d****d
发帖数: 214 | 1 A conversation with Robert Lefkowitz, Joseph Goldstein, and Michael Brown
Ushma S. Neill and Howard A. Rockman
Published May 1, 2012
Today we shift the format of our Conversations with Giants in Medicine and
allow three of our most charismatic giants (Robert Lefkowitz, Joseph
Goldstein, and Michael Brown) to interview each other (Figure 1). Lefkowitz
(Duke University) is known for his seminal discoveries in understanding G
protein–coupled receptor function. The legendary partnership between Brow... 阅读全帖 |
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t******g
发帖数: 372 | 2 u can, as long as u have the lib type accounted for
check the package vignette for a similar analysis |
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l**********1
发帖数: 5204 | 3 so what? if your found can solve solid wet or hard bio can’t solve non-
linear trend between
count level and variance by Deseq or other softs ?
pls refer,
01-16-2013, 12:40 AM #1
JesperGrud
Junior Member
Location: Odense
Join Date: Aug 2012
Posts: 5
DESeq and independent filtering
Hi everyone
I know this topic has been up a few times, but yet there is a question. So
the basic idea about filtering is that it is done unsupervised to remove
genes that are too lowly expressed to become signif... 阅读全帖 |
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b******a
发帖数: 90 | 5 I just started using the step2 qbank at UW, and was surprised that I can
finish only about 40 questions per hour. (I never had such problem with
the step1 qbank or real step1 exam). This is already day 3, still no
improvement. Very very depressed and very very worried! How
fast can you read those vignettes? Is there really that much reading in
the real exam? And why there are no problem sets or match questions in UW?
(USMLE.ORG says there will be sets and match questions)
Thank you for sharing y |
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e*****a
发帖数: 1334 | 6 The Qbank Plus also includes "Integrated Vignette" (simple Qs) and "
Physiology Qbank". Unless you get a deal for the Qbank Plus, the regular
Qbank is all you need. |
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l*********0
发帖数: 85 | 9 Old man come to ER, after falling down his head to ground a few hours ago.
Presentation: Severely headache; shortly unconciousness, now awake; BP 159/
99 mmHg; respiratory 13/min; HR 66/min; right pupil dilation; mild left
hemiparesis.
CT will be
A subdual haemorrhage; B tonsil herniation; C cingulate herniation; D uncal
herniation; E SAH.
If you can correctly answer this within 1.5 min, you are almost ready in
your neurology part. |
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l**********e
发帖数: 382 | 10 D. ipsilateral dilated pupil is usually the first sign. |
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l*********0
发帖数: 85 | 12 REMEMBER
Subarachnoid blood can be detected on CT scanning in as many as 60% of
people with traumatic brain injury.
SAH can also show pupil dilation and paresis, unlike uncal herniation, it is
not necessary to be ipsilateral together
D is a big trap, ..., the answer from other sources also say 'D' which is
not correct according to the above links. |
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c*******s
发帖数: 399 | 13 你的分析只能说SAH 是可能性之一， 根据你列的题目的关键词， fall， headcche，
pupil dilation， ，不能排除uncal herniation
是不是把原题在列一遍呢
is |
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l*********0
发帖数: 85 | 14 Ipsilateral pupil dilation and ipsilateral hemiparesis in UNCAL HERNIATION
This pateint has righ pupil dilation and left hemiparesis, against uncal
herniation.
If I am wrong, please correct me.
The following is pasted from wiki link
Uncal herniation
In uncal herniation, a common subtype of transtentorial herniation, the
innermost part of the temporal lobe, the uncus, can be squeezed so much that
it goes by the tentorium and puts pressure on the brainstem, most notably
the midbrain.[5] The tentor |
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c*******s
发帖数: 399 | 15 you are right, did not pay attention to right pupil
very tricky question
that
the |
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s******t
发帖数: 579 | 16 I would choose A (with Cushing triad):
1. "right pupil dilation; mild left hemiparesis" - Can BE induced by either epi
- or sub- dural hematoma.
2. The pt is old
3. the trauma was not very sever
I would not choose SAH. |
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S******9
发帖数: 2837 | 17 A
old man spontaneous
fluctuating level of consciousness
herniation |
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l*********0
发帖数: 85 | 18 Thanks for you explaination.
May be, you are right, we have to consider acute SDH.
Neurological findings associated with acute SDH may include the following:
Altered level of consciousness
A dilated or nonreactive pupil ipsilateral to the hematoma (or earlier: a
pupil with a more limited range of reaction)
Hemiparesis contralateral to the hematoma.
However, considering this: 'Subarachnoid blood can be detected on CT
scanning in as many as 60% of people with traumatic brain injury', the
possibili |
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l*********0
发帖数: 85 | 19 Classical SDH would show slow onsite due to the slower bleeding speed of
vein than artery or arteriole, patient feel good until after several weeks
of injury (choronic SDH), that was probably told by FA or GJ
Frequency
Acute subdural hematomas (SDHs) have been reported to occur in 5-25% of
patients with severe head injuries, depending on the study. Chronic SDH has
been reported to be 1-5.3 cases per 100,000 people per year. More recent
studies have shown a higher incidence, probably because of b |
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d******t
发帖数: 28 | 20 I will say the symptom of "pupil dilation and mild left hemiparesis"
probably is due to secondary effect of injury. The Q is not clear about the
pt's conscious level, ("awake" does not mean too much) if GCS score is
around 8, I will say most possibility should be uncal herniation induced by
secondary mass (epidural hematoma) effect. Acute subdural hemorrhage usually
has a very severe primary brain contusion and injury (more than epidural).
If this is the case (subdural), the pt's GCS probably is |
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s******t
发帖数: 579 | 21 Thanks Drsheart and Sillymd for your correction and explanation. I though I
know something about neurology, now, I found that I need lots of work on it.
Let me summarize and go though the answers one by one. Please correct me if
I am wrong!
A - subdual haemorrhage
Acute subdural hemorrhage usually has a very severe primary brain contusion
and injury (MORE than epidural). If this is the case, the pt's GCS probably
is even lower and might keep in the unconsciousness, can not be awake again.
(Thank |
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l*********0
发帖数: 85 | 22 Thanks all of you great explaination, Drsheat and Stardust made more clear.
May be, the following explaination will be helpful:
Examination:
1. Level of consciouness
- often depressed, either transiently or usually persisently
- important predictor of outcome / severity
- use GCS to grade (see WFNS grading below)
2. Pupils / Eyes:
- assess for oculomotor palsy (pupil fixed & dilated, ptosis,
ophthalmoplegia)
- can be due to early uncal herniation in comatose patient but more often (
in awake SAH |
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l*********0
发帖数: 85 | 23 Some more need to be clear.
4. Meningismus:
- nuchal rigidity important sign in patient with suspected SAH but takes 6-
12 hours to develop (in this patient, injury hapens a few hours ago, most
possibly less than 6 hours, so meninges sign might be absent)
- irritation of meninges by blood breakdown products ("chemical meningitis")
- may be absent or hard to detect in deeply comatose patients
5. Systemic Features:
- may see fever (neurogenic often), hypertensive response (to mainatin
cerebral per |
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d****y
发帖数: 2180 | 24 The best way for me to memorize is to pratice questions.
I think I remember someone said the integrated vignette Qbank is good too.
why do you |
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s**********1
发帖数: 68 | 25 I'm a little confused with the following question. Different forums have
different answers. Anybo
the following vignette applies to the next 2 items.
You have been treating a 5-month-old child in the neonatal intensive care
unit (NICU). He was delivered at 26 weeks' gestation by cesarean delivery
because of premature rupture of membranes. The mother is 18 years old and is
unemployed. There are two other children in the home. The father is not
living with them, and he has not been in contact with... 阅读全帖 |
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r*******r
发帖数: 52 | 26 昨天的talk实在是太精彩了，从头到尾听coffee和Dr.liu毫无保留真心相助，真是受益
太多了。 也实在佩服coffee，做事做人到她这个地步，不match是不可能的。非常感谢
medwater和hmis的组织，两位也不时穿插自己的理解和经验，相信都是听者受益。已经
很多同学还有速记员同学贴上了talk笔记，我印象比较深的还有这几点：
coffee：
1取消match对CMG影响应该不会很大
以前大量的prematch给了印度年轻的毕业生。CMG拿到的比重相比印度人还是小很多。
我们CMG大部分来美国时间长，有绿卡，取消prematch之后对绿卡的要求更多，结果是
CMG受到的影响要小很多。
2.找见习不要一上来就要推荐信，经过一段时间相处，带见习的老师看到你是什么样的
一个人，到时候再提推荐信就是水到渠成的事情了。有时会有意想不到的收获。
3.推荐信：如果program要求3封，给4封比3封效果要好。 推荐信里至少有一篇写得要
好，可以拿得出手。reviewer看推荐信的时候也会被impress到。
4。推荐信里一些值得一提的品质：highly motivated; highl... 阅读全帖 |
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x***4
发帖数: 7 | 27 各位前辈老师好，
自己在复习step1 first aid中发现vignette的部分在问题后会附一个小字的章节名称
加阿拉伯数字。自己不懂是什么意思，想请教。
例如在药理这章
28-year-old chemist presents with MPTP exposure → what neurotransmitter is
depleted? → dopamine. Pharm.53
这里的Pharm.53是指的什么书的53章或53页吗？那又是什么书呢？
谢谢 |
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A******s
发帖数: 77 | 28 I used LANGE, liked it. each card has a little clinical vignette. I used to
go over one section a night before bed time. Straight memorization wasnt for
me. However with that said It was over kill for my step 1. The questions I
got on the actual exam was more or less straight from FA. |
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l*****2
发帖数: 13 | 29 从2013年7月份决定考board，到今年4月27号考step1，复习的过程当中经历很多神的恩
典，得到很多人的帮助，还没考的时候就决定考完了也写个考经，既是总结回顾一下自
己这一年多来走过的路，也可以帮助后来的人更好地准备考试。
2012年12月来美国做博后，当时想着两年后很可能是会回国的，没想过要考board。1个
月后来到教会团契认识了我的他，7月份开始成为恋人。为了两个人将来可以在一起，
我开始考虑要留在美国（他在美国读了硕士拿H1B工作），科研其实并不是我真心热爱
的，做一个儿科医生给孩子们看病却是一个怎么也熄灭不了的梦想。于是下定决心要考
board。开始了解这个考试，看ECFMG booklet, 看USMLE bulletin, 看前辈们发的帖子
，看FA后面推荐哪些复习材料，制定自己的复习计划——
Study schedule
English listening and talking: 6 months for VOA, then MD. House, 30 min/day
8/7-8/11: High Yield embryology, low-yield sub... 阅读全帖 |
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j*******k
发帖数: 209 | 30 一、 材料篇
这里点评一下我用过的学习材料。我看过的书不多，其他一些我没看过的好书，这里就
不介绍了，大家可以参考别的考经。
1） MTB2 (Master to Board)：全5星推荐。绝对经典，堪比考试重点。初看
时感觉编写有些杂乱，不如MTB3清晰，但在熟悉后再看，方觉字字珠玑，主要考点均有
覆盖，而且在诊疗路径方面，层次比较突出。若能深入理解、熟练背诵，考试的基本面
可保无忧。
2） MTB3：2星推荐。考点方面与MTB2基本一致，但是编写方式有所不同，个
人觉得该书更适合STEP 3，不太适合CK。有同学建议，某些科目可以与MTB2结合使用，
这是仁者见仁的问题，所以若有时间，仍然值得一阅。
3） FA：全5星推荐。考点覆盖面广，面面俱到，堪比考试大纲，还涉及诸多
STEP 1的知识点。熟悉本书内容后，可弥补MTB2知识点的不足；其中的流行病学和统计
学，也比较详细，弥补了其他书的不足。缺点：在诊疗路径方面，层次和先后顺序不是
很突出。
4） Kaplan notes：4星推荐。按学科分类编纂的参考用... 阅读全帖 |
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T****g
发帖数: 705 | 31 Lingas’s Step 3（Score: 220+）经验：
Lingas是印尼华人，英文比中文好，于是我们麦地第一位英语考经分享出炉。也让我们
领略到还有象她一样的CMG群体，也如此热心，无私地与我们分享各种经验。
“复习时间”：从四月份到八月份，但前两个月只是很松散地学习，后两个月才开始
Intense study，并且是Part Time。
离考完CK考试越近，考Step 3效果应该越好。Lingas是去年12月考的CK，今年为了支持
签证，就在申请前拿到了Step 3分数。考试之前一直在做临床实习，发现很多东西和在
印尼的临床有所差别，和正式的考试也是有所差别的。但临床实习对临床判断的锻炼是
对考试很好的贡献，毕竟，Step 3就是考临床判断的。比如，该把病人收住普通病房，
还是直接进ICU….
“复习材料”：UW Qbank plus Guidelines from Internet.
因为没有一本很好的考试备考书，就是以UW Qbank做主线。各种Guidelines都有free
resources, eg Medscape and Epocrates. 甚至没看完MTB... 阅读全帖 |
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w*****y
发帖数: 37 | 32 俺在加州，考LCSW, written exam考了两次才过已经够郁闷的了,去年12月去考
vignette,当下被告知fail by 1 point,差点没找块豆腐撞死。昨天board寄来一封信，
说我们rescore了你的exam,你已经通过了考试，可以直接申请license了
美国还有这么忽悠人的么？ |
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b*******x
发帖数: 100 | 34 vignette('topic','package') 如果有的话，可以打开一个类似manual的pdf文档。 |
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t******g
发帖数: 372 | 36 于server local与否无关，或者至少给些error log 别人也好知道你尝试了啥，
S/W Requirements:
-----------------
MySQL client library ("libmysqlclient.so") and header files
(see www.mysql.com). For Linux/intel you may use the binary rpms
client+devel+shared, and make sure you also have the header files,
they are *NOT* included in the following
MySQL-client-4.1.7-1.i386.rpm
MySQL-shared-4.1.7-1.i386.rpm
but they are included in the latest 4.1.7 rpm versions.
The library libz. This is a stan... 阅读全帖 |
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D**u
发帖数: 288 | 37 matrix 是square的？nonzero 多不多？是不是sparse的？
anyway, 可以考虑Partial SVD + Lanczos diagonalization。
简单说：
Partial SVD 是用k dimension 去 approximate n dimesion （k
后类似 cross validation 看看是不是converge。
具体对每个k dimension的用Lanczos就是一个block接一个block的diagonalization，
然后算eigen value。
相同道理，类似的方法也有不少，不过不知道是不是你想要的答案
这些都是可以stream line的， 程序写起来很麻烦，不过如果用R早就有人package好了
。强烈推荐
R 的 irlba package参见
http://cran.r-project.org/web/packages/irlba/vignettes/irlba.pd
可以跟bigmemory package 一起用，100GB data no problem。 |
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c***z
发帖数: 6348 | 38 【 以下文字转载自 DataSciences 讨论区 】
发信人: chaoz (没钱也任性), 信区: DataSciences
标 题: ［请教］一个R问题
发信站: BBS 未名空间站 (Sat Apr 25 14:31:06 2015, 美东)
我最近做life time value，用的BTYD包
http://cran.r-project.org/web/packages/BTYD/vignettes/BTYD-walk
里面主要的方程是
pnbd.EstimateParameters 它会call optim，使用L-BFGS-B method
pnbd.LL 这是Pareto/NBD的likelihood function
我能够replicate原文章的结果，但是公司自己的数据有这么三个issue
1. L-BFGS-B method requires a finite value for fn 应该是likelihood function
overflow了，我对所有数据先取一次log，基本上解决了这个问题
2. 非常非常的慢，即使我使用十分之一的数据，把data... 阅读全帖 |
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i*S
发帖数: 175 | 39
这里应该没有nest的关系，如果是(1|subjects/days)或者（1|subjects) + (1|
subjects:days)才表示days nest于subjects, 见 https://cran.r-project.org/web/
packages/lme4/vignettes/lmer.pdf |
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k*****e
发帖数: 22013 | 40 我也猜他那个可能是暗角的问题，
ps cs5里面有个"auto remove vignette"的选项
其他软件不知道。
还有一个可能就是原片重叠的区域太小了，
没有给软件留下足够的空间来过渡。 |
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k*****e
发帖数: 22013 | 41 another possible solution is to apply "remove vignette",
if applicable. |
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i*********5
发帖数: 19210 | 42 10 Hardest Races on Earth
http://triathlon.competitor.com/2010/03/uncategorized/10-hardes
Picking the hardest race on Earth was a little tricky. Of course, a full
iron-distance has to be tougher than a 70.3 race, but we wanted our winner
to have the toughest, not necessarily the longest, course. With that in mind
it was hard to pick anything other than Maryland’s Savageman Triathlon (
need to talk about how to lead into “vignettes”)
Savageman Triathlon
Location: Deep Creek Lake State Park, Maryl... 阅读全帖 |
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c***z
发帖数: 6348 | 43 我最近做life time value，用的BTYD包
http://cran.r-project.org/web/packages/BTYD/vignettes/BTYD-walk
里面主要的方程是
pnbd.EstimateParameters 它会call optim，使用L-BFGS-B method
pnbd.LL 这是Pareto/NBD的likelihood function
我能够replicate原文章的结果，但是公司自己的数据有这么三个issue
1. L-BFGS-B method requires a finite value for fn 应该是likelihood function
overflow了，我对所有数据先取一次log，基本上解决了这个问题
2. 非常非常的慢，即使我使用十分之一的数据，把data frame变成matrix也没有帮助
3. 结果不stable，几乎总是取得local optimal，我试着用了 mothod = SANN (
simulated annealing) 也没有帮助
有点stuck了，所以想问问大家
多谢多谢！
cha... 阅读全帖 |
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w*******y
发帖数: 60932 | 44 My first post. I searched and did not find anything of the same. Sorry if
this is a repost. Moderators, if this is not where it should be, please
advise and move as appropriate. Thanks!
Print the attach coupon and bring it with you to your studio session for a
free 16x20 wall portrait. Here's the fine prints.
"A complimentary
Personalized 16x20 Wall Portrait
$84.98 value (includes no session fee)
Additional fee for mounting and framing. Limit one free offer per family,
per visit. Enhancements... 阅读全帖 |
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发帖数: 1 | 45 来自主题: _FreeSpeech版 - [无标题] Shen Yun Explained
Posted December 31, 2017 Sydney
shen yun dancer
Shen Yun program coverThe title of this post is what it is because I
willingly bought tickets for Shen Yun based entirely on assumptions that
turned out to be entirely false. Maybe you have these same assumptions. I
had seen the advertisements, posters, and TV commercials for years, and
wanted to take my kids. Shen Yun appears to be a well-crafted production
showcasing the art of Chinese dance and, because of the dancers’ po... 阅读全帖 |
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T********r
发帖数: 6210 | 46 来自主题: _Rangefinder版 - 内牛满面 softness and heavy vignette, lol |
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