wherein the system makes it possible to compile a personalised diagnosis base for each patient and to generate the triggering of appropriate alerts.
The invention relates to a health surveillance system comprising a medical diagnosis which is made by a medically-qualified person (11) in relation to a patient who is being monitored remotely, e.g. at home, via a communication network. The invention is characterised in that the medically-qualified person (11) links medical data (2) to health actions (3) in a server (1) using surveillance rules. The invention is further characterised in that the server (1) programs a remote terminal (9) which is located close to the patient, such that the remote terminal (9) uses an automatism (5) which applies the surveillance rules to the medical data supplied to the terminal by at least one sensor (8) which is associated with the patient and/or by a man/machine interface of the remote terminal (13) and/or by a man/machine interface of a network station (12) and/or by the network (7).
generate alerts in the event said health actions are not executed by said users, wherein the system makes it possible to compile a personalised diagnosis base for each patient and to generate the triggering of appropriate alerts.
generate alerts in the event said recommended health actions are not executed by said users, wherein the system makes it possible to generate the triggering of appropriate alerts.
generating at least an alert, taking into account at least one of said alert protocols, in the event said recommended health actions are not executed by said users.
6. The health monitoring method according to claim 5, wherein the step of configuring is implemented by the users by use of a second man-machine interface, connected to a data server via a communications network, said monitoring rules being recorded and indexed with said health actions in said data server, and wherein in the step of obtaining alert protocols, the alert protocols, in the event that a realised health action would be different from the corresponding monitoring rule, are input and sent to said data server, and wherein the step of applying said monitoring rules and the step of generating at least an alert are implemented by automatisms being programmed using said medical data and said health actions indexed in said data server, provided in said distant terminal, activated by said distant terminal.
analysing the compatibility of said alert protocols thus obtained.
inputting and indexing health actions, such that it is possible to compile a personalised diagnosis base for each patient.
9. Computer program product downloadable from a communication network and/or stored on a medium that can be read by computer and/or executed by a microprocessor comprising program code instructions for implementing the health monitoring method according to claim 5 when said program is executed on a computer.
applying by said automatism at least one of said monitoring rules to at least one of the medical data provided to said distant terminal by said first man-machine interface of the distant terminal, where said at least one of the medical data has been input by said medically-qualified person, in order to associate with said at least one of the medical data a health action to be executed, and generate an alert in the event said health action to be executed is different from the health action executed by at least a user.
11. The method according to claim 10, wherein in the step of applying, said at least one of the medical data input by said medically-qualified person is information contained in a syntactical expression following a medical observation.
intensity of pain, state of fatigue, alterations in the state of consciousness, and difficulties in speaking.
13. The method according to claim 10, wherein in the step of associating, at least a first data provided by a sensor and at least a second data in the form of information contained in a syntactical expression following a medical observation are associated with an health action.
saving said medical data, said health actions, and said monitoring rules onto a server connected to said communication network.
sending at least one of said medical data provided by a sensor that belongs to the patient and/or by the first man-machine interface of the distant terminal and/or by the second man-machine interface of the networked station and/or by the network to the medically-qualified person via said communication network so that the latter takes into account this data sent in order to possibly modify the monitoring rules associating data and health actions at the level of the server.
blood pressure, heart rhythm, body temperature, skin temperature, sodium content on the skin, kinetic and/or kinematic parameters of the body, blood dosage, analysis of urine and/or stool and/or blood gas, weight, electrocardiogram data, heart sounds, oxygen saturation, and thermal image.
17. The method according to claim 10, characterized in that the data provided by the network is related to results of biological examinations and/or functioning of a piece of equipment connected to the network, in particular home automation equipment for detecting presence, control of access, heating, lighting, openings, fire, flooding, mains cut-off and/or a medical device, related to an alarm signal or any signal resulting from the transformation of measurements and coming from such a connected device, in particular a pump and/or administration set and/or respirator and/or fall detector, or related to information coming from third-party software, in particular from an expert system, likely to be executed on the terminal or on a machine connected to the terminal, such as software for monitoring self-care haemodialysis and/or for monitoring glycaemia of diabetics and/or monitoring blood pressure.
18. Computer program product downloadable from a communication network and/or stored on a medium that can be read by computer and/or executed by a microprocessor comprising program code instructions for implementing the method of health monitoring according to claim 10 when said program is executed on a computer.
means for saving said medical data, said health actions, and said monitoring rules.
in order to associate with said medical data a health action to be executed, and generate an alert in the event said health action to be executed is different from the health action executed by at least a user.
The portion of remote monitoring in the overall socio-medical care of patients, and especially the maintaining of patients in the home (MPH), is likely to develop and with it the remote monitoring which makes it possible to appreciate a risk situation in the absence of care personnel. The context of remote monitoring of patients, especially with MPH, implies furthermore the use of tools that are not traumatising for the person and that are capable of detecting a possible degradation in his state of health.
Remote monitoring for a patient takes place with recording devices (medical assistance equipment, sensors, camera, etc.) placed in the environment of the patient and which, in the event of an anomaly, sends a signal via a communications network to designated persons in order to come to the aid of the patient. These systems detect crisis situations (example: falls, heart rhythm trouble) in patients for which the risks are identified and which are subject to generally intensive monitoring. On the other hand, they do not apply well to the MPH population which is made up of “fragile” people requiring daily health monitoring that is the least traumatising possible and often non intensive. Most aged people who are monitored via MPH, for which the number is expected to increase considerably in the years to come in all of the western countries, do not show dominant pathologies, which makes it difficult to anticipate crisis phases using only the measurement of a physiologic signal.
The remote alarm is widely used in MPH, either as a complement to medical equipment, or alone. This terms groups together different devices, fixed or on, activated by the person to trigger the calling of emergency numbers via the STN or GSM network. These devices, although extremely easy to use, have the major disadvantage of not enabling to appreciate the actual seriousness of the situation. Their untimely use, either on purpose or due to an error in manipulation, thus mobilises rescue teams for interventions that are not always justified.
Multisensor devices, referred to as “smart”, connected to the patient or placed in his living environment, respectively allow more complete physiological monitoring (electrocardiogram, oxygen saturation, sodium on the skin, etc.) and the appreciation of environmental factors that act on the patient. Among the existing systems, one can note “smart clothing” that incorporates chips (Medes, Nokia, etc.) or home automation experiments carried out by the CNRS of Grenoble. The use of such systems implies a constant on-duty delocalised medical team which interprets the data. Setting up this costly logistics today restricts its application as MPH to acute pathology monitoring.
In order to overcome constant health monitoring, expert systems per pathology are being developed. They remotely analyse data coming from the patient (signals, measurements, text) and can return medical advice or alert health professionals. The deterministic approach to these systems restricts their application to patients that have a pathology that is controlled well. The complexity of multiple pathologies cannot today be treated by these methods, which severely limits the use of these expert systems with older people who represent the main population treated as MPH.
i) The information read by the sensors is sent via a communications network in such a way that, if a communications problem prevents the communication between the sensor and the delocalised medical team, the data measured by the sensors cannot be used to warn the patient and/or distinct emergency services (ambulance, doctor) in case of need.
ii) Each sensor sends “raw” data that the on-duty medical team analyses and interprets at a determined frequency, i.e. discontinuously. So, if a health incident occurs between two analyses, there is a risk that this incident be detected only during the second analysis, which results in a loss of time in the reaction implemented by the delocalised on-duty medical team.
Furthermore, if an alarm is associated with the information sent by a sensor, the on-duty medical team is alerted to the health incident as soon as the information provided by the sensor reaches the alarm threshold. In this case, it is necessary to analyse the information previous to the alarm in order to possibly detect pertinent information concerning the diagnosis to be carried out.
So, when an alarm occurs, the on-duty medical team finds itself faced with an emergency situation without being able to systematically place the alarm in the general context of the patient (medical and surgical antecedents, allergies, etc.).
iii) When several sensors are used to provide different information, each piece of information is relative to a specific medical parameter—blood pressure, electrocardiogram (EKG), temperature, etc.
So, the on-duty medical team must analyse each parameter, both individually and in combination with the other parameters, these combinations again increasing the quantity of information that has to be processed by the on-duty delocalised medical team, or even by distinct on-duty teams which, where necessary, may have to consult each other in order to decide and/or trigger a health action.
The server programs a distant terminal, located near the patient in such a way that the distant terminal implements an automatism applying the monitoring rules to the medical data provided to the terminal by at least one sensor associated with the patient and/or by a man-machine interface of the distant terminal and/or by a man-machine interface of a networked station and/or by the network.
The invention seems to allow a medically-qualified person to truly be aided by automatic means in order to carry out monitoring of a patient remotely monitored according to the diagnosis determined by the medically-qualified person.
In an embodiment the medical data provided to the terminal by a sensor that belongs to the patient and/or by a man-machine interface of the distant terminal and/or by a man-machine interface of a networked station and/or by the network is sent to the medically-qualified person via a communications network so that the latter can take the sent data into account when possibly modifying the monitoring rules associating the data and health actions at the level of the server.
According to one embodiment, at least one sensor and/or man-machine interface is integrated into the distant terminal.
In one embodiment, the monitoring rules are added, modified or eliminated on the server via the communications network automatically or manually.
According to an embodiment, means are associated to the distant terminal to test its communication with the medically-qualified person and/or with a third party so as to ensure the transmission of alerts to this person and/or to this third party when the monitoring rules are implemented.
In one embodiment, the sensor and/or man-machine interface of the distant terminal and/or the man-machine interface of the networked station and/or the network sends data discontinuously to the terminal.
According to one embodiment, different sensors are used to measure several pieces of medical data of distinct categories.
In one embodiment, the sensors under consideration aim at measuring data of at least one of the following categories: blood pressure, heart rhythm, body temperature, skin temperature, sodium content on the skin, kinetic and/or kinematic parameters of the body, blood dosage, analysis of urine and/or stool and/or blood gas, weight, electrocardiogram data, heart sounds, oxygen saturation, thermal image.
In one embodiment, a sensor includes a man-machine interface in order to provide medical data to the terminal via the interface such as: intensity of pain, state of fatigue, alterations in the state of consciousness, difficulties in speaking.
According to one embodiment, means are associated to the man-machine interface of the distant terminal in order to intervene on the server.
In one embodiment, the data sent by the network is relative to data such as results of biological examinations and/or functioning of a piece of equipment connected to the network, in particular home automation equipment for detecting presence, control of access, heating, lighting, openings, fire, flooding, mains cut-off and/or a medical device, relative to an alarm signal or any signal resulting from the transformation of measurements and coming from such a connected device, in particular a pump and/or administration set and/or respirator and/or fall detector or relative to information coming from third-party software, in particular from an expert system, likely to be executed on the terminal or on a machine connected to the terminal, such as software for monitoring self-care haemodialysis and/or for monitoring glycaemia of diabetics and/or monitoring blood pressure.
According to one embodiment, monitoring rules are made available to a medically-qualified person, so that this person may render these monitoring rules operative or inoperative.
In one embodiment, a user provides data to the distant terminal via the network using a piece of equipment that is distinct from said distant terminal, in particular using a terminal that has wireless means of communication of the radiofrequency and/or infrared type.
The invention also relates to a health monitoring station characterized in that it includes means so that a person receives alerts and/or consults the data server via a man-machine interface according to a method that conforms to one of the preceding embodiments.
The invention also relates to a medical station characterized in that it includes means to that a medically-qualified person programs, via a man-machine interface, a distant terminal according to a method that conforms to one of the preceding embodiments.
The server includes means for programming a distant terminal, located near the patients in such a way that the distant terminal implements an automatism applying the monitoring rules to the medical data provided to the terminal by at least one sensor that belongs to the patient and/or by a man-machine interface of the distant terminal and/or by a man-machine interface of a networked station and/or by the network according to a method that conforms to one of the preceding embodiments.
A server including means for the medically-qualified person to associate medical data with health actions in a server via monitoring rules, the terminal, located near the patient, includes means to be programmed by the server in such a way that this distant terminal implements an automatism applying the monitoring rules to the medical data that is provided to it by at least one sensor that belongs to the patient and/or by a man-machine interface of the distant terminal and/or by a man-machine interface of a networked station and/or by the network according to a method that conforms to one of the preceding embodiments.
configure, using selected medical data, the monitoring rules, presented in particular in the form of SQL queries of the “if symptoms=vomiting and temperature >38.5° C., observation period=24 h health action=check urine” type. The monitoring rules are recorded and indexed with the health actions in the data server.
input and send alert protocols to the data server, in particular information relative to the contact information of the person to inform in the event that a realised health action would be different from the corresponding monitoring rule.
means of analysis used to analyse the compatibility of the protocols thus sent, in particular the compatibility over time between the new monitoring rules and the former monitoring rules.
a distant terminal, located with the patients, in particular with the patients that are maintained in the home. The distant terminal is connected to sensors, in particular to medical measuring devices, providing medical data to the distant terminal, and/or the distant terminal receives the medical data from the users and/or the patients via a man-machine interface of the distant terminal, used by the users and/or by the patients to input the medical data.
The system furthermore includes means of programming in order to program automatisms in the distant terminal, from the data server via the communications network. The automatisms are programmed using medical data and health actions indexed in the data server.
generate alerts in the event the health actions are not executed by the users.
The system thus makes it possible to compile a personalised diagnosis base for each patient and to generate the triggering of appropriate alerts.
Health Surveillance Assisted by Diagnosis (HSAD) is a method allowing the use of medical diagnosis for configuring monitoring functions of an alert generator on a patient. It makes use of the notion of “health monitoring rules” which describes the recommended health action (care, medical prescriptions, additional tests, hospitalisation, etc.) following medical observations (readings, symptoms, clinical exam results, etc.), in particular performed on clinical cases or with the patient himself, materialised by the recording of measurements, codes or strings of words: the “medical data”.
This method includes on one hand, control for a mechanism for triggering alerts with a check on the conformity of the health action with the medical data on a “patient machine” (PM). It includes, on the other hand, the programming of this automatism using the analysis of the data of the medical records via a specific man-machine interface (MMI) that can be accessed via a network of the Internet type. Finally, the method includes the processing and the making at the disposal on the network of data by a server so as to provide consistent management for the medical rules (review, congruence, etc.) by all of the users.
The general mechanism of the HSAD is based on the coupling between the data and the health actions, making it possible to direct the control on the implementation of actions and not directly on the value of the data. It is therefore regarding a generalisation of sensor control: if the absence of nursing personnel prevents the health actions suggested by the sensor data, the alert protocol is triggered. Inversely, the HSAD makes it possible to take into account a wider range of observations as well as the response provided by the caregivers, and therefore to flexibly regulate the process of triggering alerts. Furthermore, with a health action being conditioned to the probability of simultaneous presence of several pieces of data, the HSAD makes it possible to overcome the continuous systematic measurement of a variable and in particular to take into account the information contained in a syntactical expression. Another characteristic of the HSAD is the evaluation of the effectiveness of the monitoring rules in processing the data and in alerting, if needed, the members of the network of the need to create new rules. This self-control loop allows the diagnosis base of the patient to be enriched. Finally, the HSAD makes it possible in the network to update medical rules and remote monitoring for the patient. The MMI includes in particular assistants that facilitate updating rules.
Use of the HSAD requires, on the patient's end, to have a specific active and communicating machine (PM), equipped with memory for storing data and the automatism and, on the care givers' end and/or concerning other users, to access the MMI on a networked computer station or on a PM.
The user uses a MMI installed on a networked computing station or on a PM and enters into communication with the data server by logging in. The server verifies that the authentication codes correspond to a declared user.
Once connected to the server, the user must select the data on which he is basing his diagnosis and logs the health actions that are to be performed. For each health action, the user specifies the possible care alternatives. The MMI records the health actions on the server and indexes them with the data in the database, which is for example of the relational type.
Antecedents (data): vomiting symptoms, abdominal pain, alteration in the state of consciousness, high temperature readings for 24 hours, exam indicating acetonuria.
In a second time, the user uses the MMI to translate the data selection into monitoring rules in the form of a test on the data (in the form of a SQL query, for example) that he can simulate and modify. If needed, he can use examples of server rules, and modify or render inoperative rules that are active. The user also specifies a period of observation which conditions the collection of data on which the rule is to be applied. The rules are then saved on the server and indexed into the health actions. So, a monitoring rule is made up of tests on a collection of data and health actions.
The last step consists of using the MMI to send information concerning the alert protocol to the server, i.e. the contact information of the persons to inform as well as the means of transmission used (telephone, SMS, email, etc.) in the event where the realised health action would be different from what the rule recommends. Different alert protocols can be scheduled according to the differences in realisation that are observed.
Each step can be performed at a later moment, independent of the others.
An alternative to the above process is the automatic production of monitoring rules by the server by using known data analysis methods (statistics, neuronal, etc.) or expert systems in decision-making assistance.
After recording the monitoring rules and the alert protocols, the server performs an ambiguity check in order to verify compatibility between the new and former protocols and rules. If there is ambiguity, the server sends an alert to the user.
The server then generates a code in the language of the PM using a library where the languages of the various machines that can be connected to the network are referenced.
Updating of the PM control automatism takes place via the network either by consulting the server (PULL) or by the server sending the code (PUSH).
The automatism will process the medical data and the health actions stored in the memory of the PM. The memory stores the flow of data coming from the PM's communication ports, from the computer communications network as well as from the man-machine interface that belongs to the patient machine PM (MMIPM) used for manual local input of medical observations and health actions. Data retention time in the memory is conditioned by the monitoring rules.
In a first time, the automatism periodically applies the monitoring rules to the medical data in the memory. If the test is positive, it checks that the planned health actions for each rule are scheduled in the memory of the PM. If they are not, the automatism logs in memory one or several health actions to be validated by applying the rule.
Health action carried out: stool care, anti-vomiting.
Health action carried out: paracetamol, message to doctor.
PM logs a Health Action to be validated: transfer to hospital for hyperglycaemia within 2 h.
In a second time, the automatism checks that the times for the scheduled health actions have not passed and that the information concerning their care are in conformity with the schedule. If not, the machine executes the alert protocol by sending messages via one of the means of communication available to the PM. It is therefore not necessary that the PM be constantly connected to a computer network as long as another means of communication is available.
The PM sends a pre-recorded message to the Emergency Medical Assistance by telephone.
Once processed by the automatism, the local data (sensor readings, medical observations, etc.) and the alerts can be sent to the data server by the computing network in order to be archived.
The diagnosis base established for a patient serves therefore as a decision system in order to best trigger alerts in the absence of caregivers. This base avoids the complexity of an expert system by capitalising on the expertise acquired via the socio-medical network on a given patient. The ambiguity analysis, bringing to light possible inconsistencies between the data and the health actions, makes it possible for caregivers to be aware, where applicable, of malfunctions in caring for the patient in the network and to take corrective action. The HSAD method potentially applies to usage on a wide range of machines destined for patient monitoring, for example: a home station, a PDA (Personal Digital Assistant) on the patient or even a programmable beacon.
FIG. 1 shows a schematic view of the system according to the invention.
Note that the user in the sense of the invention can be a patient remotely monitored and/or a medically-qualified person and/or a person authorised to access the system. According to the authorisation level of this user, the latter enters data and/or associates data with health actions using the distant terminal and/or network and/or networked station.
Also note that a patient, in the sense of the invention, is a person who has recourse to a socio-medical service, in particular recourse to one or more professionals that are independent and/or report to a health care institution, independent to any consideration relative to the existence of a health problem and/or to the seriousness of this possible problem.


Alabama countess has seen amazing things -- but why did she stay?
Huntsville, Ala. -- Ruth Grafin von Saurma was in a helicopter with her boss on the morning of July 16, 1969.
Her boss was Wernher von Braun.
The helicopter lifted off at dawn and hovered in the Florida skies over the Kennedy Space Flight Center.
On the morning the Saturn V rocket designed by von Braun and his Huntsville team pushed Neil Armstrong, Michael Collins, and Edwin "Buzz" Aldrin into space and history, on a trip that would, with Armstrong's giant step, take mankind to the surface of the moon. And back.
Think about that. Think about the magnitude of the moment, and the pressure inside that helicopter.
The world had waited years to see what NASA could do. Wernher von Braun and many of his scientists - including von Saurma's husband - had been brought here for the specific purpose of bringing a space victory to America, to restore pride wounded when the Soviets put Yuri Gagarin into space a dozen years before. It had been eight years since President John F. Kennedy publicly challenged NASA to put a man on the moon, and America was breathless.
Everything was riding on that launch. Everything. The pride of their adopted country and their entire reason for being there.
You can see the relief in von Saurma's eyes still when she thinks about that rocket lifting off. A deep breath comes and it settles to serenity.
"I was so overwhelmed," she said this week, from her home in Huntsville. "It was a sight that was truly unforgettable. I get goose bumps when I think of it."
"We really were aware that this was an historical moment," she said. "We kept our fingers crossed."
One could write for days about the triumphant and tragic life of Ruth Grafin von Saurma. Of her life in Frankfurt and Berlin in the days before World War II, of her marriage in Paris to Count Friedrich von Saurma, of her life as a countess until the war turned her into a refugee, along with her husband and their daughter Lily. Of grudgingly moving with her husband to Huntsville at the invitation of von Braun and the U.S. government. Of seeing her husband die young and suddenly in 1961. Of going to work for von Braun herself as an international relations specialist. Of being part of that breathtaking moment over Florida.
Whew. She is 93 years old now, fit and firm and as graceful as your would want a countess to be. She has lived a remarkable life. She has witnessed great and horrible things. She has seen great and wonderful things.
But the thing this countess talks most passionately about is not Germany or her job, not von Braun or science or the stars. It was ... well, let's go back to 1954, when von Braun asked Friedrich to follow him to Huntsville, Alabama.
She and her husband felt good about it. After all, if von Braun could be happy in Huntsville, so could they.
"The first day I made my husband promise that we would not stay," von Saurma said.
There was nothing here. It was a cultural desert, a culinary wasteland. No arts or music and no fine dining to speak of - just a couple of middling restaurants. There was not much of anything, really, but a little town of 17,000 people surrounded by cotton fields and the stubby ends of a mountain range.
How could it possibly work for a family used to the great cities of Europe?
But something happened to Huntsville and in Huntsville that was, in its own way, as remarkable as the Apollo launch.
The people of Huntsville were not just hospitable, but generous and friendly and welcoming, she said. She became involved in building a symphony and in joining literary groups, in studying and preserving the history of the place around her.
And one day, some day, she looked up and saw a city had grown ten-fold in population and more than that in cultural variety. She looked at the land and saw natural beauty. She looked at the people and the Southern traditions and saw a loveliness she had not recognized before.
"It was a different place," she said.
But it was not just the city that had transformed. It was her.
"I was a different person," she went on. Huntsville "opened the whole world to me."
It became official after her daughter married and moved back to Germany. By then von Saurma had long since retired, her husband had been gone a half century, and she lived alone in what was once a foreign land.
People asked why she didn't move back to Germany to be with her daughter. It just made sense. But not to this countess.
She thought of the symphony and the museums, the restaurants, the work and the transformation and the people of Huntsville.
"My friends are here," she said. "This is home."


How are these images generated?
Doesn't the coordinate extraction process have errors?
I found an error in the coordinate data for a paper. How can I fix it?
How come my study isn't in the database?
How do you deal with the fact that different studies report coordinates in different stereotactic spaces?
How do you distinguish between activations and deactivations when extracting coordinates from published articles?
Are individual words or phrases really a good proxy for cognitive processes? Can you really say that studies that use the term 'pain' at a certain frequency are about pain?
Isn't selection bias likely to play a role here? If everyone thinks that the amygdala is involved in emotion, isn't it likely that an automated meta-analysis will simply capture that bias?
How come so many of the terms are non-content words no one cares about (e.g., 'addressed', 'abstract', or 'reliable')?
Why do images take a while to load?
When I enter coordinates manually, they're rounded to different numbers!
How are the images thresholded?
What format are the downloadable images in?
What do the 'forward inference' and 'reverse inference' descriptions mean in the feature image names?
How do I use the Neurosynth code to generate my own meta-analysis images?
Neurosynth is a platform for automatically synthesizing the results of many different neuroimaging studies.
Activation coordinates are extracted from published neuroimaging articles using an automated parser.
The full text of all articles is parsed, and each article is 'tagged' with a set of terms that occur at a high frequency in that article.
A list of several thousand terms that occur at high frequency in 20 or more studies is generated.
For each term of interest (e.g., 'emotion', 'language', etc.), the entire database of coordinates is divided into two sets: those that occur in articles containing the term, and those that don't.
A giant meta-analysis is performed comparing the coordinates reported for studies with and without the term of interest. In addition to producing statistical inference maps (i.e., z and p value maps), we also compute posterior probability maps, which display the likelihood of a given term being used in a study if activation is observed at a particular voxel.
Yes, and this is something we're continually working to improve. Our parser extracts coordinates from HTML articles, which presents some difficulties, because different publishers and journals format tables very differently. Moreover, many articles have idiosyncratic formatting or errors in the table HTML that can prevent data extraction. In the short term, we make an effort to patch the parser whenever we identify a systematic problem that affects multiple articles; however, this really isn't a great solution, and in the long term, we'd like to transition to a standards-based model where authors and publishers report and display activation data in a standardized, machine-readable format.
Unfortunately, we don't have any way for users to contribute to the manual verification and validation of coordinates right now. You can send us an email detailing any problems you find. We realize that this is less than ideal, and we'd love to move to a crowd-sourced model where other researchers can help validate and extend the database via a web interface. One such effort is brainspell.org, where you can manually annotate coordinates and articles in the Neurosynth database. We eventually plan to integrate the annotations on brainspell into Neurosynth. In the meantime, if you'd like to help, you can email us with the details of any problems you identify. It's particularly helpful if you can identify systematic problems with the parser (e.g., that it consistently misses the third column in a particular kind of table in ScienceDirect articles). We're unlikely to address errors on a case-by-case basis unless they're part of a broader pattern. Of course, if you'd like to dive in and help write a better parser, that's even better--all of the Automated Coordinate Extraction (ACE) code is available at github.
For technical reasons, the database currently includes only a subset of published neuroimaging studies. Specifically, to be included, a study has to (a) be in a journal that we currently cover (each new journal or publisher requires us to write a custom filter, which isn't trivial); (b) be available online in HTML form (we currently don't work with PDFs, and some journals only have HTML versions for more recent articles); and (c) contain at least one activation coordinate that's detectable by our parser. Aside from these criteria, there are a small number of studies that present special problems for various reasons (< 2% of the total). But rest assured that we don't deliberately exclude any study from the database, so if there's a study you're interested in that isn't represented, odds are it just isn't covered yet. The database is continually growing as we have time to write filters for new journals, so check back from time to time.
The results you see incorporate an automated correction for differences in stereotactic space. Specifically, we use a simple algorithm to determine whether a study is reporting results in MNI or Talairach space, and we convert Talairach results to MNI using the Lancaster et al (2007) transform. This doesn't work perfectly, but we can correctly detect the space being used about 80% of the time. In our manuscript, we report some supplemental analyses validating this approach. We plan to further improve the space detection algorithm when we have the time, and anticipate that with some work, we'll be able to achieve nearly perfect performance.
Depends. There's no question that the 'lexical assumption' we make will fail in many individual cases. For instance, many studies might use the word 'pain' in the context of emotional rather than physical pain, which might partly explain why we see a fair amount of amygdala activation in the meta-analysis map for pain (though much of that probably reflects the fact that pain is a salient and affectively negative signal). But ultimately it's an empirical question, and for the most part, the answer seems to be that, at least for relatively broad domains (e.g., working memory, language, emotion, etc.), individual terms are in fact a reasonably good substitute for much more careful coding of studies. If you compare the maps on this website with those that have been previously published in much more careful analyses (see our manuscript for examples), we think you'll be pleasantly surprised. So while we certainly don't see the current lexical approach as the final word, and ultimately hope to move to more refined approaches (e.g., we're currently working on topic modeling approaches that go beyond individual words or phrases), we feel pretty good about using words as a proxy for processes. The main limitation right now is a lack of specificity (i.e., narrower constructs like disgust are difficult to isolate from broader ones like negative emotion), and that's at the top of our agenda for improvement.
Yes, but we don't see this as any more of a concern for this type of analysis than for others. There's no question that biases in the primary literature skew the results of automated meta-analyses. We don't doubt that there's a general tendency towards confirmation bias, so that researchers are more likely than they should be to report that the amygdala is involved in emotion, that the left IFG is involved in speech production, that S2 is involved in tactile sensation, and so on. But it's important to recognize that this isn't really a limitation of our particular approach, and is a much more general problem. We all know, for example, that researchers are much more likely to look for and report emotion-related activation in the amgydala than in, say, motor cortex. Confirmation bias is unquestionably a huge problem for an automated meta-analysis, but we think it's just as big a problem for individual fMRI studies or other kinds of meta-analyses.
There are two reasons for this. One is that we didn't want to arbitrarily restrict the lexicon to just those words that we personally found meaningful. Some of the terms we think are uninteresting might be of considerable interest to someone else. Since there's no real cost to making additional terms available, we decided to make the list as comprehensive as possible in the latest version of Neurosynth.
The other reason we left non-content terms in is that they provide a nice baseline for evaluating the results of terms that we do care about. Since there's no particular reason why terms like 'several' or 'through' should be associated with specific patterns of activation, the expectation is that meta-analysis of such terms should reveal little or no activation. That's exactly what turns out to be true of most non-content words. In contrast, most of the terms researchers are likely to care about reveal robust patterns of activation, which gives us all the more reason to think the approach is working well.
There are three reasons why images may take a while to display in the interactive viewer when you first load a page. First, the image files themselves are fairly large (typically around 1 MB each), and most pages on Neurosynth display multiple images simultaneously. This means that your browser is usually receiving 1 - 3 MB of data on each request. Needless to say, the images can't be rendered until they've been received, so users on slower connections may have to wait a bit.
Lastly, some images are only generated on demand--for example, if you're the first user to vist a particular brain location, you'll enjoy the privilege of waiting for the coactivation image for that voxel to be generated anew. This will typically only take a second or two, but can take as long as a minute in rare cases (specifically, when too many users are accessing Neurosynth and we need to spin up another background worker to handle the load).
Because the overlays have a resolution of 2mm, when you enter a set of coordinates manually, they'll be rounded to the nearest point we have data for. There are no available data at odd coordinates (e.g., [-11, 35, 27]).
The images you see are thresholded to correct for multiple comparisons. We use a false discovery rate (FDR) criterion of .01, meaning that, on average, you can expect about 1% of the voxels you see activated in any given map to be false positives (though the actual proportion will vary and is impossible to determine).
When you click the download link below the map you're currently viewing, you'll start downloading a 3D image corresponding to the map you currently have loaded. The downloaded images are in NIFTI format, and the files are gzipped to conserve space. All major neuroimaging software packages should be able to read these images in without any problems. The images are all nominally in MNI152 2mm space (the default space in SPM and FSL), though there's a bit more to it than that, because technically we don't account very well for stereotactic differences between studies in the underlying database (we convert Talairach to MNI, but it's imperfect, and we don't account for more subtle differences between, e.g., FSL and SPM templates). For a more detailed explanation, see the paper.
Note that the downloaded images are not dynamically adjusted to reflect the viewing options you currently have set in your browser. For instance, if you've adjusted the settings to only display negative activations at a threshold of z = -7 or lower, clicking the download link won't give you an image with only extremely strong negative activations--it'll give you the original (FDR-corrected) image. Of course, you can easily recreate what you're seeing in your browser by adjusting the thresholds correspondingly in your off-line viewer.
Posterior probability map: the estimated probability of a term being used given the presence of activation (i.e., P(Term|Activation)).
The reverse inference maps provides somewhat different (and, in our view, more useful) information. Whereas the forward inference maps tell you about the consistency of activation for a given term, the reverse inference maps tell you about the relatively selectivity with which regions activate. Strictly speaking, these maps reflect a comparison between all the studies in our database that contain a term and all those that don't. So for instance, the fact that the amygdala shows very strong activation in the reverse inference map for emotion implies that studies that use the term emotion frequently are much more likely to report amygdala activation than studies that don't use the term emotion. That's important, because it controls for base rate differences between regions. Meaning, some regions (e.g., dorsal medial frontal cortex and lateral PFC) play a very broad role in cognition, and hence tend to be consistently activated for many different terms, despite lacking selectivity. The reverse inference maps let you make more confident claims that a given region is involved relatively selectively in a particular process, and isn't involved in just about every task.
Documentation for the Neurosynth core tools is admittedly sparse at the moment. That said, the examples folder in the github repository contains a number of worked examples that illustrates various uses of the code. Probably the best place to start is with the demo IPython notebook, which can be viewed online here.


Amazon's cashier-free convenience store may be struggling to keep track of which customer bought what, but their next brick-and-mortar operation won't share its problems with automation.
Amazon.com Inc launched AmazonFresh Pickup at its brick-and-mortar grocery store in Seattle, as the online giant attempts to crack into the multi-billion dollar grocery market dominated by retail giants such as Wal-Mart Stores Inc.
AmazonFresh Pickup, currently open only to employees, allows users enrolled in its Prime service, to drive in and pick up groceries from the company's grocery store in Seattle, which it opened last year.
Amazon Prime members can place the order online and choose a time for the pick up, the company said on Tuesday. The company will keep the order bagged.
The company also delivers groceries to homes under its AmazonFresh service.
Amazon also has a physical bookstore in Seattle, as well as pop-ups at malls where it displays Amazon devices such as the Kindle.


Article Summary: "This article is about the attacking avatar of MS Dhoni aganist MI in Eliminator match of IPL 2012..."
CSK (Chennai Super Kings) seems to hit the IPL on a hatrick. At one stage of IPL it was thought that they were out of playoffs but now they are just two wins away from hatrick IPL. In the Eliminator match against MI they have chosen to bat first and have lost two successive wickets of Murali vijay and Suresh raina on two swinging balls from Kulkarni. It was thought that they were going on a rough path. But Badrinath and Hussey has done a good job of making a beneficial partnership when needed. And then the show started after the wicket of Michael Hussey.
The captain of CSK (Chennai Super Kings) has done a wonder with his superb batting performance. He has taken the fight back on a real higher level and his counterattack has lead MI out of competition. The determination of CSK has proved too much for MI. The captain was on the mood to attack. The attacking avatar of Dhoni has made them to reach to the next level of IPL. After the brilliant partnership from Hussey and Badrinath , Dhoni has taken the match towards win. In the 11th over they were at around 90s with the loss of 4 wickets and the runs were projected at 130-140 by the end of the innings. But the dashing sixes and helicopter shots from the skipper has changed the complexion of the game. They finished at 187.
Dhoni has made his half century only in 20 balls. He scored 51 from 20 balls with 6 fours and 2 sixes at the strike rate of 255.00. With the support of Bravo who has scored 33 of 14 balls with 3 fours and 2 sixes at the strike rate of 235.71. Bravo's game has helped Dhoni to play his natural innings. On that day his game and way of hitting has given clues that he was there to go on like anything. The first six by him has gone on to the roof by hitting the longest six of the match at 112 meters whereas the previous one was of Gayle for 111 meters. Then, on for Malinga he has taken a ride with his lovely swinging helicopter shot to six. His game has really attracted the audience. He has played his game when it was in real need. There is no doubt that he is a match winner. His hitting and tenacity from CSK has made them very strong in the match.
Dwayne Smiths game has helped MI to show that they are fighting for the win. The first five overs he was on fire. The opening stand was of 47. But the left arm spinner Jakati bowled very well with discipline at the other end. The run out of Sachin Tendulkar has turned the game and smith followed him by a catch out in the same zone. Then the wickets of R sharma, D Karthik , Rayudu fell down quickly . Franklin went out in the 14th over where there was a need of 84 runs in last six overs. The pressure was on Pollard and Bhajji. But the pressure to win the matches of big chases are difficult as these are must win matches.
To conclude the pattern of Game from CSK and attacking avatar with leadership skills of Dhoni have changed the game to a win for them and meet DD in semi-final.


Management of neglected and nonunion of femoral neck fracture is a challenging task. ,,, There is no exact definition of neglected femoral neck fracture in the literature. Some studies report more than 3 weeks of delay as neglected, while others take 6 weeks as the time limit. However, definition of nonunion is relatively clear. Zuckerman defined it as a lack of radiographic evidence of union 6 months after the fracture.  The patient usually presents with pain on weight bearing after 3 months of fixation. Radiological evidence of nonunion becomes apparent within 1 year. ,,, The incidence of nonunion as reported in literature varies between 10% and 30%. , The choice of treatment in such scenario depends on the age, the activity level, the duration of injury, the extent of displacement, and osteoporosis.  This fracture is common in the elderly population in Western countries, but young individuals equally succumb to this injury in developing countries because of high incidence of road traffic accident.  While nonunion following primary fixation in the young adults is a worrisome problem for the patients and the surgeon both throughout the world, many patients in the developing or underdeveloped countries do not seek medical treatment for months and remain neglected.
NVFG for femoral neck fracture was first used by Henderson in 1940.  Subsequently, Inclan and Patrick also reported a favorable outcome with the use of NVFG in fracture neck of the femur. , "One cancellous screw and a fibular graft" was popularized by Nagi et al. in 1981 and subsequently, it was routinely used for neglected femoral neck fracture.  In this review, the success rate, outcome, and complications of NVFG in neglected and nonunion of femoral neck fracture will be appraised.
All articles except by Dooley and Hooper  used NVFG in young adults below 60 years of age for neglected and nonunion of femoral neck fracture fixation. The definition of neglected femoral neck fracture varies in these articles. Nine articles reported more than 3 weeks of delay as neglected, ,,,,,,,, whereas remaining articles mentioned more than 6 weeks as the definition of neglected fracture. ,, However, the definition of nonunion is quite clear. ,, No evidence of progressive healing on anteroposterior and lateral radiographs and disabling hip pain within 6 months of primary fixation was considered as nonunion. Sen et al. had 16 nonunion after cannulated cancellous screw fixation and 6 nonunions after dynamic screw fixation, whereas Elgafy et al. reported eight nonunions after cannulated cancellous screw fixation, seven nonunions after dynamic screw fixation, and two after initial conservative treatment. Dooley and Hooper did not find an obvious cause of nonunions in all of their cases, but they could identify four nonunions because of inability to recognize the original fracture and ten nonunions were because of poor reduction or inadequate fixation. As per the Sandhu et al., Grade I femoral neck nonunion (proximal fragment >2.5 cm, irregular fracture margin, fracture gap of <1 cm, and viable femoral head) has union rate of 100% followed by 89% in Grade II (proximal fragment >2.5 cm, smooth fracture margin, fracture gap between 1 and 2.5 cm, and viable femoral head) and 33% in Grade III (proximal fragment <2.5 cm, smooth fracture margin, fracture gap between >2.5 cm, and osteonecrotic femoral head) after NVFG osteosynthesis. Partial resorption of neck and presence of osteonecrosis in the femoral head are not a contraindication and it may show improvement after fibular osteosynthesis. ,,,, Thus, neglected or nonunion femoral neck fracture (whether displaced or undisplaced) with proximal fragment more than 2.5 cm and fracture gap of <2.5 cm can be effectively treated with NVFG osteosynthesis.
Thirteen of fifteen articles reported use of cancellous screws (preferably cannulated) as the supplementary fixation. ,,,,,,,,,,,, Dooley and Hooper used nail or plate as the supplementary fixation. Angle fixed device was reported in our own previous article.  We believed that numerous complications such as graft slippage and fibular graft fracture that have been reported with the use cancellous screw were because of excessive force exerted on the graft and not offloaded by the screws. Angled blade plate (ABP) provides better stability because of its rectangular shape and resists more torsional and shearing forces.  However, placement of ABP is technically more challenging. After this review, it is fairly apparent that a fibular graft with cannulated screws is an optimal fixation for neglected and nonunion cases of femoral neck fracture. This is technically simple and can be performed in most of the center.
Except Nagi et al. , all authors recommended placement of two or three screws (6.5 mm or 7 mm cannulated cancellous screw) along with the fibular graft. The authors believe that multiple screw fixation allows early rehabilitation of the patients in the postoperative period. While Nagi et al. , recommended hip spica cast for more than 6 weeks in their patients because of inadequate stability by one supplementary screw, remaining all authors ,,,,,,,,,,, allowed early postoperative partial weight bearing in their patients because of better stability. Thus, additional support with two or more cannulated screws is desirable in NVFG osteosynthesis.
Most of the articles reviewed used only one fibular graft for osteosynthesis [Figure 1]. ,,,,,,,,,,, However, three articles ,, reported about the dual fibular graft fixation. Sandhu et al.  used one cancellous screw and a double fibular graft in 86.3% patients and two cancellous screws with one free fibular graft in 13.7%. They noted union in all of their patients with single fibular graft who were of Grade I nonunion as per Sandhu et al. In double fibular graft group, they noted 100% union in Grade 1, 89% in Grade II, and 33% in Grade III. Pal et al. used two fibular grafts with one screw for those patients who had a longer delay and greater resorption of the neck and/or posterior comminution of the femoral neck. For other neglected patients, they used only one graft and two screws. But nothing could be concluded from this article as it was not a comparative study rather the authors themselves divided the patients into these two groups of treatment and just reported the outcome combinedly. However, they noted a longer time for union in some of their patients who had excessive resorption of neck (treated with dual fibular graft). Similarly the report of Jaiswal et al.,  who divided the patients into two treatment groups (dual fibular graft and dual graft + one screw), also could not provide extra information about the advantage of dual grafting. As per the current evidence, one fibular graft and two supplementary screws are adequate.
Except by Nagi et al., remaining all authors adopted an early rehabilitation. Nagi et al. , used hip spica cast for 6 weeks because of one supplementary screw in their patients and hence the fixation was inadequate. Remaining all authors allowed immediate postoperative nonweight bearing walking on crutches for 6-8 weeks and then partial weight bearing. Complete weight bearing was restricted until radiological evidence of union was noticed.
On cumulative evaluation of the patients in the reviewed articles, the average nonunion rate after NVFG is 7.86% [range: 0-31%, [Table 1]. ,,,,,,,,,,,,,, The nonunion rate in 12 of 15 studies was <10%.
All except two studies , have mentioned the number patients who developed osteonecrosis or who had progression of osteonecrosis. The incidence of postoperative osteonecrosis varies between 0% and 21%. ,,,,,,,,,,,, Six studies ,,,,, where the preoperative and postoperative osteonecrosis status are mentioned clearly indicate that there is an improvement in osteonecrosis after fibular osteosynthesis. A total of 26 patients (total avascular necrosis in these six articles) had osteonecrosis in the preoperative period and only 13 patients remained osteonecrotic in the postoperative period [improvement in 50% of patients, [Table 1].
Fibular osteosynthesis in neglected femoral neck fracture was popularized by Nagi et al.  They used one cancellous screw and a fibular graft in their patients and reported union in all of them. They acknowledge that fibular osteosynthesis not only promotes union, it also improves the osteonecrosis in the femoral head. They advocated that mechanical fixation by various devices depends upon the physical pressure exerted by the nail and the bone. Normal vascular bones start resorption around the implant because of the physical load and hence it starts loosening leading to nonunion. However, the fibular graft provides biological fixation by beginning to fuse with the parent bone at the end of 3-4 weeks and thus implant loosening does not occur.
From this review, it is quite evident that "one fibular graft and two cancellous screws" are optimal for fixation of neglected and nonunion cases. An early rehabilitation with crutch walking can be initiated immediately after surgery and complete weight bearing can be restricted till union at the fracture site. The success rate of NVFG is impressive with nonunion rate <10%. Besides that, there is usually an improvement in osteonecrosis in about 50% patients. There are few complications and minimal donor site morbidity after autogenous NVFG fixation. The coxa vara deformity and leg length discrepancy that have been reported after NVFG is because of preoperative varus alignment/varus malreduction during surgery. Even in varus hip, fibular graft osteosynthesis promotes union; however, residual coxa vara and limb shortening persists. In such cases, combined valgus osteotomy and fibular graft can provide a better outcome.
To conclude, in patients younger than 60 years of age with neglected femoral neck fracture or nonunion, all efforts should be directed toward hip salvage. NVFG osteosynthesis has encouraging results in such instances. It is technically less demanding, simple, and can be performed in almost all centers where image intensifier is available.
Arbab S, Ud Din S. Osteosyntheis of intracapsular fracture neck of femur with cancellous screw and fibular graft. J Postgrad Med Inst 1991;5:64-9.
Huang CH. Treatment of neglected femoral neck fractures in young adults. Clin Orthop Relat Res 1986;206:117-26.
Haidukewych GJ. Salvage of failed treatment of femoral neck fractures. Instr Course Lect 2009;58:83-90.
Pauyo T, Drager J, Albers A, Harvey EJ. Management of femoral neck fractures in the young patient: A critical analysis review. World J Orthop 2014;5:204-17.
Zuckerman JD. Comprehensive Care of Orthopaedic Injuries in the Elderly. Baltimore: Urban & Schwarzenberg; 1990. p. 23-111.
Arnold WD, Lyden JP, Minkoff J. Treatment of intracapsular fractures of the femoral neck. With special reference to percutaneous Knowles pinning. J Bone Joint Surg Am 1974;56:254-62.
Banks HH. Factors influencing the results in fractures of the femoral neck. J Bone Joint Surg 1962;44A: 931-64.
Banks HH. Nonunion in fractures of the femoral neck. Orthop Clin North Am 1974;5:865-85.
Chapman MW, Stehr JH, Eberle CF, Bloom MH, Bovill EG Jr. Treatment of intracapsular hip fractures by the Deyerle method. A comparative review of one hundred and nineteen cases. J Bone Joint Surg Am 1975;57:735-44.
Estrada LS, Volgas DA, Stannard JP, Alonso JE. Fixation failure in femoral neck fractures. Clin Orthop Relat Res 2002;399:110-8.
Jain AK, Mukunth R, Srivastava A. Treatment of neglected femoral neck fracture. Indian J Orthop 2015;49:17-27.
Raaymakers EL, Marti RK. Nonunion of the femoral neck: Possibilities and limitations of the various treatment modalities. Indian J Orthop 2008;42:13-21.
Roshan A, Ram S. The neglected femoral neck fracture in young adults: Review of a challenging problem. Clin Med Res 2008;6:33-9.
Henderson MS. Ununited fracture of the neck of the femur treated by the aid of bone graft. J Bone Joint Surg Am 1940;22:91-106.
Inclan A. Late complications in fracture of the neck of the femur treated by nailing, bone grafting or both. J Int Coll Surg 1946;9:36-50.
Patrick J. Intracapsular fractures of the femur treated with a combined Smith-Petersen nail and fibular graft. J Bone Joint Surg Am 1949;31A: 67-80.
Nagi ON, Gautam VK, Marya SK. Treatment of femoral neck fractures with a cancellous screw and fibular graft. J Bone Joint Surg Br 1986;68:387-91.
Gadegone WM, Ramteke AA, Lokhande V, Salphade Y. Valgus intertrochanteric osteotomy and fibular strut graft in the management of neglected femoral neck fracture. Injury 2013;44:763-8.
Nagi ON, Dhillon MS, Goni VG. Open reduction, internal fixation and fibular autografting for neglected fracture of the femoral neck. J Bone Joint Surg Br 1998;80:798-804.
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Sen RK, Tripathy SK, Goyal T, Aggarwal S, Tahasildar N, Singh D, et al. Osteosynthesis of femoral-neck nonunion with angle blade plate and autogenous fibular graft. Int Orthop 2012;36:827-32.
Elgafy H, Ebraheim NA, Bach HG. Revision internal fixation and nonvascular fibular graft for femoral neck nonunion. J Trauma 2011;70:169-73.
Kainth GS, Yuvarajan P, Maini L, Kumar V. Neglected femoral neck fractures in adults. J Orthop Surg (Hong Kong) 2011;19:13-7.
Pal CP, Kumar B, Dinkar KS, Singh P, Kumar H, Goyal RK. Fixation with cancellous screws and fibular strut grafts for neglected femoral neck fractures. J Orthop Surg (Hong Kong) 2014;22:181-5.
Roshan A, Ram S. Early return to function in young adults with neglected femoral neck fractures. Clin Orthop Relat Res 2006;447:152-7.
Azam MQ, Iraqi A, Sherwani M, Sabir AB, Abbas M, Asif N. Free fibular strut graft in neglected femoral neck fractures in adult. Indian J Orthop 2009;43:62-6.
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As with any civilian job, Army officers must meet specified criteria in order to be eligible for promotion. The Department of Defense calls for a given number of officers based on manpower needs and skill requirements for each category and grade.
So what is the career path for an Army officer? Here are some of the criteria and requirements that need to be met.
This is a 12-week program for enlisted soldiers, civilian college graduates and direct commission candidates (which include doctors and chaplains). Those who complete Officer Candidate School (OCS) become commissioned officers upon graduation and must serve at least three years on active duty following graduation.
The Army's Officer Candidate School is located at Fort Benning in Georgia. Roughly 70 percent of enlisted candidates and 60 percent of those accepted overall successfully complete Army OCS.
Two of the biggest factors influencing officer promotions are time in service (TIS) and time in grade (TIG). Time in service is the total time in which someone is in the Army. An officer must spend a given amount of time in each grade prior to advancement to the next and he or she typically can't skip grades.
The minimum TIG requirements for promotion to the next higher grade is shown in the table below.
Officers in the same competitive category will compete among themselves for promotions. Changes in authorizations, losses, and promotions to the next higher grade will create variations in both the TIS and TIG when these promotions may occur.
The promotion timings are expressed in terms of the years of Active Federal Commissioned Service at which promotion occurs. The promotion opportunity is the percentage of total selects over the eligible in-the-zone population.
There are three promotion opportunities in all branches of the U.S. military: Below-the-Zone, In-the-Zone, and Above-the-Zone.
Below-the-Zone only applies for promotion to the rank of O-4 (Major) to O-6 (Colonel). One year before they would be eligible for In-the-Zone consideration, about 10 percent of those recommended can be promoted Below-the-Zone.
Most promotions occur In-the-Zone. The selection rate for Above-the-Zone is only about 3 percent.
Two other significant factors in officers promotions are fitness reports and the nature of their current and past assignments. A poor fitness report may mean being passed over for promotion. An officer whose previous assignments didn't have a significant degree of responsibility may also be passed over.
For promotions beyond O-6, Army officers typically have to complete a full tour in a joint duty assignment with the Marines, Navy, Coast Guard or Air Force.
And just like the other branches of the service, the mandatory retirement age for Army officers is 62 (which can be waived to 64 in some circumstances).


How do you get a web developer job with no experience?
I'm learning to program from online classes but don't have any real world experience. Every "Junior" job on Indeed requires 2-4 years of experience. I'm a beginner but learning and eager to learn more.
The programming "Bootcamps" are way too expensive for me and no guarantee of a job after.
Can I volunteer to work for a company for free in exchange for some mentoring and real world experience?
I figure in the startup world there are smart developers who need help but low on funds, and I can do the work for them in exchange for some mentoring.
I don't know if this is a possibility to work for free for experience. I'm not in a university for college credit.
Web development jobs ask for experience, but what they're actually referring to is ability. You can "hack" this process by building projects publicly. Use GitHub, contribute to open source, and continue building for-fun projects to grow your skills.
Send your GitHub link along with applications, and you'll get some nibbles.
I'll echo Jason's comments on using GitHub and if you can build a reputation, Stack Overflow (but don't get downvoted). I'll also add my own too, since mentoring an intern in my own company is something I'm currently doing. I'm not currently looking to mentor anyone else atm, since it's a travesty for all of them to spread yourself too thin. Though am happy to discuss direction.
The short answer is yes, you can, but whether they're allowed to take you on in that capacity is another matter, since some countries rightly have laws to protect workers from exploitation. Plus, it crucially depends on the value you'll get from it and that they can provide. My experience has been quite positive taking on someone who is already degree educated, though in electronic systems engineering. My intern is very keen, has grasped the concepts of agility and DevOps well and my focus for them has been to get them doing two things.
The first, identifying a particular problem to solve and creating an open source project on GitHub to solve it. The second, blogging about it. The first encourages and attempts to exhibit technical skill. The second to communicate it. You can be the best programmer in the world but if nobody knows, you're as good as a nobody.
From the other side, you have to be willing to even present your own learning and development plan. It has to be as frictionless as possible. Especially in startup world. Many are low on funds, yes. However, they trade on time and skill. You have to respect that as every minute spent with you is a minute they're not trying to add revenue to their business, which risks them not having a business to fall back on. That does you no favours as then the reference you get isn't as powerful as it could be (though still useful). It's not uncommon for gem to spend 4 hours a week or more with you. If their revenue stream is normally 100K a year, then given a 40 hour week, that's 10K they've spent with you if they're not yet at the stage of passive income. However, it can still be a rewarding experience for both of you.
In any event, if you don't ask, you rarely get. So I wish you the best of luck in finding the right company.
2) Offer to built a site or 2 for friends and family. It can be free or paid as long as the ground rules are clear. You will get a feel for the process with a bit of a safety net attached.
"2-4 years" can be a trivial requirement as long as you have something you can show potential employers.


How do you keep caulk fresh?
I was wondering if anyone had any ideas on how to keep an open caulk tube fresh, or how to keep the tip from hardening. I bought a tube of Dicor at the end of the season last year and did a little touch-up work before winter. I put a 3in. screw in the end and thought that should work. Took the screw out today and can't get anything out at all. I'm thinking I should cut open the tube and use what I can. Any thoughts?
I simply use a piece of duct tape, making sure it's wrapped tight and sealed across the opening. Never tried it with Dicor, but it works well with caulking and 5200 sealant.
I used Saran Wrap and duct tape for many years. A year ago I saw a plug of 2 caps that slip on the end in a Lowes. So far they are as good.
6) Let it warm before you use it. After removing the nail, you may need to take a coat hanger wire and push it through the nozzle into the tube.
Even with all this, the caulk will eventually become un-useable.
I've kept caulk now for 3 months buy taking some Saran wrap, doubling it over, putting it on the tip of the tube of caulk, and than jamming the caulk tube cap back on.
What I have had really good luck with is wire nuts, depending on the tube design a red, or yellow (14-12 gauge wire size) typically work. Sometimes I use a large grey if needed. They seem to seal it up gas tight and the caulk seems to be good a year or more.
I use tin foil on the tip of the tube... it goes nice with my tin foil hat..
I talked with a coworker today about open caulk and he does almost the same thing except he puts saran wrap over the end and then screws down the wire nut. Same as above, he also stated he's had caulk stay fresh for almost a year that way. I think I'll give the wire nut thing a try. Thanks for all the suggestions.


There are a couple different models for spectra, or constructions of the categories of spectra that have the desired properties (homotopically and otherwise). The construction of the Categories of $S$-algebras in EKMM (Rings, Modules, and Algebras in stable homotopy theory by Elmendorf-Mandell-May-Kriz) is one such model. In EKMM, the authors develop a lot of "technology" for their category of spectra. In particular, they construct several spectral sequences and talk about Algebraic K-theory of S-algebras. I am curious to know if such developments have been pursued in the various other models, such as Symmetric Spectra.
All of these models yield the same homotopy category (I believe the paper of Mandell-May-Schwede-Shipley does this, or does a lot of it), but the impression I have gotten is that $S$-algebras have a lot of the technology already developed that one might want in stable homotopy theory. I believe Schwede has worked on computing homotopy groups of Symmetric Spectra, is this a sign that more technology is on its way?
I suppose the above is all background in some sense, so let me clearly state my question(s): Are there developed notions of spectral sequences for other models of spectra? Are there simple reasons why one would or would not expect such developments to occur (other than we already have them for $S$-algebras)?
Also, I don't mean for this to spark a debate about different models. I am just curious.
EDIT: Clearly, I was unclear. I am wondering if people have used, written down, proved results regarding convergence etc, spectral sequences based on other models of spectra. Is it as Tyler points out that all constructions of spectral sequences essentially occur in the homotopy category? That would certainly answer my question. I thought that since computing homotopy groups of Symmetric Spectra (non-naively) was subtle that such constructions might be subtle as well.
I don't think I noticed this question before. One point is that now that we have multiplicatively well-behaved Quillen equivalences between all reasonable models for the stable category, hence between reasonable models for categories of ring and module spectra, it is formal to transport constructions like spectral sequences from one model to any other. Another point is just historical: EKMM got there first and skimmed off the easy applications. In view of the first point, there is no reason for anyone to want to reinvent the wheel.
A technical point is that, for spectral sequences especially, it is convenient to work with CW spectra (or CW R-modules for a ring spectrum R), and these are nowhere written down in any context other than EKMM (harking back to LMS). They are only natural objects when all spectra are fibrant; more precisely, unless all spectra are fibrant, CW spectra will not be nicely related to the cell spectra relevant to the model structures of interest. (Section 24.2 of Parametrized Homotopy Theory http://www.math.uchicago.edu/~may/EXTHEORY/MaySig.pdf has some discussion of this.) This advantage of EKMM has directly related offsetting disadvantages; in particular, the sphere spectrum is not cofibrant. It is an old theorem of Gaunce Lewis that you can't have everything.
Repeating myself from other answers, it is best to be eclectic.
Not the answer you're looking for? Browse other questions tagged spectral-sequences stable-homotopy at.algebraic-topology or ask your own question.
How do you compute the space of lifts of an E-infinity map?


Interlocutor: I’d like to continue with the topic related to the Crystal skulls which main characteristic is the way they have been carved, because there are no machines, artifacts or skillful engineers in our planet capable to make something so perfect on crystal.
The most renown and mysterious skull is the one of Mitchell Hedges that has characteristics very similar to a real human skull, with teeth and a moving jaw.
The researchers emphasize that the Mayans didn't possess technical skills to make such task.
I don't doubt for a moment that these skulls are made with extraterrestrial technology.
Ruanel: Certainly they are. If the anthropologists looked carefully to these skulls they found, they would see that many of them are not human (homo sapiens sapiens) but rather they are of homo Neanderthal and homo pithecanthropus, that is to say, previous races to the human race.
In all times, different extraterrestrial civilizations have come to study the human race.
Interlocutor: Are we so privileged?
Ruanel: No, not at all. It is very normal, and this is something that human beings don't understand that other races of the universe study other beings from other planets. What I don't approve are the sacrifices, that is to say the practice of vivisection or any other type of experiments to study an inhabitant of a certain race whether it drives to its death or not, because it is always an enslavement of free will.
It is also necessary to highlight that there are extraterrestrial races that don't know to the human being so they don't know if they are experimenting with a being that has an intelligent decoder.
Interlocutor: That is to say that they believe they are experimenting with animals?
Interlocutor: And what connections have these facts with these famous Crystal Skulls?
Ruanel: I have already said that for thousands of years, extraterrestrials have come to study the human race and they have made skulls that are replicas of the human skulls they were investigating. They gave these skulls to the natives in order to revert the natural fear they felt toward those "strangers" and to the experiments they made.
Ruanel: These skulls were shown to Neanderthals so that they could play with them and see that there was nothing to fear.
Interlocutor: I continue without understanding. Weren’t These skulls replicas of the skulls of the aliens, the Neanderthal or pithecanthropus?
Ruanel: Not all the skulls were replicas of the Neanderthal or the pithecanthropus, since some of them were also from the same aliens.
Interlocutor: Let’s see if I understand: The skulls were replicas of humans and aliens, and they were used by the researchers as study objects, like the students of medicine do with the skeletons of plastic, on one hand, and on the other hand like objects familiar to the natives so that they could be studied without fear. Is it correct?
Ruanel: Why do you want to look for the mystery where there is none?
Interlocutor: Is it something similar the dentists do with the kids when they need a dental job, when he gives them some false teeth so that they play with it and in this way avoid any fear they have? Or perhaps like the white explorers made to ingratiate with the Indians giving them objects like mirrors and those things?
Interlocutor: I can’t believe that something so simple originated stories full of enigmas with these skulls!
Ruanel: It is something characteristic of human beings to complicate things.
Interlocutor: To these skulls they have been attributed many things, from miraculous cures to paranormal phenomena. I read the next thing: "Frank Dorland, an art restorer that made several experiments with the skull found by Mitchell Hedges, said that once a halo surrounded him by several minutes, he listened sharp sounds, similar to tinkling and that other times inside the skull and images of mountains, lights and other objects appeared, as well as a characteristic scent coming from its interior."
Interlocutor: Now I understand perfectly. What a pity, I expected something more spectacular!
This entry was posted at Tuesday, August 25, 2009 and is filed under Mysteries and Enigmas . You can follow any responses to this entry through the .


How do you start your morning? We all have certain habits when it comes to our morning routine but I bet breakfast depends, in part, on your schedule for the day. A leisurely breakfast is probably reserved for a lazy Sunday morning (though even those seem to be rare and we basically have to schedule them) or for days when we can hit up our favorite local diner.
I never miss breakfast. Since I love to eat so much, I look forward to waking up so I can have my first meal of the day. It's no joke. The meal doesn't have to be elaborate. In fact, it usually isn't. Occasionally, you may find me at the local coffee shop ordering my favorite coffee drink and a breakfast sandwich. At home, it's probably a cup of tea and generally something quick and simple to eat but it gets me started for the day.
For a while recently, it was all about my favorite cereal. I ate it relentlessly for nearly 6 months and finally got tired of it. Recently, I've been sticking with a nice toasted bagel. Other mornings may be a soft boiled egg with some almonds or a bowl of oatmeal. For my husband who's on a tight schedule before work, it may be a muffin or a slice of banana bread. When we have the time, we'll make pancakes, french toast, or a fried egg and ham sandwich. Once in a while I like to have a breakfast party and invite my family over to enjoy the first meal of the day together.
This little breakfast toast is something I've been making a lot for my husband and son (I love it too) and I wanted to share it with you. It's simply toast with sweetened condensed milk.
This toast with some butter and condensed milk is a very common breakfast sandwich or snack we'd have growing up in Hong Kong. You'll see in on the menu of many Hong Kong style tea shops or what would be considered Chinese cafes or diners. And you'll find this kind of restaurant in the Chinatown communities of major cities. To this day, I love visiting this type of "tea shop" where they serve a sort of fusion of Eastern and Western dishes and snacks with your choice of milk teas or other signature drinks like iced tea with lemon (hard to explain but it tastes different from what we're used to). I'm not sure that I visited many of these cafes when I was a child in Hong Kong but for whatever reason, I love these places and the eclectic variety of food you can find there.
What's great about having experienced life in Hong Kong (for the first 7-8 years of my life at least) is that while I certainly grew up around amazing Cantonese food and culture, Hong Kong being a British colony for a long time, meant we also had Cadbury chocolate bars, and enjoyed tins of butter cookies, high tea, and Christmas celebrations in our lives. European imports were common and I remember eating nutella before it became as common as it is now in the States. We love to spread it on a warm bagel for breakfast.
I hope you can make a little time for breakfast. Have a wonderful day!
Trim the crust of your pieces of white bread and lightly toast it. Smear each piece of toast with a little bit of salted butter.
Then, slather on the sweetened condensed milk. I would say about a tablespoon per slice but the amount is up to your liking.
Slice on the diagonal and it's ready to eat!
And when you're tired of butter or cream cheese on your bagel, a little nutella chocolate-hazelnut spread is a nice switch.


"Analyses of Raft and Squeezing Salt Geometries in Permian Zechstein on and offshore northern Netherlands"
Top Salt (white mesh) and the Z3 stringer in the northern Dutch onshore (view from N).
The brittle Z3 intra-salt stringer (anhydrite and dolomite) is investigated on its structural features on different scales (regional, local, intra-, inter-, and well-scale). First results show that (1) the overall stringer geometry correlates to the intensity of halokinesis, (2) the stringer geometry locally strongly differs from Top Salt, (3) halokinesis and stringer deformation are strongly influenced by tectonic movements in the pre-salt (e.g. along the boundary of the Louwerszee Trough).
E-W seimsic section northern Dutch onshore, highlighting that the stringer geometry is disharmonic to the Top Salt. Furthermore, the stringer/the salt is only locally effected by tectonics in the underburden ('corner flow'). This implies that the stringer and salt deformation is somewhat decoupled from under- and overburden tectonics, and vertical throws in the salt section much larger than expected from Top Salt geometry.
Finally, the stringer imaged in the 3D seismic volumes is of very complex geometry. This is most likely base on superimpoised, polyphase patterns of folds and boudins with offsets and stacks of stringer fragments. Interpretation of the structures implies that only one part of the stringer is visible in seimsic data (i.e., isolated fragments may represent the seismically resolved fold hinges, while the steep and thin fold limps are invisible), and that compressional and extensional (or complex sharing?) deformation mechanisms may have changed during time.
The big questions is: which part of the stringer is seismically imaged, and which structures can be interpreted from that?
Comparing interpretations of the internal structure of salt diapirs from mining literature (Seidl, 1923; left image) with the interior of similar structures in seimsic data (right image) implies that a large part of the stringer may be invisible. A model of a more or less connected stringer with isoclinal folds comes to mind. However, breaking of the brittle intra-salt stringers is not considered in the mining literature from the early last century. Consequently, their interpretations may be wrong.
Left: if we compare the seimsic data (top) with our initial interpretation (centre) and one based on salt mining literature (bottom), which interpretation is better? Right: Based on the seimsic data (top) there could be strong differences in the stringer and the salt deformation. The stringer could either be broken up and single fragments are sunken down, while the salt layers could be less deformed (centre), or the stringer is (more or less) connected and heavily folded, while the salt layers are strongly deformed (bottom). Note that stringer fragments in the first model sink into the lower salt section, while the stringer in model two still traces the boundary between both salts.
Movie of a rotating fold in the Zechstein.
Animated Illustration of van Gent et al (2011). The internal geometry of salt structures -. Journal of Structural Geology 33, 292-311.
Other articles in the category "salt deformation"


WASHINGTON -- The Obama administration in its final year in office spent a record $36.2 million on legal costs defending its refusal to turn over federal records under the Freedom of Information Act, according to an Associated Press analysis of new U.S. data that also showed poor performance in other categories measuring transparency in government.
What an imbecilic attempt to clearly imply wrongdoing on the part of the Obama administration.
While the buck certainly tops at the Oval Office, the US government is so incredibly compartmentalized and insular in procedure and management as to make this article, utterly laughable. Increases in REQUESTS for information in N0 way indicates malfeasance or criminality, and are equally as likely to be the result of (for instance) expanded efforts by Republicans to collect dirt, and or discredit the president and his administration.
Just because a record is requested, doesn't mean that the public automatically has the right to it (especially in light of anti-terrorism efforts). Nominal processing fees for records are de riguer in most FOIA request cases. Finally, with the sweeping new laws and changes of policies instituted by the administration, it's only logical that increased requests for information would result.
Don't get me wrong. I'm no big fan of the FBI in some cases. Take for instance when they grossly misstate the number of cases of smart phones by a factor of four in order to force companies like Apple to provide the government with a back-door to inspect the contents contained within (they claimed 7,800 but in fact, there were FAR less than 2,000), but let's get real here... context is EVERYTHING.
Besides, I can think of 100 more newsworthy stories that aren't over a year old. Take for instance, a story about the Trump administrations recent track record on FOIA requests.
(Washington, DC) — Judicial Watch obtained 32 pages of records showing the Obama administration sent U.S. taxpayers’ funds to a group backed by billionaire George Soros, which used the money to fund left-wing political activities in Albania, including working with the country’s socialist government to push for highly controversial judicial “reform.” The records also detail how the Soros operation helped the State Department review grant applications from other groups for taxpayer funding.
In related cases, Judicial Watch is seeking information regarding Soros’ activities in Macedonia, Romania and Colombia.
Any credible and reliable source to support those narrative or is this just another futile attempt to detract from the dysfunction going on in the White House? I would say the latter seeing that you've had several years to confirm and clear your subject matter up.
While on the topic, whats going on with the EPA since most Americans including CNN were literally barred from the meeting?
is that he uses propaganda that originated on a white supremacy blog.
More fake news for the poorly-educated racist.
It seem as if Mueller has called Trump's bluff by giving him a specific date on a Mueller/Trump interview but Trump is rebuffing this date. Donald, here's the deal, if as you say, this cloud as you call it is a "Witch Hunt" why not move the date up to say, next month since you won't be meeting Kim Un and get this entire investigation over with? Smart Liberal know the answer, as soon as you open your mouth, you will perjure yourself seeing that all you've stated in the last several months are all lies.
Trump is rebuffing this date.
A spokesman for House Speaker Paul Ryan, R-Wis., weighed in Tuesday on an NBC News report that House Freedom Caucus founder Jim Jordan allegedly turned his back on wrestlers who said they were sexually abused by an Ohio State team doctor.
“These are serious allegations and issues. The university has rightfully initiated a full investigation into the matter. The speaker will await the findings of that inquiry,” said Doug Andres, a spokesman for Ryan.
NBC News reported on Tuesday that former Ohio State wrestlers said Jordan ignored sexual abuse that was allegedly committed by team doctor Richard Strauss.
OMG Johnson, are you on Putin's payroll too?
After spending his Fourth of July holiday watching ballet in St. Petersburg and visiting with Russian officials in Moscow, Wisconsin Republican Sen. Ron Johnson is back in the states to say that we’ve been too hard on Vladimir Putin. As Roll Call reports, Johnson stated that the United States had gotten way, way too upset about the fact that Russia stole information from one campaign, fed it to the other, created hundreds of false media sites, disseminated thousands of false social media posts, sent Russian agents to conduct fake “grassroots” protests on American soil, and invested millions in targeted ads over Facebook, Google, and other services.


I don't know what to write about the match that hasn't been written. How many times do I have to write that? It's the same week in week out these days. It feels like it's ever since Lambert took over, barring a few weeks in February and March of his first season, that I used as the basis to support him last season.
It isn't going to change. And what pisses me off more than anything is how Paul Lambert can after the match say that for us, for Aston Villa, to go to West Ham and get a point, is a big result. Paul Lambert has taken this great club and made us what we are today.
Or has he? The day we appointed Alex McLeish was a dark day for Aston Villa and that was basically the headline I wrote the day it was confirmed. I was speaking to someone the other day who actually referenced that day as when she thought it was all over for her.
She has been a season ticket holder for a number of years and this season she just didn't bother. I suspect she enjoys her weekends more. But it was the utter lack of respect that they showed when they hired him. Aston Villa supporters have a part to play too; they gave Houllier another heart attack and many sang for Paul Lambert.
In that sense, I suppose it's fair to say that not many actually know what is best. I'll say this though; Houllier was the right man and Lambert should never have been hired. But again, I've written that so many times, it feels as if it doesn't matter.
And the other day I wrote something about the club having thought about relegation and I got an email on the back of that from someone that said they probably have. He said it would galvanise supporters and it would, but mark my words, if it happens it will also push some away. If it happens, some will give up.
Have you ever wondered why you don't see loads of old people at football grounds? It's because most give up because most figure out that it's a one way street, even if we try and even if we love the club. they find better things to do with the weekend, like spend time with family, go to the pub and enjoy listening to the results come in on the radio or on the TV.
I don't know what to write about the result or the performance at the weekend, because it will differ to Paul Lambert. It wasn't a big result, it was basically a poor match and one that most of the West Ham fans I've read think they should have won. Take away Guzan and they probably would have.
And before I go, ah forget it. It doesn't matter what I write about Delph and Vlaar, they're off. They're jumping ship just like so many before them have. It will take a new owner to come in and give them £100k a week to stay, but if we're going to pay that money for them, I think we can get better. It's just sad that they know more than we. They know Aston Villa Football Club is sinking.


pseudoparanormal: Woman Onboard a Ship Will Bring Bad Luck.
Looking for comfort at sea, sailors have a long standing tradition of being superstitious. One of these traditions is that having a woman on the ship will bring bad luck to the ship and it's voyage. One article stated, that sailors once believed that having a woman on board a ship would anger the gods of the sea. This would bring about violent waves and disastrous weather conditions. It is believed that in rare cases, woman were sometimes thrown from the ship to seek the forgiveness of the gods.
One possible origin of this myth is that the woman were a distraction to the crew members. At the peak of these supernatural claims, the voyages across the ocean would take months to complete. A lot of attention would be paid to the only woman that they would see for these long periods of time. The crew members may have feared that having a distraction from the ship's needs may lead them into harm's way.
Another possible contribution to this superstitious belief is that it was traditionally believed that women were not as physically or emotionally capable as men. The food onboard a ship was limited and bringing a person that was believed to be less able and significant was not a great option considering that they would still need rations to survive.
In contrast to the original myth, there is also the belief that a woman would be good luck for the ship. During the nineteenth century, images of woman became popular subjects for ship carvers. Figureheads are carved wooden decorations that are found at the prow of ships. Many of these figureheads represented woman which were said to calm the ocean and bring the ship safely back to shore.
There is no evidence of women being back luck for a ship or its crew, however these superstitions are still myths that exist in present day societies. These superstitions reminds me of the 10 percent of our brains myth because although there is no proof is continues to exist as a superstition. This myth has been made popular even in popular culture through mention in movies just like the 10 percent myth in the film "Limitless." The woman on a ship myth has been referenced in the "Pirates of the Caribbean" movies.
I heard of this myth before seeing it in movies but never payed much attention since my grand parents had a boat since I was little. Despite both going on it nothing never happened that couldn't have happened to either. I think that the figure heads are in their own mythos though.
I've heard of this superstition before too, but it's obviously bogus. There were actually a few successful female pirates in history.