text:
Interpretive Handbook
82023 :
Prostate-Specific Antigen (PSA) Screen, Serum
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Prostate-specific antigen (PSA) is a glycoprotein that is produced by the prostate gland, the lining of the urethra, and the bulbourethral gland. Normally, very little PSA is secreted in the blood. Increases in glandular size and tissue damage caused by benign prostatic hypertrophy, prostatitis, or prostate cancer may increase circulating PSA levels.
In patients with previously diagnosed prostate cancer, PSA testing is advocated as an early indicator of tumor recurrence and as an indicator of response to therapy. The role of PSA in early detection of prostate cancer is controversial. The American Cancer Society recommends annual examination with digital rectal examination and serum PSA beginning at age 50, and also for those men with a life expectancy of at least 10 years after detection of prostate cancer. For men in high-risk groups, such as African Americans or men with a first-degree relative diagnosed at a younger age, testing should begin at a younger age. It is generally recommended that information be provided to patients about the benefits and limitations of testing and treatment so they can make informed decisions.
Useful For Suggests clinical disorders or settings where the test may be helpful
Monitoring patients with a history of prostate cancer as an early indicator of recurrence and response to treatment
Prostate cancer screening
Interpretation Provides information to assist in interpretation of the test results
Prostate-specific antigen (PSA) values are reported with the 95th percentile limits by decade of age. These reference limits include men with benign prostatic hyperplasia. They exclude all cases with proven cancer.
PSA values exceeding the age-specific limits are suspicious for prostate disease, but further testing, such as prostate biopsy, is needed to diagnose prostate pathology.
The minimal reporting value is 0.1 ng/mL. Values >0.2 ng/mL are considered evidence of biochemical recurrence of cancer in men after prostatectomy.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Serum markers are not specific for malignancy, and values may vary by method. When age is not supplied, the results cannot be flagged as high or low.
Digital rectal examination generally does not increase normal prostate-specific antigen (PSA) values. However, cystoscopy, urethral instrumentation, and prostate biopsy may increase PSA levels.
Some patients who have been exposed to animal antigens, either in the environment or as part of treatment or imaging procedure, may have circulating anti-animal antibodies present. These antibodies may interfere with the assay reagents to produce unreliable results.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Age (Years)
PSA Upper Limit (ng/mL)
< or =2.0
< or =2.5
< or =3.5
< or =4.5
< or =6.5
> or =80
< or =7.2
Females: not applicable
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Oesterling JE, Jacobsen SJ, Chute CG, et al: Serum prostate-specific antigen in a community-based population of healthy men. JAMA 1993 Aug 18;270:860-864
2. Smith RA, Cokkinides V, von Eschenbach A, et al: American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin 2002;52:8-22
3. Barry MJ, Albertsen PC, Bagshaw MA, et al: Outcomes for men with clinically nonmetastatic prostate carcinoma managed with radical prostatectomy, external beam radiotherapy, or expectant management: a retrospective analysis. Cancer 2001 June 15;91(12):2302-2314
4. Blute ML, Bergstralh EJ, Scherer BG, et al: Use of Gleason score, prostate specific antigen, seminal vesicle and margin status to predict biochemical failure after radical prostatectomy. J Urol 2001 January;165(1):119-125


text:
Thank you for that last thought. But is what I wrote pro-war. (and me against global peace) I just need to know if i did it right. What would I write for religion because my other ones I had first, pro-war diminishes population. Then for the other one I had war increases the ...
April 1, 2009
32 divided by 6.77700 = 4.72185333
April 1, 2009
Business Communication
I think that it's either b or c learning more towards b though
April 1, 2009
Social Studies
website called bestserials
April 1, 2009
is this right though. Being pro-war for religion (being against global peace)
April 1, 2009
SraJMcGin read this but he didn't help me out. Pro-war & religion ( Rememeber I'm against global peace) Is this right at all and what else can I add because I need a couple more sentences. Thanks A few people feel that they believe in the only right religion and that ...
April 1, 2009
Medical billing and coding
The Patient
April 1, 2009
Pro-war & religion. (Remember i'm against global peace) Is this right at all and what else could I add. Thank. A few people feel that they believe in the only right religion and that people of other faiths should be destroyed. War is fought over what individuals believe in...
April 1, 2009
What do you mean?
April 1, 2009
It looks good to me!!
April 1, 2009
8th grade
Wow that's a tough question. Good luck maybe you could talk about being a farm and the cow being knocked over by a plow or something along that line. Good luck
April 1, 2009
You will have really good luck if you just search Martin Luther King in general and for sure you will come upon some ineffectiveness in his leadership. There is alot of information on him. Good luck!!
March 31, 2009
I understand that profit means gaining money from or derive a benefit from. So would it be something like this. Companies that sell goods to the government usually make good profits too. Since the item that is being produced is in high demand and more are being produced, the ...
March 31, 2009
What do you mean by companies that sell goods to the government usually make good profits too. I also don't understand your first point.
March 31, 2009
What would my topic sentence be for this paragraph that I have been working on? Because my points are overpopulation, economics, and religion. I have another ?. Pro-war and economics. I already expanded on the creation of more jobs due to the need of providing the soldiers ...
March 31, 2009
That means that one you go from one paragraph to another you want to use a transition word to help the flow of your paper. So far sounds good keep going!!!
March 31, 2009
we can't use the word money How about fighting a war creates economic happiness for many people. Does that sound good?
March 31, 2009
To start my first one off I put First, pro-war diminishes overpopulation. How should I write this one because I don't want it to be the same.
March 31, 2009
Pro-war and economics. What are some reasons for that besides since their is a war going on those people fighting are employed so more jobs become available (I don't have a reason why or know if that's right)
March 31, 2009
Ya I'm against global peace but aren't I suppose to be in favor of war you said that my argument above provides one reason for being in favor of war. I appreciate your other arguements but do you have one more sentence that I can add to what I have above about pro-war ...
March 31, 2009
I responded back to your last post that you didn't read. We can't use any statistics. I re-wrote what i had but can you please tell me what else I should put or how to make it stronger. Does it sound like I'm pro-war? I'm so confused right now. Thank you. I ...
March 31, 2009
We can't use no statistics I don't know how else to expand. I'm so lost.
March 31, 2009
This is what I have so far for pro-war diminishes overpopulation I need to add more any ideas? Any help would be greatly appreciated. Thanks First, pro-war diminishes overpopulation. During war many individuals are killed, physically resulting in a smaller population. War ...
March 31, 2009
I don't understand why people are pro-war because of religion purposes? Can you please explain this to me.
March 31, 2009
math{HELP HELP}
For number 1 you would do 24 divided by six so y equals 4
March 31, 2009
I understand what pro-war means but I need to come up with a couple strong reasons on how being pro-war diminishes overpopulation? I tryed searching for somethings but had no luck.
March 31, 2009
What does it mean by being "pro-war diminishes overpopulation?
March 31, 2009
This is what I have so far but I need to add more any ideas would be great. Thanks. (How does overpopulation cause epidemics) THe more people that one comes in contact with each day, the more chances there are to pass on or receive a contagious disease. Since society is ...
March 30, 2009
How would overpopulation create epademics?
March 30, 2009
Go to google and type in how are hearing and touching different and go down B2:touch & hearing and it gives the science behind them and how they are different.
March 29, 2009
global peace sorry
March 29, 2009
Can you please explain this to me the best that you can? GP would create tolerance because everyone would be in each other's space due to overpopulation. What is a good follow up sentence to put after that.
March 29, 2009
New ideas are often rejected because there may not be enough information to support their idea and may not relate fully to the subject being discussed. All the details and background of ideas need to be explored before they should be accepted by other people
March 29, 2009
What do you mean by the pitted iron nail?
March 29, 2009
Fe(NO3)3 + 3KSCN >> FeSCN(2+) + 3KNO3
March 29, 2009
I means that people in this world are eager and willing to work for what they need while those not willing to do that let others do the work for them so they don't have to anything
March 29, 2009
the answer is 21
March 29, 2009
How does overpopulation create starvation. What are some strong reasons besides people fighting over food.
March 29, 2009
Sorry this is still Kara
March 27, 2009
We were assigned this position. So I would state that overpopulation leads to increased levels of warfare. I still don't understand what my reasoning would be since i'm against global peace. When I attack this essay is it that since i'm against global peace i'm...
March 27, 2009
Conflict over scarce resources and overcrowding, leads to increased levels of warfare. What would I say about this when I'm against global peace. I think to help me understand this entire concept of the essay I need an example sentence on how to state my point. I'm ...
March 27, 2009
I understand what your saying but How does this relate back to how I'm against global peace?
March 27, 2009
I don't understand how that would affect job shortage though?
March 27, 2009
For my english class we have to write an essay on why were against global peace. The main topic that I'm doing it on global peace causes over population and that i'm against global peace in everything that i write. What are some strong reasons on how global peace would...
March 27, 2009
General ?
When your in college once your receive your associates degree their is a graduation ceremony then the same for once you receive you bachelors. So there is a graduation ceremony everytime??? Thanx I was just wondering
March 25, 2009
Algabra One
According to some kids, what is the meaning of homework?
March 7, 2009
Is there a correlation between temperature change with the changes on the molecular level? And what is it? (talking about changes in phases with melting and heating. and the temp corresponds to the time it takes for each phase to melt, vaporize, etc.) (on a phase change ...
January 30, 2009
What does it mean when a problem says "give the values for STP"?
January 27, 2009
Simplify completely: -3(4-9)+6-2(-8+5)
January 26, 2009
algebra 2
do elephants wear roller skates?
January 22, 2009
for a)you must first calculate the angular frequency,w, you are only given the frequency,f. to do that you use the equation: w=2*pi*f =2*pi*3Hz next you take that and put it into the equation with k being the spring constant,w being the angular velocity, and m being the mass: ...
December 11, 2008
classify the compound as having ionic, polar covalent, or pure covalent bonds. Sb2P5 I know that a metal and nonmetal form an ionic bond, and two nonmetals form covalent bonds. The trouble I am having is that Sb is a metalliod and when it forms with a non-metal, what kind of ...
December 9, 2008
How much energy does the electron have initially in the n=4 excited state? Enter your answer numerically in joules.
November 2, 2008
A radio station's channel, such as 100.7 FM or 92.3 FM, is actually its frequency in megahertz (MHz), where 1MHz=10^6Hz. Calculate the broadcast wavelength of the radio station 98.30 FM.
November 2, 2008
I got C2H4?
October 24, 2008
To identify a diatomic gas (X_2), a researcher carried out the following experiment: She weighed an empty 1.00-L bulb, then filled it with the gas at 1.10atm and 23.0 degrees celsius and weighed it again. The difference in mass was 1.27g . Identify the gas. Express your answer...
October 24, 2008
To identify a diatomic gas (), a researcher carried out the following experiment: She weighed an empty 1.00- bulb, then filled it with the gas at 1.10 and 23.0 and weighed it again. The difference in mass was 1.27 . Identify the gas. Express your answer as a chemical formula.
October 24, 2008
Express your answer as a chemical formula.
October 24, 2008
To identify a diatomic gas (), a researcher carried out the following experiment: She weighed an empty 1.00- bulb, then filled it with the gas at 1.10 and 23.0 and weighed it again. The difference in mass was 1.27 . Identify the gas.
October 24, 2008
Calculate the density of oxygen, , under each of the following conditions: STP 1.00atm and 25.0 degrees celsius Express your answers numerically in grams per liter. Enter the density at STP first and separate your answers by a comma.
October 24, 2008
A cylinder with a movable piston contains 2.00 of helium, , at room temperature. More helium was added to the cylinder and the volume was adjusted so that the gas pressure remained the same. How many grams of helium were added to the cylinder if the volume was changed from 2....
October 24, 2008
Social Studies 30
Did the USA enhance the ideals of the League of Nations between 1920 and 1933?
October 21, 2008
How do I find the area of the region bounded by the curves y = e^x, y = e^-x, x= -2, and x = 1? Even if you could just help me in getting started it would be a HUGE help. Thanks!
September 3, 2008
6th Grade Math
I need a little help on math. It has to do with kilograms and weight.
August 19, 2008
what is an organism that feeds off of other living or dead organisms?
April 28, 2008
If the electron in a hydrogen atom obeyed classical mechanics instead of quantum mechanics, would it emit a continuous spectrum or a line spectrum?
April 10, 2008
When an electron makes a transition from its first quantum level to ground level, the energy difference is carried by the emitted photon. In comparison, how much energy is needed to return an electron at ground level to the first quantumlevel?
April 10, 2008
Uranium-238 is 238 times more massive than hydrogen. Why, then, isn't the diameter of the uranium atom 238 times that of the hydrogen atom?
April 10, 2008
How does Rutherford's model of the atom account for the back-scattering of alpha particles directed at the gold foil?
April 10, 2008
Which color light is the result of a greater energy transition, red or blue?
April 10, 2008
Math(Easy Survey Please Help)
1. Do you exercise or work out on a regular basis? no 2. Are you male or female? female 3. Do you smoke? no 4. How many carbonated soft drinks do you consume in a week. none 5. Do you drink coffee. occasionally 6. How many servings of fruit, or fruit juice do you consume in a ...
March 22, 2008
Well, my opinion isn't expert, but it sounds like a misprint. It should just be "des" both times because the particle "des" is of course "the" and should only apply to the plurality of the word "numbers"
March 22, 2008
Physics (Mechanics)
A uniform plate of height H= 0.69 m is cut in the form of a parabolic section. The lower boundary of the plate is defined by: y= 1.10x^2. The plate has a mass of 5.62 kg. Find the moment of inertia of the plate about the y-axis. Alright, I've done this so far: So I figured...
March 21, 2008
Alright, so what you are looking at is a conservation of energy problem. Total Mechanical Energy in a system where energy is conserved is always equal to the sum of the kinetic energy and the potential energy. The sum of the change in these two quantities is also equal to zero...
March 21, 2008
thank you
January 30, 2008
A rectangle has sides of 4x 4 and 8x + 10. Find the expression that represents its perimeter
January 30, 2008
The sum of two numbers is 38. Their difference is 12. What are the two numbers?
January 25, 2008
thank you so much
January 24, 2008
The difference of two numbers(the second minus the first) is 48. The second is 8 less than 5 times the first. What are the two numbers?
January 24, 2008
math please help
The length of a rectangle is 8 in. more than twice its width. If the perimeter of the rectangle is 34 in., find the width of the rectangle.is it 1. 2 in. 2. 3 in. 3. 4 in. 4. 5 in.
January 24, 2008
can someone hep me please Population of Europe by Age Groups Population (in thousands) 1----------1950 --1970 --1995 Age 0-14--------143,175 166,367 139,464 Age15-64------- 359,162 421,432 487,110 Age 65+ 44,981- 68,642- 101,338 Age 75+ 14,553- 22,762- 38,139 Total--547,318 ...
January 11, 2008
can someone hep me please Use the following tabe to answer the question. Population of Europe by Age Groups Population (in thousands) 1----------1950 1970 1995 Age 0-14 143,175 166,367 139,464 Age15-64 359,162 421,432 487,110 Age 65+ 44,981 68,642 101,338 Age 75+ 14,553 22,762...
January 11, 2008
can someone hep me please Use the following tabe to answer the question. Population of Europe by Age Groups Population (in thousands) 1950 1970 1995 Age 0-14 143,175 166,367 139,464 Age15-64 359,162 421,432 487,110 Age 65+ 44,981 68,642 101,338 Age 75+ 14,553 22,762 38,139 ...
January 11, 2008
so it would be a and d
January 11, 2008
purple- 1 in 63 brown- 1 in 62
January 10, 2008
Algebra 1
explain: 3x-y=12 4x-5y=16 it is linear equations using substitution method
January 10, 2008
Thank You, I am just making sure before I turn this in.
September 6, 2007
Would this be correct? Factpr completley: y^3-12y^2+36y y(y^2-12y+36) y(y-6)^2
September 6, 2007
I am wondering if I did this right? Write Using a positive exponets and simplify if possiable. (-3x)^2 I took the -3^2=9 over the x^2 and the answer would be - 9 over x^2
September 6, 2007
I do not understand what I am supposed to do: The problems reads: Evaluate (assume x is not equal to 0). -10x^0 I did this though not sure about it, -10*x^0 -10*1 -10
September 6, 2007
I would say.... Mona, Jack, Pete, Nick
August 30, 2007
Ohh, I knew something looked off...so it should be x^2-5x/80-9/20
August 29, 2007
know I am supposed to use the FOIL method.But is this right? I am really not sure I did this right, something just seems off about it. So i would Multiply x/3 * 3x/4=x^2/4 x/3 *-3/5= -x/5 3/4 *3x/4=9x/4 3/4 * -3/5 I know to add both of my bottom numbers have to be the same so...
August 29, 2007
How do you Multiply this? (x/3+3/4)(3x/4-3/5)
August 29, 2007
. Describe the three key concerns that Washington had for the future of the U.S. Explain how the country has progresses in each area and give one specific example. Here's an answer I posted for this question a few days ago. http://www.jiskha.com/display.cgi?id=1187480916
August 21, 2007
Chemical Kinetics
When experimentally determining the rate law, i am getting a negative fraction. is that right or am i doing something wrong? It is possibly right. I'd have to see you calculations to determine that. It would mean that the reaction is proceeding backwards.
March 7, 2007
Does salt water evaporate faster than fresh water? No. The reduction in vapor pressure and evaporaton rate is related to the fraction of the surface that is salt ions instead of water molecules. The Na+ and Cl- ions are not volatile.
February 15, 2007
Can someone please help me find, or know of any molecules that are at least 20 bases (carbons, nitrogens..) long and have 3 hybrids (sp, sp2, dsp)
December 28, 2006
You throw a beanbag at a wall with 7 colored squares, each with an area of 1/4^2. If you hit a square, you win a prize. What is the probability of winning a prize? You need more information. For starters: 1) what is the total area of the wall? 2) Are landings on the wall ...
December 5, 2006
Social studies.. need help
What did the peolpe in Jamestown eat? Jamestown is where John Smith lived... Thankssss http://www.apva.org/exhibit/eats.html THANKSSSS!!!!!!!!!!!!!!!!!!!! LANCEEEEEEE!!!!!!!!!!!!!!
November 21, 2006

subset: commoncrawl


text:
From an email from the PDGA this morning:
"As part of this review process, the Technical Standards Committee is gathering feedback from a wide range of stakeholders who are affected by these rules. Perhaps the most important part of that feedback should come from our member players. Therefore, we have set up a poll to gather opinions on some of the key topics of interest. As regional representatives, we are especially interested in your opinion. We also ask that you encourage members in your area to make their opinions known via the member poll, which will be sent to them via the e-newsletter."
so when you receive the email from the PDGA please take time to fill out the survey (takes less than 3 minutes as it allows YOU a voice in the decision making process!
thanks for your time


text:
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The Digital Rocking Chair's curator insight, November 30, 2014 12:29 PM
Matthew Poe: "The true crime podcast has become an addiction for millions of listeners -- and the reasons why might be useful for any storyteller."
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Dominique Taste's curator insight, December 2, 2014 1:45 PM
Analyse fouillée des mécanismes du storytelling à l'oeuvre dans ce podcast-feuilleton qui rassemble plus d'1,5 million d'auditeur chaque semaine à la radio.
La storytelleuse et productrice, Sarah Koenig s'est détourné des codes classiques de narration anglo-saxonne, en créant une fiction interactive avec un personnage de narrateur. L'originalité du récit est que l'auteur elle-même n'en connaît pas l'issue. Donc aucun risque de spoiler, le suspense reste intact.
Jeni Mawter's curator insight, November 23, 2014 6:27 PM
The fixation with all things Dystopian is going to have an interesting effect on a Society that is furiously avoiding the difficult issues, in effect refusing to grow up!
The Digital Rocking Chair's curator insight, November 17, 2014 3:57 PM
Charlie Jane Anders: "Worldbuilding is the bedrock of science fiction and fantasy. We obsess about it constantly, because characters and plots are often only as compelling as the worlds they inhabit. We've decried bad worldbuilding before -- but what makes worldbuilding great?"
The Digital Rocking Chair's curator insight, November 27, 2014 1:10 PM
Keith Stuart: "Games industry professionals can make gaming communities more tolerant by actively promoting and exhibiting inclusive values, according to new research. "
Art Jones's curator insight, November 23, 2014 9:28 AM
We live in a time when we are embracing the sharing society. Sharing society seems right for the times we live in and we have embraced Airbnb and Uber because of it, however the sharing ethos isn't new Inupiat people, their lifestyle is showcased within this game, have been a sharing society for for eons. Youth of today need more games like this, where mindfulness and life lessons are intertwined with a fund adventure game experience.
The Digital Rocking Chair's curator insight, November 16, 2014 3:31 PM
Indiewire: "Need some help getting your web series out into the world? This guest post from the director and producer of "Allston Xmas" has some tips just for you."
The Digital Rocking Chair's curator insight, December 4, 2014 12:50 PM
Catalina Albeanu: "Knight Foundation has today published a guide intended to help media outlets produce their own interactive storytelling projects."
Diane Goodman's curator insight, December 5, 2014 4:32 PM
8 storytelling strategies - great for storyboarding a video, writing a script or conceptualising a short story. The graphics tell it all.
The Digital Rocking Chair's curator insight, November 24, 2014 12:38 PM
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David Collet's curator insight, November 24, 2014 8:50 PM
This is a new technology that is just getting started. Huge start-up costs. But... it is an opportunity for a creative young person to be in position to carve a niche for themselves.
Elodie L's curator insight, November 25, 2014 5:41 AM
I might try netflix finally, documentaries are that easy to see freely online :-)
The Digital Rocking Chair's curator insight, November 23, 2014 3:27 PM
Eric Johnson: "The hopes for VR movies are huge, but there are a few technical kinks to work out first."
Christian Murray's curator insight, November 26, 2014 6:53 AM
OK a personal moment of levity. Ha ha ha ha hee hee. You know i tried to reach Jaunt after they put out an open invitation for anyone with experience to call them. They did not even have the courtesyto respond!
Much like Mr Einstein and Tesla i am man who wants to share his experience and knowledge but it seems they are all locked up in their own little world and think that IP should remain 100 percent theirs. There is not one part of what they have attempted to do original! They are stumbling along a road that many others conquered long ago. They may be motivated, inspired, possibly passionate. STUDIO Execs of LA if you invest in these folks you are investing in hard development and it will still take them years to figure it out unless they just copy the proposed solutions i put forth over the years. OR you could hire me. However i think with my hard critique they will take it personally and not respond anyway!
I do like having a blog it allows me to vent my frustrations :-)


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Ralph Lauren Home
Made of silver-plate brass and lined with teak, these Ralph Lauren Home boxes have a handsome industrial look. The Stretton (top) measures 10.5" l. x 7" w. x 3.5" h. and costs $595; the Bleecker is 9" l. x 6" w. x 4" h. and sells for $395. ralphlaurenhome.com, 888-475-7674
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Bottega Veneta
Bottega Veneta's geometric enameled-silver rings make a striking statement. Shown in gray, light gray, and black, they also come in pink; $820 each. bottegaveneta.com, 212-371-5511
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Cathy Waterman
Jeweler Cathy Waterman imparts a romantic sensibility to her sterling-silver Guinevere flatware. The hand-hammered pattern costs $3,760 for a five-piece setting and is sold at the Madison Avenue and Beverly Hills locations of Barneys New York. barneys.com, 212-826-8900
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Christofle's Arborescence console re-creates tree branches in mirror-polished stainless steel. The table is pictured with a gray smoked-glass top; clear glass is also available by special order. It measures 47" l. x 12" w. x 26" h. and costs $6,900. christofle.com, 212-308-9390
Photo courtesy of Christofle
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William P. Sullivan
Sculptor William P. Sullivan has produced an ebonized version of his cast-resin Cape Linden mirror exclusively for Maison Gerard. It is 45" h. x 36" w. and sells for $19,800. maisongerard.com, 212-674-7611
Photo: Robert Levin, courtesy of Maison Gerard
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Manuel Canovas
With its vibrant printed-and-embroidered floral pattern, Manuel Canovas's Sara linen-blend fabric evokes a lush, tropical feel. Shown in rose indien (other colorways are available), it is offered to the trade at Cowtan & Tout. cowtan.com, 212-647-6900
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Elson & Co.
Elson & Co.'s Hatch rug, designed by artist Sally King Benedict, uses repetition to mesmerizing effect. The New Zealand–wool rug comes in pink (shown) and green and can be ordered in custom colors and sizes; $42 per sq. ft. elsoncompany.com, 800-944-2858
Photo courtesy of Elson & Co.
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Restoration Hardware
The Objects of Curiosity collection from Restoration Hardware features an array of reimagined artifacts, including this Kisber Cavalry horse fragment, modeled after 19th-century equestrian carvings. Conceived by French reproduction artist Stéphane Davoy, the plaster sculpture is 11" tall and costs $130 (online and catalogue only). rh.com, 800-910-9836
Photo courtesy of Restoration Hardware
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Kathryn McCoy Design
A profusion of natural stone turns Kathryn McCoy Design's Torch table lamp into a shimmering accent piece. In addition to the clear quartz pictured here, the lamp comes in amethyst, citrine, pyrite, and other materials. With a clear-Lucite base, it stands 35" tall and is priced from $3,250, shade not included. kathrynmccoydesign.com, 858-487-3600
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Paola Navone
Comfort and style meet in the Waive chaise longue, part of designer Paola Navone's Dolce Vita suite for Janus et Cie. The 74"-long seat comprises synthetic-wood planks and a powder-coated-aluminum frame, shown in bronze; $1,695. janusetcie.com, 800-245-2687
Photo courtesy of Janus et Cie
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Juliska's Firenze collection lends the classic beauty of Florentine marbled paper to stoneware. Shown in delft-blue and pistachio (cappuccino is also available), the 14"-dia. charger and 9"-dia. dessert plate cost $68 and $36 each, respectively; a set of four 7"-dia. cocktail plates is $88. juliska.com, 888-414-8448
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Susan Harter
Bring the English countryside indoors with Susan Harter's Cotswolds mural wallpaper. The 3'-w. panels come in sky (pictured), earth, and mist colorways and can be customized to make a continuous pastoral scene; to the trade. susanharter.com, 857-277-1033
Photo courtesy of Susan Harter
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Fendi Casa
Designed by Toan Nguyen for Fendi Casa, the Blixen chair, named for the author of Out of Africa, is a contemporary interpretation of a safari essential. The 33"-h. steel frame is outfitted with a removable leather seat, which is offered in five colors, including the dark gray, shown here; $3,080. fendi.com, 800-634-4043
Photo courtesy of Fendi Casa
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Horticulture goes haute with Prada's chic garden-tool set, packed in a green canvas bag with leather trim. Complete with gloves and an apron, the kit sells for $2,200. prada.com, 212-334-8888
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Cultivated Gardens
The generous breadth of the Footed Ogee Vaso porcelain planters by Cultivated Gardens provides ample room for a dramatic mass of blooms. Offered in green and gray (shown) as well as yellow, the vessels measure 15" dia. x 8" h. and are $125 each. cultivated-gardens.com, 202-316-4102


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The first version of the plugin is now released
The plugin will be available through dcupdater soon but for now here is the link for people want to play with it:
Let me know if you run into any problems. Since it's the first time I've written a plugin for FARR and the Delphi
framework itself is new as well there could be some small issues. Sofar I haven't had any problems with it myself
but you never know how people are going to use it
I'm looking into how I can add some useful scoring and other more complex stuff. Right now it just lists the results
in the FARR results window. If anyone has an idea on how to best add the scoring......
Good luck!
And Mouser, thanks for the webspace/email! You rock!
[edited to correct url -- mouser]


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- Neema Aggarwal
- New York, NY
- United States
Electrical Engineering Student, The Cooper Union for the Advance,
This conversation is closed.
Do we rely too heavily on technology for medical diagnosis?
This week in my bioelectricity class, we discussed electric fields that can be measured on the body (eg the brain, skin, eyes) and the ability to interpret signals for diagnosis, lie detection etc. Currently, there exists clinical decision support systems (CDSS), which are interactive computer software systems designed to aid doctors with medical decisions. Various test results and other data from the patient is inputted into a CDSS which then processes it and provides a list of possible diagnosis and options for treatment. The problem is, like all machines, they can often make crucial mistakes.
Dr. Lisa Sanders, a physician at Yale School of Medicine, and technical adviser for the popular TV show, House, wrote a book called "Every Patient Tells a Story" dealing with the uncertainty doctors face when analyzing a patient's symptoms. Sanders says that misdiagnoses account for as much as 17% of medical errors. She discusses how despite the many technological advances made recently, sometimes these diagnostic tools are to blame. Relying too heavily on machines and lab results can result in symptoms being missed. Or on the other hand, sometimes exam results are normal; blood tests, electrocardiograms, CT scans, all may suggest a healthy body even when that is not the case. It can take a trained, experienced eye to notice small details in the patients' behavior to unravel the mysteries of an unknown illness. Sanders states, "For all the data they collect, machines lack important components for diagnosis. They cannot hear a patient's story, touch a patient's skin, or look into a patient's eyes."
My question is, have we become too dependent on machines and technology to make medical decisions for us? Have doctors been lured into a false sense of security by allowing tools like CDSS to provide answers? How can the value of intuition which comes only from experience be balanced with technology without being lost? Can machines ever be a good enough substitute for doctors?
Kyung Lee
Apr 1 2013: Hi Neema,
- +5
I understand the concern, and I think it is important to train doctors to realize that machine-produced data should not alone dictate their diagnosis. It requires an experienced eye to check the validity of machine-produce data, and vice versa. As long as doctors equally value their experience and machines and do not rely too heavily on either one, I think technology can only help us in medical diagnosis.
Apr 2 2013: I agree Kyung.
Humans make mistakes as well. In most cases, human error occurs much more frequently than machine error. Technology is quite useful when it comes to redundancy of outputs and consistency. However, the most fool-proof way would be to have a check system where the doctor and machine must be in accordance. The reliance on technology is useful as it save human time and allows for a higher level of productivity.
Apr 3 2013: Jon has a great point. I think that Doctors and Computer technology must act together. Building on each's ideas and discoveries.
Doctors today gain SO MUCH information from the medical technology at their fingertips. In fact, when one hospital doesn't have the right test equipment, they'll send out a patient to get a certain test just because every bit of extra information can make a difference!
However, as Neema suggests, there is a case to say that perhaps too much weight is placed on the information of a computer. Computers have an incredible ability to synthesize information and compute probabilities, but they cannot think outside of the box (literally) when it comes to information that needs to be viewed in a more creative manner. This is why Dr. House gained so much popularity. He was a doctor who was able to come up with diagnoses based on facts that were often NOT based in medicine or tests. There is so many more factors than just test results that go into proper doctoring and ultimately that is why services such as webMD.com will never truly be able to replace good old fashioned medicine!
Hadar Cohen
Mar 31 2013: Hi Neema!
- +4
Thank you for posing this question, it is definitely a very important one to discuss. I do think that in a lot of cases we have become too dependent on technology, not just medically. If electricity would one day disappear, our society will not understand how to recreate and advance in many ways. This is a tremendous loss to the intellectual brain.
In the case of medical diagnosis, I think Dr. Lisa Sanders is right. Medical conditions are often dependent on personal details that machines fail to capture. Doctors need to understand the patient in order to be able to diagnose the condition properly.
Very insightful question!
Mark Thurow
Mar 31 2013: The answer to this question is yes, as it is to any group becoming too reliant on technology. Like all things in life it is about balance. The best practitioners of any skill balance the old and the new, technology and intuition, patience and agression. Those that understand the balance are the ones that can turn a skill into an art.
- +3
For thoe who have decreed it is about generating revenue, you may be right in a few cases. In my experience though, it has been more about the fear of loosing money from having to pay out a settlement on a lawsuit, rather than generating the revenue of the test itself.
In listeneing to many medical practitioners at different levels I think the biggest and fastest growing shortcoming is the ability to listen. Society is moving away from direct perosn to person, face to face contact, and the ability to ask questions, listen for nuance andsubtelty in answers and then answer patient questions seems to me to be the bigger lost art that would negate much of the need for excess technology.
Apr 1 2013: Hi Mark
Thank you for your thoughts! Do you work in the medical field?
Out of no experience, only opinion, I also agree that we rely too heavily on technology for medical diagnoses. Apart from the misdiagnoses and lawsuits and money settlements, the loss of personal care and and custom patient diagnostics is getting lost in the wires of technology. Medicine is no longer about understanding the patient, the story and the symptoms, but about being able to control a machine and read what it pops out. This isn't to say that medicine has lost the need for skill and education, but I fear that push-a-button technology makes room for much error and turns medicine into more of a business than an honorable profession.
Mark Thurow
Apr 2 2013: I have been a paramedic for over 20 years Swetha. I see this craving for technology from both sides of the equation. Not only do the practitioners want this high tech protection, but I think the patients do as well. I have seen and heard patients unhappy that providers are not more aggressive in providing the latest technology in testing, when old fashioned testing is proven to be just as efficient or older treatments just as effective. Newer is better, it is what has made Apple into the giant it is.
- +2
Ibrahim Moss
Apr 2 2013: Hi Neema:
- +2
You question is really provocative. And, not one that is easily answered. Before trying, however, I wonder whether you have seen this little TED talk: http://www.ted.com/talks/katherine_kuchenbecker_the_technology_of_touch.html
As for me, I say more technology. My position assumes most doctors are incompetent. There is a kind of blind arrogance that many have. They just make judgments after half reading chats and half listening. Some are fundamentally biased. Knowing this, I would strongly encourage not only more technology, but also data inputs on the patient side that describes symptoms. These inputs can be accomplished in a physician's office, and while the patient is waiting to be seen by his or her doctor. Once these things are inputted, certain triggering analyses may take place to help the physician make best judgment decisions.
I am actually developing a module that addresses this issue, If interested, feel free to contact me.
Apr 2 2013: Ibrahim,
I think this concept of both practitioner and patient controlling inputs to produce a possible result is absolutely the right direction. I do see a problem, in that so much of our population is not comfortable with technology and I am not sure if they will provide that part of the inputs accurately. I think this has some fantastic aplications in distance treatment of patients or in using sealth care surrogates to expand our service networks and allow more in home attention and time with patients. It might not be M.D. with patient time, but surrogate with patient time that then translates to better information to MD and better use of MD time. Sounds optimal. I would love to see how you envision using this approach.
As to the arrogance or Messiah complex of many in the health care profession, it is a difficult line to walk. I want a surgeon with b**ls made of iron and as big as grapefruits who is unflustered by whatever he or she meets while I am on the table. But before that, I want a diagnostician who is communicative and questioning and willing to second guess herself. And afterwards, I want a practitioner who is warm and caring and knows how to work with all the devils within my psyche to get me on my feet and on the mend in the fastest possible time.
Apr 2 2013: Hello Mark:
I think most persons, sans the very elderly, critically injured, or those with physical challenges can manipulate a simply designed medical UI. Just think of the millions of people around the world who input data into things like Facebook. They tend to get it right.
Geoffrey Lee
Mar 31 2013: There's a precursor to this question that should consider the quality of a healthy experience. In the US we tend to rely on governance to dictate our expectations of health and in turn our perception of a reasonable diagnosis and outcome. All while using presumptions of freedom to promote and shape our efficacy. Considering the ridiculous things that the FDA, EPA, etc endorse subjecting our bodies to without hesitation, diagnostic conflict and divergence should be expected. Practicioners in every field at some point begin to feel as if their tasks are sisyphean, the burden of proper advocacy falls to them and their ability to positively challenge perception and effectiveness. Similarly confidence is a feature of every bartered trade and product, in medicine safety and security is a more pronounced component in healthcare as opposed to other industries. As such it's also a major point of leverage for bad decision making processes.
- +2
To answer your core question, practicing medicine is a technological process. Be it a stethoscope, or the ability for a patient to effectively communicate their symptoms, depth of knowledge and ability is an immutable constraint of quality. Experiences institutionalized within a defunct system will never be able to keep up with the dangers we introduce into ourselves and our environment. Be it technology co-opted to cause harm or resolve it, the nature of our ethos will always be pitted against the quality of our experience.
However students of health and medicine will likely continue to misplace their affinity for the field of study as well as their genuine interest in it. As they approach their education as standardized rigor, with less and less direct practicality, their lack of fear and accountability in the pursuit of being practicioners will likely degrade the actual benefit of their participation in the industry.Mar 31 2013: Interesting conversation!
Has anyone considered the value of testing in remote-access medicine? I'm thinking about experiments in the US with telemedicine communications between isolated practitioners in remote settings via internet access to experts in large medical centers with access to sophisticated testing facilities. Some test result analysis can be requested via long distance (blood work and the like, or analysis of X-Ray images). Expert physicians are called upon to consult in the analysis and interpretation of test results in the patients' home town with their primary healthcare provider. This offers the benefit of extra input for isolated practitioners and no need for patients to travel a great distance for (at least initial) medical evaluation.
Apr 1 2013: Hi Donna,
I totally agree that remote-access medicine would benefit the outlook of medical care across the globe. This idea is among many that I think would augment the work of physicians both now and in the future through the use of technology. We could definitely use more of this, and other technology encouraging physicians to communicate and collaborate.
I just want to point out that like any good thing, too much of it could be harmful. I suppose the question at the heart of this conversation is as follows: how much medical technology is too much? Clearly, the question and the answer are both dynamic entities, which makes it rather difficult to nail down a quasi-definite solution...
Karl Meyer
Mar 31 2013: I don't think machines can replace good doctors, whose diagnoses are made by coupling facts with experience. As far as I can tell, there are two broadly defined ways of thinking about making diagnoses:
- +2
1) One that emphasizes experience over fact. Ayurveda and other "eastern" ways might fall into this category because they draw on extremely long traditions of observation and experience. For example, like Jayprakash mentioned, an Ayurvedic doctor can take an almost insignificant fact (subtle variations within the pulse), and relate it to the centuries of experience that has gathered in the course of the Ayurvedic tradition.
2) One that emphasizes fact over experience. The western tradition falls into this category. Here, doctors gather masses of factual data, and look for trends. One's experience is limited to how often one has seen a trend, and since technology is capable of furnishing us with such copious factual information (upon which we base our experience), western medicine has become very technological.
Naturally, these gross simplifications do not capture the reality, even if they may help to organize our thinking about the topic. I believe there are many permutations of fact and experience.
A parting thought: there is an idea that any technology we use is an amplification and extension of our natural senses and abilities. Moreover, this kind of intensification changes our behaviour. A gangster behaves much differently with a gun than with a stick. It seems that the march of technology proceeds without much thought given to its effect on our behaviour.
How has our medical behaviour changed?
Lauren Bayer
Mar 31 2013: I agree that technology cannot replace good doctors, and that we need to continue to train our doctors to interact with patients when making their diagnoses. However, one can not deny that technology has greatly enhanced the entire medical field. It is now much easier to detect certain diseases with the use of technology, and many new successful treatments have been developed against historically un-treatable diseases using the latest advances in technology. Obviously, technology has its faults and their diagnoses can be mistaken - but so can humans. Doctors are sued all the time for malpractice. I believe that by combining technology with the expertise and care from doctors, then we can greatly reduce mis or mal diagnoses and greatly improve the medical world.
- +2
Apr 2 2013: I do not believe the medical profession has become too dependent on machines and technology when it comes to making medical decisions. Although I have no experience as a doctor or surgeon, I know that technology has only enhanced my engineering education and work outside of school. For this reason, I want to see technology as limitlessly useful in all fields.
Although I believe Karl Meyer was making a different point, I agree that technology is an amplification and extension of ourselves. Further, it is also an excellent defense against malpractice lawsuits which plague today's doctors and surgeons, as mentioned by Lauren Bayer.
If learning about the risks of relying to heavily on CDSS makes you nervous about your doctor or surgeon, it is important that you research your doctor or surgeon before trusting them. Speak with them, research their practice and investigate the hospital they may work in in order to learn about their experience and reliability, especially when using this technology.Mar 31 2013: I believe the experience of a doctor must always be used in order to validate and justify the findings of technological equipment. I think this issue you bring up goes far beyond just the medical field. How much can we as humans rely on technology, machines, and 'robots'? Machines are designed and programmed to do their job and only their job, doctors are trained to use their education, experience, and decisions to make clinical decisions. Such traits hopefully enable a doctor to make the correct diagnosis, but unfortunately that's not always the case. Hundreds of test can be run with different kinds of machinery, but it takes the keen eye of a doctor to make the resolute decisions. Unfortunately, both the machine and doctor are subject to error, but without one or the other, I don't think any patient can truly be treated properly.Mar 30 2013: We may first consider a case where diagnosis is effective. This is so with regard to machines whose 'health' can be monitored periodically or continuously by analyzing say vibration signals with good software. This is because the science involved is known though in rare cases there may be problems of interpretation.
The human machine is far more complex. While good technology picks up the signals accurately their interpretation is far more involved. Medical expertise of known doctors may be built in into the software but still it falls short.
The extent to which technological diagnosis can be used is not easy to define. Caution should be the watch word.
Another issue that concerns me is the diminishing role of general practitioner who has the capability to look at the patient in a holistic manner. Each expert is looking at one part of the body thoroughly as if they are independent. We should give more emphasis to general medicine and make it more valuable.
When experience really helps in diagnosis it may perhaps be termed insight rather than intuition. Any interesting idea like figuring out the disease by sensing the pulse alone by a vaid can be useful if it can be translated into a diagnostic tool for others as well. The validity of claims also then becomes established. Research is needed.Mar 30 2013: Hey Neema!
This question reminds me of this time last year, when my modern physics professor bemoaned the fact that we (the students) were of "the wolfram alpha generation." He said we had grown to depend on websites like wolfram alpha to solve integrals for us, and so our intuition wasn't where it should be, for engineering students who have to use calculus every day. Of course he was absolutely correct, and I think it applies here, as well. I think it's important to note that the machines are doing the jobs they were programmed to do, but also that there is a risk in putting too much faith in them. Doctors who use diagnostic machines on a daily basis can lose their intuition, and those that have trained only alongside the machines might not trust their intuition at all.
On the other hand, when a diagnosis is needed, it's needed as fast as possible. Misdiagnosis can happen whether it's coming from a person or from a machine, and the more resources we have, the better. Unfortunately, I've never worked in a hospital, so I can't really say the extent to which doctors actually do depend solely on the diagnosis from the machines, but I'd have to imagine that it's balanced with their own diagnoses and hunches.
Mar 31 2013: Hi Hindi,
I do agree the the ideal situation would be a perfect balance between machine diagnoses and a doctor's own hunches. And you're right that misdiagnosis can happen from a person as well as the machine. I wonder if there was some way to ensure that the balance remained without one side being weighted more heavily than it should?
Jasvin Singh
Mar 31 2013: Before there were machines, there was Pulse Diagnosis.
- +1
Neema, this is such a relevant question today, and will continue to be so tomorrow. A small example; I work in the medical field, and operate one of the machines doctors rely on for diagnosis (and love my job), but I work in a small community of people, and when I inadvertently hear back from patients, friends, and even my co-workers in the field, the caregivers that work so hard, about all the medical bills they are slapped with for one ER or hospital or urgent care visit, I can't help but feel extremely guilty about my pay check that comes from the suffering of my friends and co-workers.
There are good, bad, and ugly scenarios in every situation, and I have experienced doctors ordering all kinds of tests without really spending time at the patient's bedside. I have also experienced patients who rely heavily on medicine to solve all the consequences of an unhealthy lifestyle, with no regard for their own bodies.
Mar 31 2013: Hi Jasvin,
Very interesting perspective. Do you think there could be a way to prevent doctors from ordering multiple tests without first studying the patient themselves? I wonder if any standards be implemented so that a doctor is spending enough time looking for the problem himself balanced with the information received from tests?
Apr 1 2013: Dear Neema
There is no way to prevent unnecessary tests except ethics. But ethics is difficult to define and more difficult to maintain. Speaking of experience in India only there are interesting ways of doing them. One is just in case.... My son suffered from severe headache and the doctor says 'I do not think there is any tumor problem. But just to rule it out please get a scan done'. The other is more direct-I am the doctor and I know what is to be done. Yet another problem sometimes is the routing of the patient.I went for treatment of mild case of spondyltis. The reception directed me to neurologist. After examining several X-rays of cervical zone plus tests in ENT(you have to walk with closed eyes+other tests) the diagnosis is mild spondylitis. The whole effort is costly. Is this all necessary? Suppose my spondilytis has deteriorated how do I know?The other way is first treat it as a mild case as the patient was free of the problem for three years with simple medication like Betavert tablets. Similar dilemmas exist. When should a heart by-pass be done? The interpretation of the level of blockage is the problem. If the surgeon is in a corporate hospital that 'expects' them to do a minimum number per month more bypasses than necessary can happen. Unfortunately good public hospitals that used to serve us well are deteriorating with few exceptions.
The above discussion is to elucidate the problem involved in developing criteria for ethics. But ethics do exist and the philosophy to promote is to say service first and money next.
Can something practical be done to check the problem?
probably internal audit by hospitals to see how effectively treatments were done and whether unnecessary tests were involved is a good starting point.
adesh saxena
Mar 31 2013: A doctor should not depend on technology to make a provisional diagnosis but take help of technology to arrive at a final diagnosis.Mar 29 2013: It depends. I recently thought I was having a heart attack. They kept me over-night during which time I didn't sleep and than made me do a stress test on a tread mill in the morning in a hot room. I thought they were trying to kill me. I wasn't in shape for that and had chest pains. And example where they don't use technology enough is that I believe the day will cone soon when no psychiatric diagnoses will be considered professional or compete without a sleep study. We spend billions on trying to hammer children into an appearance of normality which is just really acquiescence when the fact of tier behavioral issue could be tied to the level of sleep, whether they achieve delta waves and HGH is released to allow their brains to grown needed capacity. I think it's a primitive matter to deduce some kind of psychosis in a child and not even examine their sleep life, And that takes technology.Mar 29 2013: Well, I think technology is very very useful to understand the unknown world but it has also got some limitations. We have to take the results with pinch of salt. But in most case what doctors do is to rely heavily on test results for diagnosis. This may be because of human nature to protect one self from any kind of blames or responsibility.
- +1
In India, there were Aurveda doctors called " Vaid". They had excellent understanding of our body. I still remember, when I was 12, I had visited one such Vaid along with my father. He was around 65. He was diagnosing every patient by just pressing his hand on one's wrist & noting down the pulses. I still wonder how come he was able to diagnose the problem of any part of body by just watching pulses ? No instruments ! No tests ! And yes, he was no quake. I did a kind of small survey of patients & found that he was 98% correct about the diagnosis !
Though it is very sad that this kind of knowledge has not been passed to present generations but the point is that many of the ailments can be diagnosed without any tests but we have become very much dependent on technology and we are loosing faith on our own intelligence ! ( or may be we are not trying to test our intelligence ?)
Mar 29 2013: Hello Jayprakash,
Wow, that is really incredible. I wonder if that was just a gift or a real skill that could be taught and passed along. I agree with you that human nature is to protect ourselves from blame and perhaps that is why it is easier to let the machines make the difficult decisions rather than face them ourselves.
Comment deleted
Mar 30 2013: ".....any illness is attributable to an imbalance of our inner energies, so they treat the cause rather than the symptoms." ya, that is the root of Aurveda system. And that is one of the reason that treatment as per Aurveda takes long time as it tries to treat the root cause. But the real paradox is that people do understand but do not have " time" and ultimately they prefer quick fix.Mar 30 2013: Oh, that was not just a gift. They do study Aurveda and after years of experience they are able to get hold of such quality. It is really skill & it is unfortunate that nobody is interested to acquire & learn that skill and because of that, the skill has almost died. I did try to contact such Vaids & all had one answer - we want to teach but nobody really interested are coming forward to learn this. Sad but true.
What I think should be done is to take knowledge of such persons and blending that with modern technology can provide us very low cost instruments that can diagnose most of our ailments.Mar 28 2013: Sharing my personal family experience of the machine and the medical specialist, in a nut shell. An electrical voltage fluctuation during an X-Ray of the Chest - the machine part. One of the leading Chest specialist is consulted, on the recommendation of the family doctor, he sees the x-ray and without much ado comes to the conclusion that Cancer is spreading fast, and rolls out a very grim scenario in front of the family members.
Thank God some one in the family has the good sense to seek another medical opinion. This time round the machine declares, nothing is wrong !! The family member lived hail and hearty for another 10 years.
Ben Jarvis
Mar 28 2013: the problem is that a symptom can a result of an absolutely huge number of possible medical causes. misdiagnosis may account for 17% of medical errors, but that figure would be far higher if technology wasn't available to eliminate some or most of those possibilities. are these errors a result of technology or despite it? do you have a figure for the percentage of misdiagnosis 20 years ago?
- +1
also if technology is still producing errors, surely the better option would be to improve the technology rather than just abandon it?
Barry Palmer
Mar 27 2013: "Can machines ever be a good enough substitute for doctors?"
- +1
The key to this topic is "good enough". Diagnosis is never good enough. No one would have considered building a machine to help doctors with diagnosis decisions if doctors were good enough. Fortunately this is a question that can be answered by the scientific method. If you ask one of the people who sell these machines, I am sure s/he could provide you with the research studies that demonstrate that the machines improve the diagnosis results.
With all of our advances in medical knowledge, you would expect that medical practice would now be a very scientific process, and that misdiagnosis would be rare. Unfortunately, diagnosis is still, often, a doctor's best guess. In medical school they teach doctors that when in doubt, the more common diagnosis is usually right, so most doctors will never diagnose an uncommon condition.
The bigger and more important question is, why is diagnosis still more art than science?
IMO, the answer is the love of money. In the USA doctors are paid by the procedure. Diagnosis is not nearly as profitable as many other procedures. So diagnosis does not get the resources needed to get a quality diagnosis. The most critical resource is, of course, the doctor's time. Hence the critical economical opening for a machine to do the doctor's job. I am a big fan of capitalism, but it does have its down side.
Mar 27 2013: Hi Barry,
Very interesting! I hadn't even considered the economic side of this, but I do think you are right. The way our system is set up now, the amount of time and money required for an excellent diagnosis is probably not available or entirely profitable for doctors. I just hope it does not come to a point where diagnosis is reduced to completely depending on a machine's output with little effort on the doctors part for the sole reason of being more profitable for the hospital or physician.
bart hsi
Apr 3 2013: I agree with you on the diagnosis by the physicians is dependent on how much time and effort s/he could devout to a patient visit. However, this problem is actually more critical in Canada, and also in the U. S, because the physicians have generally either be "hired" by the government, or by the hospitals so that they are not allowed to spend too much time on a single patient. In the U. S. many physicians who take the Medicare patients will be paid by a fixed amount regardless of how much time you spend on him. And of course in 2014, almost all patients are being insured by the government programs. But the diagnoses by the machines in laboratories will be billed by the labs directly so the physicians don't have to worry about the restriction imposed on charges on lab tests. This certainly put a disincentive for more physicians' personal observation of the patients and instead to order lab tests. .Therefore this bad situation may or may not be caused by capitalism, and in my view this could be worse than a free-market medical practice system.Apr 3 2013: Great Question.
- 0
Based on my hospital experience of a year ago, when I passed out & was taken to the ER.
Too many tests & not enough dialogue with the Drs.
And, when you're in that situation, suddenly, as a patient, your intuition and better judgement can become clouded.
Comment deleted
Mar 29 2013: Hi Kate,
Very interesting! I have heard a lot about ancient techniques from Asian countries having been very accurate and useful for centuries. I wonder why we don't try and revisit some of those. Perhaps you're right, every aspect of our society has become so economically driven, hardly anything is developed unless it is monetarily beneficial.Mar 28 2013: as far as i can see, the doctors are becoming too much addicted towards the modern technology. but they miss the big picture. the life of a human being is at stake and only based on the decision a doctor makes their life can be saved. but they rely heavily on a machine as if its a god and what ever it says is true. the doctors should use only use it as a diagnostic tool and should never fully rely on their machines output. they can be used in simpler cases. but in complex cases you cant keep a knife on a human being only based on a machine's output & that too without full analysis of the report. its the stupidest thing you can ever makeMar 28 2013: Yes,Yes,Yes. I recently had a spell of what the doctors call numbness (I said it was tingly, the going to sleep feeling) that came and went in a matter of minutes over a three day period. Upon going to the doctor it was declared I was having a stroke. CT scans, multiple, and MRI's and sonograms and many other test showed nothing was wrong. No one ever asked about what foods, activities, or drug changes I might have experienced. The almighty machines ruled even though they could find nothing. I immediately made some life style changes and the problem ceased. I really don't know if the doc's were right or wrong, but their dependence on technology did not help them and they have not yet come up with a theory.Mar 28 2013: No
Peter Diamandis talks about this quite a bit.Mar 27 2013: Although this is not relevant, I think we as a society (I am in Canada) are far too reliant on drugs and other such technology too 'fix' us.Mar 27 2013: Neema, could anyone answer this question besides a doctor?
Mar 28 2013: Hi Greg,
We could consider it from a patients point of view as well? If you felt something was wrong in your body but the doctor said tests appeared to be normal, would that be enough for you? Or would you press for the doctor to consider his own intuition or experience and spend a greater length of time trying to find the problem?Mar 27 2013: Hi I study nursing in S.Korea. In my short opinion, development of CDSS harm the intuitions which doctors have. However, there are many unfully trained doctors are in the medical field and only CDSS can help them to prevent to make mistakes. It is true that it has side effects as you mention in the body. in medical field, bad situation always happens in the ignore something. If doctors recognize a tumor as a inflammation, it gonna be a bad situation. However, if doctors think a inflammation as a tumor, it also going to be a bed situation but not bed as that. And this is reason way medical center hire professors and highly trained doctors; screening it. However by the develop ment of technology, we may not need doctors anymore.Mar 27 2013: The mark of the good doctor, I should think, is to use both intuition and the results of medical tests to come to her best conclusion but also to consider and communicate other possible diagnoses that may explain the symptoms the patient presents. Some doctors likely have great confidence in their intuition (whether those intuitions are in fact good or bad) and others are probably more reliant on other sources of data, including the possible interpretations of medical tests.
Mar 28 2013: Hi Fritzie,
I absolutely agree, ideally some kind of combination of intuition and tests would likely yield the best results. But what happens if doctors become to comfortable just sitting back and letting the tests and machines speak? What if intuition is slowly ignored and forgotten?
Fritzie -
Mar 28 2013: I think doctors understand that tests help by providing some measures, but that the narrative including those data and other observations is for the doctor to construct with the help of his/her experience, intuition, and training. There would be nothing gratifying in sitting back and letting machines speak.
- +1
I think many people are quick to suggest other people might have the inclination to become comfortable and sit back lazily. A useful reality check might be to ask yourself, if you trained to make professional judgments by using your intuition together with the data tools can provide, do you imagine you would then just sit back comfortably and let tests and machines speak? If you believe you would not, why would you suspect such an inclination in others?
Mar 31 2013: I wish we could rely on doctors being motivated by their work.
Unfortunately, a great many doctors are motivated by money. Many doctors who are not primarily motivated by money work for people who are motivated by money, and the employer determines the conditions of their employment and places limits on the way they work.
The motivation for money is not evil. We all work for a paycheck. Doctors and nurses are not evil because they want their children to go to good schools.
The problem with the medical industry is that our culture continues to believe in the illusion of a "health care system." When we recognize that we are dealing with an industry and start using the economics of that industry to improve the results, we will get better results. Medical professionals must compete.


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Skyfall (2012)
Skyfall SynopsisDaniel Craig is back as James Bond 007 in Skyfall, the 23rd adventure in the longest-running film franchise of all time. In Skyfall, Bonds loyalty to M is tested as her past comes back to haunt her. As MI6 comes under attack, 007 must track down and destroy the threat, no matter how personal the cost.
Skyfall Release Date
In Theaters November 9, 2012
Skyfall Credits
Starring: Daniel Craig, Javier Bardem, Dame Judi Dench, Ralph Fiennes, Albert Finney, Naomie Harris, Bérénice Marlohe, Helen McCrory, Ola Rapace and Ben Whishaw
Written by: John Logan, Neal Purvis, and Robert Wade
Directed by: Sam Mendes
Produced by: Barbara Broccoli and Michael G. Wilson
MPAA Rating: [ PG-13 ]
Distributor: Columbia Pictures
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The Damascus High School girls basketball team's memory is sharp. And fortunately for the Swarmin' Hornets, their game is pretty sharp as well.
After losing a 19-point first half lead in last year's Class 3A West Region final against Frederick, top-seeded Damascus refused to allow itself to see another huge lead erased late in the postseason.
On Friday, the Swarmin' Hornets quickly established a 34-20 halftime lead against visiting South Hagerstown, and extended it to 22 points in the fourth quarter, allowing themselves to clinch the region crown with a 60-42 victory.
Damascus, which gained a measure of revenge by downing Frederick in the regional semifinals, will now advance to the Class 3A state semifinals at the University of Maryland, Baltimore County's RAC Arena on Thursday for a 7 p.m. matchup against Aberdeen, the North Region champion.
"We had one slip away last year," said Damascus coach Steve Pisarski. "We had a big, big lead last year, and we let it slip away and we thought we were the better team. We didn't want that to happen again this year."
Just to make sure it wouldn't happen, Damascus (22-2) led from the opening tip, as the Rebels never came within double digits after the first four minutes of the second quarter. Two free throws by senior Becky Barret gave the hosts a 26-16 lead four minutes before the end of the first half, and the Swarmin' Hornets took total control from that point.
"[Winning the region championship] feels great," said Barret, who tallied 13 points and grabbed 13 rebounds. "It's like I am really so excited that I still have adrenaline pumping. It's like one of the best feelings ever because this was my senior year, and my last game ever on this court, and we got a great win, and now we are going to UMBC for the state tournament."
Despite the final margin of victory, and the Swarmin' Hornets' efficient efforts on both ends of the court, the hosts did not see any lack of effort from South Hagerstown, which sported a starting lineup without one senior.
"They were so tough, they [South Hagerstown] don't quit, and in the [state] semis [our opponent], certainly aren't going to quit," Barret said. "Even though this game wasn't really close, it felt like it because they just kept fighting and never gave up. But we had memories of last year, so we did not let up."
Junior guard Jenna Kaufman led Damascus in scoring with 15 points. She also added four assists and four rebounds. Classmate Kelli Prange added 14 points, 11 rebounds and three blocked shots. A third junior, Lauren Green, chipped in with nine points and 10 rebounds.
"We were just trying to get inside, and I got some open looks driving, so I took them," Kaufman said. " This feels so amazing, we have been waiting for this for so long, and I'm just ecstatic."
Freshman guard Celensia Dickson led South Hagerstown (21-3) with a 17 point-effort. Junior forward Tayana Stewart contributed nine points for the Rebels.
"It's been a lot of years, and we've been in a lot of region finals without winning on [in recent years]," said Pisarski. "We've been in five or six of them since our last [championship] in 2004. The girls worked hard for this. They were conditioning in September when we came back to school, after playing summer league and AAU. [All season] they have played hard and they earned it, they never complained. They had their eye on this, and hopefully we'll go a little further. They deserve it."
Damascus 60, South Hagerstown 42
S. Hagerstown 10 10 12 10 — 42
Damascus 18 16 17 9 — 60
South Hagerstown (21-3): Lindsey Bedregal 5; Chelsey Scott 4; Katrice Dixon 5; Alexis Longfellow 2; Celensia Dickson 17; Tayana Stewart 9.
Damascus (22-2): Jenna Kaufman 15; Lauren Green 9; Anna Warfield 7; Kelli Prange 14; Katie Culbertson 2; Becky Barret 13.


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If you can dream it, you can do it. -Walt Disney
Quality is a great business plan. -John Lasseter
Let's make some funny pictures. -Tex Avery
I never considered a difference of opinion in politics, in religion, in philosophy, as cause for withdrawing from a friend. -Howard Zinn
When critics sit in judgment it is hard to tell where justice leaves off and vengeance begins. -Chuck Jones
And what do you benefit if you gain the whole world but lose your own soul? -Jesus
A man should never neglect his family for business. -Walt Disney
What's most important in animation is the emotions and the ideas being portrayed. -Ralph Bakshi
Once you have heard a strange audience burst into laughter at a film you directed, you realize what the word joy is all about. -Chuck Jones
Before enlightenment: chop wood, carry water. After enlightenment: chop wood, carry water. -Buddhist Proverb
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NEW!, Zey The Mouse Test Shot No. 2!! Clara Cat!
Showcase your drawings, illustrations, video and media.
3 posts • Page 1 of 1
NEW!, Zey The Mouse Test Shot No. 2!! Clara Cat!
Hi, all
I have been working on a new Test Shot (2)
which involves Clara Cat!, she is in the 'Chestnut Hall' Kitchen, walking and getting her cup and putting it in the sink!!
I personally think that it runs smoother this time round!
I hope you enjoy watching?
Re: NEW!, Zey The Mouse Test Shot No. 2!! Clara Cat!
Very good! There's a bit of shakiness going on with the camera. I realize it's a test shot but you want to keep this in mind next time. The set is very nice! A lot of conscientious work in that and it shows. Your attention to detail is excellent.
Daily Z
Re: NEW!, Zey The Mouse Test Shot No. 2!! Clara Cat!
Thank you Charles, i'm glad you liked it!
i have a big list now, of thing's to be aware of!!
also thanks for continuing to follow 'Zey'!!
3 posts • Page 1 of 1


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38 CFR 42.21 - Discovery.
(2) Requests for admissions of the authenticity of any relevant document or the truth of any relevant fact;
(b) For the purpose of this section and §§ 42.22 and 42.23 of this part, the term "documents" includes information, documents, reports, answers, records, accounts, papers, and other data and documentary evidence. Nothing contained herein shall be interpreted to require the creation of a document.
(c) Unless mutually agreed to by the parties, discovery is available only as ordered by the ALJ. The ALJ shall regulate the timing of discovery.
(1) A party seeking discovery may file a motion with the ALJ. The motion shall be accompanied by a copy of the requested discovery, or in the case of depositions, a summary of the scope of the proposed deposition.
(2) Within ten days of service, a party may file an opposition to the motion and/or a motion for protective order as provided in § 42.24 of this part.
(5) The ALJ may grant discovery subject to a protective order under § 42.24 of this part.
(1) If a motion for deposition is granted, the ALJ shall issue a subpoena for the deponent, which may require the deponent to produce documents. The subpoena shall specify the time and place at which the deposition will be held.
(2) The party seeking to depose shall serve the subpoena in the manner prescribed in § 42.8 of this part.
(3) The deponent may file with the ALJ a motion to quash the subpoena or a motion for a protective order within ten days of service.
(4) The party seeking to depose shall provide for the taking of a verbatim transcript of the deposition, which it shall make available to all other parties for inspection and copying.
Title 38 published on 2014-07-01.
No entries appear in the Federal Register after this date, for 38 CFR Part 42.


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Lt. Governor Ellspermann Names Executive Staff
Indianapolis- Lt. Governor Sue Ellspermann announced her executive office team today. The staff is made up of individuals from former Lt. Governor Becky Skillman's office as well as several additional hires from the public and private sectors. The staff began working Jan. 14.
"I have surrounded myself with a professional and devoted staff that will make Indiana a better place through their hard work and dedication," said Lt. Governor Sue Ellspermann. "I will challenge my staff to exceed the expectations of Hoosiers."
Legislative Director – Ryan Heater will work on legislation and policy pertinent to the lieutenant governor's office, agencies and state government. Heater previously worked for the Indiana Cable Telecommunications Association and was responsible for their government affairs initiatives. He also worked in the Indiana House of Representatives as a legislative assistant. He is a graduate of Purdue University and the Indiana University Robert H. McKinney School of Law.
Deputy Legislative Director – Daniel Workman will oversee legislative committees and work with the legislative director to work on and shape policy pertinent to the lieutenant governor's office and agencies. Workman worked under Lt. Governor Becky Skillman as a special assistant. He is a DePauw University graduate.
Intergovernmental Affairs – Marita Steltenpohl will serve as the link to issues and policy between the lieutenant governor's office, state legislators and local units of government. She worked for Indianapolis Mayor Greg Ballard as Deputy Finance Director and Operations Manager. Steltenpohl has a degree from IUPUI.
Press Secretary – Tyler Stock will be responsible for the lieutenant governor's communications and media. He served in the same capacity under Lt. Governor Becky Skillman. He also served as a press secretary in the Indiana House of Representatives. Stock is a graduate of Butler University.
Scheduler – Nancy Ketterman served in the same capacity under Lt. Governor Becky Skillman and Attorney General Steve Carter. She is a graduate of Ball State University.
Constituent Services Director – Karen Davis served in the same capacity under Lt. Governor Becky Skillman. She also worked in the North Gibson School Corporation for 23 years. She is a graduate of the University of Evansville and has a Master's from Indiana Wesleyan University.
Special Assistant – Joey Fox will aid the lieutenant governor in all of her travels while handling all logistics and details for every event. He previously worked for Indianapolis Mayor Greg Ballard and Beech Grove Mayor Terry Dilk.
Administrative Assistant – Sarah Rossier will manage the day to day operations of the lieutenant governor's office. She previously worked for Malinowski Consulting and was a deputy legislative director for the Association of Indiana Counties. Rossier has a degree from Indiana University.
Previously announced
Chief of Staff – Tonya Brothers-Bridge
Senior Advisor – David Terrell
Lt. Governor Sue Ellspermann oversees the Office of Community and Rural Affairs, the Indiana Housing and Community Development Authority, the Office of Tourism Development, the Office of Defense Development and the State Department of Agriculture.


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Gummi shot glasses are shown here, but the same idea could be applied to chocolate with or without various jams as filling, or other candies (gummi-types are recommended). You can also use this mold/tray to make awesome chocolate cake shots.
Note: If you're underage and feel like getting drunk, don't - if you do, don't blame me.
Also Note: The mold used here is from thinkgeek.com - it's intended for making ice shot glasses which are awesome, but not as tasty as gummies.
And one more note: If your finished shot glasses are a little on the sticky side, try a (very) light dusting of corn starch, and make sure to keep them cool if you can. Both will help cut down on the stick-factor.
Step 1: You'll Need. . .
- Nifty Fred silicone shot glass mold available from thinkgeek.com
- Bowl for melting gummies (microwave safe, please!)
- 16 ounces gummi worms (or bears)
1. Glasses are very sticky
2. Glasses melt extremely quickly and turn into a mess/fall apart
I'm not quite sure what I'm doing wrong since you don't seem to have these issues.
My process: Cover mold with confectioners sugar. Melt the gummy bears for about 45 seconds in the microwave. Pour into mold. Freeze for about 2 hours. Remove glasses. I was really looking forward to making these for a few Thanksgiving parties but it's just not working.
Even 5 minutes after taking them out of the freezer and putting them in the fridge they still melt. I did notice my freezer is set to the warmest setting so maybe they weren't getting cold enough.
I'm still planning on making them and I guess I'll just tell people to eat them quick.
Few more things since you're around. I made one, left it in the freezer for about an an hour and a half. I dusted the inside of the mold with corn starch but it was still hard to get the glass out without crushing it. Additionally the glass was not hard and easy to misshape and finally it was very sticky. What are your recommendations?
Hope that helps!
On the other hand, by utiliizing your Instructable, my Fred mold & my gummies, I will create a vastly similar product at less than 1/4 of their cost!
- Filling a large container with corn starch and inverting a shot glass into it in several places (open side down). Then fill these spaces with the melted gummies.
- As you mentioned, placing a small plastic cup (lightly oiled) inside of a larger cup and taping the two together along the rim.
Please let me know how it goes!
Thanks for all your help!
Ingredients - Corn Syrup, Sucrose, Gelatin, Citric Acid, Apple Juice Concentrate, Sodium Citrate, Natural and Artificial Flavor, Coconut Oil, Carnauba Wax, Ascorbic Acid (Vitamin C), Red 40, Yellow 5, Blue 1
Hope that helps!
I was also thinking to maybe spray the mold with pam before pouring in the gummy bears, but idk... PLEASE HELP!!
Just as a note, I had to totally invert the mold (as pictured in the picture in step 3) in order to unmold them (they don't just slip out). If you pull on them as gently as possible with the mold inverted you should be able to get them unmolded without any major issues.
I inverted mine also, the outside of the shot glass was perfectly fine, the only issue I had was the inside of the mold itself ( like where the alcohol would go normally ).
I will try this again tonight with cooking spray. I really hope this works. I was soooo excited about this...
Also, any other ideas as far as what I can melt and put into the mold to use?


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Ive never had any issues with bike parts. Last cover I checked had somewhere around 12% zinc ( easy to believe with a die cast part ). 4043 or 4047 were appropriate in that case. One of the best investments I ever made was getting an ultrasonic heated cleaner to rattle aluminum castings clean, its a night a day difference. Always used one at work....finally had to shell out for one.
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04-09-2010, 11:32 AM #11"Better Metalworking Through Research"
Miller Dynasty 300DX
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Miller Spectrum 375 extreme
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Smith, Meco, Oxweld , Cronatron, Harris, Victor, National, Prest-o-weld, Prest-o-lite, Marquette, Century Aircraft, Craftsman, Goss, Uniweld, Purox, Linde, Eutectic, and Dillon welding torches from 1909 to Present. (58 total)
04-09-2010, 12:34 PM #12Senior Member
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It corrodes to a Dark gray like Magnesium, but it isn't Magnesium. How do you correctly match a filler when you have no idea what alloy it is? Honda does occasionally use pure Magnesium for outer case parts on their racing bikes (HRC), but this was a factory part.2007 Miller Dynasty 200 DX
2005 Miller Passport 180
Aerometal worker please elaborate about yor little machine, What size part does it hold.
4043 is all I've used on almost all those and seriously I don't recall the mag rod I have had forever, but it is very expensive.
Now all that said I'll give you a bit of wiggle room here. I have done bunches of Honda stuff but I may have never done the exact case you are referring to.
From my perspective, if a guy brings me a part, I am gonna do my dangdest to get his money. We did have one local welder that would weld your pontoon and then coat his work with JB. I pretty much took every customer he had that hadn't run him off.
I truly wonder if that cast was very high in mag and if so how a mag richer filler would work. That I have NOT tried but as of yet never needed to. I cannot find anywhere something like 5356 is recommended for a casting, altho I have heard people speak of it. Temp would make it a problem anyway.
You can bet I will be looking specifically for a CR250 repair now just because I am curious. I fix loads of their other stuff. Like outboard lower units, PWC engine parts, and small motor and ATV engine stuff.
BTW, I'm never sure what any casting I am dealing with as far as actual composition. It would be nice to know but seldom practical to pursue on my part.
If you (or anyone) finds Honda's composition info on this I would love to here the answer myself. Always looking for an edge.
Miller Dynasty 700...OH YEA BABY!!
Miller Dynasty 280 with AC independent expansion card
Miller Dynasty 200 DX "Blue Lightning"
Miller Bobcat 225 NT (what I began my present Biz with!)
Miller 30-A Spoolgun
Miller WC-115-A
Miller Spectrum 300
Miller 225 Thunderbolt (my first machine bought new 1980)
Miller Digital Elite Titanium 9400
MikeDogg, this is not a bad repair if you take your time and don't get in a hurry. I do quite a few of these on bikes and especially ATVs where the front sprocket is close to the transmission/engine case. The clients will try to skimp on chain quality and/or maintenance and the chain will break and wedge between the sprocket and trans and blow a hole in the case.
Usually the customer will still have the piece or it is somewhat still attached and can be put back in place with little effort. Sometimes I have to fabricate a new piece to fill the void.
Either way cleanliness is the key. I haven't had the best luck of V-ing the already thin casting. I generally clean in the solvent tank after disassembly, spray with a non-clorinated (make sure it is non-clorinated) cleaner, lighlty run a Roloc disk over the area to remove the surface irregularities and then I will use a heat gun to try to extract as much oil from the casting as possible.
I then make a small bead alongside the crack preferably on both sides to "float" the impurities to the surface. One thing I have had great results with is to set the machine to pulse at a high rate if you have access to an advanced squarewave machine. This greatly helps to get the impurities to the surface. After making the preliminary passes, wire brush the surface very well and then fuse the area together generally 4043 rod seems to work the best.
Also, depending on the size of the case half (some are quite large and do a good job of dissipating the heat and others are very small and can warp fairly easy. If the part is on the smaller side I clamp it to my welding table to act as a large heat sink and also to help it hold it's shape with less chance of distortion.
After the part has cooled and the repair looks solid I run it across some sandpaper that I tape down to my surface table and lap the part to make sure it is perfectly flat. No sense in going through all that work on one leak and create another.
Good luck, Mike.
05-06-2010, 09:37 PM #16Senior Member
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I just welded a Kawasaki cylinder head, with excellent results, with my Dialarc HF.AutoArc 230 (MM 210)
3035 spoolgun
Spectrum 625
Dialarc HF w/Coolmate 4