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PubMed1991

Management of the dairy herd treated with bovine somatotropin.

Cows that produce large quantities of milk require more management and higher quality of management than cows producing smaller quantities of milk. This is true whether improvements in milk production occur through genetic selection, increased milking frequency, or use of bovine somatotropin (bST). The milk response to use of bST is similar (10 to 15%) to that of three times a day (3x) milking and we expect that the management required to maintain the increased production through successive lactations with bST will be similar to that required for the 3x herd. Maximum economic benefit from use of bST will be achieved by dairy managers who (1) feed cows to maximize intake of diets with appropriate nutrient content and balance, (2) maintain proper body condition of their cows, and (3) have health and reproduction management programs that prevent rather than cure problems. Efficient use of record-keeping systems that enable the manager to monitor individual cow status will be advantageous. Economic forces will continue to bring change to the dairy industry. The manager that plans for change and ensures that the dairy's management programs allow for the most economically efficient production will be in position to adapt to these changes. The well-managed dairy will be able to adopt new, efficiency-enhancing technologies, such as bST, to ensure the continued opportunity to compete in the dairy industry.

Animal Husbandry↗
PubMed2000

[Epidemiological surveillance of Chagas disease].

Chagas disease still constitutes an important medical problem in affected countries. In some, the extent of the disease is still unknown and control programs have not been implemented. In others the disease has been reduced due to regular control programs and other economic and social factors. Epidemiological surveillance with community participation to guard against disease transmission is now the basic challenge. Applied research and in-depth reformulation of health systems are required to establish efficient and sustainable Chagas disease surveillance programs, considering low density of peridomiciliary vectors as the most relevant factor. In addition, a large population of already infected, poor individuals require specific medical attention and social security. As a consequence of health care decentralization, Federal institutions such as the Brazilian National Health Foundation (FNS) are being progressively decommissioned, and new participants must be engaged in the process. Communities themselves, together with regional and local institutions, must take charge of surveillance in order to guarantee its efficiency and sustainability.

Animals↗
PubMed2005

Integration of a medication management model into outcome-based quality improvement: a pilot program in a rural propriety home healthcare agency.

This article describes a rural proprietary home health agency's successful initiative to adapt a previously tested medication management model and integrate it into existing processes of care. The rationale to improve medication management in response to current national fiscal, clinical and external quality measures and evolution of this process in the agency is detailed. The agency refined the model's screening procedures, incorporating them into the mandated OASIS assessment and then computerizing the medication risk analysis, in keeping with the original intent of the model. In a four-month pilot test of the computerized risk assessment procedure 1006 OASIS assessments were screened; risk factors for medication-related problems in 201 (19.9%) resulted in pharmacist review. Of these, 30 (17%) were ruled out as potential medication errors, 143 (82.6%) were found with potential MRP and 58 (33.5%) had evidence of problems warranting follow-up. With this computer-assisted process, the agency created a more comprehensive assessment that was in line with the new regulatory emphasis on patient outcomes. Consultant pharmacist services also transitioned from drug regimen review to more comprehensive medication therapy management. By enhancing efficiencies in its medication management program, an agency not only stands to improve quality of care, but also to maximize resources, making the intervention affordable to implement and decreasing burden on staff.

Health Facilities, Proprietary↗
PubMed1977

Evaluation and accountability in a parent-implemented early intervention service.

Traditionally human-service programs have lacked systematic procedures of evaluation and accountability to the clients served. The Regional Intervention Program, a parent-implemented early intervention service, developed and instituted one system of program evaluation to demonstrate its efficiency and effectiveness. The system as developed incorporates an economic justification in terms of the costs and benefits to the funding source, evaluation of specifically defined organizational and clinet objectives, data-based assessments of child progress, and accountability to a consumer-based evaluation committee. Collectively, these four components provide a means of continuous and reliable feedback to the funding source and to the clients served.

Child, Preschool↗
PubMed1993

Medicaid program; eligibility and coverage requirements--HCFA. Final rule with comment period.

These regulations amend the requirements for coverage of certain groups of individuals under Medicaid and the requirements for determining Medicaid eligibility. The regulations relate to coverage of individuals in optional categorically needy groups; aged, blind and disabled individuals in States that use more restrictive requirements for Medicaid than those under the Supplemental Security Income (SSI) program; individuals receiving optional State supplementary payments; individuals under age 21 who are not receiving AFDC; individuals who are ineligible for cash assistance under the Social Security Act because of requirements that do not apply under Medicaid; and medically needy groups. In addition, the regulations revise the methodologies for determining income and resource eligibility under Medicaid, including financial responsibility of relatives, and for determining financial eligibility of medically needy groups, including determining medically needy income levels. These regulations interpret provisions of the Tax Equity and Fiscal Responsibility Act of 1982, as amended by several acts, including, most recently, the Omnibus Budget Reconciliation Act of 1987, the Medicare Catastrophic Coverage Act of 1988, the Family Support Act of 1988, the Omnibus Budget Reconciliation Act of 1989, and the Omnibus Budget Reconciliation Act of 1990. We are also making some administrative changes to achieve more efficient operation of the Medicaid Program.

Adolescent↗
PubMed2026

Ruminosignatures associated with methane emissions and feed efficiency across geographies and cattle breeds.

The cattle rumen microbiota represents a complex and dynamic ecosystem whose organization and relationship to host phenotypes are important for food security and environmental sustainability. We analyzed rumen microbiota profiles from 2496 cattle representing five breeds and production systems across five countries, identifying microbial co-abundance groups termed Ruminosignatures. We detected 14 distinct Ruminosignatures, including 2 observed across all populations dominated by Prevotella and UBA2810. Additional Ruminosignatures showed breed- and diet-specific patterns and collectively explained 96%-99% of variance in rumen microbial composition. Integrative cross-country analysis confirmed 10 out of 14 Ruminosignatures identified in cohort-specific analyses. Several Ruminosignatures were associated with methane emissions and feed efficiency traits and were partially under host genetic control, with heritability estimates ranging from 0.09 to 0.58. Structural equation modeling revealed consistent negative genetic and phenotypic correlations between the UBA2810-dominated Ruminosignature (RS_UBA2) and methane emissions across cohorts (rg = -0.40 to -0.65), with structural coefficients concordant in sign across all populations, supporting the expected direction of phenotypic response to selection on RS_UBA2. Meta-analysis confirmed positive associations of RS_UBA2 with average daily gain and negative associations with methane-related traits and feed conversion ratio. Functional genome-based predictions suggested RS_UBA2 may reduce methanogenesis through alternative hydrogen utilization pathways competing with methanogenic archaea. Production system type influenced both Ruminosignature occurrence and relationships with host phenotypes, emphasizing the relevance of context-specific strategies for microbiome modulation. Our findings highlight the potential of the Ruminosignatures framework for microbiome-informed breeding programs aimed at improving feed efficiency while reducing the environmental impact of cattle production.

Animals↗
PubMed2005

Selection theory for marker-assisted backcrossing.

Marker-assisted backcrossing is routinely applied in breeding programs for gene introgression. While selection theory is the most important tool for the design of breeding programs for improvement of quantitative characters, no general selection theory is available for marker-assisted backcrossing. In this treatise, we develop a theory for marker-assisted selection for the proportion of the genome originating from the recurrent parent in a backcross program, carried out after preselection for the target gene(s). Our objectives were to (i) predict response to selection and (ii) give criteria for selecting the most promising backcross individuals for further backcrossing or selfing. Prediction of response to selection is based on the marker linkage map and the marker genotype of the parent(s) of the backcross population. In comparison to standard normal distribution selection theory, the main advantage of our approach is that it considers the reduction of the variance in the donor genome proportion due to selection. The developed selection criteria take into account the marker genotype of the candidates and consider whether these will be used for selfing or backcrossing. Prediction of response to selection is illustrated for model genomes of maize and sugar beet. Selection of promising individuals is illustrated with experimental data from sugar beet. The presented approach can assist geneticists and breeders in the efficient design of gene introgression programs.

Alleles↗
PubMed2000

5-HT reuptake inhibitors with 5-HT(1B/1D) antagonistic activity: a new approach toward efficient antidepressants.

As part of our research program toward new, potential antidepressants, a series of unsymmetrical ureas has been prepared and evaluated as 5-HT reuptake inhibitors with 5-HT(1B/1D) antagonistic activities. The design of these compounds was based on coupling of various indole derivatives, previously shown to inhibit 5-HT reuptake, to three different aniline moieties, which are part of known 5-HT(1B/1D) ligands. Binding experiments in rat frontal cortex using [(125)I]iodocyanopindolol, in calf striatum using [(3)H]5-HT, and in rat hippocampus using [(3)H]8-OH-DPAT as radioligands, respectively, revealed significantly higher affinity at the 5-HT(1B) receptor as compared to the affinities for the 5-HT(1A) and 5-HT(1D) receptors for a number of compounds, among them 4-(5-fluoro-1H-indol-3-yl)piperidine-1-carboxylic acid [4-methoxy-3-(4-methylpiperazin-1-yl)phenyl]amide (5), the corresponding 4-fluoro-1H-indol-3-yl analogue 21a, and the corresponding 6-fluoro-1H-indol-3-yl analogue 21b. Conformational restriction of the aniline moiety in 5 only slightly enhanced the 5-HT(1B) affinity, whereas introduction of an aniline moiety with higher conformational flexibility resulted in a less potent 5-HT(1B) receptor ligand as compared to 5. The functional 5-HT(1B/1D) antagonistic activity was investigated using the rabbit saphenous vein model as well as the [(3)H]5-HT release from guinea pig cortical slices. All new compounds tested in the rabbit saphenous vein model were shown to antagonize the sumatriptan-evoked contractile responses with pA(2) values ranging from 7.3 to 8.7. These observations were consistent with the results of the cortical slice model, in which the ureas were found to block the sumatriptan-induced inhibition of potassium-evoked [(3)H]5-HT release. The 5-HT reuptake inhibition of the ureas determined in rat brain synaptosomes was found to be either increased or decreased as compared to the uncoupled indole derivatives indicating that the reuptake inhibition shown by the ureas is not only due to the indole part but also affected by the aniline moiety of the molecule. Among this series of compounds described the ureas 5, 21a, and 21b seem to be the most interesting candidates showing both 5-HT reuptake inhibition and 5-HT(1B/1D) antagonism in vitro. This dual pharmacological profile should in theory lead to a pronounced enhancement in serotonergic neurotransmission and consequently to a more efficient treatment of depression.

Animals↗
PubMed2002

Rapid grid-based construction of the molecular surface and the use of induced surface charge to calculate reaction field energies: applications to the molecular systems and geometric objects.

This article describes a number of algorithms that are designed to improve both the efficiency and accuracy of finite difference solutions to the Poisson-Boltzmann equation (the FDPB method) and to extend its range of application. The algorithms are incorporated in the DelPhi program. The first algorithm involves an efficient and accurate semianalytical method to map the molecular surface of a molecule onto a three-dimensional lattice. This method constitutes a significant improvement over existing methods in terms of its combination of speed and accuracy. The DelPhi program has also been expanded to allow the definition of geometrical objects such as spheres, cylinders, cones, and parallelepipeds, which can be used to describe a system that may also include a standard atomic level depiction of molecules. Each object can have a different dielectric constant and a different surface or volume charge distribution. The improved definition of the surface leads to increased precision in the numerical solutions of the PB equation that are obtained. A further improvement in the precision of solvation energy calculations is obtained from a procedure that calculates induced surface charges from the FDPB solutions and then uses these charges in the calculation of reaction field energies. The program allows for finite difference grids of large dimension; currently a maximum of 571(3) can be used on molecules containing several thousand atoms and charges. As described elsewhere, DelPhi can also treat mixed salt systems containing mono- and divalent ions and provide electrostatic free energies as defined by the nonlinear PB equation.

Journal Article↗
PubMed2002

The elderly nutrition program: an effective national framework for preventive nutrition interventions.

OBJECTIVE: To guide national policy, Congress mandated the 1992 research evaluation of the Elderly Nutrition Program (ENP), the nation's oldest framework for providing community- and home-based preventive nutrition and health-related services to older persons. This article summarizes key findings on the program's influence on nutritional health, the targeting and costs of its nutrition services, and the study's policy implications. DESIGN: The research included a nationally representative sample of ambulatory and homebound ENP participants And a matched sample of nonparticipants drawn from the US Health Care Financing Administration's Medicare beneficiary listings. Interviews conducted in respondents' homes considered demographic and health characteristics and assessed anthropometry and physical functioning, nutrient intake and socialization patterns, and utilization of ENP program services (participants only). Administrative and service delivery data were gathered from all levels of the ENP infrastructure. RESULTS: The ENP program currently provides congregate and home-delivered meals and other nutrition- and health-related services to about 7% of the older population overall, including an estimated 20% of the nation's poor elders. Compared with nonparticipants, ambulatory and homebound ENP participants are better nourished (4% to 31% higher mean daily nutrient intakes; P<.001) and achieve higher levels of socialization (17% higher average monthly social contacts; P<.001). Federal spending on ENP nutrition services is efficiently leveraged by funding from other public and private sources, allowing ENP to more than double the nutrition services it provides to program participants. CONCLUSIONS: ENP is a well-targeted, effective, and efficient federal program available to dietetics and other professionals for providing elderly persons with community-based and home-delivered nutrition and related services. The ENP infrastructure offers a potential model for preventive nutrition intervention programs in ambulatory and homebound at-risk older populations.

Activities of Daily Living↗
PubMed1995

[A PC program for evaluating electrophysiologic signals of mammalian eyes].

BACKGROUND: Electrophysiological measurements in the mammalian eye in vivo or in vitro, i.e. in the arterially perfused cat eye, require storage and analysis of a large amount of data: light-evoked signals, including the electroretinogram (ERG) and the optic nerve response (ONR) are stimulus-related and have to be measured in a triggered mode, whereas the DC-standing potential and flow rate of perfusion medium should be measured continuously. METHOD AND RESULT: In order to facilitate the analysis of these various signals, we developed a computer program, that allows an on-line data analysis and a trend indication for pharmacologically induced changes in signal size as well as efficient storage. The flexible system is based on a "labview" program, the application and efficiency of which are discussed.

Animals↗
PubMed2006

Genetic drift and selection effects of modified recurrent full-sib selection programs in two F2 populations of European flint maize.

Selection response of a modified recurrent full-sib (FS) selection scheme conducted in two European flint F(2) maize (Zea mays L.) populations was re-evaluated. Our objectives were to (1) determine the selection response for per se and testcross performance in both populations and (2) separate genetic effects due to selection from those due to random genetic drift. Modified recurrent FS selection was conducted at three locations using an effective population size N(e) = 32 and a selection rate of 25% for a selection index, based on grain yield and grain moisture. Recombination was performed according to a pseudo-factorial mating scheme. Selection response was assessed using a population diallel including the source population and advanced selection cycles, as well as testcrosses with unrelated inbred line testers and the parental F(1) generation. Selection response per cycle was significant for grain yield and grain moisture in both populations. Effects of random genetic drift caused only a small reduction in the selection response. No significant selection response was observed for testcrosses, suggesting that for heterotic traits, such as grain yield, a high frequency of favorable alleles in the elite tester masked the effects of genes segregating in the populations. We conclude that our modified recurrent FS selection is an alternative to other commonly applied intrapopulation recurrent selection schemes, and some of its features may also be useful for increasing the efficiency of interpopulation recurrent selection programs.

Crosses, Genetic↗
PubMed2006

Localization of ERK/MAP kinase is regulated by the alphaherpesvirus tegument protein Us2.

Many different viruses activate the extracellular signal-regulated kinase (ERK)/mitogen-activated protein (MAP) kinase signaling pathway during infection and require ERK activation for the efficient execution of their replication programs. Despite these findings, no virus-encoded proteins have been identified that directly modulate ERK activities. In an effort to determine the function of a conserved alphaherpesvirus structural protein called Us2, we screened a yeast two-hybrid library derived from NIH 3T3 cells and identified ERK as a Us2-interacting protein. Our studies indicate that Us2 binds to ERK in virus-infected cells, mediates the incorporation of ERK into the virion, and inhibits the activation of ERK nuclear substrates. The association of Us2 with ERK leads to the sequestration of ERK at the plasma membrane and to a perinuclear vesicular compartment, thereby keeping ERK out of the nucleus. Us2 can bind to activated ERK, and the data suggest that Us2 does not inhibit ERK enzymatic activity. The treatment of cells with U0126, a specific inhibitor of ERK activation, resulted in a substantial delay in the release of virus from infected cells that was more pronounced with a virus deleted for Us2 than with parental and repaired strains, suggesting that both ERK and Us2 activities are required for efficient virus replication. This study highlights an additional complexity to the activation of ERK by viruses, namely, that localization of active ERK can be altered by virus-encoded proteins.

Animals↗
PubMed1987

Silver reclamation: management controls maximize yields.

This article presents an overview of how radiology managers can establish a series of controls that will insure efficient recovery and maintenance of silver reclamation programs. Once this tracking system is established, it will become an easy task to evaluate equipment efficiency, refiner capabilities, and assure the highest return possible from their "silver mines."

Hospital Departments↗
PubMed1988

Community models for cancer prevention and detection.

Optimal community programs in cancer prevention and detection have as their goals the lowering of incidence, complications, and mortality from cancer in a population, and are characterized by efficiency, self-sustainability, and generalizability. Programs fall into three categories according to their degree of integration into the normal health-care system. "Extra-systemic" programs are temporary demonstration activities, which may have research goals. "Quasi-systemic" activities include public health department programs, worksite programs, and specialized centers such as breast screening centers. "Systemic" activities involve counseling and screening in routine medical practice. The greatest potential for reaching the indicated goals lies in facilitating systemic activities by allowing primary-care practitioners to define their own prevention goals, to make changes in their practices to address these goals, and to educate consumers of the need to demand preventive services.

Community Health Services↗
PubMed1991

Effectively marketing prepaid medical care with decision support systems.

The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches.

Accounting↗
PubMed2006

Improving murine health surveillance programs with the help of on-site enzyme-linked immunosorbent assay.

Timely and accurate detection of murine pathogens is essential in contemporary biomedical research. Cost, accuracy, and reproducibility of test results are frequent concerns when initiating an on-site serology program. This study was conducted to evaluate the advantages of on-site serology performed by enzyme-linked immunosorbent assay (ELISA) versus pathogen surveillance conducted off-site by a commercial vendor. We divided 92 sentinel mouse serum samples and tested them in parallel for a panel of 10 murine pathogens at our institution and by an off-site vendor. On-site testing was performed with commercially available test kits and according to the kit manufacturer's directions, whereas serum samples for off-site testing were prepared according to the vendor's specifications. Results from the 2 testing strategies were compared, and a good beyond- chance level of agreement was demonstrated by means of the kappa test (kappa = 0.86). The turn-around time between sample preparation and results availability for on-site ELISA was 16 h versus 72 h for off-site testing. On-site ELISA demonstrated considerable cost reduction, ranging from 15.10% to 43.33% depending on the number of agents being tested. This study demonstrates the accuracy and time- and cost-effectiveness of on-site ELISA as well as its potentially valuable role in achieving more timely and efficient disease surveillance and control programs in contemporary biomedical research facilities.

Animals↗
PubMed2004

Effectiveness and efficiency of opportunistic cervical cancer screening: comparison with organized screening.

BACKGROUND: Several countries have adopted nationally organized cervical screening programs, but many continue with opportunistic screening. Comparison of the effectiveness and efficiency of the 2 systems is important for informing policy. OBJECTIVES: The objectives of this study were to assess the effectiveness and efficiency of an opportunistic cervical screening system, and to compare this with what could be achieved through an organized program. RESEARCH DESIGN: We propose a model for estimating the effectiveness and efficiency of opportunistic screening systems and demonstrate it using data from a cross-sectional study of 1826 women in Hong Kong. We estimated the coverage and frequency of screening and used this to estimate effectiveness (number of cases of invasive cervical cancer potentially prevented) and efficiency (tests per case prevented) of the current system. Similar estimates were made for various organized programs with different screening intervals and coverage. RESULTS: Ever screening coverage in this opportunistic system was 44%, resulting in 26% to 31% reduction in potential new cases (n = 144-183). Compared with this, a 3-yearly or 5-yearly screening policy aiming for 80% coverage would prevent an additional 46% (equivalent to 254 new cases out of a population of 2.3 million women per year) and 41% (222 per year), respectively. This could be achieved with more efficient use of resources, reducing the number of tests per case prevented from 2018 to 1545 and 1007, respectively. CONCLUSIONS: At best, the effectiveness of this opportunistic system is equivalent to an organized program with 10-yearly screening and 50% coverage but at much greater cost. Poor coverage and over screening of a minority of women contributes to its inefficiency.

Adult↗