This presentation is from Performance Marketing Summit 2017 (March 14, 2017 in Austin, TX). Session description: How A/B tests lie to us, and how to drive genuine improvement.
Stuart Reid - When Passion Obscures the Facts:The Case For Evidence-Based Te...TEST Huddle
EuroSTAR Software Testing Conference 2010 presentation on When Passion Obscures the Facts:The Case For Evidence-Based Testing by Stuart Reid. See more at: http://conference.eurostarsoftwaretesting.com/past-presentations/
This presentation is from Performance Marketing Summit 2017 (March 14, 2017 in Austin, TX). Session description: How A/B tests lie to us, and how to drive genuine improvement.
Stuart Reid - When Passion Obscures the Facts:The Case For Evidence-Based Te...TEST Huddle
EuroSTAR Software Testing Conference 2010 presentation on When Passion Obscures the Facts:The Case For Evidence-Based Testing by Stuart Reid. See more at: http://conference.eurostarsoftwaretesting.com/past-presentations/
This is a crash course in A/B testing from the statistical view. Focus is placed on the overall idea and framework assuming very little experience/knowledge in statistics.
Evidence based medicine is now focusing on diagnostic tests: how accurate and useful could be ? sensitivity and specificity are no longer the important criteria for a test
How A/B Tests Lie to Us and How to Drive Genuine ImprovementWP Engine UK
Smart marketers know that A/B testing helps take the guesswork out of website optimizations. Often times though, A/B testing doesn't give you a true view of how your site or web page is performing.
In this presentation, WP Engine Founder & CTO Jason Cohen covers why tools that show “statistical significance” are often wrong, and how you can correct it, how to use insights from Google Analytics to drive A/B tests and what elements of your marketing campaigns should be A/B tested.
Diagnostic, screening tests, differences and applications and their characteristics, four pillars of screening tests, sensitivity, specificity, predictive values and accuracy
Disease screening and screening test validityTampiwaChebani
Full lecture covering screening tests and validity testing. Covers topics such as calculation and interpretation of sensitivity, specificity, positive predictive value and negative predictive value of a screening test.
AMC Clinical exam preparation Course ! AMC part 2 notes.pdfShahriarAhmedSujoy
To join AMC part 2 course contact +8801670636131
whats app
Facebook : shahriar ahmed sujoy
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#AMCClinical #amcpart2 #AMCmcq #AMCexamcenter #AMCnotes #Austratralian medical council exam #can u get job in australia after amc part 1 exam #isit difficult to pass amc exam
This is a crash course in A/B testing from the statistical view. Focus is placed on the overall idea and framework assuming very little experience/knowledge in statistics.
Evidence based medicine is now focusing on diagnostic tests: how accurate and useful could be ? sensitivity and specificity are no longer the important criteria for a test
How A/B Tests Lie to Us and How to Drive Genuine ImprovementWP Engine UK
Smart marketers know that A/B testing helps take the guesswork out of website optimizations. Often times though, A/B testing doesn't give you a true view of how your site or web page is performing.
In this presentation, WP Engine Founder & CTO Jason Cohen covers why tools that show “statistical significance” are often wrong, and how you can correct it, how to use insights from Google Analytics to drive A/B tests and what elements of your marketing campaigns should be A/B tested.
Diagnostic, screening tests, differences and applications and their characteristics, four pillars of screening tests, sensitivity, specificity, predictive values and accuracy
Disease screening and screening test validityTampiwaChebani
Full lecture covering screening tests and validity testing. Covers topics such as calculation and interpretation of sensitivity, specificity, positive predictive value and negative predictive value of a screening test.
AMC Clinical exam preparation Course ! AMC part 2 notes.pdfShahriarAhmedSujoy
To join AMC part 2 course contact +8801670636131
whats app
Facebook : shahriar ahmed sujoy
Instagram : shahriar ahmed sujoy
Youtube : shahriar ahmed sujoy
#AMCClinical #amcpart2 #AMCmcq #AMCexamcenter #AMCnotes #Austratralian medical council exam #can u get job in australia after amc part 1 exam #isit difficult to pass amc exam
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
9. Sensitivity 97%
Specificity 54%
H-FAB in AMI
125125
44
261261
315315
H-H-
FABPFABP
10. What does a +ve test
result mean?
What does a -ve test result
mean?
What answers do we really
get from a Truth table?
125125
44
261261
315315
H-H-
FABPFABP
11. H-FAB testing for AMI
• A +ve test means they have
the diagnosis
• A +ve test means they
probably have the diagnosis
• A +ve test means they are
more likely to have the
diagnosis than before I did
the test
125125
44
261261
315315
H-H-
FABPFABP
12.
13. • Medicine is a science of
uncertainty and an art of
probability.
22. Example - PERC rule
• Age>49
• Pulse>100
• Pulse Ox<95%
• Current haemoptysis
• Oestrogen use
• Previous venous thromboembolism
• Recent surgery
• Unilateral leg swelling
PERC Rule
sens = 97.4%
spec = 21.9%
^ Kline, JA; et al (2008).
"Prospective multicenter evaluation of the pulmonary embolism rule-out criteria".
Journal of Thrombosis and Haemostasis 6 (5): 772–780.
45. Diagnosis missedDiagnosis missed
They don’t comeThey don’t come
backback
It gets worseIt gets worse
The treatmentThe treatment
does not workdoes not work
Harm takes placeHarm takes place
They get betterThey get better
anywayanyway
They do comeThey do come
backback
The treatmentThe treatment
worksworks
Significant harmSignificant harm
avoidedavoided
Diagnosis madeDiagnosis made
..but the diagnosis is..but the diagnosis is
missed again!missed again!
53. • Good problem solving, sound judgement and
effective clinical decision making are
considered the highest attributes of physicians.
The theory and practice of clinical decision making
Croskerry P. Can J Anaesth 2005;52:1-8
54. Only when disclosure of uncertainty
becomes commonplace in medical practice
will the physician/patient relationship evolve
to a level of greater understanding and
satisfaction for both the physician and
patient.
55. 4 Things
• You are not a diagnostician
• You are a risky doctor
• You get lucky (a lot)
• The dangers of diagnosis
56. 4 Things
• You make probability assessments
• You take risks (but you understand them)
• Even when you miss, you usually get lucky
• Pursuing a diagnosis is not always right
Editor's Notes
General question as ice breaker Common reasons likely to be labels, prognosis, therapy. Ultimately because it is useful to know. BUT the key to a rational diagnostician is that it should be beneficial for the patient and not just the physician
55 year old man with 2 hour hx of chest pain. no risk factors. previously fit and well
Digivote slide Answer is 90-95%
Digivote LR +ve 2.138 LR -ve 0.057
So as a clinician we have no idea whether our patient has the right diagnosis or not. We just know that they probably do or they probably don’t. Even with tests that have a high sensitivity.
Howard Atwood Kelly (February 20, 1858 – January 12, 1943) was an American gynecolo gist . He was one of the "Big Four" founding professors at Johns Hopkins Hospit al . [1] (The "Big Four" were William Osler , Professor of Medicine; Will iam Stewart H alsted , Professor of Surgery; Howard A . Kelly, Professor of G ynecology; and William H. Welch , Professor of Pathology.) Kelly is credited with establishing gynecology as a true specialty. [2] Harvey Williams Cushing , M.D. (April 8, 1869 - October 7, 1939), was an American neurosurgeon and a pioneer of brain su rger y, and the first to describe Cushing's syndrome . [1] He i s often call ed the "father of modern neuro surge ry. Thayer prof medicine at John Hoplins
Point 1 you are not a diagnostician
Point 2 is that..... Probability So if we accept that we have a probability issue then we have a problem of risk.
chest pain tests.
Digivote
1666 ?PE patients in 13 US and NZ EDs Gestalt plus PERC gives the following PERC Rule sens = 97.4% spec = 21.9% Designed with acceptable miss rate of 2% Even in this study PEs were missed. ^ Kline, JA; Courtney, DM; Kabrhel, C; Moore, CL; Smithline, HA; Plewa, MC; Richman, PB; O'Neil, BJ et al (2008). "Prospective multicenter evaluation of the pulmonary embolism rule-out criteria" . Journal of Thrombosis and Haemostasis 6 (5): 772–780. doi : 10.1111/j.1538-7836.2008.02944.x . PMID 18318689 .
Digivote
6.9 % pre test probability of PE. Kline study multicentre 8138 patients gestalt plus PERC
Point 3
Sequence has to be completefor harm to occur IN appendicitis. Miss diagnosis, not come back early, not get recognised, not get to theatre, not respond to treatment, not survive.
Sequence has to be complete for harm to occur IN appendicitis. Miss diagnosis, not come back early, not get recognised, not get to theatre, not respond to treatment, not survive.
So what have we established thus far?
Monty hall Game Show - let’s make a deal in the 70s
headache low risk chest pain dvt/vte appendicitis bacterial infections in children meningitis
