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PubMed1996

Modular group therapy in a community mental health center.

To use staff resources more efficiently, a community mental health center in South Carolina initiated an eight-session modular psychoeducational and group therapy program with a classroom format. Groups were composed of three to 12 patients with the same or similar diagnoses. Each session in the series constituted a complete module and included didactic presentations and group discussion about the material. At follow-up two years after the program started, the program was well accepted by staff and patients. The proportion of patient contacts for group therapy and revenue generated by group contacts had increased. Although an aim of the program was to reduce the frequency of contacts for individual therapy, these contacts did not decline over the follow-up period.

Case Management↗
PubMed1984

Computer software design for pediatric practice. A modular approach.

Practical applications for using computers in everyday medical practice have not kept pace with the technical developments that now make this tool available to the pediatric practitioner. A modular approach to user-developed applications software is presented as a model for computerizing the pediatric office. Benefits have included lower cost, greater data reliability and validity, standardization of office and medical procedures, and automation of jobs formerly requiring much personnel time. Some patient services have improved, and other new services have become possible, through the application of computer software designed in accordance with our practice philosophy.

Computers↗
PubMedDate not supplied

A model for the prediction of osmolalities of modular formulas.

A model is proposed for evaluation of osmolality of multicomponent formulas composed of modular ingredients. Nonlinear curve-fitting techniques applied to empirical data result in prediction of the osmolality of ingredients for any concentration desired. Osmolality of a multicomponent formula can be obtained by adding osmolalities of ingredients. Data handling is made possible by the use of simple microcomputer programs. The model is tested with products available for construction of amino acid-restricted diets.

Amino Acids↗
PubMedDate not supplied

Home enteral nutrition system: one patient, one daily ration of an "all-in-one" sterile and modular formula in a single container.

A home enteral nutrition (HEN) system was introduced to deliver a day's ration of an "all-in-one" sterile and modular formula from a large container. The nutrient formula consisted of carbohydrate, protein, and lipid modules sterilized separately, in an autoclave at 120 degrees C, then mixed and supplemented with minerals and trace elements. Vitamins were given the patients through a feeding tube before connecting the nutrient container. The system was used to feed 12 malnourished patients (10 men and two women) with cancer (carcinoma of esophagus or tongue) or without cancer (esophageal perforation). All patients had normal gastrointestinal function but could not take in more than 500 kcal/day orally, because of their primary disease or the treatment for it (surgery in four patients; and radiotherapy, associated in some cases with chemotherapy, in eight). HEN duration ranged from 30 to 435 days at a daily cost of approximately US $15 to $20. Statistical analysis (Student's t-test for paired data) showed significant body weight gain (p less than 0.05) and significant increases in serum levels of albumin, transthyretin (p less than 0.05, respectively), and transferrin (p less than 0.01). Increases of serum total protein level were not statistically significant (p less than 0.09). The nutrient formula was well tolerated and there were no HEN-related rehospitalizations. Seventy-five % (nine of the patients) considered that HEN had improved their quality of life. The daily savings per patient, compared to the cost of treatment in a hospital, was about $260/day.(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed2006

Designing validation studies more efficiently according to the modular approach: retrospective analysis of the EPISKIN test for skin corrosion.

It is claimed that the modular approach to validation, which involves seven independent modules, will make the assessment of test validity more flexible and more efficient. In particular, the aspects of between-laboratory variability and predictive capacity are formally separated. Here, the main advantage of the approach is to offer the opportunity for reduced labour, and thus to allow study designs to be more time efficient and cost effective. The impact of this separation was analysed by taking the ECVAM validation study on in vitro methods for skin corrosivity as an example of a successful validation study - two of its methods triggered new OECD test guidelines. Lean study designs, which reduced the number of tests required by up to 60%, were simulated with the original validation data for the EPISKIN model. By using resampling techniques, we were able to demonstrate the effects of the lean designs on three between-laboratory variability measures and on the predictive capacity in terms of sensitivity and specificity, in comparison with the original study. Overall, the study results, especially the levels of confidence, were only slightly affected by the lean designs that were modelled. It is concluded that the separation of the two modules is a promising way to speed-up prospective validation studies and to substantially reduce costs, without compromising study quality.

Animal Testing Alternatives↗
PubMed2002

Primary human liver cells as source for modular extracorporeal liver support--a preliminary report.

Cell-based extracorporeal liver support is an option to assist or replace the failing organ until regeneration or until transplantation can be performed. The use of porcine cells or tumor cell lines is controversial. Primary human liver cells, obtained from explanted organs found to be unsuitable for transplantation, are a desirable cell source as they perform human metabolism and regulation. The Modular Extracorporeal Liver Support (MELS) concept combines different extracorporeal therapy units, tailored to suit the individual and intra-individual clinical needs of the patient. A multi-compartment bioreactor (CellModule) is loaded with human liver cells obtained by 5-step collagenase liver perfusion. A cell mass of 400 g - 600 g enables the clinical application of a liver lobe equivalent hybrid organ. A detoxification module enables single pass albumin-dialysis via a standard high-flux dialysis filter, and continuous veno-venuous hemodiafiltration may be included if required. Cells from 54 human livers have been isolated (donor age: 56 +/- 13 years, liver weight: 1862 +/- 556 g resulting in a viability of 55.0 +/- 15.9%). These grafts were not suitable for LTx, due to steatosis (54%), cirrhosis (15%), fibrosis (9%), and other reasons (22%). Out of 36 prepared bioreactors, 10 were clinically used to treat 8 patients with liver failure. The overall treatment time was 7-144 hours. No adverse events were observed. Initial clinical applications of the bioreactor evidenced the technical feasibility and safety of the system.

Bioreactors↗
PubMed2002

Modular organization of spinal motor systems.

The vertebrate nervous system produces a wide range of movement flexibly and efficiently, even though the simplest of these movements is potentially highly complex. The strategies by which the nervous system overcomes these complexities have therefore been of interest to motor physiologists for decades. In this review, the authors present a number of recent experiments that propose one strategy by which the nervous system might simplify the production of movement. These experiments suggest that spinal motor systems are organized in terms of a small number of distinct motor responses, or "modules." These distinct modules can be combined together simply to produce a wide range of different movements. Such a modular organization of spinal motor systems can potentially allow the nervous system to produce a wide range of natural behaviors in a simple and flexible manner.

Animals↗
PubMed2003

A modular, fully integrated ultra-high-throughput screening system based on confocal fluorescence analysis techniques.

The rapid increase in size of compound libraries, as well as new targets emerging from the Human Genome Project, require progress in ultra-high-throughput screening (uHTS) systems. In a joint effort with scientists and engineers from the biotech and the pharmaceutical industry, a modular, fully integrated system for miniaturized uHTS was developed. The goal was to achieve high data quality in small assay volumes (1-4 microL) combined with reliable and unattended operation. Two new confocal fluorescence readers have been designed. One of the instruments is a 4-channel confocal fluorescence reader, measuring with 4 objectives in parallel. The fluorescence readout is based on single-molecule detection methods, allowing high sensitivity at low tracer concentrations and delivering an information-rich output. The other instrument is a confocal fluorescence imaging reader, where the images are analyzed in terms of generic patterns and quantified in units of intensity per pixel. Both readers are spanning the application range from assays with isolated targets in homogenous solution or membrane vesicle-based assays (4-channel reader) to cell-based assays (imaging reader). Results from a comprehensive test on these assay types demonstrate the high quality and robustness of this screening system.

Anti-Bacterial Agents↗
PubMed2002

A useful endovascular technique for treating modular limb disconnection in a bifurcated stent-graft.

PURPOSE: To report a technique for treating a type III endoleak owing to disconnection of an iliac graft limb from a modular aortic stent-graft. TECHNIQUE: A hydrophilic guidewire is introduced via a homolateral femoral access and passed through the thrombosed iliac extension. Once the errant graft limb is recanalized, wire exchange for an extra stiff guidewire facilitates passage of an angioplasty balloon into the stent. Inflated under low pressure, the balloon is used to push the thrombosed limb retrograde into the aneurysm sac. With the aortoiliac axis restored, a new covered stent can be deployed. CONCLUSIONS: This approach is one of several that may be used to treat a type III endoleak arising from a disconnected and occluded stent-graft limb. It avoids the bleeding complications of thrombolysis and restores the aortoiliac axis so that another stent-graft may be implanted to re-exclude the aneurysm.

Aged↗
PubMed2002

Side-branched modular endograft system for thoracoabdominal aortic aneurysm repair.

PURPOSE: To describe a side-branched modular endograft system that provides adequate visceral artery perfusion with perfect seal during thoracoabdominal aortic aneurysm (TAAA) repair. CASE REPORT: A 76-year-old man with a 57-mm TAAA involving the celiac artery was treated with a customized Talent endograft consisting of a 46-mm x 18-cm stented main body and a 6-mm x 30-mm nonstented Dacron side branch. The graft was delivered through a surgical exposure of the left common femoral artery. A 6-mm x 10-cm Hemobahn stent-graft was introduced in the 30-mm side branch from the aorta to the celiac trunk through a long 8-F sheath via the left brachial artery. The patient recovered uneventfully except for a mild reactive inflammatory syndrome. Postoperative computed tomography demonstrated total exclusion of the TAAA sac and good antegrade perfusion of the celiac and superior mesenteric arteries, which has been maintained at the 6-month follow-up. CONCLUSIONS: Endovascular treatment of TAAA is feasible with further technical refinements of available technology.

Aged↗
PubMedDate not supplied

Aorto uni-iliac modification of a bifurcated stent graft for endovascular aneurysm repair: Expanding the versatility of a modular device.

As endografting technology advances, anatomical constraints limiting access and deployment have become less of a burden. While unsuitable candidates for endografting exist, these patients are becoming less frequent. To broaden the applicability of endovascular abdominal aortic aneurysm repair (EVAR), we have modified the bifurcated AneuRx device into a unilimb modular prosthesis, by placing an aortic extender cuff across the flow divider, thus excluding its contralateral limb. This technique was used with success in 3 groups of patients: with occlusion of 1 iliac artery, with a nontraversable iliac stenosis, or with a small calcific aortic bifurcation. In these patients, anatomy can make it difficult, if not impossible, to place a bifurcated stent graft. Whether as a planned preoperative procedure or as a ;;bail-out'' maneuver, this procedure has been successful in avoiding open surgical conversion.

Aged↗
PubMed2005

JACOP: a simple and robust method for the automated classification of protein sequences with modular architecture.

BACKGROUND: Whole-genome sequencing projects are rapidly producing an enormous number of new sequences. Consequently almost every family of proteins now contains hundreds of members. It has thus become necessary to develop tools, which classify protein sequences automatically and also quickly and reliably. The difficulty of this task is intimately linked to the mechanism by which protein sequences diverge, i.e. by simultaneous residue substitutions, insertions and/or deletions and whole domain reorganisations (duplications/swapping/fusion). RESULTS: Here we present a novel approach, which is based on random sampling of sub-sequences (probes) out of a set of input sequences. The probes are compared to the input sequences, after a normalisation step; the results are used to partition the input sequences into homogeneous groups of proteins. In addition, this method provides information on diagnostic parts of the proteins. The performance of this method is challenged by two data sets. The first one contains the sequences of prokaryotic lyases that could be arranged as a multiple sequence alignment. The second one contains all proteins from Swiss-Prot Release 36 with at least one Src homology 2 (SH2) domain--a classical example for proteins with modular architecture. CONCLUSION: The outcome of our method is robust, highly reproducible as shown using bootstrap and resampling validation procedures. The results are essentially coherent with the biology. This method depends solely on well-established publicly available software and algorithms.

Algorithms↗
PubMed2006

Gemvid, an open source, modular, automated activity recording system for rats using digital video.

BACKGROUND: Measurement of locomotor activity is a valuable tool for analysing factors influencing behaviour and for investigating brain function. Several methods have been described in the literature for measuring the amount of animal movement but most are flawed or expensive. Here, we describe an open source, modular, low-cost, user-friendly, highly sensitive, non-invasive system that records all the movements of a rat in its cage. METHODS: Our activity monitoring system quantifies overall free movements of rodents without any markers, using a commercially available CCTV and a newly designed motion detection software developed on a GNU/Linux-operating computer. The operating principle is that the amount of overall movement of an object can be expressed by the difference in total area occupied by the object in two consecutive picture frames. The application is based on software modules that allow the system to be used in a high-throughput workflow. Documentation, example files, source code and binary files can be freely downloaded from the project website at http://bioinformatics.org/gemvid/. RESULTS: In a series of experiments with objects of pre-defined oscillation frequencies and movements, we documented the sensitivity, reproducibility and stability of our system. We also compared data obtained with our system and data obtained with an Actiwatch device. Finally, to validate the system, results obtained from the automated observation of 6 rats during 7 days in a regular light cycle are presented and are accompanied by a stability test. The validity of this system is further demonstrated through the observation of 2 rats in constant dark conditions that displayed the expected free running of their circadian rhythm. CONCLUSION: The present study describes a system that relies on video frame differences to automatically quantify overall free movements of a rodent without any markers. It allows the monitoring of rats in their own environment for an extended period of time. By using a low-cost, open source hardware/software solution, laboratories can greatly simplify their data acquisition and analysis pipelines and improve their workload.

Journal Article↗
PubMedDate not supplied

Interdisciplinary modular teaching for patients undergoing progenitor cell transplantation.

Patient-education information provided to patients undergoing progenitor cell transplantation (PCT) is complex. Patients' and caregivers' inability to process this information and apply principles of self-care can result in poor outcomes. An interdisciplinary team developed a three-part modular teaching program and documentation tool to address the complex informational needs of patients undergoing PCT. The modules were designed to reflect information relative to the three phases of PCT: pretransplantation, transplantation, and post-transplantation. The structured content of the documentation tool allows for consistent documentation that systematically reflects the content of the patient-education modules.

Caregivers↗
PubMed2004

Platelet-derived growth factor receptor inhibitor imatinib mesylate and docetaxel: a modular phase I trial in androgen-independent prostate cancer.

PURPOSE: To study the platelet-derived growth factor receptor (PDGFR) inhibitor imatinib mesylate in androgen-independent prostate cancer (AIPC), alone and in combination with docetaxel, we designed a modular phase I trial. Our goals were to (1) evaluate the toxicity and maximum-tolerated dose of docetaxel with imatinib, and (2) evaluate the decline of prostate-specific antigen (PSA) induced by imatinib alone, and imatinib and docetaxel. PATIENTS AND METHODS: Twenty-eight men with AIPC and bone metastases were enrolled to receive imatinib 600 mg daily lead-in for 30 days, then imatinib 600 mg daily and one of six possible doses of docetaxel weekly for 4 weeks every 6 weeks. RESULTS: During the imatinib lead-in module, one dose-limiting toxicity (DLT) event was observed, while two (7%) of 28 had PSA decline (both < 50%). With imatinib and docetaxel, cycle 1 DLT was found in three of 12 patients at docetaxel 30 mg/m(2), in three of four patients at docetaxel 45 mg/m(2), and in five of six patients at docetaxel 35 mg/m(2). DLTs (n = 40 total events) were principally fatigue (35%) and nausea (20%). Eight (38%) of 21 had PSA decline greater than 50%, and six (29%) of 21 had PSA decline less than 50%. Serial PSA declines beyond 18 months were observed. PDGFR-expressing tumor declined on serial bone marrow biopsies with combination therapy alone. CONCLUSION: With imatinib 600 mg daily, the maximum-tolerated dose of docetaxel was determined to be 30 mg/m(2) weekly for 4 weeks every 6 weeks. Long-term responses were observed. The role of imatinib in modulating outcomes to docetaxel in AIPC is being tested in a randomized phase II trial.

Adult↗
PubMed2002

Teaching cultural sensitivity in psychological assessment: a modular approach used in a distance education program.

In this article, I describe the teaching and evaluation of 8 multicultural assessment competencies in an American Psychological Association accredited, distance education, clinical psychology doctoral program. This modular approach consists of 15 hr of face-to-face, didactic and experiential multicultural assessment training designed to (a) augment personal awareness, (b) develop a conceptual base, (c) provide exposure to available assessment technologies, (d) ensure an understanding of an integrative model of culturally sensitive assessment, and (e) offer opportunities to apply this material to assessment cases. In addition to completing this training, students are evaluated on these competencies as part of their preinternship clinical comprehensive. I present preliminary evaluative outcome data as well as a critique of this approach.

Colorado↗
PubMed1993

An alternative Pit-1 RNA splicing product reveals modular binding and nonmodular transcriptional activities of the POU-specific domain.

We have identified a form of the pituitary-specific POU protein Pit-1 that results from deletion of the POU-specific (POUs) domain by alternative RNA splicing. This natural variant of Pit-1 (called delta 4Pit-1) has revealed several aspects of the function of the POUs domain. The delta 4Pit-1 protein was characterized using a delta 4Pit-1-specific antiserum. Further, selection assays of random oligonucleotide pools identified binding site preferences for both wild type and delta 4Pit-1. Methylation interference, copper phenanthrolene, and missing contact analyses were used to compare the binding characteristics of the two forms of Pit-1 on a selected site. DNA binding affinity assays on several DNA elements revealed that the POUs domain contains a modular DNA binding activity affecting the DNA binding affinity of the entire POU domain on some, but not on other, DNA sites. Functional analysis on such DNA elements has revealed that the POUs domain is an essential, but nonmodular, component of the Pit-1 trans-activation domain dependent on its natural context within the Pit-1 protein.

Amino Acid Sequence↗
PubMed2005

Neuropsychological evidence of modular organization of the near peripersonal space.

BACKGROUND: The space closely surrounding the body, near peripersonal space, is represented through multisensory coding, as witnessed by the spatial distribution of visual-tactile extinction in brain-damaged patients. Typically, tactile stimuli delivered on the contralesional hand are more severely extinguished by visual stimuli presented near to than far from the ipsilesional hand. OBJECTIVE: To investigate whether the near peripersonal space is a unitary multisensory representation of the peribody space or is organized in a modular fashion, separately representing different body parts. METHODS: Cross-modal extinction was used to assess right brain-damaged patients with left tactile extinction by presenting a combination of ipsilesional visual and contralesional tactile stimuli, both between homologous body parts (i.e., the two hands and sides of the face) and between nonhomologous body parts (i.e., right hand + left face and right face + left hand). RESULTS: Visual-tactile extinction observed in the near peripersonal space of homologous body parts was more severe than that obtained between nonhomologous body parts. In contrast, cross-modal extinction observed in the far peripersonal space was overall weak and comparable when stimulating homologous or nonhomologous body sectors. In addition, a clear near-far modulation of visual-tactile extinction was obtained only when stimulating homologous, but not nonhomologous, body parts. These findings were observed irrespective of the severity of unisensory tactile extinction. CONCLUSIONS: Near peripersonal space is not unitary but is functionally organized in modules and consists of at least two different spatial representations, one around the hand and another around the face, which might be selectively affected in patients with extinction.

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