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At least 1,261 records · Page 70Linked to original sources
PubMed1991

Fusimotor reflex profiles of individual triceps surae primary muscle spindle afferents assessed with multi-afferent recording technique.

The experiments were performed on 21 cats anaesthetized with alpha-chloralose. The aim of the study was to investigate sets of simultaneously recorded spindle afferents (2-4 in each set) from the triceps surae muscle (GS) with respect to the pattern of fusimotor reflex effects evoked by different types of ipsi- and contralateral reflex stimulation. The afferents' responses to sinusoidal stretching of the GS muscle were determined and the fusimotor reflex effects were assessed by comparing the afferent responses (i.e. the mean rate of firing and the depth of modulation) elicited during reflex stimulation with those evoked in absence of any reflex stimulus. Natural of electrical activations of ipsi- and contralateral muscle, skin and joint receptor afferents were used as reflex stimuli. The spindle afferents were influenced by several modalities and from wide areas, with a majority responding to both ipsi- and contralateral stimuli. A particular reflex stimulus often caused different effects on different afferents, and the various reflex stimuli seldom gave similar effects on a particular afferent. Multivariate analysis revealed that the variation in response profiles among simultaneously recorded afferents were as great as between afferents recorded on different occasions. This suggests that the individualized response prifiles, observed in earlier investigations, represent a very diversified reflex control of the spindle primary afferents, and are not a reflection of changes in the setting of the spinal interneuronal network, occurring during the time interval between the recordings of different units. Also, there was no relation between the conduction velocity of the afferents and the reflex profiles of the afferents, but non-linear relations were found between effects elicited by different types of stimuli. Indications were also found that it may be possible to separate the population of GS muscle spindles into subgroups, according to the fusimotor effects exhibited by activation of various categories of ipsi- and contralateral receptor afferents. It is concluded that one possible way of making the very complex reflex system controlling the muscle spindles intelligible may be a combination of multiple simultaneous recordings of spindle afferents and multivariate analysis.

Afferent Pathways↗
PubMed1989

Understanding the beliefs of Jehovah's Witnesses.

The individual religious belief system of the patient who is one of Jehovah's Witnesses regarding the refusal of blood products may have a direct impact on his or her treatment and its outcome. The critical care nurse is in a unique and powerful position to support this patient through the many potentially stressful clinical and emotional situations that this decision may engender. A thorough understanding of the rationale behind the Jehovah's Witnesses' belief system is necessary to provide intelligent and ethical nursing care.

Blood Transfusion↗
PubMed1981

[Contribution to the question of keratodermia palmo-plantaris insularis et striata. The phenomenon of the focal character of phenotypic expression of the pathological gene (author's transl)].

Two siblings with symptoms of Keratodermia palmo-plantaris areata and striata are described. The late father had some inherited disease of the skin. Neither ophthalmologic system nor a defect of intelligence existed in these cases. In the first case aminoacids in the blood and urine were examined, but neither thyrosinaemia nor thyrosinuria was found. The clinical signs in the siblings differed, and this difference was dependent from environmental factors. The focal character of the phenotypic expression of the pathologic gen of this inherited abnormality as well as other inherited diseases has been stressed.

Adult↗
PubMed1994

Lead poisoning.

Lead poisoning is the most common disease of environmental origin in the United States today. Adult lead poisoning results primarily from exposure by inhalation in the workplace. Pediatric lead poisoning results principally from the ingestion of lead from environmental media, including paint chips, dust, soil, drinking water, ceramics, and medications. Lead is toxic to many organ systems, among them developing erythrocytes, the kidneys, and the nervous system. Lead-induced toxicity to the central nervous system causes delayed development, diminished intelligence, and altered behavior. In young children, this effect has been demonstrated convincingly to occur at blood lead levels between 10 and 20 micrograms per dl. The Centers for Disease Control and Prevention has recommended that a blood lead level of 10 micrograms per dl or higher be considered evidence of increased lead absorption, and the National Academy of Sciences has concurred in that recommendation. Unresolved issues in need of further study include the frequency of screening young children for lead, the question of whether women should be offered screening for lead before conceiving a pregnancy, the role of x-ray fluorescence analysis in assessing lead in bone, and the appropriate legislative response of the United States government to lead-based paint abatement.

Adult↗
PubMed1997

Dysarthric speech: a comparison of computerized speech recognition and listener intelligibility.

The purpose of this study was to identify and compare the recognition of dysarthric speech by a computerized voice recognition (VR) system and non-hearing-impaired adult listeners. Intelligibility "functions" were obtained for six dysarthric speakers who varied in severity and six age- and gender-matched controls. Speakers produced 70-item word lists over 5 sessions. VR using the IBM VoiceType and perceptual judgment scores were obtained and functions plotted by session. Data indicate that computerized recognition of both dysarthric and nonimpaired speech was characterized by initially steep increases in correct recognition with more gradual increases noted during the second through fifth sessions. Perceptual recognition by non-hearing-impaired adults indicates generally stable intelligibility scores over time. Severity of dysarthria did appear to influence recognition of target stimuli. Implications of these data to the application of computerized VR technology are presented.

Adolescent↗
PubMed1994

The use of medical logic modules at LDS hospital.

The development of medical knowledge bases for use in a clinical information system (HELP) has been an ongoing goal at LDS Hospital in Salt Lake City, Utah, for the past 25 years. In building our medical knowledge base we felt the need to implement a decision support syntax which could capture the logic of our experts in a way that was not only executable, but also easily read and shared by others. During these 25 years we defined several simple syntaxes to express this medical logic. Our current approach is to cooperate with international standards groups (ASTM) and use the Arden Syntax for medical logic modules. We are working with the 3M Corporation in the joint development of an Arden Compiler for HELP. We plan to use the Arden Syntax initially to support our alert/reminder system and computerized management protocols.

Artificial Intelligence↗
PubMed1996

Patient result validation services.

Patient result validation is a vital final stage of laboratory quality assurance and is usually the responsibility of senior laboratory staff. Computerised validation systems have recently been introduced to autovalidate data meeting certain pre-defined criteria, thereby allowing senior staff to focus on problematic cases. This article describes the patient results validation service module developed for an advanced instrument workstation in the OpenLabs project. Using knowledge-based techniques, the module provides a range of locally configurable advanced validation procedures (e.g., internal consistency checks, delta checks, and checks for selected specific errors) in addition to the standard reference range and pathological limits checks offered by many laboratory information systems.

Artificial Intelligence↗
PubMed1999

Take care: guidelines for patients with chronic hepatitis C.

Alcohol consumption has significant impact on the condition of the liver, by itself, and even more in conjunction with other liver diseases such as chronic hepatitis C. Drinking habits might be delicate issues to address and could harm otherwise satisfying communication. Therefore, we intended to outline guidelines for advising hepatitis C patients concerning alcohol consumption. Analysis of a relatively limited knowledge base revealed the complexity of the disease rather than statistically significant findings regarding consumption. Thus, we instead chose to suggest a set of patient educational guidelines, which could be implemented on the Internet, hypothesizing that a better informed patient will be more able to comply with restrictions concerning alcohol consumption. A brief ad hoc evaluation pointed out Internet as a favourable media to present the information. We also suggest a tentative algorithm for further development of clinical decision support systems addressing monitoring of chronic hepatitis C patients.

Adolescent↗
PubMed2005

Ontology-based knowledge repository support for healthgrids.

Healthgrids unite a large amount of independent and distributed organisations to provide for various healthcare services. Often the involved organisations can belong to different areas of healthcare and even different countries. However to achieve efficient operation they have to act in a well coordinated manner. As a result, an efficient knowledge sharing between multiple participating parties of the healthgrid is required. The paper describes application of an earlier developed ontology-driven KSNet (Knowledge Source Network) - approach to knowledge repository support for healthgrids. This approach is based on representation of knowledge via ontologies using formalism of object-oriented constraint networks. Such representation makes it possible to define and solve various tasks from the areas of management, planning, configuration, etc., by using constraint solving engines such as, for instance, ILOG or CLP. The major discussed aspects cover the formalism of knowledge representation via ontologies and implementation of the approach as a decision support system for a case study from the area of health service logistics.

Artificial Intelligence↗
PubMed2002

Molecular imprinting within hydrogels.

Hydrogels have been used primarily in the pharmaceutical field as carriers for delivery of various drugs, peptides and proteins. These systems have included stimuli-responsive gels that exhibit reversible swelling behavior and hence can show modulated release in response to external stimuli such as pH, temperature, ionic strength, electric field, or specific analyte concentration gradients. The focus of this article is to review molecular imprinting within hydrogels and discuss recent efforts on analyte-responsive intelligent gels, specifically suggesting the possibility of utilizing molecular imprinting strategies to impart analyte specificity and responsiveness within these systems. Molecular imprinting is an emerging field that produces precise chemical architecture that can bind analytes and differentiate between similar molecules with enantiomeric resolution. On the forefront of imprinting gel systems are intelligent, stimuli-sensitive imprinted gels that modify their swelling behavior and in turn modulate their analyte binding abilities. We discuss the challenges creating an imprinting effect in hydrogels and the possibilities of using molecularly imprinted mechanisms within controlled release gels.

Chemistry, Pharmaceutical↗
PubMed2003

The development of variable MLM editor and TSQL translator based on Arden Syntax in Taiwan.

The Arden Syntax standard has been utilized in the medical informatics community in several countries during the past decade. It is never used in nursing in Taiwan. We try to develop a system that acquire medical expert knowledge in Chinese and translates data and logic slot into TSQL Language. The system implements TSQL translator interpreting database queries referred to in the knowledge modules. The decision-support systems in medicine are data driven system where TSQL triggers as inference engine can be used to facilitate linking to a database.

Artificial Intelligence↗
PubMed1997

Endemic cretinism in Thailand: a multidisciplinary survey.

Endemic cretinism has been classified into neurological and myxedematous types. Profound mental deficiency, deaf-mutism and cerebral diplegia are predominantly found in the former. The latter have been described as less mentally retarded but with severe growth retardation and myxedematous features. The pathogenesis of different clinical types of endemic cretinism is still unclear. Recently, a unifying hypothesis suggested that iodine deficiency, severe enough to cause maternal and fetal hypothyroxinemia, results in neurological defects in all cretins. We conducted the present study in northern Thailand to determine the validity of this hypothesis in another geographical area. The study consisted of a multidisciplinary survey on 112 endemic cretins aged 2-66 years in Nan. They were categorized clinically into three types of endemic cretins, neurological (n = 57), myxedematous (n = 19) and mixed form (n = 36). The subjects were generally short and the majority had severe mental retardation (mean intellectual quotient (I.Q.) 30.8 +/- 8.8), psychomotor defect and profound sensorineural hearing loss. The I.Q. score and proportion of cretins with sensorineural hearing loss and psychomotor defect were similar among the three types of cretins. The most frequent neurological abnormalities were spasticity, hyper-reflexia, the presence of primitive reflexes and gait disturbance. These abnormalities were distributed equally among the three types of endemic cretins. Delayed skeletal maturation and abnormal epiphysis were also present in all types of cretins. However, myxedematous cretins were shorter (P < 0.01), having more myxedematous features (P < 0.05 to P < 0.001) and less sexual maturation (P < 0.05). Thyroid volume was lower in cretins with hypothyroidism (P < 0.01). In conclusion, our findings support the hypothesis that neurological features are present in all types of cretins, and are the consequence of maternal and fetal hypothyroxinemia due to severe iodine deficiency. The clinical manifestations of the cretins were subsequently modified by the length and severity of postnatal iodine deficiency and hypothyroidism.

Adolescent↗
PubMed1991

Applications of expert computer systems.

An expert system is a computer program which uses artificial intelligence to make logical decisions on the basis of input data. The rules the system uses to make its decisions are called heuristics which can be provided in the form of IF . . . THEN statements, or they can be learned by the system from examples. The term "expert" is used because the rules or examples come from human experts and the program is considered to have captured their expertise. Currently there are many expert systems in business and medical use but few, if any, are used in optometry. The rule-oriented nature of many ophthalmic procedures suggests a future role for these systems, but their cost-effectiveness may not yet be favorable enough to justify development of expert systems for optometric practice.

Diagnosis, Computer-Assisted↗
PubMed1987

[Development of a magnetic urethral closure and initial clinical experiences].

The new magnetic closure device consists of a retropubically implanted magnet and another removable intravaginal magnet, which gently closes the urethra. The system has shown its proper function in animal experiments up to an urethral pressure of 120 cm water pressure and in an animal model - female merino sheep - during a period of observation up to 33 weeks. The first experiences with a magnetic urethral closure system in female patients with recurrent urinary incontinence, when common incontinence surgery is useless (no descensus, extremely hypotone urethral), are promising. Continence can be achieved, the handling is easy and can be managed by intelligent and well motivated patients. The system has been used successfully in 7 patients carrying the magnet in the vagina over 8 h daily for up to 3 years.

Animals↗
PubMed2006

Obesity and attained education: cohort study of more than 700,000 Swedish men.

OBJECTIVE: To study the relationship between BMI at age 18 years and later attained education, with control for intelligence and parental social position. RESEARCH METHODS AND PROCEDURES: A cohort of 752,283 Swedish men born from 1952 to 1973 were followed in registers with respect to attainment of high education (>or=15 years of education) until December 31, 2001. Intelligence and BMI (kilograms per meter squared) were measured at compulsory military conscription at age 18 years. Ninth grade school marks were available for a subgroup born from 1972 to 1973 (N = 93,374). The hazard ratio for attaining high education was estimated with proportional hazard regression analysis controlling for intelligence, height, parental socioeconomic position, country of birth, conscription center, and municipality. RESULTS: Young men who were obese (BMI >or= 30) at age 18 years (N = 10,782) had a much lower chance of attaining a high education than normal-weight subjects [(18.5 <or= BMI < 25); adjusted hazard ratio 0.48 (95% confidence interval, 0.45, 0.52)]. Young men who were obese at age 18 had lower mean ninth grade school marks than young men with normal weight at any given intelligence level. DISCUSSION: Obese men in Sweden are doing much worse in the educational system than their normal-weight counterparts even after adjustments for intelligence and parental socioeconomic position. Discrimination in the educational system and other sectors of the society may explain these strong associations.

Adult↗
PubMed2000

Implementing clinical practice guidelines while taking account of changing evidence: ATHENA DSS, an easily modifiable decision-support system for managing hypertension in primary care.

This paper describes the ATHENA Decision Support System (DSS), which operationalizes guidelines for hypertension using the EON architecture. ATHENA DSS encourages blood pressure control and recommends guideline-concordant choice of drug therapy in relation to comorbid diseases. ATHENA DSS has an easily modifiable knowledge base that specifies eligibility criteria, risk stratification, blood pressure targets, relevant comorbid diseases, guideline-recommended drug classes for patients with comorbid disease, preferred drugs within each drug class, and clinical messages. Because evidence for best management of hypertension evolves continually, ATHENA DSS is designed to allow clinical experts to customize the knowledge base to incorporate new evidence or to reflect local interpretations of guideline ambiguities. Together with its database mediator Athenaeum, ATHENA DSS has physical and logical data independence from the legacy Computerized Patient Record System (CPRS) supplying the patient data, so it can be integrated into a variety of electronic medical record systems.

Artificial Intelligence↗
PubMed2000

Integrating knowledge based functionality in commercial hospital information systems.

Successful integration of knowledge-based functions in the electronic patient record depends on direct and context-sensitive accessibility and availability to clinicians and must suit their workflow. In this paper we describe an exemplary integration of an existing standalone scoring system for acute abdominal pain into two different commercial hospital information systems using Java/Corba technolgy.

Abdomen, Acute↗