Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “cost of complexity”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 721 records · Page 40Linked to original sources
PubMed1982

Telephone sampling bias in surveying disability.

Results of the California Disability Survey indicate that telephone interviewing is well suited for undertaking disability studies that provide (1) estimates of subgroups of the disabled population, including those that are statistically rare: (2) information on current and anticipated areas of policy concern; and (3) information for geographic areas important in rehabilitation program planning. Although these objectives necessitated a large sample size and a complex instrument, the costs and timeliness of telephone interviewing enabled the survey objectives to be reached. This paper discusses the advantages of telephone interviewing, as well as biases inherent in its use. The magnitude of the bias from the omission of nontelephone households is assessed, and the results confirm that the omission of nontelephone households introduces only minor biases into estimates for the total working-age population. A method of weighting is developed and illustrated.

Adolescent↗
PubMed2005

Prevalence of chronic renal failure in adults in Delhi, India.

BACKGROUND: Chronic renal failure (CRF) is a debilitating condition responsible for high morbidity and mortality and is a financial burden on government and society. Because of its costs and the complexity of its treatment, proper care is available to very few patients in India. A community-based study has not been done to determine the prevalence of CRF in India. METHODS: We used a multi-stage cluster sampling method in the South Zones of Delhi. In each area, we first contacted the local social leader and explained the study and the medical information pamphlets. On pre-scheduled days, the study team canvassed the study zone. The individuals contacted responded to a detailed questionnaire, and had a physical examination, a dipstick urine test for albumin and sugar and a blood test for serum creatinine. A serum creatinine >1.8 mg% defined renal failure. A repeat test for serum creatinine was done after 8-12 weeks to confirm chronicity of renal failure. If it was >1.8 mg% after 3 months in the absence of reversible factors, CRF was diagnosed. The person found to have CRF was asked to attend a hospital renal clinic for further investigations and individualized management. RESULTS: A total of 4972 persons were contacted for the study. Their mean age was 42+/-13 years; 56% were males. Out of the 4972 who were initially approached, 4712 agreed to give the blood sample, and thus were included for the evaluation of CRF. CRF was found in 37 of them. Thus, the prevalence of CRF in that adult population was 0.785% or 7852/million. CONCLUSIONS: The prevalence of CRF in India makes it a serious problem in need of urgent efforts to contain it.

Adult↗
PubMed2003

Recent advances in the treatment of pulmonary hypertension.

PURPOSE OF REVIEW: Pulmonary hypertension is a debilitating life-threatening disease of all ages. The long-term prognosis can be dismal despite maximal medical therapy. There have been significant advances in our understanding of the pathobiology and genetics of this disease, and novel pharmacological approaches appear to offer promising alternatives to conventional therapy. Anesthesiologists have been instrumental in the development and widespread clinical introduction of inhaled nitric oxide. Unfortunately, despite early optimism, inhaled nitric oxide has several significant limitations related to its cost, toxicity, required complex technology, and occasional therapeutic failure. Therefore, there is a need for an effective alternative pulmonary vasodilator. The early diagnosis and treatment of pulmonary hypertension are crucial if improvements are to be realized. This review will present recent work in this field in an attempt to increase anesthesiologists' awareness of potential new treatment options. RECENT FINDINGS: Emerging data concerning the genetics of certain pulmonary hypertension variants have provided insight into the pathobiology of this disease and may lead to advances in the early detection or new treatment options. New pharmacological approaches include drugs such as nitric oxide donors, phosphodiesterase inhibitors, endothelin antagonists, and prostacyclin analogues. Attention has also been focused on the use of combinations of drugs of different classes. SUMMARY: The clinical outcome of pulmonary hypertension is dependent upon early detection and therapy. Increased awareness of current therapeutic options will facilitate earlier effective treatment.

Journal Article↗
PubMed1993

Radioactive waste management at a large university and medical research complex.

A radioactive waste management program was developed for a large university and medical research complex to contain costs and to reduce the impact of the Low-Level Radioactive Waste Policy Act. The program takes advantage of decay-in-storage, incineration, special packaging techniques, and increased training and awareness. A series of metrics are presented to evaluate the effectiveness of the radioactive waste management program. Through the use of this program the amount of waste disposed of at commercial burial sites decreased from 98% to 1.61% of the waste generated. At the same time the volume of waste generated per laboratory declined by almost 45%, from 0.35 m3 (12.31 ft3) to 0.19 m3 (6.80 ft3).

Academic Medical Centers↗
PubMed1993

Safety belt restraints and compartment intrusions in frontal and lateral motor vehicle crashes: mechanisms of injuries, complications, and acute care costs.

A 3-year prospective study examined 76 frontal (F) and 45 lateral (L) motor vehicle crash (MVC) patients with regard to seatbelt restraint use and occupant compartment contact and intrusion injuries. These 121 MVC victims with multiple injuries (39 belted [B] and 82 non-belted [NB]), admitted to a level I trauma center, were studied by accident reconstruction and medical data analysis. They had a MVC mean impact velocity (delta V) of 30 +/- 11 mph and an injury Severity Score of 29 +/- 12. Proper restraint use reduced brain injury in F MVCs (30% FB vs. 47% FNB) but had no effect in L MVCs (63% LB vs. 30% FB [p < 0.06]). Belt use did not protect against lung, liver, spleen, pelvis, or lower extremity (LE) injury. These appeared to be more a function of crash direction, with LE injuries higher in F crashes (p < 0.04) and pelvis injuries (p < 0.001) higher in L crashes. In FB crashes, however, properly used safety restraints were the primary cause of bowel or colon injuries (p < 0.006). Belts did not prevent thoracic or abdominal solid organ injuries in L crashes. Contact-intrusions (CI) of the car occupant compartment in F crashes were the main cause of brain (A-pillar), lung and liver (steering wheel and instrument panel), and LE (toepan) injuries; but in L crashes, side-door CI caused lung, aorta, liver, and pelvic injuries. In contrast, contact-only (CO) injuries of the steering assembly were mainly responsible for injuries to the lung, heart, and liver in F crashes, and side-door CO for lung, liver, and spleen injuries in L crashes. Deaths and complications after injury were higher among F MVC occupants, or when delta V was > or = 30 mph. Hospital and professional costs reflect the complex care needed for victims of multiple injuries: FB, $99,000; FNB, $95,000; LB, $75,000; LNB, $79,000; total, $10.7 million. Present vehicle safety standards are not adequate, and structural design changes are needed to improve restraints and protect occupants from intrusion-related injuries.

Abdominal Injuries↗
PubMed2000

Can you make a merger pay off?

When three perinatal departments in three hospitals merged into a single department, the transition was complex, but cost-effective.

Cost Savings↗
PubMed2001

Is a dissection balloon beneficial in bilateral, totally extraperitoneal, endoscopic hernioplasty? A randomized, prospective, multicenter study.

SUMMARY: Laparoscopic hernioplasty has been criticized because of its technical complexity and increased costs. Disposable dissection balloons can be used to gain the initial working space in totally extraperitoneal endoscopic (TEP) hernioplasty, but this increases its cost. Forty-four men with bilateral, primary or recurrent inguinal hernias were randomized to undergo TEP with or without dissection balloon. There were two conversions to transabdominal preperitoneal hernioplasty, or open herniorrhaphy, in the group with balloon and four in the group without balloon. There was no difference in the postoperative morbidity or operation time between the two groups, and there were no major complications in either group. The recurrence rate was 4.3% in the group with the balloon and 7.1% in the group without the balloon. There were no statistically significant differences between the groups. Although our study population is too small to detect small differences between the groups, it seems that the use of a dissection balloon is not beneficial in a bilateral TEP.

Adult↗
PubMedDate not supplied

New technology for deep light distribution in tissue for phototherapy.

Photodynamic therapy is one of several techniques developed for phototherapy for solid cancers and hematologic malignancies. Photodynamic therapy is a treatment that utilizes a molecular energy exchange between visible light and a photosensitive drug, which results in the production of 1O2, a highly reactive cytocidal oxygen species. The effect is limited to the region where light and drug are combined so that malignant tissue is destroyed and the usual side effects associated with standard cancer therapies are avoided. The light component of photodynamic therapy is customarily generated via dye-pumped or diode lasers. The cost and the complexity of lasers have seriously limited the clinical use of photodynamic therapy for malignancies. A new device technology, based on light-emitting diodes, has been developed (Light Sciences Corporation, Issaquah, WA) that allows light production inside the target tissue. This new technology will expand the current range of indications that are treatable with photodynamic therapy to include moderate- and large-volume refractorytumors. Conventional photodynamic therapy utilizes the delivery of intense light for seconds or minutes. The new approach differs from conventional photodynamic therapy in that it combines a novel interstitial light delivery system with prolonged photoactivation of photosensitive drugs. Prolonging photoactivation time in order to deliver a higher light dose results in an amplification effect, whereby the repeated activation of each photosensitive drug molecule leads to the generation of many thousands of 1O2 molecules. The production of overwhelming numbers of these powerful oxidants in individual cells and the vascular supply of tumors leads to irreversible damage and death of the targeted lesions. Results of preclinical studies have indicated a significant correlation between increased duration of photoactivation and increased volume and depth of photodynamic therapy-induced necrosis. The new developments will enable photodynamic therapy to be used effectively against refractory bulky disease as frontline therapy or in combination with chemotherapy, radiation therapy, or biologics. Perhaps most promising, many patients with advanced refractory disease may now be relieved of symptoms or may return to the treatable population.

Animals↗
PubMed2002

Usefulness of the BASIS-32 in evaluating program level outcomes.

The Behavior and Symptom Identification Scale (BASIS-32) is a survey used to collect clients' reported perceptions of their symptoms and functioning. This article assesses the usefulness of the BASIS-32 for evaluating program outcomes in California's statewide performance outcome system for adults with serious mental illnesses. The authors found that, while the instrument could be useful at the clinical level, it did not work well when data were aggregated at the program or system level. Not only did clients drastically under-report their symptoms, but improvements over time, although statistically significant, were negligible and of little practical use for assessing system-level outcomes. In addition, the costs and logistical complexities associated with site licensing became increasingly difficult to justify when compared to obtaining similar information from other sources.

Journal Article↗
PubMed2004

Discrete variable representation for singular Hamiltonians.

We discuss the application of the discrete variable representation (DVR) to Schrödinger problems which involve singular Hamiltonians. Unlike recent authors who invoke transformations to rid the eigenvalue equation of singularities at the cost of added complexity, we show that an approach based solely on an orthogonal polynomial basis is adequate, provided the Gauss-Lobatto or Gauss-Radau quadrature rule is used. This ensures that the mesh contains the singular points and by simply discarding the DVR functions corresponding to those points, all matrix elements become well behaved, the boundary conditions are satisfied, and the calculation is rapidly convergent. The accuracy of the method is demonstrated by applying it to the hydrogen atom. We emphasize that the method is equally capable of describing bound states and continuum solutions.

Journal Article↗
PubMed2006

Fast image and video colorization using chrominance blending.

Colorization, the task of coloring a grayscale image or video, involves assigning from the single dimension of intensity or luminance a quantity that varies in three dimensions, such as red, green, and blue channels. Mapping between intensity and color is, therefore, not unique, and colorization is ambiguous in nature and requires some amount of human interaction or external information. A computationally simple, yet effective, approach of colorization is presented in this paper. The method is fast and it can be conveniently used "on the fly," permitting the user to interactively get the desired results promptly after providing a reduced set of chrominance scribbles. Based on the concepts of luminance-weighted chrominance blending and fast intrinsic distance computations, high-quality colorization results for still images and video are obtained at a fraction of the complexity and computational cost of previously reported techniques. Possible extensions of the algorithm introduced here included the capability of changing the colors of an existing color image or video, as well as changing the underlying luminance, and many other special effects demonstrated here.

Algorithms↗
PubMed2006

Multiscale hybrid linear models for lossy image representation.

In this paper, we introduce a simple and efficient representation for natural images. We view an image (in either the spatial domain or the wavelet domain) as a collection of vectors in a high-dimensional space. We then fit a piece-wise linear model (i.e., a union of affine subspaces) to the vectors at each downsampling scale. We call this a multiscale hybrid linear model for the image. The model can be effectively estimated via a new algebraic method known as generalized principal component analysis (GPCA). The hybrid and hierarchical structure of this model allows us to effectively extract and exploit multimodal correlations among the imagery data at different scales. It conceptually and computationally remedies limitations of many existing image representation methods that are based on either a fixed linear transformation (e.g., DCT, wavelets), or an adaptive uni-modal linear transformation (e.g., PCA), or a multimodal model that uses only cluster means (e.g., VQ). We will justify both quantitatively and experimentally why and how such a simple multiscale hybrid model is able to reduce simultaneously the model complexity and computational cost. Despite a small overhead of the model, our careful and extensive experimental results show that this new model gives more compact representations for a wide variety of natural images under a wide range of signal-to-noise ratios than many existing methods, including wavelets. We also briefly address how the same (hybrid linear) modeling paradigm can be extended to be potentially useful for other applications, such as image segmentation.

Algorithms↗
PubMed2006

Multiplex ligation-dependent probe amplification to detect subtelomeric rearrangements in routine diagnostics.

Subtelomeric rearrangements are believed to be responsible for 5-7% of idiopathic mental retardation cases. Due to the relative complexity and high cost of the screening methods used till now, only preselected patient populations including mostly the more severely affected cases have been screened. Recently, multiplex ligation-dependent probe amplification (MLPA) has been adapted for use in subtelomeric screening, and we have incorporated this technique into routine diagnostics of our laboratory. Since the evaluation of MLPA as a screening method, we tested 275 unselected patients with idiopathic mental retardation and detected 12 possible subtelomeric aberrations: a der(11)t(11;20)(qter;qter), a 19pter duplication, a der(18)t(18;10)(qter; pter), a 15qter deletion, a 8pter deletion, a 6qter deletion, a der(X)t(X;1)(pter;qter), a der(X)t(X;3)(pter;pter), a 5qter duplication, a 3pter deletion, and two 3qter duplications. The patients can be subdivided into two groups: the first containing de novo rearrangements that are likely related to the clinical presentation of the patient and the second including aberrations also present in one of the parents that may or may not be causative of the mental retardation. In our patient cohort, five (1.8%) subtelomeric rearrangements were de novo, three (1.1%) rearrangements were familial and suggestively disease causing, and four (1.5%) were possible polymorphisms. This high frequency of subtelomeric abnormalities detected in an unselected population warrants further investigation about the feasibility of routine screening for subtelomeric aberrations in mentally retarded patients.

Base Sequence↗
PubMed1990

Reducing polypharmacy in the elderly. A controlled trial of physician feedback.

A prospective, controlled trial to reduce polypharmacy in patients 65 years or older was carried out in the residents' clinic of a teaching hospital. Of 272 elderly patients surveyed, 89 (33%) were taking five or more prescription drugs. Recommendations to discontinue medications or to simplify regimens were formulated for 79 polypharmacy patients. Compared to 41 controls, the 38 patients whose physicians were informed of the recommended changes demonstrated a small but significant reduction in the mean number of drugs, the complexity, and the cost of their regimens. Physicians complied with eight (100%) of eight recommendations to simplify a dosage schedule, eight (62%) of 13 recommendations to substitute a new drug for the old one, and only eight (40%) of 20 recommendations to stop a medication (P = .04). Noncompliance usually resulted from patient refusal or from medications being prescribed by another provider. Whereas feedback to the primary physician is beneficial, more substantial reductions in outpatient polypharmacy may require overcoming patient barriers and limiting the number of prescribing physicians.

Aged↗
PubMed2002

Coronary artery "pseudothrombus" due to collateral flow artifact distal to left circumflex coronary stenosis.

Since the complexity, morbidity, and costs of coronary interventions are increased when coronary thrombus is present, identification of the cause of an angiographic filling defect is potentially important. We present a case report and review our experience with a flow artifact that mimicked thrombus ("pseudothrombus") in the setting of a severe proximal stenosis in the left circumflex coronary artery.

Collateral Circulation↗
PubMed1998

Preliminary studies with recombinant chorionic gonadotropin beta-subunit produced in Escherichia coli for use as an antigen in a birth control vaccine.

PROBLEM: Prototype human chorionic gonadotropin (hCG) vaccines based on natural sources are unsuitable for widespread applications due to their complex manufacturing procedures, cost, and carrier-mediated immune suppression. METHOD OF STUDY: Wistar rats were immunized with alum-adsorbed CG beta (recombinant), CG beta-TT, and nCG beta (native CG beta)-TT, whereas Bonnet monkeys were immunized with only CG beta. The anti-hCG antibody titre in the sera obtained at different time points were quantified by radioimmunoassay. The sera of Wistar rats were characterized in terms of their affinity to hCG, bioneutralization capacity (by inhibition of hCG-induced testosterone production in Leydig cells), and cross-reactivity with human luteinizing hormone, human follicle-stimulating hormone, and human thyroid-stimulating hormone (by direct binding assays). RESULTS: Antigen-binding capacities of sera obtained upon immunization with CG beta were 3,080 +/- 943 ng/ml (n = 6) and 3,993 +/- 1,292 ng/ml (n = 4), respectively, in rats and monkeys. The analysis of data revealed that immunization of rats with CG beta produced antibodies comparable to that of CG beta-TT and nCG beta-TT. CONCLUSION: The study opens up the possibility of producing pure and highly immunogenic CG beta by a recombinant DNA route, as a consistent source of antigen for birth control vaccine.

Animals↗
PubMed2001

Just coercion? Detention of nonadherent tuberculosis patients.

The need to balance the rights of individuals and to protect the public health will bring with it demands for the restriction of individuals' liberty. Three points should always be considered when these measures are adopted: (1) the lack of evidence that detention benefits the public health; (2) the risk that fundamental human rights may be overridden unnecessarily; and (3) that coercive practices may act as a smokescreen for improved, but more complex or more costly, public health responses to the causes of TB control failures. The policies of New York City and England are presented, and the argument is made that neither is just.

Coercion↗
PubMed1998

Molecular typing of enteroviruses: current status and future requirements. The European Union Concerted Action on Virus Meningitis and Encephalitis.

Human enteroviruses have traditionally been typed according to neutralization serotype. This procedure is limited by the difficulty in culturing some enteroviruses, the availability of antisera for serotyping, and the cost and technical complexity of serotyping procedures. Furthermore, the impact of information derived from enterovirus serotyping is generally perceived to be low. Enteroviruses are now increasingly being detected by PCR rather than by culture. Classical typing methods will therefore no longer be possible in most instances. An alternative means of enterovirus typing, employing PCR in conjunction with molecular genetic techniques such as nucleotide sequencing or nucleic acid hybridization, would complement molecular diagnosis, may overcome some of the problems associated with serotyping, and would provide additional information regarding the epidemiology and biological properties of enteroviruses. We argue the case for developing a molecular typing system, discuss the genetic basis of such a system, review the literature describing attempts to identify or classify enteroviruses by molecular methods, and suggest ways in which the goal of molecular typing may be realized.

Encephalitis, Viral↗