Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “big data”

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 1,099 records · Page 61Linked to original sources
PubMedDate not supplied

The next stage of managed care.

Since the turn of the century, we have gone from medicine as a cottage industry, based largely on barter, to the complex entity it is today. What we will see in the coming decade, if not sooner is the emergence of the next level of managed care. As managed care matures, contradictions in the health care system that we have not been able to resolve will be addressed, as well as other value-related issues. The ability to deliver value and then to monitor outcomes will be the nut to crack. The next big movement will be to hone in on outcomes and measurement. This will be the path to increasing the inherent value of the medical care system. This will go hana in hand with accountability, which is where physician-sponsored networks (PSNs) will be an indispensable tool. Centered as they are around accountability and responsibility, PSNs will be a natural starting point for developing the protocols to produce and collect this data. The standardization of care, anchored upon medical evidence, is the objective.

Benchmarking↗
PubMedDate not supplied

[Plasticity of the central nervous system and treatment strategies for sensory and motor reprogram: comparison between two cases of cerebrovascular disease in the middle cerebral artery territory].

INTRODUCTION: Injury to the central nervous system causes a series of symptoms, which lead to a process of cerebral plasticity. Proprioceptive and exteroceptive information processing from the outside to the brain, influence the development of neuroplasticity, which contributes to either the recovery or maintenance of sensory-motor alterations after a stroke. CASE REPORTS: Two patients with cerebrovascular accident in the left middle cerebral artery territory, one of them ischemic and the other hemorrhagic, whose sensory and motor therapy applied show big differences. CONCLUSIONS: Treatment strategies for functional rehabilitation following a cerebrovascular accident, must be established in relation to current hypotheses on cerebral neuroplasticity and central nervous system pathways, which shows less damage or better sensory motor response. The assessment of neurological signs and symptoms, can indicate which tracts show more or less damage and which ones show greater response to motor recovery treatment. Nevertheless, functional neuroimaging diagnosis provides us with the data in a more reliable way. Even so, among patients that show similar lesion zones, according to diagnosis of computerized tomography or magnetic resonance imaging, there exists a significant clinical variability among different cases, in which case we confirm, in reference to physical treatment, that there are no patients alike, or identical patients even if they have the same clinical diagnosis of the disease.

Central Nervous System↗
PubMed1977

[Tribuliphorus salilotae gen. et spec. nov., a new representative of the monogena].

Belonging to the Monogenean family Diclidophoridae, Tribuliphorus salitotae nov. gen. nov. spec. is described from a gadiform fish, Salilota australia (family Moridae). Its specific characteristics are: big and sharp clasps at the anterior lateral and the posterior lateral plates of the adhesing valves. All 8 valves are structured in the same manner, but they differ in their situation and size: the first 3 pairs are smaller and are inverted (180 degrees to the body's length exis) the hind pair is twice as big and situated normally. --In respect to its morphology, Tribuliphorus nov. gen. could belong to the lowes (most primitive) genera of the subfamily Diclidophorinae, which parasitize the Macruriformes. On the other side, the genus shows affinities to Anchophorus, whose only representative (A. sinensis Bychovsky & Nagibina, 1958) has been found on cynoglossids (an apart group of the Pleuronectiformes), and which has been put in a monotypic family Anchophoridae. By this, the parasitological data again support the previously expressed view (by one of the authors) regarding the relationship of the Pleuronectiformes to the Gadiformes and Goryphaenoididae = Macruriformes).

Animals↗
PubMedDate not supplied

[Quality and shortages of patient safety--how big is the problem?].

Patient safety is essential to quality health care, to ensure patients are not harmed, but also to ensure that resources are not wasted. More research evidence is becoming available about deficiencies in health care quality and safety. This evidence is reviewed in three consecutive articles in Läkartidningen. Research has discovered high rates of "adverse events" in health care services. The actual rate varies depending on definition, methods of measurement, and type of service. Rates as high as 46% of patients admitted to hospital have been reported. Sometimes high reported rates indicate that a service is serious about collecting data, rather than being an unsafe service. Generally, half of the events can be classified as "avoidable", and a significant proportion as "serious" causing death, disability or a longer hospital stay. Adverse drug events account for a high proportion and are probably the most well studied of patient safety problems. Although most of the current research has been done in the US, there is some evidence which suggests that problems within Swedish health care are of a similar magnitude and type. This article summarises the main studies and focuses on evidence of the economic consequences of deficiencies in patient safety and quality.

Drug-Related Side Effects and Adverse Reactions↗
PubMed2002

The ebb and flow of the NHS waiting list: how do recruitment and admission affect event-based measures of the length of 'time-to-admission'?

The likelihood of admission is reported in England as the percentage of elective episodes occurring within a certain time, for example, within three months of the date of enrollment on the waiting list. This event-based measure is calculated from cross-sectional data: the denominator is the number of elective episodes occurring in a specified calendar period, and the numerator is the number found to have enrolled on the waiting list less than three months previously. Now the number of elective episodes occurring within three months reflects the likelihood of admission and the numbers eligible to be admitted. If there is any increase in the likelihood of admission or in the number of people exposed to that likelihood then there will be an increase in the number of elective episodes found to have enrolled on the waiting list less than three months previously. Thus the numerator used by the Government Statistical Service accurately reflects conditions during the calendar period and within the enrollment cohorts of interest. The Government Statistical Service also needs a denominator so the episodes observed 0-2, 3-5, 6-8, 9-11 etc. months after enrollment are added as an indication of the number of people that could have been admitted within three months. This denominator implies that the number of people eligible for admission from the 3-5 month waiting time category is the same as the number surviving admission from the 0-2 month waiting time category but, during the period of interest, these two groups of people belong to cohorts that were recruited to the waiting list quite independently. As a result, this denominator will be too big if the number surviving to the end of one waiting time category is bigger than the number eligible for admission from the next and it will be too small if the number surviving to the end of one waiting time category is smaller than the number eligible for admission from the next. The event-based measure assumes that the waiting list is stationary and closed and only gives unbiased estimates under these conditions. This paper describes three alternative measures which recognize that the number of people recruited or admitted may vary from one quarter to the next. It uses Department of Health data to assess the size of the error if the event-based measure is used in these circumstances.

Elective Surgical Procedures↗
PubMed2003

Non-particulate (continuous bed or monolithic) restricted-access reversed-phase media for sample clean-up and separation by capillary-format liquid chromatography.

Restricted-access reversed-phase non-particulate (continuous bed or monolithic) stationary phases of different hydrophobicity synthesized in 100 microm i.d. fused silica capillaries have been evaluated. A specific property of restricted-access media (RAM) is that they interact with small analytes and exclude big molecules, e.g. proteins, from access to the active sites and adsorption on the surface. This dual property facilitates direct injection of biological fluids for drug or drug-metabolite analysis. Different RAM and RAM-precursor capillary columns were tested to assess the influence of chromatographic bed morphology on loadability. Inverse size-exclusion chromatography was used for investigation of pore structural properties of the capillary-format continuous beds. The data obtained were used to discuss the mechanism of separation of the biological samples using capillary columns and to propose a model for the topochemical architecture of the RAM investigated. Different morphology of the non-particulate reversed-phase precursors resulted in two types of RAM material shielded with hydrophilic polymer, classified as homogeneous or heterogeneous topochemistry stationary phases. Capillary columns were applied for chromatography of biological fluids. High resolution was obtained, without the need for column switching, when capillary columns operated in gradient conditions. Extensive evaluation of the chromatographic properties (hydrophobicity, efficiency, separation impedance, and loadability) of the non-particulate reversed-phase materials was performed before and after shielding with hydrophilic polymer to generate restricted-access properties. Minor changes of hydrophobicity, efficiency, or separation impedance were observed after the shielding.

Acetaminophen↗
PubMed1990

Generation of human endothelin by cathepsin E.

Highly-purified cathepsin D processed human big endothelin1-38 into endothelin-like fragments but did not appear to generate endothelin1-21 under the conditions employed. By contrast, human cathepsin E specifically cleaved human big endothelin into endothelin1-21 and the C-terminal fragment under identical conditions but did not degrade either product further.

Amino Acid Sequence↗
PubMed1998

Variations of the frontal exit of the supraorbital nerve: an anatomic study.

Until now, it has been taken for granted that the point of emergence of the supraorbital nerve is by way of a notch or a foramen at the border of the inner to the medial third of the supraorbital rim. In contrast to several anatomic textbooks, we noticed that the exit point was repeatedly not at the site where anticipated when implanting lid springs for facial palsy. This gave us the idea of investigating these variations and how big they are, because most open and recent endoscopic forehead lift techniques have relied on a constant exit point of the supraorbital nerve. A total of 507 macerated skulls (1014 orbits) from three anatomic collections in Austria and Germany were studied. All skulls were adult European skulls gathered from the prehistoric age up to the twentieth century. Additionally, 18 fixed cadavers (36 orbits) and 25 fresh cadavers (50 orbits) were studied. These data were not included in the statistical analysis but in the discussion. The anatomic measurements on the skulls were carried out with an anthropometric calliper. The examinations concentrated on the configuration (notch/foramen) and the number of exit point(s) on the supraorbital rim, the vertical distance from the supraorbital rim, and the distance from the nasion to the various exit point(s). Combining all of these parameters, 74 percent of the skulls showed asymmetric findings between the right and left orbits. In 15 percent of both orbits, the supraorbital nerve left the orbital cavity already in its two branches, the medial and lateral branch, either through a notch or a foramen, the foramen being sometimes the exit of a supraorbital canal. The average distance from the nasion to the frontal notch/foramen was 25 mm on both orbits (range 16 to 55 mm) and to the supraorbital notch/foramen 31 mm (range 20 to 49 mm). The largest vertical distance from the supraorbital rim to its farthest exit point was 19 mm. Other than what is cited in literature, the variations concerning the configuration and the distance of the exit point(s) of the supraorbital nerve were so significant that all forehead operations, especially those using endoscopic techniques, must take into account these findings.

Adult↗
PubMed1999

Pharmacological profile of ZD1611, a novel, orally active endothelin ETA receptor antagonist.

The endothelins (ETs), potent vasoconstrictor peptides, have been implicated in the pathogenesis of various cardiovascular disorders. In the present study, we describe the novel, potent, orally active, selective ET(A) receptor antagonist ZD1611 [3-(4-[3-(3-methoxy-5-methylpyrazin-2-ylsulfamoyl)-2-pyridyl ]phenyl)- 2,2-dimethylpropanoic acid]. ZD1611 competitively inhibited (125)I-labeled ET-1 binding at human cloned ET(A) and ET(B) receptors with pIC(50) values of 8.6 +/- 0.1 and 5.6 +/- 0.1, respectively, showing 1000-fold selectivity for the ET(A) receptor. ZD1611 caused a parallel rightward shift of the concentration response curve to ET-1 in the rat isolated aorta yielding a concentration of antagonist that caused a 2-fold rightward shift in the ET-1-response curve (pA(2)) of 7.5 +/- 0.3. When administered i. v. to anesthetized rats and dogs, ZD1611 caused dose-related rightward shifts of partial dose-response curves to the precursor of ET-1, big ET-1. Threshold doses for significant antagonist activity were determined as 0.1 mg/kg and 0.3 mg/kg in the rat and dog, respectively. Importantly, ZD1611 was able to reverse an established big ET-1-induced pressor response in pithed rats in the presence of continuous big ET-1 infusion. Failure of ZD1611 to inhibit the BQ3020 (ET(B)-selective)-induced depressor response in pithed rats indicated a lack of activity at the endothelial ET(B) receptor. ZD1611 was orally active in the rat at 0.3 mg/kg and had a duration of action of more than 7 h, and, in the dog, a dose of 0.6 mg/kg p.o. was active for at least 6 h. In conclusion, these data demonstrate that ZD1611 is a potent and orally active, selective ET(A) receptor antagonist with a long duration of action which may be of therapeutic use.

Administration, Oral↗
PubMed2003

[Reliability of measurement and the methods of estimating reliability].

OBJECTIVE: To explore the methods of estimating measurement reliability and their limitations. METHODS: According to the given examples, reliabilities of measurement were calculated and limitations of the methods of estimating reliability were analyzed. RESULTS: The Kappa value of interobserver reliability was 0.793 between two pathologists. Between the two populations with different prevalence rates, the values of Kappa were 0.800 and 0.137 respectively, and with big difference. Cronbach's alpha coefficient of compositive index for A type behavior was 0.55. CONCLUSION: The Kappa index and alpha coefficient were both inherently population-specific. Before generalizing to different populations, the reliability needs to be measured.

Algorithms↗
PubMed1996

Further observations on comparison of immunization coverage by lot quality assurance sampling and 30 cluster sampling.

Lot Quality Assurance Sampling (LQAS) and standard EPI methodology (30 cluster sampling) were used to evaluate immunization coverage in a Primary Health Center (PHC) where coverage levels were reported to be more than 85%. Of 27 sub-centers (lots) evaluated by LQAS, only 2 were accepted for child coverage, whereas none was accepted for tetanus toxoid (TT) coverage in mothers. LQAS data were combined to obtain an estimate of coverage in the entire population; 41% (95% CI 36-46) infants were immunized appropriately for their ages, while 42% (95% CI 37-47) of their mothers had received a second/ booster dose of TT. TT coverage in 149 contemporary mothers sampled in EPI survey was also 42% (95% CI 31-52). Although results by the two sampling methods were consistent with each other, a big gap was evident between reported coverage (in children as well as mothers) and survey results. LQAS was found to be operationally feasible, but it cost 40% more and required 2.5 times more time than the EPI survey. LQAS therefore, is not a good substitute for current EPI methodology to evaluate immunization coverage in a large administrative area. However, LQAS has potential as method to monitor health programs on a routine basis in small population sub-units, especially in areas with high and heterogeneously distributed immunization coverage.

Cluster Analysis↗
PubMed2002

Nocturnal non-invasive positive pressure ventilation for stable chronic obstructive pulmonary disease.

BACKGROUND: Nocturnal non-invasive positive pressure ventilation (NIPPV) might be beneficial in stable hypercapnic patients with chronic obstructive pulmonary disease (COPD). However, evidence remains equivocal as conflicting results have been published. OBJECTIVES: To determine the effect of nocturnal non-invasive positive pressure ventilation via nasal mask or face mask in patients with COPD. SEARCH STRATEGY: An initial search was carried out using the Cochrane Airways Group COPD RCT register using the search terms: (nasal ventilat* OR positive pressure OR NIPPV). An additional search was done by hand searching of abstracts from meetings of the American Thoracic Society, British Thoracic Society and European Respiratory Society. SELECTION CRITERIA: Randomised controlled trials in stable patients with COPD that compared nocturnal non-invasive positive pressure ventilation plus standard therapy with standard therapy alone. DATA COLLECTION AND ANALYSIS: Data extraction was performed by two independent reviewers. MAIN RESULTS: The only outcome for which the 95% confidence interval excluded zero was PI max. The 95% confidence interval (CI) of the other outcomes included zero. These included FEV1,FVC, PaCO2, sleep efficiency and 6-minute walking distance (6MWD). The mean effect on 6MWD was modest at 27.5 m, but the 95% CI were wide (-28.1, 81.8 m) suggesting that some patients had a big improvement. Such patients could not be identified a priori. REVIEWER'S CONCLUSIONS: Nocturnal NIPPV for at least 3 months in hypercapnic patients with stable COPD had no consistent clinically or statistically significant effect on lung function, gas exchange, respiratory muscle strength, sleep efficiency or exercise tolerance. However, the small sample sizes of these studies precludes a definite conclusion regarding the effects of NIPPV in COPD.

Humans↗
PubMedDate not supplied

A research-oriented medical cost accounting system.

Prospective research into factors affecting health care costs for individual patients requires a hybrid information management system with some features usually associated with a medical billing package and other features common to research databases. Furthermore, data collection for such a project must often be done in the field where a portable computer is most convenient. A software program is described which has been developed to address these disparate needs. It allows classification by study protocol assignment and provides multiple summary formats for the assessment of costs. For example, charges can be stratified by specialty, by category of service (pharmacy, room, surgery, respiratory therapy, etc.), by magnitude of expense ('big' vs 'little' ticket items) and so forth. The system design described may prove useful to other investigators studying variation in health care costs.

Accounting↗
PubMed1994

The use of shuttle vectors for mutation analysis in transgenic mice and rats.

The establishment in recent years of transgenic shuttle vector-based mutagenicity assays has provided improved systems for analysis of mutagenic and carcinogenic processes. Results in the mouse have stimulated the development of an alternate species suitable for mutation analysis and have increased our understanding of the existing models. A previously described shuttle vector (lambda LIZ), based on a lacI target gene, was constructed in this laboratory for the study of mutagenesis in transgenic mice and in cultured cell lines. The shuttle vector allows for several options in its recovery from the host genome and in mutant identification. Of the 9 transgenic lineages that were generated with the lambda LIZ vector, one was chosen for use in a standardized mutagenicity assay (Big Blue, mouse lineage A1). Characterization of this lineage included copy-number determination, chromosomal localization of transgene integration and analysis of copy-number stability. As part of the validation process, the standardized color-screening assay has been tested in the mouse, both for spontaneous mutant frequencies and with a variety of model mutagenic compounds, and has been shown to identify most major classes of mutations as evidenced by mutant spectra data. A discussion of the relative sensitivity of the shuttle vector to each of these classes of mutations is included. These studies have now been extended to the generation of transgenic rats containing the same shuttle vector for cross-species analysis. Spontaneous mutant frequencies in two transgenic rat lineages were measured in liver and in germ cells. Preliminary data suggest that spontaneous mutant frequencies in somatic tissue are lower in rats than in mice, a result consistent with historical observations of DNA damage and repair in these two species. Also under evaluation are alternative selectable systems for mutant identification, and hybrid animals obtained from mating lambda LIZ transgenics with genetically engineered mice possessing an inactivated tumor suppressor gene. It is expected that each of these widely varying endeavors will contribute, not only in furthering our understanding of the role transgenic systems should play in human risk assessment, but in illuminating the mechanisms of mutation in general.

Animals↗
PubMed2005

Solid-phase extraction of esculetin from the ash bark of Chinese traditional medicine by using molecularly imprinted polymers.

A molecularly imprinted polymer solid-phase extraction method is used to extract esculetin from the ash bark of Chinese traditional medicine. Ratio of ethanol and water as washing solution were investigated. Data of accumulative adsorption on molecularly imprinted polymers from the continuous loading experiment suggests that there are two different kinds of recognition sites in molecularly imprinted polymers. By selecting the washing and eluting solution a scheme was designed to separate esculetin and its analogues including esculin, coumarin, 7-methoxylcoumarin and daphnetin. Finally, by applying the revised scheme esculetin was extracted from the ash bark of Chinese traditional medicine that was purchased from two big drugstores, respectively, with both molecularly imprinted polymers and non-molecularly imprinted polymers.

Chromatography, High Pressure Liquid↗
PubMed1999

New estimates of the demand for health: results based on a categorical health measure and Swedish micro data.

In this paper we estimate a "Grossman" model of demand for health based on Swedish micro data. The data set consists of a random sample of over 5000 individuals taken from the Swedish adult population. Health capital is measured by a categorical measure of overall health status, and an ordered probit model is used to econometrically estimate the demand for health equation. The results are consistent with the theoretical predictions and show that the demand for health increases with income and education and decreases with age, male gender, overweight, living in big cities and being single.

Adult↗
PubMed2003

Dodecahedral space topology as an explanation for weak wide-angle temperature correlations in the cosmic microwave background.

The current 'standard model' of cosmology posits an infinite flat universe forever expanding under the pressure of dark energy. First-year data from the Wilkinson Microwave Anisotropy Probe (WMAP) confirm this model to spectacular precision on all but the largest scales. Temperature correlations across the microwave sky match expectations on angular scales narrower than 60 degrees but, contrary to predictions, vanish on scales wider than 60 degrees. Several explanations have been proposed. One natural approach questions the underlying geometry of space--namely, its curvature and topology. In an infinite flat space, waves from the Big Bang would fill the universe on all length scales. The observed lack of temperature correlations on scales beyond 60 degrees means that the broadest waves are missing, perhaps because space itself is not big enough to support them. Here we present a simple geometrical model of a finite space--the Poincaré dodecahedral space--which accounts for WMAP's observations with no fine-tuning required. The predicted density is Omega(0) approximately 1.013 > 1, and the model also predicts temperature correlations in matching circles on the sky.

Journal Article↗
PubMed1977

Molecular description of dioxygen bonding in hemoglobin.

From ab initio quality calculations on model systems, we conclude that in unliganded Fe-porphyrin the FE lies in the plane for both the high-spin (q) and intermediate-spin (t) states. Thus, the high-spin d6 Fe is not too big to fit into the porphyrin plane (as often suggested). We find the q state lower for a porphyrin hole radius greater than 1.94 A and the t state lower for smaller sizes. For the five-coordinate complex including an axial nitrogenous ligand [a model for myoglobin (Mb) and hemoglobin (Hb)], we find the ground state to be q with the Fe 0.3 A out of the plane (recent x-ray data on deoxy Mb suggests about 0.4 A). The origin of this out-of-plane displacement is the nonbonded repulsions between the axial ligand and porphyrin nitrogen orbitals. Pushing the Fe of the five-coordinate complex into the plane does not lead to a stable low-spin state (as usually suggested), the q and t states being the low-lying states. Bonding the O2 to form the six-coordinate complex stabilizes the t form of the Mb model, leading to a singlet state of MbO2 with Fe in the plane. (It has often been suggested that the Fe of MbO2 and HbO2 is low-spin Fe2+; however, we find this not to be the case.) The bonding in the MbO2 model confirms the ozone model of the bonding, leading to a structure consistent with the Pauling model (our calculated FeOO bond angle is 119 degrees). The total charge transfer to the O2 is 0.10 electron, in disagreement with the Weiss model. Molecular orbital calculations (Hartree-Fock) incorrectly lead to septet ground state (S = 3) for the MbO2 model. The implications for the cooperative O2 binding in hemoglobin and protein modifications of the energetics of the active site are considered. Use of our calculated force constants for displacement of Fe perpendicular to the heme plane suggests that the movement of the Fe upon a change in the quaternary structure from the T to the R form is only about 0.04 A toward the heme plane.

Binding Sites↗