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At least 1,441 records · Page 80Linked to original sources
PubMed2002

High reliability of neonatal screening for congenital adrenal hyperplasia in Switzerland.

Newborn screening for congenital adrenal hyperplasia (CAH) is justified by the sometimes difficult clinical diagnosis and the risks associated with missed diagnosis, particularly the life-threatening salt-wasting crisis. In Switzerland, nationwide screening for CAH by measuring 17-hydroxyprogesterone levels in dried blood spots was introduced in 1992. At the Zurich University Children's Hospital, 50% of the population of Switzerland is screened. The aim of the study was to evaluate the efficiency of the Zurich screening program. Between January 1, 1993, and May 31, 2001, 333,221 newborns were screened for CAH. Thirty-one newborns had CAH (incidence, 1 in 10,749); 30 were detected through screening (sensitivity, 97%). A recall for suspected CAH was performed in only 60 cases, corresponding to a very low recall rate (0.0018%). In 30 recalls CAH was confirmed (positive predictive value, 50%; specificity, 99.99%). Fifteen of 31 patients profited from screening, as CAH had not been recognized clinically. The timely availability of screening results made therapy possible within the first week of life in most cases and helped in preventing salt-wasting crisis in all patients. With a sensitivity of 97%, a specificity of 99.99%, and a positive predictive value of 50%, the Zurich neonatal screening program for CAH can be considered highly reliable.

17-alpha-Hydroxyprogesterone↗
PubMed1987

Immune reactivity in the nervous system: modulation of T-lymphocyte activation by glial cells.

The vertebrate central nervous system (CNS) has been traditionally thought to be inaccessible for the passenger lymphocytes of the immune system. This does not seem to be the case: activated T-lymphocytes can readily cross the endothelial blood-brain barrier (BBB) and some glial cells, notably the astrocytes, seem to be programmed to act as most efficient and complex partners for antigen-specific T-lymphocytes. We used myelin basic protein (MBP) specific permanent rat T-lymphocyte lines as probes to assess the immune status of the CNS. These cells, upon activation in vitro, are able to transfer lethal, experimentally induced autoimmune-encephalomyelitis (EAE) to normal syngeneic recipients. Activated T-lymphocytes, but not resting ones, can break through the BBB irrespective of their antigen specificity. Immune surveillance of the CNS thus seems to be executed by activated T-lymphocytes. Having crossed the BBB, the activated T-cells interact with local glial cells by releasing factors, including interferon-gamma, which induced astrocytes to synthesize and express, on their membranes, class II major histocompatibility antigens (Ia determinants), which are critically required for immunogenic presentation of antigens to T-cells. Indeed, Ia-induced astrocytes of the CNS (and the Schwann cells of peripheral nerves) are efficient antigen presenter cells, which are able strongly to up-regulate antigen-reactive T-lymphocytes. In addition, it has recently been shown that at least some astrocytes are able to down-regulate immune cells. Some, but not all, astrocytes are capable of suppressing activation of T-cells. This suppression can be modulated by interferon-gamma, and is sensitive to irradiation. The question of whether suppression is mediated by direct cell-to-cell contact or via soluble mediators (e.g. apolipoprotein E) is under investigation. Astrocytes have been found to be most subtle regulators of immuno-competent T-cells. Most probably they are centrally involved in physiological immune reactivity of the CNS, and it will be tempting to learn how far glial cells are involved in transmitting regulatory signals between the immune and nervous systems.

Animals↗
PubMed1986

Mass screening of blood pressure in school children: results of the Karatsu Study.

The purpose of this study was to determine the prevalence of persistent blood pressure elevation in school children. Mass screening of blood pressure was performed simultaneously with a cardiovascular health check in school children. Forty four hundred and eighty school children were selected as subjects for this study, consisting of 2289 first grade primary school students aged six and seven (group A), and 2191 second grade junior high school students aged thirteen and fourteen (group B). Of the 4480 students, 4031 were examined at the initial blood pressure screening. Three hundred and sixty students whose systolic and/or diastolic pressures were above the 95th percentile were recalled for a second examination. Three hundred and thirty one students were studied at the 2nd examination, and 69 students were listed for a third survey. 1.7% of the original subjects were examined at the final survey. At the first screening, mean blood pressures were 101.5 +/- 8.5/61.2 +/- 6.6 mmHg (mean +/- SD) for males and 100.3 +/- 8.3/60.9 +/- 6.5 for females in group A. In group B, blood pressures were 120.2 +/- 11.3/66.6 +/- 7.4 mmHg for males and 117.4 +/- 11.2/66.9 +/- 7.8 mmHg for females. This screening system, if incorporated into the school health program, is an effective and efficient method of screening for persistent blood pressure elevation in school children in Japan.

Adolescent↗
PubMedDate not supplied

Bounds on a trauma outcome function via optimization.

One measure of the effectiveness of institutional trauma and burn management based on collected patient data involves the computation of a standard normal Z statistic. A potential weakness of the measure arises from incomplete patient data. In this paper, we apply methods of fractional programming and global optimization to efficiently calculate bounds on the computed effectiveness of an institution. The measure of effectiveness (i.e., the trauma outcome function) is briefly described, the optimization problems associated with its upper and lower bounds are defined and characterized, and appropriate solution procedures are developed. We solve an example problem to illustrate the method.

Age Factors↗
PubMed2007

Integrating and promoting medical podcasts into the library collection.

Podcasts offer a way for medical professionals to listen to current information in medicine from an iPod, MP3 player, handheld device, or computer. As podcasts become more popular, libraries may be interested in integrating programs into the library collection. South Pointe Medical Library evaluated medical podcasts relevant to the scope of the library collection and explored methods for finding and organizing such programs in ways that are efficient for both the librarian and the patron. doi:10.1300/J115v26n01_03.

Access to Information↗
PubMedDate not supplied

Collaboration between community pharmacists and family physicians: lessons learned from the Seniors Medication Assessment Research Trial.

OBJECTIVES: To learn about the experiences of specially trained expanded role pharmacists (ERPs) and family physicians in a program in which they worked together to optimize drug therapy for elderly patients (aged 65 and older) and to identify shortcomings of the program, obstacles to its implementation, and strategies to overcome these obstacles. DESIGN: Qualitative opinion analysis. PARTICIPANTS: Six family physicians and six community-based ERPs who had participated in a randomized controlled trial (Seniors Medication Assessment Research Trial [SMART]). INTERVENTION: In-depth interviews. MAIN OUTCOME MEASURES: Themes that emerged from the interviews regarding the strengths and weaknesses of and ways to improve the program. RESULTS: ERPs and physicians differed in their perceptions of appropriate roles for ERPs. ERPs saw the program as an opportunity to take on new professional roles. Physicians appreciated the information they received from ERPs about their patients' adherence and use of nonprescription medications, but they did not want ERPs to directly counsel their patients. Some physicians questioned the value of the program for some patients, since the inclusion criteria for patients were broad and not all patients meeting the criteria needed intense interventions by ERPs. Both ERPs and physicians identified the need to refine the referral process and to work out professional role relationships and ongoing collaboration more fully. If the program were to be implemented as a routine service, physicians were concerned about the demands on their staff and office space and the need for an external compensation mechanism. CONCLUSION: Issues to be addressed for future programs include clarification of the roles of pharmacist and physician when the professionals work together, targeting of appropriate patients for the program, identification of a more efficient way to deliver recommendations, and development of an appropriate compensation mechanism.

Aged↗
PubMedDate not supplied

Fact, fiction, and fairness: resource allocation under the Ryan White CARE Act.

Debate over the reauthorization of the Ryan White CARE Act (RWCA) raises questions of fairness, equity, and efficiency. Critics charge that the program targets disproportionate resources to historical urban epicenters at the expense of underserved areas of incident HIV infection. We used 1998-2004 data on RWCA allocations to examine these claims. We found that states' concentration of AIDS cases within urban areas remains the dominant predictor of RWCA funding, although the impact of concentration declined after 2000. Other state characteristics, such as poverty rates or racial/ethnic diversity, play a much smaller role.

Geography↗
PubMedDate not supplied

An architecture for distributed visual memory.

The development of autonomous as well as situated robots is one of the great remaining challenges and involves a number of different scientific disciplines. In spite of recent dramatic progress, it remains worthwhile to examine natural systems, because their abilities are still out of reach. Motivated by research work done in the fields of cognitive systems, visual perception, and psychology of memory we designed and implemented a memory architecture for visual tasks. Structural and functional concepts of the memory architecture were modeled on the ones found in natural systems. We present an efficient implementation based on parallel programming techniques. The memory module is integrated into a distributed system for speech and image analysis, which is currently developed in the Sonderforschungsbereich (SFB) 360, Situated Artificial Communicators, where a hybrid vision system combining neural and semantic networks is used.

Animals↗
PubMed2006

Assisted and resisted sprint training in swimming.

This study was undertaken to determine whether the resisted-sprint in overstrength (OSt) or the assisted-sprint in overspeed (OSp) could be efficient training methods to increase 100-m front crawl performance. Thirty-seven (16 men, 21 women) competition-level swimmers (mean +/- SD: age 17.5 +/- 3.5 years, height 173 +/- 14 cm, weight 63 +/- 14 kg) were randomly divided into 3 groups: OSt, OSp, and control (C). All swimmers trained 6 days per week for 3 weeks, including 3 resisted or assisted training sessions per week for the groups OSt and OSp respectively. Elastic tubes were used to generate swimming overstrength and overspeed. Three 100-m events were performed before, during, and after the training period. Before each 100-m event, strength of the elbow flexors and extensors was measured with an isokinetic dynamometer. Stroke rate and stroke length were evaluated using the video-recorded 100-m events. In the OSt group, elbow extensor strength, swimming velocity, and stroke rate significantly increased (p < 0.05), while stroke length remained unchanged after the 3-week training period. In the OSp group, stroke rate significantly increased (p < 0.05) and stroke length significantly decreased (p < 0.05) without changes in swimming velocity. No significant variations in the C group were observed. Both OSt and OSp proved to be more efficient than the traditional training program. However, the OSt training program had a larger impact on muscle strength, swimming performance, and stroke technique than the OSp program.

Adaptation, Physiological↗
PubMed2003

Vaccine adjuvant technology: from mechanistic concepts to practical applications.

Distinct types of immune responses are required for efficient elimination of different pathogens. Programming of the desired type of immune response by safe nonreplicating vaccines requires suitable vaccine adjuvants. Adjuvants largely determine the magnitude and quality of immune responses specific for the coadministered antigen. Unfortunately, rational vaccine design requiring a rational choice of vaccine adjuvant, is hampered by a lack of knowledge about the mechanism(s) of vaccine adjuvant activity. The current review addresses different critical immunological processes possibly explaining adjuvant functions. In addition, we discuss traditional vaccine adjuvant formulations and their possible mode of action. Finally, we reflect on the latest technologies for the identification of novel adjuvants using molecular analysis of immune activation and functional genomics.

Adjuvants, Immunologic↗
PubMed2004

Comparison of different probe-level analysis techniques for oligonucleotide microarrays.

Three different software packages for the probe-level analysis of high-density oligonucleotide microarray data were compared using an experiment-derived data set that was validated using real-time PCR. The efficiency with which these three programs could identify true positives in this data set was assessed. In addition, estimates of false-positive and false-negative rates were determined. The performance of the programs using very small data sets was also compared, and recommendations for use are suggested.

Animals↗
PubMed2000

Pharmacological classification of drugs based on neural network processing of molecular modeling data.

The performance of artificial neural network (ANN) models in predicting pharmacological classification of structurally diverse drugs based on their theoretical chemical parameters was demonstrated. The classification coefficients for psychotropic agents, beta-adrenolytic drugs, histamine H(1) receptor antagonists and drugs binding to alpha-adrenoceptors were 100, 100, 95 and 86%, respectively. A set of easily accessible non-empirical molecular parameters describing the structure of xenobiotics can provide information allowing the prediction of some pharmacological properties of drugs and drug candidates employing ANN models. Since ANN analysis can help cluster as well as segregate drugs and drug candidates according to their known and expected pharmacological properties, the number of routine biological assays might be reduced. The results presented here might be used to improve the efficiency of high throughput screening programs for new drug hits by demonstrating a promising procedure for diverse combinatorial library design and evaluation.

Models, Molecular↗
PubMed2004

[Functional status of stroke patients among different long-term care settings].

PURPOSE: The purpose of this study was to measure the functional status of stroke patients cared for in different long-term care settings. METHOD: We assessed all stroke patients in two home health care agencies, four nursing homes and one geriatric hospital in Korea (n=171) using the Resident Assessment Instrument (RAI), which comprises Activity of Daily Living (ADL), urine incontinence, bowel incontinence, a Cognitive Performance Scale (CPS),and being understood and understanding others. Data was collected by face-to-face surveys with patients. RESULT: The mean ADL score, urine incontinence score, bowel incontinence score, CPS, and being understood score and understanding others score were lowest for the patients receiving home health care, and highest for the patients in nursing homes. Low scores described poor and high scores good functional status. The results showed significant differences in physical and cognitive function scores between the three groups of patients. CONCLUSION: This study suggests that there may be large differences between the patients in these three types of long-term care settings. These findings can be used to help develop and implement efficient long-term care programs.

Activities of Daily Living↗
PubMed1995

Understanding productivity, a key to Aedes aegypti surveillance.

The objective of this work was to define criteria that could be applied to achieve faster, more economical, and accurate assessment of vector populations for control of dengue viruses. During 1989-1990, 1,349 premises were surveyed in Townsville, Charters Towers and Mingela/Ravenswood, Queensland, Australia. In each locality, 1.9-8.4% of premises contained three or more containers with Aedes aegypti immature forms and were designated as key premises. Comparison of surveys in Townsville from 1989 to 1990 indicated that positive premises (i.e., those with at least one container with Ae. aegypti present) were 3.22 times more likely to remain positive than negative houses to become positive the following year. The Ae. aegypti population in Townsville was seen to be totally associated with garden receptacles, discarded household items, and trash but one well and one rainwater tank were responsible for 28% of all immature forms recorded in the 1,349 premises inspected. These breeding sites of high productivity were designated as key containers. At Charters Towers, Mingela, and Ravenswood, rainwater tanks were seen as the most important key container because although they constituted 13-29% of positive containers, they supported 60-63% of the immature forms. This study demonstrates that there is a certain degree of stability with regard to positive premises and that some of these, or some container types, contribute disproportionately to the Ae. aegypti population. Control programs could be made more efficient if efforts were concentrated on these sites of key vector productivity.

Aedes↗
PubMedDate not supplied

Give tech a try.

More than simply increasing speed and efficiency, technology can help achieve program goals. But staff need to keep an open mind.

Attitude to Computers↗
PubMed1998

Health insurance reform: standards for electronic transactions--HCFA. Proposed rule.

This rule proposes standards for eight electronic transactions and for code sets to be used in those transactions. It also proposes requirements concerning the use of these standards by health plans, health care clearinghouses, and health care providers. The use of these standard transactions and code sets would improve the Medicare and Medicaid programs and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. It would implement some of the requirements of Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

National standard health care provider identifier--HCFA. Proposed rule.

This rule proposes a standard for a national health care provider identifier and requirements concerning its use by health plans, health care clearinghouses, and health care providers. The health plans, health care clearinghouses, and health care providers would use the identifier, among other uses, in connection with certain electronic transactions. The use of this identifier would improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. It would implement some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

Health insurance reform: national standard employer identifier--HCFA. Proposed rule.

This rule proposes a standard for a national employer identifier and requirements concerning its use by health plans, health care clearinghouses, and health care providers. The health plans, health care clearinghouses, and health care providers would use the identifier, among other uses, in connection with certain electronic transactions. The use of this identifier would improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. It would implement some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996.

Career Mobility↗