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In the mid 1990s, we started a program on the development of more efficient palladium catalysts for the C-C and C-N coupling reactions of aryl halides, especially aryl chlorides. In this contribution, our investigations on new catalyst systems and their application in organic synthesis are summarized.
Programs devoted to the analysis of protein sequences exist either as stand-alone programs or as Web servers. However, stand-alone programs can hardly accommodate for the analysis that involves comparisons on databanks, which require regular updates. Moreover, Web servers cannot be as efficient as stand-alone programs when dealing with real-time graphic display. We describe here a stand-alone software program called ANTHEPROT, which is intended to perform protein sequence analysis with a high integration level and clients/server capabilities. It is an interactive program with a graphical user interface that allows handling of protein sequence and data in a very interactive and convenient manner. It provides many methods and tools, which are integrated into a graphical user interface. ANTHEPROT is available for Windows-based systems. It is able to connect to a Web server in order to perform large-scale sequence comparison on up-to-date databanks. ANTHEPROT is freely available to academic users and may be downloaded at http://pbil.ibcp.fr/ANTHEPROT.
A review of the literature and the experience of a residency program in internal medicine indicate that house officers have special problems during training. Some are shared by all residents, whereas others are unique to certain groups. These problems are caused by historical and cultural factors that have led to the current structure of many residency programs and often interfere with the parallel development of professional, personal and family growth. Program directors and chiefs of service need to be flexible and humane and should negotiate clear expectations with house staff to allow efficient functioning of the residency program and insightful personal growth.
The most important factors in cost-benefit analyses of worksite influenza immunization programs are vaccine cost and administration, vaccine efficacy, and the assumptions used to calculate lost productivity from worker absenteeism or decreased effectiveness. Based on several models published in the literature, estimates of savings per healthy working adult employee could be anticipated to range between dollars 15 and dollars 50. Variations of this net savings are primarily based on assumptions of productivity estimates of the employee. Efficient large worksite influenza immunization programs are feasible and worthy of employer consideration for economic and employee satisfaction reasons.
Here, we present PatMatch, an efficient, web-based pattern-matching program that enables searches for short nucleotide or peptide sequences such as cis-elements in nucleotide sequences or small domains and motifs in protein sequences. The program can be used to find matches to a user-specified sequence pattern that can be described using ambiguous sequence codes and a powerful and flexible pattern syntax based on regular expressions. A recent upgrade has improved performance and now supports both mismatches and wildcards in a single pattern. This enhancement has been achieved by replacing the previous searching algorithm, scan_for_matches [D'Souza et al. (1997), Trends in Genetics, 13, 497-498], with nondeterministic-reverse grep (NR-grep), a general pattern matching tool that allows for approximate string matching [Navarro (2001), Software Practice and Experience, 31, 1265-1312]. We have tailored NR-grep to be used for DNA and protein searches with PatMatch. The stand-alone version of the software can be adapted for use with any sequence dataset and is available for download at The Arabidopsis Information Resource (TAIR) at ftp://ftp.arabidopsis.org/home/tair/Software/Patmatch/. The PatMatch server is available on the web at http://www.arabidopsis.org/cgi-bin/patmatch/nph-patmatch.pl for searching Arabidopsis thaliana sequences.
The records management program at Kingston General Hospital is by no means complete, though considerable progress has been made. Users are gaining confidence in the records centre and more departments are becoming involved. To date, 12 departments are participating fully in the program. In the future, we may consider computerization--for faster retrieval of records--staffing requirements and storage of paperless abstracts to maintain an efficient and effective records management program.
OBJECTIVE: Clinicians often have difficulty determining the appropriate Current Procedural Terminology Evaluation and Management code to assign to the type and intensity of patient care they provide. The purpose of this study was to develop, implement, and evaluate a handheld charge capture program for use by providers in the long-term care setting. DESIGN: Using a pre-post study design, we compared the coding accuracy and user satisfaction of an established paper process with a handheld charge capture program created for this study by means of: (1) preimplementation and postimplementation assessment of coding accuracy, and (2) preimplementation and postimplementation clinician survey. SETTING: We studied an academic division of geriatric medicine. PARTICIPANTS: Participants consisted of six clinicians who currently spend at least 50% of their clinical time practicing in the long-term care setting. INTERVENTION: A handheld charge capture program to replace the current paper-based charge capture process was reviewed. RESULTS: Overall coding accuracy improved by approximately 20% when the handheld program was used instead of a paper coding process. The majority of clinicians found that the handheld program was more widely available, efficient, easier to use, and encouraged the participants to document more completely and accurately in the patient's medical record. CONCLUSION: A handheld billing and coding program used by clinicians who provide care for long-term care residents is not only feasible, but leads to an improvement in coding accuracy when compared with a paper process. In addition, clinician satisfaction toward the billing and coding processes improved with the use of the handheld program.
BACKGROUND: Under economical constraints, blood centers need to identify ways to improve their efficiency. Because there is little evidence regarding the technical efficiency of blood centers, international comparisons may be useful in identifying efficiency discrepancies and can reveal opportunities for enhancing efficiency, such as allocating resources more effectively. STUDY DESIGN AND METHODS: Data were collected for years 2000 through 2002 from 16 blood centers in 10 European countries. Input variables included working hours, whole-blood (WB) collections, premises, and equipment, and the output variables were red blood cells and platelets (PLTs). A nonparametric method, data envelopment analysis (DEA), was used in the analyses of technical efficiency in blood component preparation departments. Efficiency scores were calculated with DEA linear programming techniques and evaluated for site characteristics that possibly affect efficiency, such as the production method of PLTs and the proportion of BCs (buffy coats) from WB and BC PLTs from all PLTs produced. RESULTS: With working hours and equipment as inputs, median technical efficiency was 60 percent (range, 41%-100%). Four departments were efficient (efficiency, > 90%), and 12 were inefficient (range, 41-89). Efficiency remained roughly the same in 13 departments through the 3-year study period and decreased in 3. Efficiency was mainly affected by staffing levels (working hours). Efficiency did not directly relate to production volume, method, or any other site characteristic. CONCLUSIONS: The major cause of inefficiency was excess staffing resulting from a suboptimal combination of manpower and production output levels. Further research is needed to manage factors affecting efficiency, such as the fluctuation of demand in production planning.
American children are worse off than those in the previous generation in several important dimensions of mental, physical, and emotional well-being. During the 1960s cultural changes adversely affected children while their material condition improved substantially. By contrast, material conditions deteriorated in the 1980s, especially among children at the lower end of the income distribution. Public policies to improve the material condition of children require a transfer of resources from households that do not have children to those that do. Government programs such as tax credits and child allowances are more efficient and equitable than employer-mandated programs.
Effective and efficient resuscitation skills are especially significant for pediatric care providers because of the increased neurologic morbidity and mortality associated with pediatric arrests. A mock code system was initiated to assess and enhance the competency of the medical and nursing staff who respond to pediatric arrests in all areas of an acute care general hospital. Two mock codes are conducted each month using a data collection tool. All of the critical skills involved in a pediatric resuscitation are listed in the tool and each skill is evaluated as met or not met. The tool identifies areas for further education and quantifies improvement in skills over a period of time. In addition, the Pediatric CPR Committee uses the data from the mock codes to initiate systems and equipment improvements.
Analysis of epidemiological indicators is of particular importance, and relevant for assessing the efficiency of the prevention and fighting programs against tuberculosis. The most relevant epidemiometric indicators are the incidence of the infection and that of the disease itself. The annual risk of infection with tuberculous bacilli is considered as the most valuable indicator of extension or limiting tendencies of endemia, and of the efficiency of anti-tuberculosis programs. The annual incidence of the infection at the age of 14 years established by various methods, and improper conditions determined by mass allergizing of the infantile population by mandatory B.C.G. vaccination has decreased from 3,5% in 1960 to 0.8-1.0% in 1980. The level is still high, as compared with other european countries, but the rate of decrease has accelerated over the last years, a fact which demonstrates the efficiency of fighting measures applied. The incidence of contracting tuberculosis should be dealt with separately with regard to children and adults, since in children it is mainly related to primary infection, while in adults it is related to the presence of minimal lesions with phtysiogenic potential which can be traced to the post-primary stage, as well as to immuno-depressing influence of some environmental factors. In this connection the incidence of tuberculosis in children has been reduced in our country in the last 25 years from 297.2% to 10.3%. The risk of developing the disease has fallen from 1/230 in 1950 to 1/9 700 in 1980. The risk of developing the disease has decreased more rapidly in older children (between 5 and 9 years) than in the younger ones (0 to 4 years). The incidence of tuberculosis in the population aged above 15 years has fallen from 352.6% in 1955 to 70.5% in 1980. The risk of developing the disease in adults was of 1/284 in 1956 and 1/1 418 in 1980. The authors also make an analysis of the dynamics of some demographic risk factors, such as sex, age and environment.
The increasing availability of analytical methods based on saturation analysis call for efficient assay calculation. A comprehensive computer program was developed, allowing the calculation of different kinds of assays. Due to the user friendly structure it can be used also by inexperienced laboratory staff without difficulties. Its large adaptability can be a usefull support to optimize various kinds of assays.
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BACKGROUND: Considering the difficulties in providing screening and vaccination services for inmates in short-stay incarceration facilities, an evaluation was conducted of the integration of prevention services in an alternative sentencing drug rehabilitation program (alternative to incarceration) in San Diego CA. METHODS: During the period April 1999 to December 2002, clients were asked to complete a brief risk-assessment questionnaire, and were offered hepatitis B virus (HBV) vaccination, HBV and hepatitis C virus (HCV) serologic testing, STD screening, and HIV counseling and testing. RESULTS: Of the estimated 1125 rehabilitation program enrollees, 930 (83%) participated in the integration program services. Most clients were male (64%), were aged >30 years (64%), and few (7%) reported previous HBV vaccination. Of the 854 clients eligible for hepatitis B vaccination, 98% received the first dose, 69% the second dose, and 42% completed the series. Eleven percent of clients had prior HBV infection, and 14.7% had HCV infection, with positivity rates being highest among those with a history of injection drug use-HBV, 19%, and HCV, 36%. HIV infection was rare (prevalence, 0.3%), and STDs were uncommon (chlamydia prevalence, 2%, and gonorrhea prevalence, 0.6%). Total annual cost of integration services (excluding HIV testing) was dollar 31,994 equating to dollar 122 per client served. CONCLUSIONS: Alternative sentencing drug rehabilitation programs provide a venue to efficiently deliver integrated hepatitis and other prevention services. Considering the vast number of high-risk persons in drug rehabilitation, probation, parole, and inmate release programs, an opportunity exists to greatly expand hepatitis services.
Many diseases that account for the majority of morbidity and mortality in African Americans are also associated with racial disparity. Such diseases include cardiovascular disease, diabetes, hypertension, cancer, acquired immunodeficiency syndrome, and violent injuries. Epidemiologic associations find the excess burden for these diseases to be rooted in biological, psychosocial, and socioeconomic factors. Community-based efforts often function in isolation, attempting to have impact on diseases that affect local residents; unfortunately, such programs cannot be comprehensive in their approach. Foreseeable gaps allow morbidity and mortality to continue to exist. The Baltimore Alliance for the Prevention and Control of Hypertension and Diabetes (the Alliance), based at the University of Maryland School of Medicine, provides an infrastructure where successful community-based programs that target hypertension and diabetes join together in collaborative effort. The Alliance creates an association that supports community-based efforts, helping improve the efficiency and efficacy of such programs. Such associations can help close gaps, enabling programs to have a more comprehensive impact on communities.
A neural system within the cerebral and buccal ganglia of the terrestrial mollusc Limax maximus responds to lip chemostimulation by emitting a feeding motor program (FMP) in vivo and in vitro. We have analyzed chemically the cerebral and buccal ganglia of Limax for neurotransmitters involved in controlling expression of FMP. Dopamine was found in clusters of cells in and the neuropil of the cerebral ganglia at a concentration of 62 pmol/ganglion; a large proportion of such dopamine-containing cells projected to the lips. The buccal ganglia contained several small dopaminergic cells and large amounts of dopamine in the neuropil; the measured concentration was 10 pmol/ganglion. Exogenous dopamine applied to the cerebral and buccal ganglia in vitro between 10(-7) M and 3 X 10(-6) M excited an autoactive salivary duct motor neuron (FB) and inhibited an autoactive secretomotor neuron (BSN). Concentrations of dopamine between 3 X 10(-6) M and 3 X 10(-5) M triggered FMP output, with an increased probability of triggering at higher concentrations of dopamine. ADTN and SK&F38393 were potent agonists in this system, whereas ergonovine was the only potent antagonist found; none of the neuroleptics tested was effective. Thus, the Limax system shows agonist responses similar to the vertebrate D1 receptors, but its antagonist-binding properties appear to have requirements quite different from vertebrate receptors. The effects of exogenous serotonin differed from dopamine's effects; serotonin excited BSN and several buccal motor neurons, could not elicit synchronized motor program cycling, and was not efficiently blocked by ergonovine. These data suggest that dopamine is a good candidate as an endogenous triggering and sustaining transmitter for the Limax feeding motor program.
Software for non-linear curve fitting has been written in BASIC to execute on the British Broadcasting Corporation Microcomputer. The program uses the direct search algorithm Pattern-search, a robust algorithm that has the additional advantage of needing specification of the function without inclusion of the partial derivatives. Although less efficient than gradient methods, the program can be readily configured to solve low-dimensional optimization problems that are normally encountered in life sciences. In writing the software, emphasis has been placed upon the 'user interface' and making the most efficient use of the facilities provided by the minimal configuration of this system.
Successful screening mammography programs aim to screen large numbers of women efficiently and inexpensively. Development of an effective screening mammography program requires skilled personnel, solid infrastructure, and a robust computer system. A group of physicians, technologists, computer support personnel, and administrators carefully analyzed a growing screening mammography program as a series of steps, starting with the request for the examination and ending with the receipt of a hard-copy consultation. The analysis involved a detailed examination of every step and every possible outcome in the screening process. The information gained through process mapping may be used for identification of systemic and personnel problems, allocation of resources, modification of workplace architecture, and design of computer networks. Process mapping is helpful for those involved in designing and improving screening mammography programs. Viewing a process (i.e., obtaining a screening mammogram) as a series of steps may allow for the identification of inefficient components that may limit growth.