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OBJECT: To examine the usual methods of blood pressure (BP) measurement by primary care physicians and to compare them with the standard methods. METHOD: Design: Cross-sectional survey by self-administered questionnaire. Subjects: Primary care physicians who graduated from Jichi Medical School and were working at clinics. Each standard method for 20 items was defined as the one that was most frequently recommended by 6 guidelines (USA 3, UK 1, Canada 1, Japan 1) and a recent comprehensive review about BP measurement. RESULTS: Of 333 physicians, 190 (58%) responded (median age 33, range 26 to 45 years). Standard methods and percentages of physicians who follow them are: [BP measurement, 17 items] supported arm 96%; measurement to 2 mmHg 91%; sitting position 86%; mercury sphygmomanometer 83%; waiting > or = 1 minute between readings 58%; palpation to assess systolic BP before auscultation 57%; check accuracy of home BP monitor 56%; Korotkoff Phase V for diastolic BP 51%; bila!

That the visual arts have been among the last to embrace any form of stylometry is perhaps more a matter of tradition than anything else. As a discipline, connoisseurship has scientific origins, usually attributed to Giovanni Morelli, a 19th-century Swiss-Italian government official with a deep appreciation for the arts. It was in a large part shaped by an early education focused on the sciences, and, in particular, his experiences accompanying the renowned and naturalist Louis Agassiz on his glacier expeditions in Switzerland. Morelli brought the skills of an expert naturalist to the problem of looking at, comparing, and, finally, classifying works of art. In his major lifework, Italian Painters: Critical Studies of their Works, Morelli foreshadows the still unborn science of literary styometry as he writes, "As most men, both speakers and writers, make use of habitual modes of expression, favorite words and sayings, which they often employ involuntarily and sometimes even most appropriately, so almost every painter has his own peculiarities, which escape him without being aware of it." According to Morelli, these "peculiarities" would find expression in the quiet comers of a work of art. Thus the "Morellian method" relies on the comparison of seemingly minor details in paintings: folds in drapery, a fingernail, or an earlobe. In Morelli's view, it was only in details such as these, which he called the "grundformen" (fundamental forms) of the artist, that the forces of tradition or schooling would be diminished enough so that the artist's true nature could shine through. In spirit, it is a visual form of Zipf ' s principle of least effort, a view of the artistic output as shaped by a battle between the expectations of the receiver and the predilections of the sender. Morelli was only able to apply his ideas with the tools he had at hand, mainly his eyes. Lacking digital scanners and image processing software, he built an internal database of grundformen that, to some degree, would permit him to distinguish between details such as hands painted by Boticelli and Bellini. But with today's technology, we can begin to make mathematics out of Morelli. Through the use of "wavelet analysis," a mathematical technique originally developed in the 1980s as a means of determining within sonar data the fingerprint of oil deposits beneath the ocean floor, my Dartmouth colleagues and I have made headway. We have found that a statistical summary of the density of simple linear elements in some of the drawings of the great Flemish artist Pieter Bruegel the Elder, as extracted from high resolution digital scans of the originals, can provide a numerical signature that seems to act as a classifier for Bruegel's work. Even more Morellian than that, we have applied the same technique to the comparison of details within Madonna and Child, a huge altarpiece attributed to the great Renaissance master Perugino, in the hopes of determining the number of artists who contributed to the work. Whether or not the exploration for oil in the oceans has resulted in a definitive tool for the exploration of oils on the wall is still up for debate. Wavelets are an example of a multiscale analysis-that is, they proceed by analyzing a work at successive levels of detail, like examining a work through varying the magnification on a microscope. In a wavelet analysis, what becomes important is the difference between what is measured at two scales, in a sense, representing the original image as some baseline structure to which is added a successive layering of detail.

American Journal of Hypertension. 11(12):1469-74, 1998 Dec.

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Readings differing by less than 5, 10 and 15 mmHg for SBP and DBP fulfilled IP recommendations. According to the BHS protocol, for the better observer, the percentage of test device readings differing from the mercury standard by 5, 10 and 15 mmHg or less were: 92.9, 100 and 100% for SBP and 94.9, 98.8 and 99.6% for DBP. The mean differences +/- standard deviation between the device and mercury sphygmomanometer readings were 1.7 +/- 3.1 mmHg for SBP and 1.1 +/- 3.2 mmHg for DBP, achieving AAMI requirements. Standard deviation of mean differences were 2.4 for SBP and 2.1 for DBP, following the IP, and 3.1 and 3.2, respectively, for BHS protocol. The variance of all 99 differences (total deviance), with 98 degree of freedom, was 585.6 for SBP and 444.1 for DBP. The 33 differences obtained from the mean differences for each participant (between-subject variance), with 32 degree of freedom, were 275.6 and 152.1, respectively. F test was 1.83 with P = 0.0191 for SBP, and 1.07 (!

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