduced as a means for tamper detection in digital images and for image Fragile watermarks are designed to detect every possible change in pixel values. In many schemes, it can be shown that without the secret key, the probability of a modification that will not be detected can be related to a cryptographic element present in the scheme, such as a hash function. Semi-fragile watermarks are moderately robust and thus provide a softer evaluation criterion (authentication with a degree). Some schemes have been specifically designed to be compatible with certain distortion, such as JPEG or wavelet compression. There is another special group of authentication techniques that can be termed authentication. In those schemes, robustly extracted image features are embedded in the image in a semi-robust manner to help identify gross changes in the image. In the security domain, an integrity service is unambiguously defined as one, which ensures that the sent and received data are identical. This binary definition is also applicable to images. In real life situations, images can be transformed, their pixel values can be modified but not the actual meaning of the image. In order to provide an authentication service for still images, it is important to distinguish between malicious manipulations, which consist of changing the content of the original image and manipulations related to the use of images. In this paper, we focus on different attacks on different watermarking techniques. So many watermarking schemes have been designed to provide authenticity to the digital images. But many of the proposed ideas are not totally secure because of the cused on the identification of the attacks to which the proposed watermarking schemes are vulnerable..

Obesity and spine surgery: reassessment based on a prospective evaluation of perioperative complications in elective degenerative thoracolumbar procedures

Background Context The correlation between obesity and incidence of complications in spine surgery is unclear, with some reports suggesting linear relationships between body mass index (BMI) and complication incidence and others noting no relationship. Purpose The purpose of this article was to assess the relationship between obesity and occurrence of perioperative complications in an elective thoracolumbar surgery cohort. Study Design/Setting Prospective observational cohort study at a tertiary care facility. Patient Sample Cohort of 87 consecutive patients undergoing elective surgery for degenerative thoracolumbar pathologies over a 6-month period (May to December 2008). Outcome Measures Incidence of perioperative complications (those occurring within 30 days of surgery). Methods A prospective assessment of perioperative spine surgery complications was completed, and data were prospectively entered into a central database. Two independent auditors assessed for the presence and severity of perioperative complications. Previously validated binary definitions of major and minor complications were used. Patient data and early complications (those occurring within 30 days of index surgery) were analyzed using multivariate regression. Results Mean BMI in this cohort was 31.3; 40.8% of patients were obese (BMI>30) and 10 patients (11.5%) were morbidly obese (BMI>40). The overall complication incidence was 67%. Minor complications occurred in 50% of patients, and major complications occurred in 17.8% of patients. No positioning palsies occurred in this series. Age correlated with an increase in complication risk (p=.006) as did hypertension (p=.004) and performance of a fusion (p<.0001). BMI did not correlate with the incidence of minor, major, or any complications (p=.58). Conclusions This prospective assessment of perioperative complications in elective degenerative thoracolumbar procedures shows no relationship between patient BMI and the incidence of perioperative minor or major complications. Specific care in perioperative positioning may limit the risk of perioperative positioning palsies in obese patients.

A new fuzzy unidimensional poverty index from an information theory perspective

This article proposes to use an information theory approach to design a fuzzy unidimensional poverty index. In order to avoid the usual binary definition of poverty, a fuzzy set approach has been used. The total population is partitioned into three mutually exclusive groups around the poverty line. This builds on fuzzy set theory whereby the definition of the threshold of who is poor or non-poor is fuzzy. This article proposes a method using a membership function and a confidence interval of poverty line to identify to what extent households can be considered as poor or non-poor. According to this membership function, a relative entropy measure is adopted to assess an aggregation method of fuzzy individual poverty. An application using individual well-being data from Tunisian households is presented.

Density and Shape as CT Predictors of Intracerebral Hemorrhage Growth

Intracerebral hemorrhage (ICH) growth predicts mortality and functional outcome. We hypothesized that irregular hematoma shape and density heterogeneity, reflecting active, multifocal bleeding or a variable bleeding time course, would predict ICH growth. Three raters examined baseline sub-3-hour CT brain scans of 90 patients in the placebo arm of a Phase IIb trial of recombinant activated Factor VII in ICH. Each rater, blinded to growth data, independently applied novel 5-point categorical scales of density and shape to randomly presented baseline CT images of ICH. Density and shape were defined as either homogeneous/regular (Category 1 to 2) or heterogeneous/irregular (Category 3 to 5). Within- and between-rater reliability was determined for these scales. Growth was assessed as a continuous variable and using 3 binary definitions: (1) any ICH growth; (2) >or=33% or >or=12.5 mL ICH growth; and (3) radial growth >1 mm between baseline and 24-hour CT scan. Patients were divided into tertiles of baseline ICH volume: "small" (0 to 10 mL), "medium" (10 to 25 mL), and "large" (25 to 106 mL). Inter- and intrarater agreements for the novel scales exceeded 85% (+/-1 category). Median growth was significantly higher in the large-volume group compared with the small group (P<0.001) and in heterogeneous compared with homogeneous ICH (P=0.008). Median growth trended higher in irregular ICHs compared with regular ICHs (P=0.084). Small ICHs were more regularly shaped (43%) than medium (17%) and large (3%) ICHs (P<0.001). Small ICHs were more homogeneous (73%) compared with medium (37%) and large (17%) ICHs (P<0.001). Adjusting for baseline ICH volume and time to scan, density heterogeneity, but not shape irregularity, independently predicted ICH growth (P=0.046) on a continuous growth scale. Large ICHs were significantly more irregular in shape, heterogeneous in density, and had greater growth. Density heterogeneity independently predicted ICH growth using some definitions.

The broadening spectrum of osteoporotic vertebral fracture

Osteoporotic bone is structurally insufficient and predisposed to low-energy fracture [1]. Fractures are deemed osteoporotic when they result from generalized skeletal demineralization and low-energy trauma rather than from focal pathologic destruction of bone or high-energy trauma. Osteoporotic fractures are accompanied by substantial morbidity and signify increased mortality [2]. Vertebral fractures, the most prevalent osteoporotic fracture, is a powerful harbinger of future vertebral and non-vertebral fracture. Since vertebrae generally fail by compression in axial loading, these fractures are often called vertebral compression fractures. Since fracture morphology is often more complex then this name suggests, the more inclusive term, vertebral fracture (VF), is preferred. In clinical practice, osteoporotic VFs are usually identified by characteristic changes in vertebral shape on a lateral spine radiograph. For research consensus, VFs are defined by a reduction in anterior, middle, or posterior vertebral height although the minimum required reduction (e.g., 15% or 20% of vertebral height) varies among definition schemes [3]. Alterations in vertebral shape consistent with osteoporotic VF are further classified based on the presence or absence of fracture symptoms. Those associated with fracture pain are termed “clinical” while all others “morphometric” VFs (Fig. 1). This dichotomous view teaches that the majority of osteoporotic VFs are morphometric (75%), that is, clinically silent, rather than clinical (25%) [4]. Descriptive fracture morphology further characterizes VFs by shape (e.g., compression, wedge, concave, plana), severity (mild, moderate, severe), number and location within the spine. In this discussion, the term “vertebral deformity” will refer to other non-osteoporotic, non-fracture alterations of vertebral shape. These binary fracture definition schemes have served as the basis for the epidemiology of osteoporosis, defining the economic burden of osteoporotic fractures and as therapeutic endpoints in pivotal pharmaceutical osteoporosis trials [5]. Prevalent VFs have been shown to increase the risk of future vertebral and non-vertebral osteoporotic fracture independent of bone mineral density (BMD). Further, a linear correlation exists between both the number and severity of prevalent VFs and future VF risk. These relationships are the underpinnings of vertebral fracture analysis (VFA) meant to enhance BMD-based fracture risk assessment by combining detected prevalent VFs with BMD T-scores [6]. Substantial clinical data indicates that osteoporotic VF, whether symptomatic or not, correlates with disability from back pain, reduced physical function, reduced quality of life, and increased mortality [2, 7–10]. While binary fracture definition schemes have served the osteoporosis community well, clinical experience, refined by recent conceptual advances in vertebral morphometry [5, 11, 12], and the emerging vertebral augmentation experience [13], suggest that the spectrum of osteoporotic VFs is broader than these definition schemes suggest. The intention of this perspective is to challenge the prevailing dichotomous view of osteoporotic VF. Some of what follows is speculation based upon published clinical and bench research of varying rigor. All of what follows is intended to stimulate a multidisciplinary discussion of a broader view of osteoporotic VFs. Skeletal Radiol (2009) 38:303–308 DOI 10.1007/s00256-008-0632-3

New algorithm for attribute reduction in inconsistent decision tables

In order to correct some problems of computing the core of a decision table,an improved binary discernable matrix definition based on distribution function for computing the core was put forward in this paper.The improved binary discernable matrix is not only small in scale but also suitable for any decision tables for computing the core.A new algorithm for attribute reduction in inconsistent decision tables was also presented based on getting the core.Only increasing appropriate rows in the improved binary discernable matrix for computing the core,attribution reduction will be obtained by utilizing logic operation.And the absorptive law was used in attribution reduction,which raised the efficiency of attribute reduction greatly.

Female Power and Gender Transcendence in the Work of Martha Graham and Mary Wigman

This paper contrasts the iconic embodiments of empowered femininity characteristic of Martha Graham's choreographic work and the gender ambiguity found in Mary Wigman's early solos. These modern dance pioneers both emancipated the female body from dominant Western culture's insistence on binary gender definitions. However, their differing approaches to how a liberated female body looks, moves, and dresses provides an opportunity to examine modern dance as a forum for diverse shifts in gender representation. This research draws on my personal experience dancing with the Martha Graham company and historic research investigating Wigman's solo concerts in Germany from 1917 to 1919. This paper makes the claim that modern dance, as a conscious fusion of body and mind, can embrace the fluid complexity of personal identity and encourage both conceptual and embodied transcendence of hegemonic male/female paradigms.