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An incremental algorithm for efficient multipoint linkage analysis.

While much effort has gone into developing efficient algorithms for calculating multipoint likelihoods, these calculations still form a significant bottleneck in the construction of genetic linkage maps. Our approach to this problem is based on incremental processing techniques, which attempt to reduce the time required to perform iterative computations by storing intermediate results during the initial iteration, so that they may be reused with little extra computation in subsequent iterations. We have developed an incremental program which provides a more efficient substitute for the CMAP program of the LINKAGE package. Our incremental approach stores intermediate results of the computations in the form of a rational function. Thus, computing the likelihood for one position of an unmapped marker locus requires only the reevaluation of the rational function. Timing data suggest that when pedigrees are fully or nearly fully typed, our program runs about 3-fold faster than CMAP to compute the likelihood for one position of a marker locus. Additional positions do not add any appreciable time to our program; thus, speedups become more pronounced as more marker locus positions are considered.

Algorithms↗

[Development of hospice care service program about advanced cancer patient. I--The effect of hospice education programs on the death orientation].

The purpose of this study was to investigate what effect providing the hospice care team with hospice education programs had on the death orientation. The subjects of study were 28 volunteers, 14 nurses, 30 clergies who registered on hospice education programs from Aug. 6th, 1996 to May 20th, 1997. The data were analysed by descriptive analysis, ANOVA, Duncan test, paired t-test. The results of the study can be summarized as follows: 1. The degrees of death orientation were 85.70 in volunteers group, 84.31 in nurses group, and 73.00 in clergies group. So, clergies group has more positive death orientation than others (F = 6.33, p = .000). The degree of death orientation showed significant differences between age groups (F = 5.78, p = .002), and religiosity (t = 3.92, p = .000). There were no significant differences between the degree of death orientation and the others general characteristics of subjects. 2. The mean of death orientation was 80.04 before hospice education programs, but was 75.56 after hospice education programs (t = 3.92, p = .000). In conclusion, the subjects who received the hospice education programs showed the positive change in the degree of the death orientation. Therefore, it has been judged that education programs has been prerequisite in positive death orientation for hospice care. Furthermore, all of the hospice care members those who complete the hospice education program, will be performed efficient hospice care intervention for dying patients and their families.

Analysis of Variance↗

A new program to reward and retain volunteer clinical faculty at the Medical College of Wisconsin.

UNLABELLED: BACKGROUND AND PROBLEM: Volunteer clinical faculty (VCF) are vital to the educational mission of medical schools. At the Medical College of Wisconsin (MCW), VCF are increasingly relied upon to meet clinical training needs in medical student and resident education. However, many VCF receive little or no preparation to excel in their teaching roles, and they are under increasing time demands that limit their availability to teach. METHODS: Beginning in 2001, the primary care departments at MCW began a series of initiatives called "ExCEED" to promote VCF teaching excellence and efficiency through two main program components: Advisory Councils, made up of VCF leaders, and Support Services, such as web-based resources and teaching workshops. RESULTS: Preliminary ExCEED findings show that VCF have acquired important knowledge, skills, and tools that have better prepared them for their teaching roles. CONCLUSION: ExCEED is a systematic, multi-method approach to engage VCF that is positively influencing the clinical education of MCW students and residents.

Education, Medical↗

A clinical research data base system for the Apple IIe/IIc.

A data base program for some types of patient visits, especially medical procedures, is described. It would be primarily useful as a tool for clinical research, but its implementation would depend on its contributing to the routine documentation of patient visits (i.e. generate typed reports appropriate for charting). To achieve this, and to standardize the information to be collected, several concepts have been developed: a data base template; a branched data structure; bit-mapped, multi-option data fields; and flexible, efficient search capabilities. The program is presently configured for the Apple IIe/IIc and it is not a substitute for keeping patient records (although it may be helpful). It is presented as an approach to the "computerization" of medical information developed through a combined appreciation of basic computer capabilities, and an awareness of how some clinical information may be categorized.

Computers↗

An efficient projection protocol for chemical databases: singular value decomposition combined with truncated-newton minimization.

A rapid algorithm for visualizing large chemical databases in a low-dimensional space (2D or 3D) is presented as a first step in database analysis and design applications. The projection mapping of the compound database (described as vectors in the high-dimensional space of chemical descriptors) is based on the singular value decomposition (SVD) combined with a minimization procedure implemented with the efficient truncated-Newton program package (TNPACK). Numerical experiments on four chemical datasets with real-valued descriptors (ranging from 58 to 27 255 compounds) show that the SVD/TNPACK projection duo achieves a reasonable accuracy in 2D, varying from 30% to about 100% of pairwise distance segments that lie within 10% of the original distances. The lowest percentages, corresponding to scaled datasets, can be made close to 100% with projections onto a 10-dimensional space. We also show that the SVD/TNPACK duo is efficient for minimizing the distance error objective function (especially for scaled datasets), and that TNPACK is much more efficient than a current popular approach of steepest descent minimization in this application context. Applications of our projection technique to similarity and diversity sampling in drug design can be envisioned.

Database Management Systems↗

Genetic variability in the area searched by a parasitic wasp: analysis from automatic video tracking of the walking path.

The ability of foraging hymenopterous parasitoid females to discover their hosts, and thus to be efficient agents in biological control programs, is likely to be related to the surface they are able to prospect per unit of time. However, this behavioural trait has never been accurately estimated, and its implication in female efficiency has never been really demonstrated. This paper provides an algorithmic method that can be used to estimate this trait from an automatic recording of the females' walking path. Using stochastic procedures simulating walking tracks, this trait is shown to be strongly related to the number of hosts that parasitoid females are able to attack per unit of time. This trait was estimated for individual females of Trichogramma brassicae Bezdenko (Hymenoptera; Trichogrammatidae). On average, females of this species are able to prospect about 28mm(2)s(-1). Finally, the genetic variation in this trait was studied using the iso-female line method. A significant genetic variability was observed. It provides the basic information that is necessary to start a genetic selection of mass-reared Trichogramma in order to improve their efficiency in controlling target pests in biological control programs. The functional and evolutionary implications of these results are discussed.

Journal Article↗

Health and environmental benefits from air pollution reductions in Hungary.

The aim of this study was to assess the cost and benefit of the implementation of a specific energy saving program in Hungary. We have considered the possible reduced damage to public health, building materials and agricultural crops that may be obtained from reducing emissions of important air pollutants and also how the program contributes to reduced emissions of greenhouse gases. The measures are described in the National Energy Efficiency Improvement and Energy Conservation Programs (NEEIECP), elaborated by the Hungarian Ministry of Industry and Trade and accepted by the Government in 1994. The energy saving expected from the program is approximately 64 PJ/year. The benefits were estimated using monitoring data and population/recipient data from urban and rural areas in Hungary together with exposure-response functions and valuation estimates mainly from western studies. Our analysis indicates that the main benefit from reducing the concentrations of pollutants relates to public health and that reduced prevalence of chronic respiratory diseases is an important effect. Reduced premature mortality is also important and the estimated attributable risk of air pollution to excess mortality at present is approximately 6%. The estimated annual benefit of improved health conditions alone is likely to exceed the investments needed to implement the program. In addition there are significant benefits due to reduced replacement and maintenance costs for building materials (30-35 million US$ annually in Budapest only). The damage to crops due to ozone is large, but a significant improvement in Hungary depends upon concerted actions in several countries.

Agriculture↗

On the limitations of automated restriction mapping.

Eight important restriction mapping programs, developed between 1978 and 1993, are analyzed and their performance evaluated. The analyses concentrate on the practical value of the programs to molecular biologists who do restriction mapping on a daily basis, rather than on theoretical efficiency. Although all of the programs could find maps consistent with the data, none were able to discriminate reliably the true map from the other consistent maps, given realistic levels of error. To alleviate this problem, we propose an expert mapping system which utilizes the same inferences and mapping techniques used by expert human mappers to reduce the number of false maps found.

Algorithms↗

Starting a crossover kidney transplantation program in the Netherlands: ethical and psychological considerations.

On April 15th, 2003, the first crossover kidney transplantation took place in The Netherlands. In September of the same year, a national database was established to facilitate kidney exchange between two donor-recipient couples. During 2004, kidneys from living donors will be exchanged between the seven university medical centers in The Netherlands. One of the conditions for successfully implementing this program was the need to address the ethical and psychologic implications involved. In this article we will discuss the ethical and psychologic considerations that are accompanying the practical preparations for the first Dutch crossover transplantation program. We identified five topics of interest: the influence of "donation by strangers" on the motivation and willingness of donor-patient couples, the issue of anonymity, the loss of the possibility of "medical excuses" for unwilling donors, the view that crossover is a first step to commercial organ trade, and the interference with existing organ donation programs. We concluded that whether viewed separately or in combination, these issues do not impede the efficient organization of a crossover program or raise worrying ethical issues.

Anonyms and Pseudonyms↗

A palmtop computer program for the treatment of generalized anxiety disorder.

This is the first report of a palmtop computer program developed to increase the efficiency and cost-effectiveness of cognitive behavioral therapy for generalized anxiety disorder (GAD). The computer program offers advantages to researchers, therapists, and clients. These advantages include continuous, unobtrusive collection of process data on treatment adherence as well as on the impact of cognitive behavioral therapy techniques in the client's natural setting. In addition, the computer extends treatment beyond the therapy hour and motivates clients to comply with homework assignments by prompting practice of cognitive behavioral strategies. The successful application of the palmtop computer program reported in this integrated series suggests a new line of research directed toward increasing the cost-effectiveness of what is currently the gold-standard treatment for GAD.

Adult↗

[Comprehensive approach to the evaluation of psychophysiological status in man].

Psychophysiological rating (PR) as an integral index of the human cognitive level has been evaluated in 95 pupils from senior classes using a set of 8 psychophysiological parameters (QI, two indices of strength of the nervous system, functional mobility of the nervous processes, brain efficiency, speed and quality of analytical, logical and imagine mentality) determined by means of original computer programs. PR correlated with teaching efficiency (r = 0.535). It is offered to use PR for estimation of human cognitive level and professional selection.

Adolescent↗

Effective outcomes management in occupational and environmental health.

In the final analysis, outcomes management is about changing behavior, specifically in the occupational and environmental health practitioner's communication process and practice patterns and in the workers' prevention and compliance behavior. Outcomes management is also about quantifying results, establishing occupational and environmental health performance benchmarks, developing a best practices model and asking even more questions. As health care embraces the use of outcomes in evaluating its effectiveness, similar developments can be anticipated in occupational and environmental health. While occupational and environmental health outcomes management is still in its infancy, nurses in the workplace are well positioned to "shape it" into a useful tool that meets the needs of all the various practice settings. As nurses in the workplace begin to evaluate, report, and benchmark results, measurement tools will be refined, data bases will grow and new, useful benchmarks will be established. Because occupational and environmental health programs usually operate as part of a larger business unit, nurses in the workplace are continually faced with the challenge of ensuring that corporate programs including workers' compensation, health and disability benefit programs, vaccination programs, injury prevention, and health promotion or wellness programs are delivered in an efficient and cost-effective manner and that the expected outcomes are achieved. Effective outcomes management programs are the vehicles to effective goal achievement.

Environmental Health↗

KCaM (KEGG Carbohydrate Matcher): a software tool for analyzing the structures of carbohydrate sugar chains.

KCaM (KEGG Carbohydrate Matcher) is a tool for the analysis of carbohydrate sugar chains, or glycans. It consists of a web-based graphical user interface that allows users to enter glycans easily with the mouse. The glycan structure is then transformed into our KCF (KEGG Chemical Function) file format and sent to our program which implements an efficient tree-structure alignment algorithm, similar to sequence alignment algorithms but for branched tree structures. Users can also retrieve glycan tree structures in KCF format from their local computers for visualization over the web. The tree-matching algorithm provides several options for performing different types of tree-matching procedures on glycans. These options consist of whether to incorporate gaps in a match, whether to take the linkage information into consideration and local versus global alignment. The results of this program are returned as a list of glycan structures in order of similarity based on these options. The actual alignment can be viewed graphically, and the annotation information can also be viewed easily since all this information is linked with KEGG's comprehensive suite of genomic data. Analogously to BLAST, users are thus able to compare glycan structures of interest with glycans from different glycan databases using a variety of tree-alignment options. KCaM is currently available at http://glycan.genome.ad.jp.

Algorithms↗

[Significance of mammography study in the detection of 2,511 breast cancers 1977 to 1987].

The relation between the way of cancer detection and tumor stage was studied in 2511 cases of breast cancers patients. 85.0% of those patients discovered cancer by themselves. 12.7% of the carcinomas were detected through the screening program (used in FRG). It was found that there exists a clear dependence between the tumor stage and the kind of diagnosis finding. When the breast carcinoma was detected by the patient herself--in spite of attending regularly the above mentioned screening program--it showed that 16.1% had a small, favourable tumor up to 1.0 cm, in 39.8% a rest-tumor and in 48.1% axillary metastases were found. In cases diagnosed through the screening program the number of small carcinomas amounted to 21.4%, a rest-cancer frequency was 30.5%, and the axilla was afflicted in 25.6%. When the tumor was detected only on account of mammography, 47.7% of the women had a small tumor up to a size of 1.0 cm and 89.7% of the patients had no axillary metastases. The results of the study show that the sensitivity of palpation and inspection is insufficient in the search for breast carcinomas. By including the mammography the efficiency of the screening programs is significantly improved. A routine mammography as a part of the screening program on the one hand makes the diagnosis "no cancer" more reliable, and the earlier detection of breast cancer on the other hand statistically renders the chances of healing significantly more favourable.

Breast Neoplasms↗

Economic evaluation of occupation-based programs: conflicting criteria and the case for government subsidy.

Differences in the economic criteria for evaluating the efficiency of occupation-based intervention programs vs public (nonprofit) rehabilitation programs are highlighted and the consequences of these differences are discussed. It is shown that if the development of such programs is determined strictly by the employer's criteria, they will not produce the full benefits for society that they are capable of. The incentive therefore exists for government to encourage the development and proliferation of quality programs. It is proposed that this can be accomplished by altering the employer's incentives (through subsidies or tax credits), thus making the private and public economic criteria for program evaluation more consistent.

Alcoholism↗

Rehabilitation of serious postural insufficiency after falling in very elderly subjects.

Postural insufficiency, gait disorders and fear of falling have been observed after falling in frail older patients. The aim of this study was to assess the benefit of a specific rehabilitation program in patients demonstrating 'post fall syndrome'. The studied population consisted in 13 females aged 70 years and over who were admitted to hospital after falling. They suffered from post-fall syndrome. 'Get-Up and Go' and 'Timed Get-Up and Go' tests, and assessment of functional activities and postural abilities (AFAPA) were performed at hospital admission (T1), then at hospital discharge (T2) again. A specific rehabilitation program was performed during the hospital stay. The main goal of this rehabilitation program was to correct postural insufficiency and to improve motor patterns, which underlie independence in ADL. The results showed a significant improvement in score and time of 'Get up and Go' test between T1 and T2. In the same way, a great number of subjects showed better performances in several items of AFAPA between T1 and T2, and rising from the floor with support was performed by 6 out of the 13 subjects at T2 compared to 0 subject at T1. This study highlights the efficiency of specific rehabilitation programs in frail elderly people demonstrating 'post fall syndrome'.

Journal Article↗

Developing quality assurance programs in ambulatory surgery.

Cost and efficiency are only two outcomes considered in evaluating surgical ambulatory services. More important, quality of care and the patient's physical and emotional health and well-being must be evaluated. Nurse practitioners play a key role in initiating and implementing quality assurance programs to meet these outcomes.

Ambulatory Surgical Procedures↗