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PubMed1986

[Determination of progesterone levels in the milk of mares: a useful aid in the diagnosis of early pregnancy].

The concentration of progesterone in milk was determined in 327 mares to establish pregnancy in an early stage (sixteen days or more). The 5 ng/ml-level of progesterone as a threshold in the EIA-system used resulted in a very useful aid in the diagnosis of early pregnancy in mares. The results of testing were not in accordance with the confirmed reality in fourteen out of 327 mares (4.3 percent). The result of the test was false non-pregnant in five mares (1.5 percent) and false pregnant in nine mares (2.8 percent).

Animals↗
PubMed2005

Cognitive behavioral therapy for public-speaking anxiety using virtual reality for exposure.

This study used an open clinical trial to test a cognitive-behavioral treatment for public-speaking anxiety that utilized virtual reality as a tool for exposure therapy. Treatment was completed by participants (n = 10) meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for social phobia, or panic disorder with agoraphobia in which public speaking was the predominantly feared stimulus. Treatment was conducted by a licensed psychologist in an outpatient clinic. Treatment consisted of eight individual therapy sessions, including four sessions of anxiety management training and four sessions of exposure therapy using a virtual audience, according to a standardized treatment manual. Participants completed standardized self-report questionnaires assessing public-speaking anxiety at pre-treatment, post-treatment, and 3-month follow-up. Participants were asked to give a speech to an actual audience at pre- and post-treatment. Results showed decreases on all self-report measures of public-speaking anxiety from pre- to post-treatment, which were maintained at follow-up (n = 8; all P = 05). Participants were no more likely to complete a speech post-treatment than at pre-treatment. This study provides preliminary evidence that a cognitive-behavioral treatment using virtual reality for exposure to public speaking may reduce public-speaking anxiety and suggests that further research with a controlled design is needed.

Anxiety↗
PubMed1994

Familial breast cancer. Approaching the isolation of a susceptibility gene.

Family history is recognized widely as a significant risk factor for the development of breast cancer. A gene (BRCA1), mutations in which confer susceptibility to early-onset breast and ovarian cancer, has been mapped to chromosome 17q12-21. An intensive search for this gene is currently underway in a number of laboratories. Recent data support the hypothesis that BRCA1 is a tumor suppressor gene that may be important in the development of both inherited and sporadic breast and ovarian cancers. Genetic and physical maps of the BRCA1 candidate region largely have been completed and efforts are being directed at identification of candidate genes from within this region. A small number of families recently have received results of genetic-linkage testing, indicating which family members likely are to be carriers of a germline BRCA1 mutation, and, therefore, have a lifetime risk of developing breast cancer of approximately 85%. The imminent isolation of BRCA1 will make predictive testing for breast cancer a reality for many women and likely will pave the way for novel diagnostic and therapeutic strategies in the future.

Breast Neoplasms↗
PubMed1989

Monte Carlo simulations of a protein molecule with and without hydration energy calculated by the hydration-shell model.

Monte Carlo simulations of a small protein, crambin, were carried out with and without hydration energy. The methodology presented here is characterized, as compared with the other similar simulations of proteins in solution, by two points: (1) protein conformations are treated in fixed geometry so that dihedral angles are independent variables rather than cartesian coordinates of atoms; and (2) instead of treating water molecules explicitly in the calculation, hydration energy is incorporated in the conformational energy function in the form of sigma giAi, where Ai is the accessible surface area of an atomic group i in a given conformation, and gi is the free energy of hydration per unit surface area of the atomic group (i.e., hydration-shell model). Reality of this model was tested by carrying out Monte Carlo simulations for the two kinds of starting conformations, native and unfolded ones, and in the two kinds of systems, in vacuo and solution. In the simulations starting from the native conformation, the differences between the mean properties in vacuo and solution simulations are not very large, but their fluctuations around the mean conformation during the simulation are relatively smaller in solution than in vacuo. On the other hand, in the simulations starting from the unfolded conformation, the molecule fluctuates much more largely in solution than in vacuo, and the effects of taking into account the hydration energy are pronounced very much. The results suggest that the method presented in this paper is useful for the simulations of proteins in solution.

Chemical Phenomena↗
PubMed2000

The role of cardiovascular magnetic resonance in heart failure.

Cardiovascular Magnetic Resonance (CMR) is an accepted gold standard for non-invasive, accurate, and reproducible assessment of cardiac mass and function. The interest in its use for viability, myocardial perfusion and coronary artery imaging is also widespread and growing rapidly as the hardware and expertise becomes available in more centres, and the scans themselves become more cost effective. In patients with heart failure, accurate and reproducible serial assessment of remodelling is of prognostic importance and the lack of exposure to ionizing radiation is helpful. The concept of an integrated approach to heart failure and its complications using CMR is fast becoming a reality, and this will be tested widely in the coming few years, with the new generation of dedicated CMR scanners.

Heart Failure↗
PubMed2001

Unilateral temporal lobectomy patients show lateralized topographical and episodic memory deficits in a virtual town.

A large-scale virtual reality town was used to test the topographical and episodic memory of patients with unilateral temporal lobe damage. Seventeen right and 13 left temporal lobectomy patients were compared with 16 healthy matched control subjects. After they had explored the town, subjects' topographical memory was tested by requiring them to navigate to specific locations in the town. The ability to recognize scenes from and draw maps of the virtual town was also assessed. Following the topographical memory tests, subjects followed a route around the same town but now collected objects from two different characters in two different locations. Episodic memory for various aspects of these events was then assessed by paired forced-choice recognition tests. The results showed an interaction between laterality and test type such that the right temporal lobectomy (RTL) patients were worse on tests of topographical memory, and the left temporal lobectomy (LTL) patients worse on tests of context-dependent episodic memory. Specifically, the RTL group was impaired on navigation, scene recognition and map drawing relative to control subjects. They were also impaired on recognition of objects in the episodic memory task. The LTL group was impaired relative to control subjects on their memory for contextual aspects of the events, such as who gave them the objects, the order in which objects were received and the locations in which they received them. They were also mildly impaired on topographical memory, but less so than the RTL group. These results suggest that topographical memory is predominately mediated by structures in the right medial temporal lobe, whereas the context-dependent aspects of episodic memory in this non-verbal test are more dependent on the left medial temporal lobe.

Adult↗
PubMed2001

[Prevention of infections transmitted by intravascular devices (catheters, implanted sites)].

Infection remains a major complication of central veinous catheters. A clinically or bacteriologically proven infection is identified in 5 to 10% of the cases although the actual risk varies from less than 1 to more than 30 episodes of infection per 1000 catheter-days. Systemic spread follows colonization of the catheter tip via the skin or the connectors, less frequently via hematogenous seeding from a distant focus of infection. Excepting emergency situations, search for proof of catheter-related infection or noninfection without removing the catheter now appears to be acceptable for selected intensive care patients if appropriate safety measures are taken; the reasonable choice is between maintaining the catheter while performing tests susceptible of determining the reality of catheter-related infection (in this case there remains a certain doubt concerning the respective performance of the different methods proposed for early diagnosis) and catheter exchange on a metal or plastic guide-wire. Rigorous application of the rules of hygiene, asepsis, and local care is crucial: systematic and repeated hand washing is by far the best antiinfectious prophylaxis. Three types of future developments susceptible of improving the current situation can be identified: better knowledge of host defense mechanisms against foreign bodies, reduction of hand-transmitted contamination by wider use of hydro-alcohol solutions for decontamination of the hands, and elaboration of new connectors, and most importantly, biomaterials capable of inhibiting colonization by the growing number of increasingly virulent strains. Discussions concerning the real clinical efficiency, ecological risk and the cost-effectiveness of catheters impregnated with antiseptics and/or antibiotics is a perfect illustration of the current debate.

Antibiotic Prophylaxis↗
PubMed2001

[Physiologic evaluation of explosive force in sports].

Although we all possess the capability for anaerobic and aerobic energy metabolism, the capacity for each form of energy transfer varies considerably among individuals. Sports such as football or weightlifting, rely almost exclusively on energy derived from the muscles's pool of high-energy phosphates. Researchers have proposed different tests to estimate the power-generating capacity of high energy phosphates: stair-sprinting power tests, jumping-power tests or sprint cycling. In reality, however, it is difficult to obtain precise physiological or biochemical data during all-out exercise of brief duration.

Adenosine Triphosphate↗
PubMed1991

Alma Ata and health for all by the year 2000. The roles of academic institutions.

The title of this article raises a complex set of questions. To begin, what happened at Alma Ata and the goal that emanated from it-Health for All by the Year 2000--are themselves controversial matters. At least there are some who are strongly critical of those events and ideas. Even without linking academic institutions with Alma Ata and HFA/2000, a controversy is spawned when one asks about the roles of such institutions in dealing with societal problems--which problems should a university address, and how deeply does a university become engaged in them, particularly if it carries the university out of the cloister into the trenches of societal conflict? Linking academic institutions with Alma Ata and HFA/2000 deepens the controversy but also provides a framework for examining the basic principles on which each is based, and for testing those principles against the realities of real world problems of health development. This article draws on recent critical assessments of both sides of the equation: a recent Consultative Committee to the Director General of WHO that analyzes the successes and failures of PHC development to date, and lays out conditions for greater effectiveness in the future; and the Technical Discussions of WHO on the Roles of Universities in the Strategy for Health for All that review traditional and progressive arguments about the roles of universities in their societies, and how HFA can be seen as fitting into that debate. The thinking contained in these documents provides ample opportunity to examine whether or not academic institutions should have a role that relates to Alma Ata and Health for All, and, in the end, takes the position that, indeed, this is an appropriate role for those universities prepared to make the commitment. The point is also made that such involvement cannot be effective if the scale of the institutional commitment is marginal--it must be substantial and institution-wide. An example is given of the Aga Khan University in Karachi, Pakistan, an institution avowedly committed to a community orientation and to health services development. The Network of Community-Oriented Educational Institutions for Health Sciences can be considered a movement of educational institutions in this direction. It is functioning with considerable creative initiative in addressing issues having to do with problem-based teaching methods, community orientation, and partnerships with governmental health services.(ABSTRACT TRUNCATED AT 400 WORDS)

Academic Medical Centers↗
PubMed1982

Patterns of health care utilization in an academic family practice.

The theoretical model of family practice is one of primary, comprehensive, and continuous care to families. This model is not yet fully documented. In a test of a model's reality, 130 regular users of an academic family practice were surveyed. Eighty-two (63 percent) identified the practice as their usual source of care. Projected use of the practice within this subset ranged from 100 percent for general health examination to 20 percent for marital/sexual problems. Only 35 percent of the other 156 members of these 82 patients' households were said to use the practices as their usual source of care. To the extent that these findings can be generalized to other settings, it can be concluded that the health care utilization patterns of family medicine patients and their immediate family members fall short of specialty's expectations.

Adolescent↗
PubMed1993

The arterial thrombotic process and emerging drugs for its control.

Unabated, the arterial thrombotic process continues to be a major challenge in the management of acute coronary artery disease. Pharmacologic and mechanical revascularization therapies, which have proliferated over the last decade, remain impeded by arterial thrombosis and its clinical sequelae. New antithrombotic drugs aimed at specific points in the arterial thrombotic process offer the potential for substantial improvements in the management of coronary artery disease. The use of these agents as a mainstay of patient care is becoming a reality as controlled clinical studies test their safety and potential benefits.

Angioplasty, Balloon, Coronary↗
PubMed2005

Testing repeatability of forces when using neurosurgical spatulas.

Virtual reality systems seems to be useful for training the use of brain spatulas without damaging brain tissue but the success of such a system is dependant on the human ability to discriminate pressures applied with the spatula. This paper describes an experiment designed to explore some central issues related to this ability: are surgeons better than laypeople, are the abilities in Virtual Reality (VR) and real world (RW) comparable, and will visual feedback enhance the ability. A group of surgeons and a control group of laypeople were tested in VR and RW. The results showed that surgeons performed better than the control group in RW but worse in VR, and that visual feedback improved the surgeons' abilities more than the control group. The results indicated that visual feedback is important for the success of such a virtual training system.

Computer Simulation↗
PubMed2006

Perceptual, visuospatial, and psychomotor abilities correlate with duration of training required on a virtual-reality flexible endoscopy simulator.

BACKGROUND: Trainees acquire endoscopic skills at different rates. Fundamental abilities testing could predict the amount of training required to reach a performance goal on a virtual-reality simulator. METHODS: Eleven medical students were tested for fundamental abilities. Baseline endoscopic proficiency was evaluated with the GI Mentor II VR simulator (Simbionix, USA, Cleveland, OH). Subjects trained on the simulator with a defined performance goal. Subjects who achieved the goal were then reassessed. RESULTS: All subjects completed at least 10 trials or reached the performance goal. The <10 trial group (n=6) tested better for all fundamental abilities and baseline endoscopic performance than the >10 trial group (n=5). The number of trials required to reach the performance goal correlated significantly with both perceptual (r=.92, P=0.001) and visuospatial ability (r=.76, P=.03). Multiple regression showed strong correlation of all three abilities with duration of training (r=.95, P=.015). CONCLUSIONS: Most of the variability in acquisition of endoscopic skills can be accounted for by differences in fundamental abilities of trainees. Testing of fundamental abilities could help identify trainees who will require additional training to achieve desired performance objectives.

Adult↗
PubMed2006

[Comparison of two or more samples of quantitative data].

In the study of the difference between the two or more data groups, first a scientific hypothesis is to be presented involving guessing, questing, and hypothesizing that motivate research. Statistical hypothesis is drawn from the scientific hypothesis, namely, the hypothesis of the researcher (which, as a rule, is affirmative). The mode of statistical hypothesis is presented so as to be valued by statistical and analytical procedures. Testing of the hypothesis is a statistical procedure that can determine whether and how reliably the available data support the given hypothesis. Testing of hypotheses, namely, testing of the significance is basically the procedure of the quantification of impressions regarding the specific hypothesis. The sequence of actions in the testing of the hypothesis: stating a null and an alternative hypothesis; the choice of the significance level (alpha); collection of relevant data based on the adequate sample of subjects; evaluation of the value of results of the statistical test specific for the null hypothesis (Ho); comparison of results of the statistical test with the values from the known value distribution specific for the given test; interpretation of the statistical test results in the probability terms (P-value). The Ho is a supposition of the absence of effect, i.e. that there is no difference between the samples in the population of interest (for example, that there is no difference in arithmetical means). This is a hypothesis of no difference. It is (mostly) made with the aim of rejection. It is either rejected or accepted. The choice of the corresponding statistical test depends on the researcher's design (dependent or independent study design of two or more data samples) as well as on the nature of data (distribution normality and variance homogeneity). Parametric tests carry more strength (the power to detect the difference if in reality it really exists) than nonparametric or distribution free tests. The latter are practical for smaller samples and situations in which the conditions for conducting parametric tests have not been satisfied.

Analysis of Variance↗
PubMed1989

Age differences in source forgetting: effects on reality monitoring and on eyewitness testimony.

Age differences in memory for the source of memories were investigated using two different experimental paradigms. Experiment 1 used a reality monitoring paradigm. A series of actions were either performed, imagined, or watched, and subjects were later tested for their ability to recognize the actions and identify their origins. Elderly subjects made more false positive responses than did young subjects, and they made more source confusion errors, attributing actions to the wrong sources. Both new and imagined actions were most often misclassified as watched. Experiment 2 used an eyewitness testimony paradigm. After watching a film, subjects read a written version of the story. A recognition test showed that elderly subjects were more often misled by false information in the story than were the younger subjects, and were more confident that their erroneous responses were correct. The findings suggest that a decline in memory for sources may diminish the accuracy of elderly witnesses.

Adult↗
PubMedDate not supplied

The amplitude and phase responses of the firing rates of some motoneuron models.

A vertebrate motoneuron receives an enormous amount of synaptic activity from descending pathways, from spinal cord interneurons and directly from mechanoreceptor afferents. The intrinsic characteristics of the motoneuron will determine how its output spike train will encode the activities of all its inputs. Therefore, the essence of the intrinsic motoneuron characteristics should be well studied and modelled if the roles of the motoneuron as a processing or encoding element are to be well understood. Mathematical models of motoneurons have been described in the literature and tested mostly under static conditions. To increase the reality of the validation of such models, the objective of the present work is to test a few selected models described in the literature using sinusoidal injected current of different frequencies. The resulting frequency responses are compared with data available in the literature from cat type F motoneurons. Discrepancies between some of the models' responses and real motoneuron data suggest that improvements are needed in the modelling of the afterhyperpolarization mechanism.

Models, Neurological↗
PubMed1979

Reality orientation and staff attention: a controlled study.

A trial was carried out of Reality Orientation (R.O.) in a residential home for the elderly mentally infirm with a 'social therapy' control group, receiving the same amount of staff attention as the R.O. group, in addition to an untreated control group. R.O. residents improved more on tests of information and orientation and various aspects of memory than controls. These results support the hypothesis that the nature of staff attention is crucial and that it should encourage and reward appropriate behaviour. No differential effects of treatment were found on rating scale assessments of the resident's functioning in the home.

Aged↗
PubMedDate not supplied

A primer on genetic testing.

Use of genetic tests in the clinical practice setting is a current reality, and an increasing number of patients are asking about and requesting genetic testing. The push to translate genetic research findings and technological innovations into clinical practice will continue as our understanding of the genetic basis of disease increases. Special consideration is required when ordering genetic tests, beyond that of other laboratory tests, and an understanding of the unique aspects involved will help optimize clinical outcomes. The purpose of this primer is to provide a basic understanding of genetic testing, discuss current issues related to the use of tests, and outline practical steps for critically using genetic tests in clinical practice.

Genetic Techniques↗