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PubMed1998

1996-based national population projections for the United Kingdom and constituent countries.

The 1996-based national population projections, carried out by the Government Actuary in consultation with the Registrars General, show the population of the United Kingdom rising from 58.8 million in 1996 to over 62 million by 2021. The population will become gradually older with the mean age expected to rise from 38.4 years in 1996 to nearly 42 years by 2021. The number of children aged under 16 is projected to fall by 1.0 million (9 per cent) by 2021, while the number aged 65 and over is projected to increase by 2.7 million (29 per cent). Longer-term projections suggest the population will peak around 2031 and then gradually start to fall.

Actuarial Analysis↗
PubMed1998

[Trends of genomic researches for drug discoveries].

In drug discoveries it becomes more important to search and validate target genes that control diseases. The development of novel strategies for functional genomics is indispensable for large scale analysis of human genes. (1) Recently, several research projects sequencing 5'-end of full-length enriched cDNA libraries were started because most of expressed sequence tags(ESTs) lack the 5'-end information of mRNA that is necessary for identifying the correct coding region. (2) New key technologies to quantify numerous gene expression levels simultaneously are now in progress. (3) Toward the functional analysis of unpredictable human genes, new strategies by using model animals (mouse, yeast, nematode) are under construction. Advances in molecular genetics and functional genomics will create new challenges for both drug discoveries and clinical evaluations.

Animals↗
PubMed2004

Towards data management of the HUPO Human Brain Proteome Project pilot phase.

The pilot phase of the Human Brain Proteome Project as a part of the Human Proteome Organisation has just been started. In two pilot studies, 18 different laboratories are analyzing mouse brains of three age stages and human brain autopsy versus biopsy material, respectively. The overall aim is to elucidate the portfolio of available techniques as well as to elaborate common standards. As a first step, it was decided to use the common bioinformatics platform ProteinScape that was introduced to the participating groups in a two day course in Bochum, Germany.

Animals↗
PubMed1975

[Delayed initiation of voluntary movements after pyramidal lesions in man (author's transl)].

The reaction times for rapid movements in muscles of arm and leg were measured in 20 patients with unilateral lesions of the motor cortex and the internal capsule. Rapid unilateral and bilateral movements after an acoustic signal (click) on the pyramidally paretic side were compared with the normal side. In these patients and in 10 normal subjects, electromyographic and mechanical recordings from symmetrical muscles of both sides were compared. 2. All patients with pyramidal lesions showed in the case of unilateral movements a marked prolongation of motor latency in the affected muscles: compared to the normal side, the movement started 30-160 msec later in muscles contralateral to the lesion of the motor cortex. In contrast, normal subjects showed equal latencies on both sides with maximal differences of 10-20 msec. 3. When movements were executed bilaterally the latency prolongation in the pyramidally paretic muscles was markedly diminished or disappeared in later stages. In most patients the bilateral movements started simultaneously in the normal and the paretic muscles, except in 5 recent lesions of the contralateral motor cortex. 4. The significance of the findings is discussed in terms of the function of the human motor cortex in starting and controlling voluntary movements. It is assumed that the disappearance of latency prolongation when movements are executed bilaterally in patients with unilateral pyramidal lesions can be best explained by homolateral projections of uncrossed pyramidal fibres to the motoneurones. 5. These results, and other observations, suggest that the motor cortex starts and controls voluntary movements via rapidly conducting pyramidal fibres to the motoneurones. This occurs after a preprogramming and a readiness posture is established by other cerebral structures. The prolongation of motor latencies after motor cortex lesions is probably due to a disturbance in the rapidly conducting cortico-spinal projections to spinal motoneurones and interneurones.

Adult↗
PubMed1993

Ethical decision making on starting terminal care in different health-care units.

Set in the context of a major research project on terminal care for cancer patients, this paper examines the process in which the ethical decision is taken to proceed to the stage of terminal care. The sample consisted of 191 nurses from three different health-care units in Finland: a health centre, a central hospital and a radiotherapy clinic. The data were collected in August and September 1989 by means of a postal questionnaire, and they were analysed by cross-tabulation and chi-squared tests. According to the nurses in all three units, there is often no definite and explicit decision to commence terminal care with elderly cancer patients. It was felt that patients and relatives have only very little say in the decision-making process. The nurses themselves would also have wanted to be more closely involved. Most of them said that the decision is usually taken by the doctor alone, especially in the central hospital. The nurses at the radiotherapy clinic said that almost all of their patients are informed of the decision to start terminal care. At the health centre and central hospital, only less than half of the patients are informed.

Aged↗
PubMedDate not supplied

Development of a software for the design of custom-made hip prostheses using an open-source rapid application development environment.

The present work describes a technology transfer project called HIPCOM devoted to the re-engineering of the process used by a medical devices manufacturer to design custom-made hip prostheses. Although it started with insufficient support from the end-user management, a very tight scheduling and a moderate budget, the project developed into what is considered by all partners a success story. In particular, the development of the design software, called HIPCOM Interactive Design Environment (HIDE) was completed in a time shorter than any optimistic expectation. The software was quite stable since its first beta version, and once introduced at the user site it fully replaced the original procedure in less than two months. One year after the early adoption, more than 80 custom-made prostheses had been designed with HIDE and the user had reported only two bugs, both cosmetics. The scope of the present work was to report the development experience and to investigate the reasons for these positive results, with particular reference to the development procedure and the software architecture. The choice of TCL/TK as development language and the adoption of well-defined software architecture were found to be the success key factors. Other important determinants were found to be the adoption of an incremental software engineering strategy, well suited for small to medium projects and the presence in the development staff of a technology transfer expert.

Computer-Aided Design↗
PubMed2005

Inhomogeneous multiscale dynamics in harmonic lattices.

We use projection operators to address the coarse-grained multiscale problem in harmonic systems. Stochastic equations of motion for the coarse-grained variables, with an inhomogeneous level of coarse graining in both time and space, are presented. In contrast to previous approaches that typically start with thermodynamic averages, the key element of our approach is the use of a projection matrix chosen both for its physical appeal in analogy to mechanical stability theory and for its algebraic properties. We show that thermodynamic equilibrium can be recovered and obtain the fluctuation dissipation theorem a posteriori. All system-specific information can be computed from a series of feasible molecular dynamics simulations. We recover previous results in the literature and show how this approach can be used to extend the quasicontinuum approach and comment on implications for dissipative particle dynamics type of methods. Contrary to what is assumed in the latter models, the stochastic process of all coarse-grained variables is not necessarily Markovian, even though the variables are slow. Our approach is applicable to any system in which the coarse-grained regions are linear. As an example, we apply it to the dynamics of a single mesoscopic particle in the infinite one-dimensional harmonic chain.

Journal Article↗
PubMed2006

[Latest progress on the chicken genome project].

The publication of draft sequence of the chicken genome in early 2004 marks expressly the start of functional genomics of poultry. Chicken is not only a widely raised economic farm animal, but also a valuable model organism for the study of life sciences. The draft sequence of the chicken genome has significant impact on both animal breeding and basic biological research. The current progress of the chicken genome research is reviewed in this paper, which includes data from the chicken genome, its physical map, genetic linkage map and comparative genome map, as well as expressed sequence tags and bioinformatics. Potential applications of chicken genome research are also envisaged.

Animals↗
PubMedDate not supplied

24-Hour ambulatory blood pressure monitoring in primary care.

BACKGROUND: Both the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of Hypertension in Adults and the British Hypertension Society have made recommendations for the use of ambulatory blood pressure monitoring (ABPM) in select patient populations. This demonstration project explores the feasibility of a 24-hour ABPM service in assisting physicians with decisions regarding the implementation and modification of antihypertensive therapy. METHODS: After physician referral, patients met with a pharmacist for evaluation of their blood pressure. The pharmacist obtained a medication profile and instructed each patient on the proper use of the monitor. Patients completed an activity diary while wearing the monitor. After analysis of the reports, the pharmacist forwarded recommendations and the 24-hour blood pressure data to the referring physician. RESULTS: Sixty patients took part in the demonstration project. The primary reasons for referral included evaluation of suspected isolated office hypertension, drug resistance, blood pressure control in diabetic patients, and suspected drug-induced orthostatic hypotension. The referring physicians accepted 100% of the pharmacists' therapeutic recommendations. Unnecessary therapy was avoided in 12 of 40 of patients with suspected isolated office hypertension (30%), and more aggressive treatment was started in 6 of 7 of patients with type 2 diabetes (87.5%). CONCLUSIONS: This project shows that a 24-hour ABPM consultation service can provide useful information for determining which patients have isolated office hypertension and in guiding drug regimen modification for patients with diabetes, suspected resistant hypertension, or drug-induced alterations in blood pressure.

Aged↗
PubMed1997

Results of a pilot study of endoscopic screening of first degree relatives of colorectal cancer patients in Italy.

STUDY OBJECTIVE: Screening recommendations for colorectal cancer include sigmoidoscopy in asymptomatic, average risk persons aged 50 and over and colonoscopy every three to five years in high risk groups. Little is known about the eligible population's compliance with endoscopic screening. This is the first Italian report of an endoscopic screening programme for colorectal cancer patients' relatives. DESIGN: In 1986, a pilot project for colorectal cancer screening by endoscopy in high risk subjects was started in the Desio (Milan, Italy) public health service region. The results obtained after seven years are described. SETTING: The names of 536 inhabitants with colorectal cancer diagnosed between January 1975 and December 1984 and their relatives' addresses were obtained from the Regione Lombardia Health System records and from the municipal registry offices respectively. PARTICIPANTS: From October 1986 to October 1993, 778 first degree relatives aged 20-75 were offered colonoscopy. MAIN RESULTS: After seven years, 233 (29.9%) had undergone endoscopic examination, mostly up to the splenic flexure. Being > 60 in age at the start of the programme negatively affected the participation (p < 0.05). Two cancers were detected and adenomatous polyps were found in another 24 of those screened (frequencies 0.9% and 10.3% respectively). Male gender (p < 0.05), increasing age in males (p < 0.01), and two or more affected relatives in females (p < 0.01) positively affected the frequency of polyps detection. CONCLUSION: These results suggest that about 30% of the eligible population would comply at least with sigmoidoscopic screening. The collaboration of family doctors and more widespread public information about the ability to cure colorectal cancer are necessary for better compliance.

Adenomatous Polyposis Coli↗
PubMed2003

Centering the projection reconstruction trajectory: reducing gradient delay errors.

The projection reconstruction (PR) trajectory was investigated for the effect of gradient timing delays between the actual and requested start time of each physical gradient. Radial trajectories constructed with delayed gradients miss the center of k-space in an angularly dependent manner, causing effective echo times to vary with projection angle. The gradient timing delays were measured in phantoms, revealing delays on the x, y, and z gradients which differed by as much as 5 micro sec. Using this one-time calibration measurement, the trajectories were corrected for gradient delays by addition of compensatory gradient areas to the prephasers of the logical x and y readout gradients. Effective projection-to-projection echo time variability was reduced to less than 1 micro sec for all imaging orientations. Using corrected trajectories, artifacts were reduced in phantom images and in volunteer studies. This correction should potentiate greater clinical use of the PR trajectory.

Algorithms↗
PubMed1997

A Candida albicans genome project: cosmid contigs, physical mapping, and gene isolation.

A new project to map the genome of the pathogenic fungus, Candida albicans, has been started. The entire genome was cloned as 5088 cosmids, stored in individual microtiter plate wells. DNA was prepared and fingerprinted using restriction digestion, fluorescent labeling, and analysis on an ABI sequencer. These data are being used to construct contigs of the genome. Simultaneously, a DNA pooling system has been set up, suitable for PCR-based isolation of cosmids containing any known gene. Ultimately, these approaches will lead to the creation of a physically based map of the C. albicans genome, providing the means to localize precisely all the genes, act as a substrate for genome sequencing projects, and provide probes for future studies of genome rearrangement and comparative genomics.

Candida albicans↗
PubMed1998

Improving health care, Part 5: Applying the Dartmouth clinical improvement model to community health.

BACKGROUND: Traditional approaches to community health initiatives provide guidance on community mobilization, health assessment, planning, and intervention. Yet direction in how to frame the action steps to implement and measure results is often missing. Many community health initiatives find implementation overwhelming and ineffectual. FRAMEWORK FOR COMMUNITY HEALTH-THE CLINICAL IMPROVEMENT MODEL: The process--outcome methodology of continuous quality improvement (CQI) can translate large community aims into manageable projects. The sequential application of the clinical improvement model and the Community Health Value Compass for measuring outcomes-in state of health, quality of life, satisfaction, and costs-provides a link between data and action, thereby producing accountability for the community health initiative. USING THE CLINICAL IMPROVEMENT MODEL IN TWIN FALLS: Healthy Magic Valley (Twin Falls, Idaho) is the vision for long-term improvement in health status and reduction of health risks for the Southcentral Idaho Health Network. Since 1996 the Twin Falls Community Health Collaborative and SAFE KIDS Coalition have used the Value Compass model and CQI methods to decrease the rate of motor vehicle collisions, serious injuries, and deaths involving teens, while reducing the health, educational, legal, and financial consequences associated with teen-involved motor vehicle collisions. In 1993 the Twin Falls collaborative convened to apply CQI methods to the health of the community. The team has since met periodically to address the issues of community health, using the Dartmouth value compass model since 1996. Each sequential application of the process-outcome CQI framework exposes a blueprint for action and the unfolding of a health improvement strategy. The interventions should affect one or more dimensions of the value compass for teenage driving and motor vehicle collisions. CASE STUDY OF THE CLINICAL IMPROVEMENT MODEL: The motor vehicle death in October 1997 of a high school football player, who was not wearing a seat belt, led to a call to action for injury prevention. Implementation of a local community health initiative on seat belt use started in 1998. A strategy was developed to address implementation of the project among high school teens (for immediate impact) and elementary school children (for long-term impact) and to promote collaboration between the school and the rest of the community. RESULTS: Observed use of seat belts increased from January to September 1998. Data on fatality rates; injury rates; percentages of teens in crashes, of teens injured, and of teen collisions involving use of alcohol; and comprehensive costs are also monitored. DISCUSSION: Once coalitions are built and priorities set, the Dartmouth clinical improvement model presents a method that emphasizes measuring the benefits to the individual members of the community. A portfolio composed of a value compass for each health improvement initiative provides ongoing feedback for guiding subsequent strategic planning by the governing community health network.

Accidents, Traffic↗
PubMed1997

Addressing issues of face validity in the application of a clinical guideline.

In 1995, a statewide project to improve the practice of electroconvulsive therapy (ECT) in the Medicare population was started in Louisiana. A retrospective baseline study found high concurrent utilization of lithium and benzodiazepines, medications considered detrimental to ECT by the second American Psychiatric Association Task Force on ECT. Resistance to a clinical guideline because of lack of face validity by clinicians was used as an opportunity to involve clinicians in using data to evaluate their clinical practices. Results of the first two quarters of the project demonstrated that the strategy was successful.

Clinical Trials as Topic↗
PubMed1993

Two-dimensional crystallization of Escherichia coli-expressed bacteriorhodopsin and its D96N variant: high resolution structural studies in projection.

Highly ordered two-dimensional (2-D) crystals of Escherichia coli-expressed bacteriorhodopsin analog (e-bR) and its D96N variant (e-D96N) reconstituted in Halobacterium halobium lipids have been obtained by starting with the opsin protein purified in the denaturing detergent sodium dodecyl sulfate. These crystals embedded in glucose show electron diffraction in projection to better than 3.0 A at room temperature. This is the first instance that expressed bR or a variant has been crystallized in 2-D arrays showing such high order. The crystal lattice is homologous to that in wild-type bR (w-bR) in purple membranes (PM) and permit high resolution analyses of the structure of the functionally impaired D96N variant. The e-bR crystal is isomorphous to that in PM with an overall averaged fractional change of 12.7% (26-3.6-A resolution) in the projection structure factors. The projection difference Fourier map e-bR-PM at 3.6-A resolution indicates small conformational changes equivalent to movement of approximately < 7 C-atoms distributed within and in the neighborhood of the protein envelope. This result shows that relative to w-bR there are no global structural rearrangements in e-bR at this 3.6 A resolution level. The e-D96N crystal is isomorphous to the e-bR crystal with a smaller (9.2%) overall averaged fractional change in the structure factors. The significant structural differences between e-D96N and e-bR are concentrated at high resolution (5-3.6 A); however, these changes are small as quantified from the 3.6 A resolution e-D96N-e-bR Fourier difference map. The difference map showed no statistically significant peaks or valleys within 5 A in projection from the site of D96 substitution on helix C. Elsewhere within the protein envelope the integrated measure of peaks or valleys was < approximately 3 C-atom equivalents. Thus, our results show that for the isosteric substitution of Asp96 by Asn, the molecular conformation of bR in its ground state is essentially unaltered. Therefore, the known effect of D96N on the slowed M412 decay is not due to ground-state structural perturbations.

Bacteriorhodopsins↗
PubMedDate not supplied

[Atherosclerosis: a childhood problem].

The project "Precursors of Atherosclerosis (ATS) in Children" following the protocol of WHO started in Modena in 1981/82. A total of 527 schoolchildren of 6, 9, 12 and 15, living in the area around Modena, Emilia Romagna Region, were examined, sampled from whole schools or classes. Each group exceeds the minimum of 100 children with the exception of the group including subjects of 15. The population sampled is fairly homogeneous. There are no immigrants to the area and the intra-population differences due to social-classes are minimal. The standard of life is very high: the rate of income is one of the highest in Italy and the incidence of ATS manifestations is very high. The children will be reexamined each year for three years at the same season and the study will be over in 1984. A questionnaire with family story has been filled by the parents and the parents were directly examined about: height, blood pressure, cholesterolemia, triglyceridemia, smoking habit. Following the protocol in each child are determined: height, weight, Quetelet's index (kg/m2), skinfold thickness, blood pressure, cholesterolemia, triglyceridemia, sexual maturity and smoking habit. The statistical elaboration methods of data are chosen in cooperation with the "Centro di Calcolo" of the University of Modena, and elaborated with the Statistical Package for the Social Science (SPSS) method.

Adolescent↗
PubMed2004

It's time to retire. Retirement.

Companies have been so focused on down-sizing to contain costs that they've largely neglected a looming threat to their competitiveness: a severe shortage of talented workers. The general population is aging and with it, the labor pool. People are living longer, healthier lives, and the birthrate is at a historical low. During the next 15 years, 80% of the native-born workforce growth in North America--and even more in much of Western Europe--is going to be in the over-50 age cohort. When these mature workers begin to retire, there won't be nearly enough young people entering the workforce to compensate. The Bureau of Labor Statistics projects a shortfall of 10 million workers in the United States in 2010, and in countries where the birthrate is well below the population replacement level (particularly in Western Europe), the shortage will hit sooner, be more severe, and remain chronic. The problem won't just be a lack of bodies. Skills, knowledge, experience, and relationships walk out the door every time somebody retires--and they take time and money to replace. And while the brain drain is beginning now, the problem is going to become much more acute in the next decade or so, when baby boomers--more than one-quarter of all Americans, amounting to 76 million people--start hitting their mid sixties. Based on the results of their yearlong research project, the authors of this article offer recommendations for gaining the loyalty of older workers and creating a more flexible approach to retirement that allows people to continue contributing well into their sixties and seventies. Companies can no longer afford to think of retirement as a onetime event, permanently dividing work life from leisure.

Aged↗
PubMed2002

Experience of the first survey of the pilot project of Asian Quality Assurance Survey program.

The Asian Network for Clinical Laboratory Standardization (ANCLS) decided to start her First Inter-laboratory Quality Assurance survey at the business meeting during the Second Asian Colloquium on October 21-22, 2000 in Kobe, Japan. The first survey materials of Asian Quality Assurance Survey (AQuAS) were distributed in July 2001 to 21 hospitals in the field of chemistry and 22 hospitals in the field of hematology among total 24 participating laboratories from seven Asian countries: Indonesia, Japan, Korea, Malaysia, Philippines, Singapore and Thailand. The survey methods in chemistry and in hematology were somewhat different. In chemistry the survey material was considered as unknown but handled similarly to the sample from the patient. Nineteen routine tests were performed only once. The hematology samples were considered as unknown but handled similarly to control or calibration material. Five parameters were tested five times repetitively and their average for each parameter was calculated. All the results were supposed to be sent back to the office within two weeks. Although it took more than two weeks, the return rate was 100%. The analysis was performed in several ways such as all the results together, by instruments and by methods. Mean, standard deviation (SD), standard deviation index (SDI), coefficient of variation (CV) and variance index score (VIS) were to be calculated in chemistry, and in hematology the same parameter were to be calculated except CV and VIS. In the first survey, the CV in chemistry was not calculated and the analysis by instrument or by methodology was also not attempted since there were not enough participating hospitals to do such analysis. In hematology the analysis was done by instrument only. The survey process was carried out successfully though there were some difficulties in communication tools, transportation methods and handling of specimens due to different weather conditions, and returning the report in the correct unit and to the correct place. The submitted data were acceptable for analysis. There were some differences in the units of measurement in different countries or laboratories. It was necessary to convert some of the units. Some laboratories apparently do not perform certain tests such as calcium, potasium and gamma-glutamyltransferase (gamma-GT). The gamma-GT is the most frequently not performed test. With the experience of this first survey, all the members involved in the survey have been trained well to do future surveys.

Asia↗