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At least 955 records · Page 53Linked to original sources
PubMed1999

Technical solution for an interactive functional MR imaging examination: application to a physiologic interview and the study of cerebral physiology.

Studies with functional magnetic resonance (MR) imaging produce large unprocessed raw data sets in minutes. The analysis usually requires transferring of the data to an off-line workstation, and this process frequently occurs after the subject has left the MR unit. The authors describe a hardware configuration and processing software that captures whole-brain raw data files as they are being produced from the MR unit. It then performs the reconstruction, registration, and statistical analysis, and displays the results in seconds after completion of the MR image acquisition.

Brain↗
PubMed1997

Reaching movements with similar hand paths but different arm orientations. I. Activity of individual cells in motor cortex.

This study shows that the discharge of many motor cortical cells is strongly influenced by attributes of movement related to the geometry and mechanics of the arm and not only by spatial attributes of the hand trajectory. The activity of 619 directionally tuned cells was recorded from the motor cortex of two monkeys during reaching movements with the use of similar hand paths but two different arm orientations, in the natural parasagittal plane and abducted into the horizontal plane. Nearly all cells (588 of 619, 95%) showed statistically significant changes in activity between the two arm orientations [analysis of variance (ANOVA). P < 0.01]. A majority of cells showed a significant change in their overall level of activity (ANOVA, main effect of task, P < 0.01) between arm orientations before, during, and after movement. Many cells (433 of 619, 70%) also showed a significant change in the relation of their discharge with movement direction (ANOVA, task x direction interaction term, P < 0.01) during movement, including changes in the dynamic range of discharge with movement and changes in the directional preference of cells that were directionally tuned in both arm orientations. Similar effects were seen for the discharge of cells while the monkey maintained constant arm postures over the different peripheral targets with the use of different arm orientations. Repeated data files from the same cell with the use of the same arm orientation showed only small changes in the level of discharge or in directional tuning, suggesting that changes in cell discharge between arm orientations cannot be explained by random temporal variations in cell activity. The distribution of movement-related preferred directions of the whole sample differed between arm orientations, and also differed strongly between cells receiving passive input predominantly from the shoulder or elbow. The electromyographic activity of most prime mover muscles at the shoulder and elbow was also strongly affected by arm orientation, resulting in changes in overall level of activity and/or directional tuning that often resembled those of the proximal arm-related motor cortical cells. A mathematical model that represented movements in terms of movement direction centered on the hand could not account for any of the arm-orientation-related response changes seen in this task, whereas models in intrinsic parameter spaces of joint kinematics and joint torques predicted many of the effects.

Analysis of Variance↗
PubMed2000

How could static telepathology improve diagnosis in neuropathology?

The present paper reports our experience with, and our opinion of static telepathology as applied to neuropathology by means of the PHAROS acquisition system and conventional telephone data transmission (modem). The classical procedure of expert consultation based on surface mailing of histological slides is routinely performed, especially in highly specialized fields of pathology. Telepathology is an easy means of sharing scientific expertise at international level and could thus improve diagnosis particularly in neuropathology, where certain tumor types are very rare and complex to diagnose. Dynamic telepathology allows the referring pathologist to capture by himself images supporting their diagnosis. Using static telepathology the pathologist could be limited in diagnosis by problems in fields selection. We devoted a whole year to collecting all the technical parameters characterizing the use of digitized neuropathological data files in order to investigate the feasibility of telepathology and the extent to which its use could improve diagnoses. Our results on a series of 38 histological brain examinations illustrate how we successfully established an international connection between two departments of pathology in Belgium and the USA. The referring pathologists gave diagnoses in 35 cases and deferred only 3. Despite a time-consuming procedure for the telepathology session of a few cases, this tool provides easy access to expert diagnosis and real-time discussion, both of which are of considerable interest and offer significant improvements in neuropathology.

Adolescent↗
PubMed1999

Quantitating donor behaviour to model the effect of changes in donor management on sufficiency in the blood service.

BACKGROUND AND OBJECTIVE: To describe donor behaviour quantitatively and apply the information on actual donations derived during observed changes in blood collection in Melbourne between July 1990 and June 1996 to construct a logical model to examine the effects of changes in donor management on the sufficiency of the blood supply. METHOD: Computerised donation data files were searched to determine time to next or previous donation for donors giving blood between 1990 and 1996 stratified by age, donation history and venue. Actual numbers of whole blood donation given by new and repeat donors, July 1990 to June 1996, and numbers of donors refused were used to construct and test a logical predictive model. RESULTS: 558,682 donation intervals were analysed. Donor return rates at 2 years were shown to increase with donor donation history and donor age. The prediction model showed that a 25% decline in whole blood collections over 2 years could be explained by the cumulative effect of a decrease in donor return rates of 2-4%. Between 1990 and 1996 many donors moved from static city collection sites to suburban mobiles. New donor attendance correlated with repeat donor attendance. Donor complaints correlated with donor deferral numbers. CONCLUSIONS: The model showed that large shifts in nett blood collections can be explained by relatively small shifts in donor return rates at 2 years.

Behavior↗
PubMed2006

Intracranial pressure parameters in idiopathic normal pressure hydrocephalus patients with or without improvement of cognitive function after shunt treatment.

BACKGROUND/AIMS: Previous research has shown improvements in the clinical triad (gait, incontinence and cognitive dysfunction) after shunt surgery in idiopathic normal pressure hydrocephalus (iNPH) patients with intracranial pulse pressure amplitudes >4-5 mm Hg, the pulse amplitudes being <4 mm Hg in the nonresponders. However, it is unknown whether similar differences exist regarding change in cognitive functioning after shunt surgery. The aim of this study was to compare preoperative intracranial pressure (ICP) parameters between iNPH that either improved or not improved in cognitive function after shunt treatment. METHODS: Neuropsychological testing was performed before and after surgery in 27 consecutive iNPH patients treated with ventriculoperitoneal shunts. The ICP recordings were performed as part of routine preoperative assessment, stored as raw data files, and analyzed retrospectively. The mean ICP as well as single ICP wave amplitudes were computed and analyzed in consecutive 6-second time windows. RESULTS: Significant improvement in neuropsychological tests, defined as a 4-point improvement in Folstein Mini-Mental State Examination or improvement by one standard deviation in 50% of subtests of Dementia Rating Scale, was found in 12 patients (44%; shunt responders). In these patients, mean ICP was similar though the mean ICP wave amplitude was significantly higher than in the shunt nonresponders. CONCLUSIONS: While preoperative mean ICP was similar, the mean ICP wave amplitudes were considerably higher in iNPH patients with significant change in cognitive function following shunt surgery.

Aged↗
PubMed2002

Oral citicoline in acute ischemic stroke: an individual patient data pooling analysis of clinical trials.

BACKGROUND AND PURPOSE: No single neuroprotective agent has been shown to influence outcome after acute stroke. Citicoline has been studied worldwide in many clinical trials with positive findings, but only 1 trial has obtained significant results in the primary efficacy variables. Our objective was to evaluate the effects of oral citicoline in patients with acute ischemic stroke by a data pooling analysis of clinical trials. The primary efficacy end point chosen was the common evaluation of recovery, combining National Institutes of Health Stroke Scale </=1, modified Rankin Scale score </=1, and Barthel Index >/=95 at 3 months using the generalized estimating equations analysis. METHODS: A systematic search of all prospective, randomized, placebo-controlled, double-blind clinical trials with oral citicoline (MEDLINE, Cochrane, and Ferrer Group bibliographic databases) was undertaken. Individual patient data were extracted from each study and pooled in a single data file. The main inclusion criteria included compatible neuroimaging with ischemic stroke, National Institutes of Health Stroke Scale >/=8, and prior modified Rankin Scale score </=1. Four clinical trials using various doses of oral citicoline (500, 1000, and 2000 mg) were identified. RESULTS: Of 1652 randomized patients, 1372 fulfilled the inclusion criteria (583 received placebo, 789 received citicoline). Recovery at 3 months was 25.2% in citicoline-treated patients and 20.2% in placebo-treated patients (odds ratio [OR], 1.33; 95% CI, 1.10 to 1.62; P=0.0034). The dose showing the largest difference with placebo was 2000 mg, with 27.9% of patients achieving recovery (OR, 1.38; 95% CI, 1.10 to 1.72; P=0.0043). The overall safety of citicoline was similar to placebo. CONCLUSIONS: Treatment with oral citicoline within the first 24 hours after onset in patients with moderate to severe stroke increases the probability of complete recovery at 3 months.

Acute Disease↗
PubMed1994

A mental health capitation program: I. Patient outcomes.

OBJECTIVE: The Monroe-Livingston demonstration project's capitation payment system (CPS) was evaluated to determine whether capitated funding of mental health care, compared with fee-for-service funding, could reduce hospitalization rates and improve functioning and symptoms for severely and persistently mentally ill adults without increasing the total cost of care. METHODS: The experiment was a communitywide prerandomized clinical trial involving 422 patients. Patients who were randomized into the experimental group were eligible for enrollment in a capitated funding program administered by one of five community mental health centers. Those randomized into the control group received standard fee-based services. Follow-up interviews with patients one and two years after enrollment in the study assessed changes in symptoms and functioning. Data files of the membership corporation that coordinated community mental health services for the CPS provided measures of study patients' use of inpatient mental health services. RESULTS: During the two-year follow-up period, patients in the experimental group had significantly fewer hospital inpatient days than patients in the control group, but the two groups had no significant differences in functioning or level of symptoms. CONCLUSIONS: The CPS successfully maintained severely ill patients in the community but did not improve their functioning or level of symptoms.

Adult↗
PubMed1977

Data processing in pathology laboratories: the Phoenix system. 3. Further programs, staff training, and system performance.

This paper completes the description of the Phoenix system by outlining the additional programs necessary to maintain the data files in a satisfactory condition and prevent them from becoming overfilled. The standards of training required by the operating staff are discussed an assessment is made of the system performance in terms of cost/benefit. This was achieved by observing the time spent by staff during a period when the throughput of work was accurately measured. From these figures it is possible to estimate the needs of another laboratory. Finally, the continued extension of the computer facilities into other pathology disciplines and the provision of terminals in the hospital is described.

Chemistry, Clinical↗
PubMed1988

A computer program for rapid generation of receiver operating characteristic curves and likelihood ratios in the evaluation of diagnostic tests.

We describe a MUMPS program to facilitate the evaluation of the diagnostic effectiveness and efficiency of laboratory tests using receiver operating characteristic (ROC) curves and likelihood ratios (LR). Test results from a population with and without a disease are stored into retrievable, editable data bases. Either single or a combination (less than or equal to 9) of different test data files can be accessed to generate tables of calculated frequency distribution, sensitivity, l-specificity and LR at variable decision thresholds. The program also calculates the area under the ROC curve, confidence intervals and SE. The selection of the optimum cut-off value is assisted by graphical plots of frequency distribution, ROC and decision level curves as illustrated by using some 'cardiac' enzyme tests.

Clinical Enzyme Tests↗
PubMed1990

Dental caries prevalence and the use of fluorides in different European countries.

Data in a WHO report relating caries prevalence and the use of fluorides in different European countries were compared with data obtained directly from investigators in the field of oral epidemiology. The reliability of DMFT indices of 12-year-old children, mentioned in the WHO report, appeared sufficient to make comparisons between countries on the basis of these data. The WHO data files on the different applications of fluoride were incomplete. When figures were present, they were not always in agreement with those from the investigators. A decrease of the DMFT indices could be shown in a large number of countries. In further comparative studies between European countries, cultural differences (in dietary habits, for instance) should be taken into account.

Adolescent↗
PubMed1994

A Turbo Pascal program to convert ICD-9CM coded injury diagnoses into injury severity scores: ICDTOAIS.

Diagnoses of injuries as a result of trauma are commonly coded by means of the International Classification of Diseases (9th rev.) Clinical Modification (ICD-9CM). The Abbreviated Injury Scale (AIS) is frequently employed to assess the severity of injury per body region. The Injury Severity Score (ISS) is an over-all index or summary of the severity of injury. To compute one of these two types of scores the entire medical record of each patient must be examined. The program ICDTOAIS replaces the manual coding or translation between the two scores. The program converts the ICD-9CM coded diagnoses into AIS and ISS scores. The program also computes the maximum AIS (MAXAIS) per body region, enabling the researcher to assess the relative impact of the severity of trauma of different body regions in both morbidity and mortality studies. The program locates invalid ICD-9CM rubrics in the data file. ICDTOAIS may be employed as a program alone or as a procedure in database management systems (e.g., DBase III plus, DBase IV, or the different versions of FOXPRO). The program is written in Turbo Pascal, Version 6.

Abbreviated Injury Scale↗
PubMed2002

Ethnic differences in exercise among adults with diabetes.

The purposes of this secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) III Household Adult Data File (1988-1994) were to describe and compare exercise practices and preferences of adult Caucasians, African Americans, and Hispanics with diabetes and to relate that information to diabetes treatment modalities. The research questions were: (a) What proportion of ethnically diverse adults with diabetes do and do not exercise? (b) What are the preferred types of exercise by ethnicity, gender, and age? and (c) What are the relationships among exercise participation, exercise preference, and treatment of diabetes by ethnic group? More than one third of the total sample reported no exercise within the last month. There were no significant differences in amount of exercise by ethnic group. Gardening and walking were the preferred forms of exercise across age, gender, ethnicity, and treatment.

Adolescent↗
PubMed2003

The relationship between serotonergic function and the Psychopathy Checklist: Screening Version.

Reduced serotonergic (5-HT) neurotransmission has been reported in impulsive and aggressive personality disordered and offender samples. What is not clear is the relationship between 5-HT function and the North American construct of psychopathy assessed using the Psychopathy Checklist and its derivatives, which emphasizes the core interpersonal/affective as well as behavioural components of this syndrome. Fifty-one DSM-III-R personality disordered offenders who had a dynamic assessment of 5-HT function (prolactin response to 30 mg d-fenfluramine challenge) were rated on the Psychopathy Checklist: Screening Version based on interview and file data. The Psychopathy Checklist: Screening Version (PCL: SV) mean score in the sample was similar to other reports in European forensic samples. A three-factor structure best explained the PCL: SV data: arrogant/deceitful, callous-unemotional and impulsive-antisocial behaviour factors. 5-HT function did not correlate with psychopathy as a unidimensional phenomenon. The impulsive-antisocial component correlates negatively with 5-HT function while the arrogant/deceitful component correlates positively with 5-HT. In line with previous research findings, impulsive-antisocial conduct shows an inverse relationship with 5-HT function. Arrogant/deceitful traits correlate positively with 5-HT function and may be an adaptive component of psychopathy.

Adult↗
PubMed1996

An examination of the relationship of homelessness to mental disorder, criminal behaviour, and health care in a pretrial jail population.

OBJECTIVE: To examine the prevalence of homelessness and its relationship to mental disorder, criminal behaviour, and health care. METHOD: Interview and file data were collected for 790 male admissions to a large, pretrial jail facility over a 12-month period. RESULTS: A significant relationship was found between homelessness and severe mental disorder as well as between homelessness and prior psychiatric history. There were no significant differences found between the homeless and the nonhomeless on the types of crimes for which they were incarcerated or on contact with health care services within the past year. CONCLUSION: The findings indicate the need for a link between the jail and community services for homeless individuals.

Adult↗
PubMed1989

Volatile substance abuse: the role of agencies in the community in prevention and counselling.

1. Voluntary agencies fulfill a need by providing information on volatile substance abuse to schools, the parents/guardians of abusers and, last but by no means least, the abusers themselves. 2. Consideration of case file data from the period 1982-1987 shows that the average age of clients has dropped from 15.9 years (n = 70) to 13.3 years (n = 312) while the male:female ratio has dropped from 8:1 to 3:1. 3. In 1982, 80% of clients 'sniffed' glue but by 1987, 42% of new clients claimed to abuse butane and 23% aerosols. Of the 945 clients counselled, 41 have since suffered 'sudden sniffing death'. 4. Voluntary agencies can offer intensive, confidential counselling of abusers in an informed setting. It is hoped to extend the services provided outside the Greater London area and to provide residential care for those in need.

Counseling↗
PubMed2004

Reexamining the effects of gestational age, fetal growth, and maternal smoking on neonatal mortality.

BACKGROUND: Low birth weight (<2,500 g) is a strong predictor of infant mortality. Yet low birth weight, in isolation, is uninformative since it is comprised of two intertwined components: preterm delivery and reduced fetal growth. Through nonparametric logistic regression models, we examine the effects of gestational age, fetal growth, and maternal smoking on neonatal mortality. METHODS: We derived data on over 10 million singleton live births delivered at >/= 24 weeks from the 1998-2000 U.S. natality data files. Nonparametric multivariable logistic regression based on generalized additive models was used to examine neonatal mortality (deaths within the first 28 days) in relation to fetal growth (gestational age-specific standardized birth weight), gestational age, and number of cigarettes smoked per day. All analyses were further adjusted for the confounding effects due to maternal age and gravidity. RESULTS: The relationship between standardized birth weight and neonatal mortality is nonlinear; mortality is high at low z-score birth weights, drops precipitously with increasing z-score birth weight, and begins to flatten for heavier infants. Gestational age is also strongly associated with mortality, with patterns similar to those of z-score birth weight. Although the direct effect of smoking on neonatal mortality is weak, its effects (on mortality) appear to be largely mediated through reduced fetal growth and, to a lesser extent, through shortened gestation. In fact, the association between smoking and reduced fetal growth gets stronger as pregnancies approach term. CONCLUSIONS: Our study provides important insights regarding the combined effects of fetal growth, gestational age, and smoking on neonatal mortality. The findings suggest that the effect of maternal smoking on neonatal mortality is largely mediated through reduced fetal growth.

Journal Article↗
PubMed2002

Changes in the tear proteins of diabetic patients.

BACKGROUND: Previous studies have shown a significant increase in tear protein peaks in the tears of diabetic patients suffering from dry eye. The aim of this study was to analyze the tear protein patterns from patients with diabetes mellitus who do not suffer from ocular surface diseases (DIA). METHODS: A total of 515 patients were examined in this study (255 healthy subjects (controls) and 260 patients suffering from diabetes mellitus). Tear proteins were separated by sodium-dodecyl-sulfate polyacrylamide gel electrophoresis. After digital image analysis densitometric data files were created and subsequently used for multivariate statistical procedures. RESULTS: A significant increase in the number of peaks was detected in diabetic patients compared to controls (P < 0.0003). The analysis of discriminance revealed a highly significant discrimination between diabetic patients and controls (Wilks lambda: 0.27; P < 0.000001). Furthermore, a significant difference in the protein pattern of diabetic patients could be detected between those suffering from dry eye or not (P < 0.002). The changes in protein patterns of diabetic patients increased with the duration of the diabetic disease. In diabetic patients with a disease duration longer than 10 years the changes were significantly more expressed than in patients with a shorter diabetic history (P < 0.003) and in healthy subjects (P < 0.0001). CONCLUSIONS: The tear protein patterns of diabetic patients are very different in the number and intensity of spots from those of healthy subjects. Furthermore, it could be demonstrated that the differences found in the tear patterns of diabetic patients are not equal to those found in previous studies in patients suffering from dry-eye disease. The alterations in the diabetic tears were correlated with the duration of the diabetic disease. With longer disease, history changes in the tear protein patterns increased. With the course of the disease some protein peaks appeared that are not present in healthy persons. Our study shows that the analysis of electrophoretic tear protein patterns is a new non-invasive approach in the early diagnosis and analysis of the pathogenesis of diabetes induced ocular surface disease.

Diabetes Mellitus↗
PubMed2004

WINPEPI (PEPI-for-Windows): computer programs for epidemiologists.

BACKGROUND: The WINPEPI (PEPI-for-Windows) computer programs for epidemiologists are designed for use in practice and research in the health field and as learning or teaching aids. They aim to complement other statistics packages. The programs are free, and can be downloaded from the Internet. IMPLEMENTATION: There are at present four WINPEPI programs: DESCRIBE, for use in descriptive epidemiology, COMPARE2, for use in comparisons of two independent groups or samples, PAIRSetc, for use in comparisons of paired and other matched observations, and WHATIS, a "ready reckoner" utility program. The programs contain 75 modules, each of which provides a number, sometimes a large number, of statistical procedures. The manuals explain the uses, limitations and applicability of specific procedures, and furnish formulae and references. CONCLUSIONS: WINPEPI provides a wide variety of statistical routines commonly used by epidemiologists, and is a handy resource for many procedures that are not very commonly used or easily found. The programs are in general user-friendly, although some users may be confused by the large numbers of options and results provided. The main limitations are the inability to read data files and the fact that only one of the programs presents graphic results. WINPEPI has a considerable potential as a learning and teaching aid.

Journal Article↗