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PubMed1970

Q-I-IIA-OS formula for predicting left atrial pressure in mitral stenosis.

The relation of the phonocardiographic time intervals (Q-I) and (IIA-OS) and the use of two formulas (Q-I, IIA-OS difference versus their ratio) for estimation of left atrial pressure were investigated in 70 cases of pure mitral stenosis. It was noted that, in cases with normal blood pressure and pluse rate, there was a fair correlation of the two intervals to left atrial pressure. In our studies the best correlation was obtained by using the ratio of these two intervals (Q-I)/(IIA-OS). These results indicate that it is possible to use a new formula and equation that are dependable for phonocardiographic evaluation of left atrial pressure.

Adolescent↗
PubMed1975

Cardiac lymph flow and composition in acute myocardial ischemia in dogs.

Cardiac lymph was obtained from 12 normal dogs (group 1) for two consecutive 2-h control periods and from 7 dogs (group 2) for 2 h before and 2 h after occlusion of the circumflex branch of the left coronary artery. Lymph composition was studied with reference to pH, red blood cell (RBC) concentration, total protein content, potassium and sodium ion concentrations, and creatine phosphokinase (CPK) and acid phosphatase enzyme activities. No significant difference was noted in any variable between the two groups during the firts 2-h period. In group 1, no significant changes occurred in any variable as a result of the passage of time alone. In group 2, 2 h of myocardial ischemia produced increases of 53.3 plus or minus 5.1% in lymph flow, 67 plus or minus 5% in protein content, and 418 plus or minus 27% in the RBC concentration, suggesting increased blood capillary permeability. Lactate rose 120.5 plus or minus 27%, potassium concentration increased 16.9 plus or minus 2.4%, acid phosphatase increased 30 plus or minus 3%, and CPK rose 61.6 pluse or minus 10.9%, suggesting ischemic injury of myocardial cells. These changes in lymph were statistically significant (P LESS THAN 0.05) and reflect both capillary and myocardial cell abnormalities.

Animals↗
PubMed2006

Integrating treatment and education for mood disorders: an adolescent case report.

This case study illustrates one successful outcome of an intensive, outpatient, treatment project for adolescents with mood disorders. An 18-year-old female with symptoms across several DSM-IV Axis I classifications, including a depressive disorder, and her parents participated in a year-long, multimodal intervention that included mood-focused psychoeducation and coaching designed to impact on her, her family, school, and community systems. Self-report, clinician-driven, and ecologically valid measures were used to assess treatment effects on psychiatric symptoms and psychosocial functioning. Results on the Child and Adolescent Functional Assessment Scale demonstrated considerable gains in the following areas: Home, school/work, social behavior, self-harm, thinking/communication, and substance use. During the intervention, she went from failing several of her classes to graduating from high school. In addition, she made the Honours' List in her first semester at a local community college. A discussion of intervention pluses and pitfalls specific to the case highlight the necessity to influence the various spheres of the young person's life.

Achievement↗
PubMed1986

Rapid determinations of preference in multiple concurrent-chain schedules.

With concurrent chains arranged for a pigeon's key pecks, pecks on two concurrently available initial-link keys (left and right) respectively produce separately operating terminal links (A and B). Preferences for terminal link A over terminal link B are usually calculated as deviations of relative initial-link response rates (left divided by total pecks) from those during baseline conditions, when A equals B. Baseline preferences, however, are often variable and typically are determined indirectly (e.g., with unequal A and B, reversing left-right assignments of A and B over sessions and estimating the baseline from differences between the relative rates generated). Multiple concurrent-chain schedules, with components each consisting of a pair of concurrent chains, speed the determination of preferences by arranging A and B and their reversal within sessions. In two experiments illustrating the feasibility of this procedure, one component operated with circles projected on initial-link keys and the other with pluses; when left and right initial-link pecks respectively produced terminal links A and B in one component, they produced B and A in the other. Even as the baselines fluctuated, preference was observable within sessions as the difference between relative initial-link response rates in the two components. The first experiment demonstrated the rapid development of preferences when terminal links A and B consisted of fixed-interval 15-s and 30-s schedules. The second demonstrated the sensitivity of the procedure to preference for a fixed-interval 30-s schedule operating for pecks on either of two keys (free choice) over its operating for pecks on only a single key (forced choice).

Animals↗
PubMed1994

Deming meets Braverman: toward a progressive analysis of the continuous quality improvement paradigm.

The continuous quality improvement (CQI) model has rapidly become the dominant management paradigm in U.S. industrial and health care leadership circles. Despite its widespread corporate acceptance and its relevance to public sector policy issues, there has been a paucity of progressive analysis of CQI. The authors begin by noting remarkable similarities between CQI critiques of Taylorism (so-called scientific management of work) with those made by Braverman, a leading Marxist analyst of the work process. Each of the 14 principles of CQI pioneer W. E. Deming are explained and analyzed for their progressive content. These pluses are then contrasted with 18 problematic issues in an attempt to challenge and go beyond the constraints of CQI as it is currently being applied in health care and other sectors. These issues include (1) mismatch between rhetoric and reality, (2) public sector issues, and (3) broader contradictions. The authors emphasize the genuine need for improving health care quality and the relevance of CQI for addressing this need. They challenge progressives to grapple with the profound contradictions by the CQI paradigm inviting a broader dialogue on CQI's meaning for improving the public's health.

Delivery of Health Care↗
PubMed2003

Visual image analysis by square wavelets: empirical evidence supporting a theoretical agreement between wavelet analysis and receptive field organization of visual cortical neurons.

It was proposed that the human visual system analyzes images into square wavelets. To test this view, comparisons were made between the perceived similarity-dissimilarity of alphabet letters and the wavelet analyses of those same letters. For the proposal to be considered tenable, the coefficients of the wavelet analysis of similar letters must be similar, and the coefficients of the wavelet analysis of dissimilar letters must be dissimilar. From a selection of 12 letters, four pairs of letters had been reported by Van der Heijden, Mathas, and Van den Roovaart as very similar, and four other pairs of letters dissimilar. Each of the 12 letters was separately depicted in 8 x 8 matrices, and the signal represented by each of the matrices was analyzed into square wavelets using a new and original procedure which yielded a single set of coefficients for each matrix. Correlations between sets of coefficients were high (r ranged from .88 to .58) for those letter pairs judged high in similarity; correlations were low (r ranged from -.02 to .29) for those letter pairs judged low in similarity. When the correlations between the coefficients of wavelets of all eight-letter pairs were compared with the judged similarity-dissimilarity of all eight-letter pairs, the linear agreement was statistically significant. Agreement was found between the neurophysiological mapping of receptive fields of visual cortical neurons and the vectors or the pattern of pluses and minuses which characterized the wavelet analysis. Furthermore, regeneration of the visual image, or the pattern of neural activity representing the image, could be described by a tree-like flow of information among visual cortical neurons which received response data from visual receptive fields, the response data being wavelet coefficients. Results indicate the analysis accurately produces reliable transformations of visual patterns and may be a process used by the visual system.

Algorithms↗
PubMedDate not supplied

Postmortem serum levels of tryptase and total and specific IgE in fatal asthma.

Sera were obtained postmortem from 55 subjects classified into three groups; death due to asthma (FA, n = 21), asthmatic but death not due to asthma (NFA, n = 24) and a nonasthmatic control group (NAC, n = 10). A full autopsy was performed on all cases and a medical history, including details of allergies, was obtained by questionnaire from the next of kin. Grading of asthma severity by either questionnaire or autopsy was comparable (tP = 0.435, p > 0.05) and the mean pathology-grade was significantly higher for the FA group (3.375) compared to the NFA group (2.375), p < 0.05. Tryptase was elevated (> 2.0 micrograms/L) in 21/55 sera (38%) and there was no significant difference between the groups. ROC plots showed that tryptase levels did not discriminate between the FA and NFA groups, even if specimens were collected within 24 hours after death. Total IgE was significantly elevated in the FA group (geometric mean 140.3 kU/L) compared to the other two groups (NFA 30.2 kU/L, NAC 9.4 kU/L), p = 0.05. Fatal asthmatics also had a greater positivity (67%) to a screen for common inhalant allergens than did the other groups (NFA 30%, NAC 20%). Sera with a positive screen were tested against a panel of 10 common aero-allergens. Each sample was then assigned a number (N) and a score (S), dependent on either the number of allergens positive (N) or the total sum of pluses for all allergens (S). Both the N and S values were higher for the FA group (N = 98, S = 264) than the NFA group (N = 52, S = 151) and NAC group (N = 4, S = 8). The ratio (S/N) which gives an index (I) was 2.69, 2.90, and 2.00, respectively. Tryptase was poorly correlated to the total IgE level (r = 0.036); however, mean values for N and S were significantly different (N 6.81, S 4.50, and N 19.25, S 11.5, p < 0.05) for sera with tryptase levels < 2.0 or > or = 2.0 micrograms/L, respectively. We conclude that total and specific IgE may be useful predictors of asthma severity but that postmortem tryptase is not useful in the diagnosis of a fatal asthmatic attack.

Adolescent↗
PubMed1998

The prostate cancer screening controversy in perspective.

Until long-term ongoing trials show that screening for prostate cancer is beneficial and cost-effective, physicians should focus screening efforts on high-risk patients most likely to benefit from treatment, and inform patients about the pluses and minuses of current screening, diagnostic, and treatment methods.

Humans↗
PubMed1975

[The importance of the eyelids for ophthalmodynamographic recordings-- an oscillographic study before and after total plastic reconstruction of the eyelids (authors transl)].

Ophthalmodynamography (ODG) of an empty orbit apart from a covering of atrophic skin 1mm thick revealed only one twentieth of the pluse amplitude of the contralateral normal orbital oscillographic waves. After total plastic surgical reconstruction of the lids, isolated oscillographiy of the eyelids was performed for the first time. The pulse amplitude now reached about 1/4 of that of the contralateral side. It is concluded that these reconstituted eyelids contribute at least 25% towards the volume and 25% towards the oscillographic pulse wave amplitude on performing ODG in the usual manner. These values could well be exceeded in normal lids on account of their better blood supply.

Adult↗
PubMedDate not supplied

What is it like to work for a big five consulting firm? Interview by Barbara J. Linney.

Is consulting for a big five a career direction you've thought about pursuing? In this column, Barbara Linney interviews physician executive Don Gessler, MD, MBA, CPE, FACPE, to talk about his experience in working for a big five consulting firm. He discusses how he got his position at ABC Consulting Firm, the nature of the work, the rigorous travel schedule, the pluses, and the type of physician executive that is satisfied in this environment. He describes some of the projects and tasks he has been involved in as a consultant. He emphasizes that if physicians don't like to do selling, consulting is not a place for them to be and that it is a very team-based structure.

Consultants↗
PubMed1992

Fathers and sons. Practices not necessarily made in heaven.

Partnerships result in many pluses to a dental practice. Interpersonal relationships result in many minuses to the partners' rapport. This is magnified manyfold when the relationship is father and son. This article attempts to resolve some of the problems.

Dentists↗
PubMed2004

Alarm-enhancement systems for ventilators.

Ventilator alarms can be crucial for safeguarding the health and even the lives of patients. Therefore, it's vital that they--like other critical alarms--be readily detected in even the busiest, noisiest hospital departments. One way to make sure that this happens is to use alarm-enhancement systems, which communicate ventilator alarms to locations where they are more likely to be detected by caregivers. There are four basic categories of ventilator alarm enhancements: (1) interfacing ventilators with networked physiologic monitors, (2) incorporating commercially available systems for centralized remote monitoring of ventilator alarms, (3) interfacing ventilators with nurse call systems, and (4) utilizing remote annunciators for ventilator alarms. These options range widely in complexity, cost, and the types of care settings for which they're likely to be suitable. In this article, we describe the ventilator alarm-enhancement systems that are currently on the market. We highlight their pluses and minuses based on information we have gained from product literature, through conversations with suppliers, and, where possible, through discussions with users. We also provide guidance to facilities on how to choose among the various options and products available.

Decision Making, Organizational↗
PubMed2003

[Concept of system productivity and its significance in ecological reconstruction of pasture and agriculture transitional zone in China].

In recent years, the debate on the strategies of developing Loess Plateau has been ended with a consensus, i.e., instead of traditional grain production, grass/livestock industries together with some other specific industries such as fruits and forests ought to be the "polar" industries in this area. However, such a new pattern has not appeared. Enlightened by the basic principles of ecology, the intrinsic contradiction between output and maintenance/repair of agro-ecosystem, in terms of energy requirement, could not be well coordinated and resolved just by raising the primary productivity or secondary productivity, which is particularly the case for such a ecologically fragile area as Loess Plateau. In this paper, a new concept of system productivity was proposed as a possible way that could use pluses and bypass minuses in ingeniously fitting the natural conditions and fully and rationally utilizing natural resources, especially the superiorities of climate resources, and centered on the selection and utilization of plant germplasms with higher water use efficiency, better coverage effect, and maximum biomass potential for fodder, i.e., cultivating fodder/feed-oriented plants for new livestock industry, thus finding an unprecedented approach that can harmonize the ecological reconstruction and development of vital industries.

Agriculture↗
PubMed2004

Does cancer solve an optimization problem?

Many cancers are characterized by a high degree of aneuploidy, which is believed to be a result of chromosomal instability (CIN). The precise role of CIN in cancer is still the matter of a heated debate. We present a quantitative framework for examining the selection pressures acting on populations of cells and weigh the "pluses" and "minuses" of CIN from the point of view of a selfish cell. We calculate the optimal rate of chromosome loss assuming that cancer is initiated by inactivation of a tumor suppressor gene followed by a clonal expansion. The resulting rate, p* = 10(-2)per cell division per chromosome, is similar to that obtained experimentally by Lengauer et al. (1997). Our analysis further suggests that CIN does not arise simply because it allows a faster accumulation of carcinogenic mutations. Instead, CIN must arise because of alternative reasons, such as environmental factors, epigenetic events, or as a direct consequence of a tumor suppressor gene inactivation. The increased variability alone is not a sufficient explanation for the presence of CIN in the majority of cancers.

Aneuploidy↗
PubMed2004

[Low-dose granulocyte colony-stimulating factor combined with granulocyte-macrophage colony-stimulating factor for mobilizing peripheral CD34+ hematopoietic progenitor cells].

OBJECTIVE: To study the efficacy of combined use of low-dose granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) in mobilizing hematopoietic stem/progenitor cells. METHODS: Twenty adult patients with malignant hematologic diseases were paired using statistical methods, and the 10 pairs were divided into 2 equal groups. For non-Hodgkin lymphoma, the treatment regimen adopted intravenous infusion of cytoxan (2 g/d for 1 or 2 d) and VP16 (0.2 g/d for 1 to 3 d), while for acute non-lymphocytic leukemia, Ara-C (2 g/d for 1 to 3 d) and VP16 (0.2 g/d for 1 to 3 d) were used. When the while blood cell count (WBC) was below 1.0 x10(9)/L, G-CSF and GM-CSF were administered subcutaneously at the same dose of 2.5 microg/d.kg in the 10 patients in the experimental group, while the patients in the control group received only 5 microg/d.kg G-CSF, both for 5 to 6 d. After WBC>5.0 x 10(9)/L, the peripheral blood mononuclear cells (PBMNC) were separated by CS-3000 pluse separator and CD34+ cells were determined by flow cytometry. RESULTS: The purity of the isolated PBMNC was 95%-99%. In the experimental group, the mean number of CD34+ cells acquired was 9.4 x 10(6)/kg ranging from 8.4 x 10(6) to 10.2 x 10(6)/kg, and granulocyte-macrophage colony-forming unit (CFU-GM) was 42.4 x 10(4)/kg on average ranging from 21.9 x 10(4) to 72.8 x 10(4)/kg, as compared with 4.8 x 10(6)/kg [(4.1-8.3) x10(6)/kg] for CD34+ cells and 28.1 x 10(4)/kg [(7.1-60.2) x 10(4)/kg] for CFU-GM in the control group (P<0.05). No obvious difference was observed between the two groups in terms of the adverse effects of the treatment (P>0.05). CONCLUSION: Combined use of G-CSF and GM-CSF can be more effective than the exclusive use of GM-CSF for mobilizing CD34+ cells.

Adult↗
PubMed2004

Spinal cord injury nursing and evidenced-based practice.

The importance of the dissemination of current data-based research findings cannot be said enough! Nurse researchers have an obligation to report their findings and potentially improve nursing practice and patient care outcomes. Conclusions drawn from the "evidence," whether good, bad, or indifferent, benefit nursing practice. Nurses need to know "what works," "what doesn't work," and the pluses and minuses of every finding. Reporting the "evidence" at national and international platforms can reach many health care providers. To reach the largest possible audience, however, research findings must be published in refereed journals. SCI Nursing is a refereed journal that reaches across our national boundary to other countries and the entire world. Publishing scholarly works is a responsibility of professional nurses!

Diffusion of Innovation↗
PubMed1991

Top developments in health care: a watershed year.

Regulations, reimbursement battles, collaboration efforts, financial difficulties and the reform process all helped make 1991 a watershed year for health care issues--and an eventful one for executives. News media attention to health care policy, financing and delivery issues was intense: television, radio and print coverage focused on overcrowded emergency departments, uninsured pregnant women with no access to obstetrical care, employers demanding cost-efficient care and the pluses and minuses of foreign health care systems. The close of 1991 left hospital executives dealing with the effects of issues like the Medicare capital payment fold-in, physician payment reform, hospitals' geographic reclassification and the push for national health care reform. Below are brief summaries of some of the year's top issues.

Acquired Immunodeficiency Syndrome↗
PubMed2005

A novel approach for the management of the chalkbrood disease infesting honeybee Apis mellifera L. (Hymenoptera: Apidae) colonies in Egypt.

Except for, very few articles regarding the influence of some organic acids on the causative pathogen, Ascosphaera apis Maassen, no other studies pertaining to the management of the chalkbrood disease were performed, so far in Egypt. Laboratory investigations indicated that the fungicides, i.e (Galben C 46%, Radomil gold pluse WP 42.5% and Daconil 2787) at their recommended rates did not exert any effect on the mycelical growth of the fungus. Therefore, these fungicides were completely excluded from the subsequent apiary trials. As to the Mycostatin, it was found clearly that this mycostatic compound was effective at the rates of 50.000 and 100.000 IU. Regarding the essential oils (ceder, clove, peppermint, parsley, black cumin, garden rocket, and ricin), ceder oil surpassed the other oils and materials in controlling the subject disease. It is peculiar that no studies on the efficacy of ceder are available in the literature, so the present work using ceder oil is recorded for the first time worldwide. Thymol substance at the rate of 2% showed also a great success in managing the CHB disease. Baised on the obtained results, the promising materials in controlling the disease could be arranged according to their efficacy in a descending order as follows: ceder oil>thymol>mycostatin and oxalic acid, so these highly effective materials were again tested under the apiary conditions. Outdoors (apiary) studies revealed that ceder oil 4% gave 100% reduction in mummies numbers. Reductions in number of fallen mummies ranged from 63.22 to 96.94, 18.93 to 81.74, and 10.11 to 68.16%, on average, for thymol, mycostatin, and oxalic acid, respectively. From the practical point of view, thymol could be recommended for controlling the CHB disease, as it is the cheapest material and proved to increase the brood nest as well. In addition, thymol has other uses in the field of apiculture.

Animals↗