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At least 55 records · Page 3Linked to original sources
PubMed2005

A neural network model for reconstructing EMG signals from eight shoulder muscles: consequences for rehabilitation robotics and biofeedback.

This paper demonstrates the ability of a fully connected feed forward neural network (FFNN) using the backpropagation training algorithm to predict the electromyography (EMG) signal from eight muscles of the shoulder for both exercises not used for training and EMG signals from subjects not used for training. The network showed a good predictive ability for subjects not used for training (r(2) between 0.33 and 0.84) and for activities not used for training (r(2) between 0.56 and 0.89). This may have applications for patients, physical therapists and doctors to monitor patient performance by reviewing the level of agreement between the patient EMG and the predicted EMG. Coupled with traditional methods of evaluation, EMG can provide an excellent measure of how well a patient has responded or is responding to treatment. Incorporating robotic technology could facilitate the use of EMG as an input to an intelligent decision making algorithm used to increase or decrease the level of difficulty according to patient performance.

Adult↗
PubMed1990

Research in physical medicine and rehabilitation. VII. The role of the principal investigator.

The roles and responsibilities of the principal investigator of a research project are described to allow the young researcher to make an intelligent decision regarding which role to take in a research project. Guidelines are given about which tasks may be delegated and how to do this. These tasks include formulation of the question, project design, obtaining funding, project startup and ongoing management, data analysis and publication. Particular attention is paid to design/analysis and publication, since these determine authorship on biomedical research articles.

Humans↗
PubMed1983

Patient selection for prophylactic mastectomy: who is at high risk?

Patient selection for prophylactic mastectomy should be based on an individual assessment of risk factors. These should be correlated with the patient's age, the difficulty of clinical examination, and, in the case of a previous breast cancer, its prognosis. Only then can the patient and her surgeon make an intelligent decision regarding management.

Axilla↗
PubMed1982

Is it time for a computer in your practice? II. What tasks your computer can perform.

In this article, the potential benefits of an office computer system have been detailed. As computer costs and sizes decrease, and computing capabilities increase, even more benefits will be had in the future. Of course, not all of these benefits are applicable to all practices. Equally important to note are the many problems associated with installation and use of computer systems, and these must be taken into account before an intelligent decision can be made as to whether its acquisition would benefit your practice. Helping the physician to weigh the benefits of an office computer system against its costs and potential problems will be the subject of the next article in this series.

Computers↗
PubMed1998

The chromatin pattern of cell nuclei is of prognostic value for renal cell carcinomas.

Using a series of 105 renal cell carcinomas (RCCs) we investigated whether features quantitatively describing the appearance of Feulgen-stained nuclei and, more particularly, of their chromatin (on the basis of computer-assisted microscopy) can contribute any significant prognostic information. Thirty morphonuclear and 8 nuclear DNA content-related variables were thus generated. The actual prognostic values of this set of cytometric variables was compared (by means of discriminant statistical analysis) to conventional diagnostic and/or prognostic markers including histopathological grades, tumour invasion levels and the presence or absence of metastases. We obtained complete clinical follow-ups for 49 of the 105 RCC patients under study, making it possible to define a subset of patients with a bad prognosis (i.e., who died in the 12 months following nephrectomy) and a subset of patients with a good prognosis (i.e., who survived at least 24 months following nephrectomy). An original method of data analysis related to artificial intelligence (decision tree induction) enabled a strong prognostic model to be set up. In the case of 10 new patients, this model identified all the dead patients as having a bad survival status, with a total of 8 correct predictions. Another prognostic model similarly generated enabled the correct predictions to be confirmed.

Adult↗
PubMed1997

Preparticipation screening of children for sports. Current recommendations.

Every year physicians all over the world are asked to perform preparticipation physical evaluations (PPE) for children involved in sports. The PPE should be brief yet comprehensive enough to determine which athletes are at risk. In addition, the examination may help determine the athlete's general health and maturity level, uncover any disqualifying conditions and may also help establish a doctor-patient relationship. PPEs should be performed 4 to 6 weeks prior to initiation of the sport and be repeated every 1 to 3 years. A station-based exam may help evaluate large numbers of athletes within a limited time period. The history is the most important aspect of the PPE and should focus on prior cardiovascular complications, a family history of cardiovascular death before 50 years of age and any other limiting medical problems. A general physical examination should be performed to focus on areas involved in sports participation. Laboratory tests are not usually necessary. Disqualifying conditions may be determined based on the physical abnormality present and the amount of contact or energy involved in the sport to be played. Throughout the world, sports participation is growing rapidly. Although these guidelines have been drafted by a consortium of sports-related and general practice groups in the US, they can easily be applied worldwide. Unfortunately the health of young adults in developing countries may not be as good as that of those residing in more industrialised countries, therefore each athlete must be considered individually. With this type of individualised approach the examining physician can make informed and intelligent decisions concerning the athlete's participation.

Adolescent↗
PubMedDate not supplied

DIABNET: a qualitative model-based advisory system for therapy planning in gestational diabetes.

An intelligent decision support system for the analysis of home monitoring data and therapy planning in gestational diabetes is presented. The paper describes the integration of qualitative and quantitative reasoning modules within the DIABNET advisory system. The system kernel is a qualitative model of the physiological processes involved in the glucose metabolism of this type of diabetic patient. A causal probabilistic network (CPN) has been used to represent the qualitative model in order to manage uncertain and missing monitoring data. The DIABNET inputs are the patient's available ambulatory monitoring data, and the output is a dietary and insulin therapy adjustment that includes initiation of insulin therapy, quantitative insulin dose changes and qualitative diet and schedule modifications. Over periods of up to seven days, monitoring data are analysed by the CPN to detect any diet or insulin therapy items which may require modification. The qualitative insulin needs are translated into a quantitative proposal in line with the characteristics of the patient and the modification strategies usually used by doctors. The first evaluation of the system has been accomplished, the encouraging results of which are also presented.

Blood Glucose Self-Monitoring↗
PubMed1997

Evaluate and communicate health care benefits.

Both employers and employees need appropriate information to make intelligent decisions about health care benefits. For employers, analysis of health care data offers an approach to monitoring quality care and can provide a tool for controlling costs. For employees, an education and communication strategy is probably the single most important factor influencing both program utilization and employee acceptance.

Communication↗
PubMed1985

Office management: increasing productivity in the workplace.

Healthcare managers are seeking new ways to increase productivity in the workplace. New technologies, such as word processing, electronic mail, electronic conferencing, calendar management, data base management systems, artificial intelligence, decision support systems, and local area networks, are being developed to help the healthcare manager make the workplace more productive. The challenge therefore is to implement these systems smoothly and address the organizational issues associated with implementation.

Decision Making↗
PubMed1987

Developing price, charge, and cost rationales.

The health care industry has experienced some turbulent years recently, and the end does not seem near. Payment methods are being established that are entirely new and have not stood the test of time. For hospitals to remain competitive, they must be able to understand and master the different payment methods. The one common thread discussed throughout this article is that intelligent decisions concerning payment cannot be made until the costs are known. Hospitals cannot commit to these contracts and cannot expect to perform well and generate profits without this knowledge--without detailed cost information, it is a "stab in the dark." A good working relationship between cost accounting and materiel management is needed to accumulate timely and accurate information. This is why their relationship is so important. Those hospitals that master this information requirement will have the best chance of survival in the increasingly competitive field of health care.

Economic Competition↗
PubMed2000

The role of the clinical laboratory in managing chemical or biological terrorism.

BACKGROUND: Domestic and international acts of terrorism using chemicals and pathogens as weapons have recently attracted much attention because of several hoaxes and real incidents. Clinical laboratories, especially those affiliated with major trauma centers, should be prepared to respond rapidly by providing diagnostic tests for the detection and identification of specific agents, so that specific therapy and victim management can be initiated in a timely manner. As first-line responders, clinical laboratory personnel should become familiar with the various chemical or biological agents and be active participants in their local defense programs. APPROACH: We review the selected agents previously considered or used in chemical and biological warfare, outline their poisonous and pathogenic effects, describe techniques used in their identification, address some of the logistical and technical difficulties in maintaining such tests in clinical laboratories, and comment on some of the analytical issues, such as specimen handling and personal protective equipment. CONTENT: The chemical agents discussed include nerve, blistering, and pulmonary agents and cyanides. Biological agents, including anthrax and smallpox, are also discussed as examples for organisms with potential use in bioterrorism. Available therapies for each agent are outlined to assist clinical laboratory personnel in making intelligent decisions regarding implementation of diagnostic tests as a part of a comprehensive defense program. SUMMARY: As the civilian medical community prepares for biological and chemical terrorist attacks, improvement in the capabilities of clinical laboratories is essential in supporting counterterrorism programs designed to respond to such attacks. Accurate assessment of resources in clinical laboratories is important because it will provide local authorities with an alternative resource for immediate diagnostic analysis. It is, therefore, recommended that clinical laboratories identify their current resources and the extent of support they can provide, and inform the authorities of their state of readiness.

Animals↗
PubMed1991

Managing patient education: a perspective for the 1990s.

Changes in the delivery and complexity of health care make it imperative that the patient and family are provided with the information needed to make intelligent decisions and choices about health care alternatives. The intent of this paper is to outline the nurse manager's responsibilities for patient education and to provide a practical framework by which to structure patient teaching programs. Although the philosophies of self-care and self-determination are outlined and provide the primary orientation to the concept of patient education, the description of the nurse manager's clinical and aggregate skills provide both the training and practice guidelines.

Assertiveness↗
PubMed1990

Informed consent for presbyopic contact lens patients.

The doctrine of informed consent requires that health care practitioners provide each patient with sufficient information about a proposed treatment so that the patient can make a knowing, willing and intelligent decision about the recommended treatment. The need for a thorough, well documented informed consent is especially important when prescribing monovision or bifocal contact lenses for presbyopic patients because of the relatively low success rate and possible associated vision compromise. Patients should be advised of the alternatives available and provided with a supplemental or alternative correction which will optimize the patient's vision for driving and other potentially hazardous activities. An example of an informed consent document that could be used to record the warnings and advice given to presbyopic contact lens patients is included. Failure to obtain the patient's informed consent and properly document it can be a major source of liability in contact lens practice. Use of informed consent documents such as the one described in this paper can minimize this possibility.

Contact Lenses↗
PubMed1990

[Measures for reducing the risks of anesthesia].

To reduce the risks to human health and life has become an increasing demand by society. Physicians and engineers must develop and adopt measures to reduce such risks. The administration of anesthesia may be viewed as a closed-loop control system consisting of three major components: the anaesthesia system, the patient, and the system operator. An analysis of human element involved in the administration of anaesthesia indicates that the human brain is best qualified to make intelligent decisions; however, the reliance on human vigilance for the continuing monitoring of monotonous processes is questionable. Human error may be divided into slips, mistakes and omissions, each of them requiring different means of prevention. The events during a critical incident follow a certain sequence. Preventive measures can best be prepared by analyzing this sequence. The designer of medical equipment has four different approaches available to prevent injury to the patient: (1) to design the equipment which prevents a human error, (2) to design the equipment that injury is not possible when the human error occurs, (3) to warn of the possibility of a human error, or (4) to monitor for changes of important parameters which indicate the beginning of a critical situation. The most important safety measure is an integrated monitoring system with centralized, structured alarm announciation.

Accident Prevention↗
PubMedDate not supplied

[Clinical aspects (especially nephropathologic) and genetic counseling in tuberous sclerosis. Presentation of a case with polycystic kidney].

Tuberous sclerosis (TS) represents a relatively frequent inherited disorder of the skin and neurological tissues. Defects of other organs may also be present, but subjects differ significantly in their individual involvement. Usually, white leaf - shaped macules, even though most subtle, are the first precocious sign of the disease in young patients. Other signs tend to appear when the patient grows older. Visceral disorders include renal angiomyolipomata; clinical behavior of these solid tumors is almost always benign. Sometimes the renal lesions present themselves as polycystic kidneys, and may be the earliest sign and the only manifestation of TS, such as the case here described. This unusual form of renal involvement may be a severe potential complication of TS for the possible blood hypertension, recurrent urinary sepsis and chronic renal failure. It is of the utmost importance to search for the classical stigmata of TS in any patient who has cystic renal enlargement as only apparent abnormality. Careful inquiry into the family history cannot be overemphasized. The authors believe that, failing availability of adequate therapy for TS, the role in genetic counseling is to provide as much informations as possible to enable the involved family to make an intelligent decision about future children.

Child↗
PubMedDate not supplied

Selecting child care workers for adolescents: the California Psychological Inventory.

The findings of this study suggest that the CPI can be used to identify characteristics of desirable CCWs for emotionally disturbed adolescents. They include the ability to make intelligent decisions and exert reasonable leadership (Do); to be effective in dealing with others (Cs); to be outgoing and enterprising (Sy); to be socially poised (Sp); to be assertive and self-assured (Sa); to be broad-minded and accepting of different people and values (To); and to be direct, active, and realistic (low Fe). These seven scales of the CPI showed significant difference between the most desirable (Group D) and the unacceptable (Group U) CCWs. Discriminant analysis revealed that selection of the most desirable CCWs can be achieved by using only five of the scales: high Do, Sp, Sa, To, and low Fe; this process identified the most acceptable and unacceptable employees over 85% of the time. If the CPI is used as an adjunct to interviews and adequate reference checks, this multi-evaluative process can greatly improve the likelihood of selecting the best potential CCW candidates. Since CCWs play a direct role with the young people in their charge, and the most effective treatment for disturbed youths can be carried out by the most effective CCWs, the selection process of CCWs becomes a critical factor in the development of any program for emotionally disturbed adolescents.

Adolescent↗
PubMed1985

Operative risk of mitral valve replacement: discriminant analysis of 1329 procedures.

The influence of 34 variables on the operative mortality rate for isolated mitral valve replacement (MVR) was assessed by univariate and multivariate logistic regression analysis. The physiologic lesions were classified as stenosis (20%, operative mortality rate 8 +/- 1%), regurgitation (44%, operative mortality rate 13 +/- 2%), and mixed (34%, operative mortality rate 8 +/- 1%). Functional class (NYHA), previous myocardial infarction, and hepatic dysfunction were powerful independent clinical determinants of operative mortality (p less than .001), along with age at operation and emergency operation (p = .001, p = .04). Concomitant coronary artery bypass grafting or tricuspid annuloplasty, angina, ischemic etiology, and physiologic lesion were not significant independent determinants of operative risk. Interestingly, year of operation, prosthetic valve dysfunction, and previous cardiac surgery had no important effect on operative mortality. Early operative risk for MVR was related to preoperative cardiac and hepatic function. Prior myocardial infarction substantially increased the risk even if the mitral valve disease was not ischemic in origin. Increased operative mortality rate in the subgroup with mitral regurgitation was related to advanced left ventricular failure and myocardial infarction rather than the etiology of the mitral regurgitation. These clinical factors coupled with more refined measurements of left ventricular systolic pump function (independent of loading conditions) should permit more intelligent decision making regarding the optimal timing of MVR, at least in terms of early operative risk.

Adult↗
PubMed1982

Canadian Red Cross lecture. Current concepts of oxygen-transporting blood substitutes.

Blood substitutes are being developed that will provide oxygen-transporting capabilities as well as volume replacement. Perfluorochemical and hemoglobin solutions have potential clinical use. A perfluorochemical blood substitute, Fluosol-DA 20%, is being used in clinical trials in several countries. These blood substitutes are not capable of totally replacing the need for blood transfusions but could be used temporarily in situations where blood is contraindicated or not available. They may be useful for a wide range of clinical conditions other than blood replacement, such as impending tissue ischemia. Before large-scale clinical use of these products is realized, more information is needed about drug efficacy and safety so that intelligent decisions can be made about indications for this type of transfusion therapy.

Animals↗