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PubMed2006

Gradients in the health status and developmental risks of young children: the combined influences of multiple social risk factors.

OBJECTIVES: To analyze child vulnerability as a profile of multiple risk factors for poorer health based on race/ethnicity, social class (maternal education and family poverty status), child health insurance coverage, and maternal mental health. Profiles are examined in relation to disparities in the health status and developmental risks of young children. DATA SOURCES: Cross-sectional data on 2,068 children ages 4-35 months from the 2000 National Survey of Early Childhood Health. STUDY DESIGN: Multiple logistic regression models are used to examine risk profiles in relation to child health status and developmental risk (based on parent concerns about development). The profiles are also examined in relation to three measures of basic access to health care: telephone contact with a physician, well-child visit in the past year, and missed or delayed needed care. PRINCIPAL FINDINGS: About one-third of (or 3.1 million) young children in the United States have two or more risk factors (RF) for poor health. Controlling for other family factors, having more RFs is associated with poorer health status (i.e., percent reported "good/fair/poor" vs. "excellent/very good") and being higher risk for developmental delays. For example, the likelihood of having either poorer health or higher developmental risk increases with each RF (vs. zero): 1 RF (OR = 1.70, CI: 1.20-2.38), 2 RFs (OR = 3.28, CI: 2.27-4.73), 3 RFs (OR = 4.69, CI: 2.84-7.73), 4 RFs (OR = 14.58, CI: 4.98-42.64). Higher RFs were also associated with poorer health care access. CONCLUSIONS: This study demonstrates a dose-response relationship of higher risk profiles with poorer child health status and higher developmental risk. Because children with higher profiles of risk are also more likely to lack access to care, this suggests that children who most need care have the greatest difficulty obtaining it. Addressing health gradients for vulnerable children will require explicit attention to these multiple, overlapping risk factors.

Black or African American↗
PubMed1996

The feasibility of linking hospital and police road crash casualty records without names.

Government and other agencies routinely collect complementary information on road crash casualties and there may be opportunities to widen the scope of data available for research and policy evaluation if mechanisms can be established to combine these data sources. Where unit record data are available, direct links within and between individual records can often be achieved using record linkage techniques. Without the benefit of unique identifiers, sufficient other identifying information such as the full name, date of birth and sex of the casualty, their role in the crash and the date of the crash are required to enable correct links between individual records to be made. However, all these data items may not be available and it is therefore important to investigate the effect this may have on the quality and quantity of links between records. The research reported here used the hospital admission and police records from the Western Australian Road Injury Database, which had previously been linked using all the identifying characteristics mentioned above, special purpose software and comprehensive manual checking. This set of linked records were considered to be a "gold standard" which could be used to measure the quantity and quality of links produced using fewer identifying characteristics. Results from this process showed that about 90% of the original links could be identified when a phonetic code of the family name of the casualty was used with age, sex, road user type and crash date. However, only about 50% of the original links were found if linking was performed without using names or phonetic name codes.

Accidents, Traffic↗
PubMed1996

Fetal transfusion for red blood cell alloimmunization in pregnancy.

OBJECTIVE: To present an up-to-date review of the literature encompassing all important aspects of fetal transfusion for red blood cell alloimmunization in pregnancy. DATA SOURCES: A MEDLINE computer data base search was conducted for pertinent articles through August 1995. Additional publications were identified by cross-referencing. METHODS OF STUDY SELECTION: All pertinent references were reviewed by the authors, and their clinical significance in the fetal treatment of red blood cell alloimmunization was summarized. TABULATION, INTEGRATION, AND RESULTS: Fetal intraperitoneal transfusion in the treatment of severe red blood cell alloimmunization was first reported by Liley in 1963. Since then, major advancements have included intravascular techniques and fetal paralysis. A total of seven different approaches have been used. Case series describing fetal intravascular transfusion were reviewed, and outcomes were analyzed for all pregnancies and, separately, for those presenting with and without hydrops fetalis. Eighty-four percent of 411 fetuses that underwent intravascular transfusion had good outcomes. Ninety-four percent of nonhydropic fetuses and 74% of hydropic fetuses survived. Those with severe anemia but no hydrops at transfusion were five times more likely to survive than fetuses already hydropic. CONCLUSION: For pregnant patients presenting with severe red blood cell alloimmunization remote from term, fetal transfusion remains the best available therapeutic option. It is a safe procedure with a perinatal loss rate of approximately 1-3%, and overall neonatal survival exceeds 80%. It is the best available option until red blood cell alloimmunization can be prevented altogether.

Blood Circulation↗
PubMed1989

Current estimates of HIV prevalence and incidence: sources and data.

The acquired immune deficiency syndrome (AIDS) is in reality only the most severe manifestation of an aggregate of overlying and interacting smaller epidemics. Distribution of these epidemics in the population remains extremely variegated and localized, making assessment of HIV prevalence and incidence extremely difficult. Data from a wide range of population surveys does give an indication of the number of persons infected. A working estimate, based on mathematical modeling and expert consensus, is that 1-1.5 million persons in the United States are currently infected.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Susceptibility-weighted imaging and proton magnetic resonance spectroscopy in assessment of outcome after pediatric traumatic brain injury.

OBJECTIVE: To assess the role of magnetic resonance imaging, specifically magnetic resonance spectroscopy (MRS) and susceptibility-weighted imaging (SWI), in the evaluation of children with traumatic brain injury (TBI). DATA SOURCES: Literature review and data from our recently published clinical studies. STUDY SELECTION: Children with pediatric TBI who underwent SWI. SWI is a 3-dimensional high-resolution magnetic resonance imaging technique that is more sensitive in detecting hemorrhagic lesions seen with diffuse axonal injury (DAI) than conventional imaging. MRS acquires metabolite information that reflects neuronal integrity and function from multiple brain regions and offers early prognostic information regarding outcome. DATA EXTRACTION: Literature review. DATA SYNTHESIS: Literature review and review of recently published data from our institution. CONCLUSIONS: The data suggest that more sensitive imaging techniques that provide early evidence of injury and that are better predictors of outcome are needed to identify children at risk for such deficits. Specifically, the number and volume of hemorrhagic DAI lesions as well as changes in spectral metabolites such as reduced N-acetylaspartate or elevations in choline-related compounds correlate with neurologic disability and impairments of global intelligence, memory, and attention.

Aspartic Acid↗
PubMed2026

Applications of quantum AI in brain disorder diagnosis: A systematic review.

BACKGROUND AND OBJECTIVE: Brain disorder diagnosis and prediction remain challenging because neuroimaging, electrophysiological, behavioral, and multimodal data are high-dimensional, noisy, heterogeneous, and limited by small clinical cohorts. This systematic review synthesised applications of quantum artificial intelligence (QAI) for brain disorder diagnosis, prediction, detection, and monitoring. METHODS: Following PRISMA guidelines, studies published from 2016 to 13 January 2026 were retrieved from Scopus, Web of Science, and IEEE Xplore. After screening, 36 studies met the eligibility criteria and were qualitatively analysed according to disorder category, data modality, QAI method, implementation setting, validation strategy, and performance. RESULTS: At the broader disease-group level, neurodegenerative disorders were the most frequently investigated, followed by mental health and psychiatric disorders. At the individual level, Parkinson's disease and schizophrenia were the leading applications, followed by depression, anxiety, Alzheimer's disease, and stress-related tasks. MRI-based modalities were the most frequently used data source, followed by multimodal data and EEG. Methodologically, primary QAI approaches were dominated by quantum neural and QDL architectures, followed by quantum-inspired optimization or feature-selection methods and quantum-kernel/conventional QML classifiers. Qiskit/IBM Quantum and PennyLane were the most frequently reported quantum software frameworks. However, most studies relied on simulators, classical quantum-inspired implementations, or unclear implementation settings, with limited real-hardware evaluation. CONCLUSIONS: QAI shows emerging potential for brain disorder analysis, particularly through hybrid quantum-classical learning, quantum neural architectures, quantum-kernel methods, and quantum-inspired optimization. Nevertheless, current evidence remains preliminary and requires larger datasets, subject-level and external validation, fair classical benchmarking, noise-resilient circuits, real quantum hardware evaluation, explainability, and clinical validation.

Humans↗
PubMed2006

Trends in admissions to internal medicine wards in a community hospital in Israel.

BACKGROUND: Epidemiological studies are useful both for investigating possible etiologic factors and for determining the extent of health provisions required. In an attempt to improve the quality of care, we have analyzed the trends of admissions to the four internal medicine wards in a community hospital in Israel. METHODS: Data was collected on admission to all of the internal medicine wards of Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel, from 1999 to 2004, including discharge diagnosis, duration of stay, and mortality. The data source was the "Bina" data warehouse system of Clalit Health Services. RESULTS: The yearly admission rate was 10,482+/-386. Ninety-six percent of the admissions were of Jews and 3% were of Arabs. Most of the patients were older than 75 years (43.1%); 23.6% were between 65 and 74 years of age. The readmission rate was 7.4% within 1 week and 16.3% within 1 month. The three most common discharge diagnoses, not including pre-existing illnesses, were: coronary artery disease-related (21.9%), heart failure (5.4%), and pneumonia (5.6%). The average duration of stay was 4.6+/-0.1 days. Patients admitted for newly diagnosed malignancy, pneumonia, or CVA had a longer duration of stay (7.1, 6.8, and 6.5 days, respectively). There was a steady decline in mortality from 4.5% in 1999 to 4.2% in 2004. CONCLUSION: In the 5-year period studied, there was a changing trend in mortality rate, hospital duration rate, and patient age.

Journal Article↗
PubMed2005

Stochastic analysis to assess the spatial distribution of groundwater nitrate concentrations in the Po catchment (Italy).

A large database including temporal trends of physical, ecological and socio-economic data was developed within the EUROCAT project. The aim was to estimate the nutrient fluxes for different socio-economic scenarios at catchment and coastal zone level of the Po catchment (Northern Italy) with reference to the Water Quality Objectives reported in the Water Framework Directive (WFD 2000/60/CE) and also in Italian legislation. Emission data derived from different sources at national, regional and local levels are referred to point and non-point sources. While non-point (diffuse) sources are simply integrated into the nutrient flux model, point sources are irregularly distributed. Intensive farming activity in the Po valley is one of the main Pressure factors Driving groundwater pollution in the catchment, therefore understanding the spatial variability of groundwater nitrate concentrations is a critical issue to be considered in developing a Water Quality Management Plan. In order to use the scattered point source data as input in our biogeochemical and transport models, it was necessary to predict their values and associated uncertainty at unsampled locations. This study reports the spatial distribution and uncertainty of groundwater nitrate concentration at a test site of the Po watershed using a probabilistic approach. Our approach was based on geostatistical sequential Gaussian simulation used to yield a series of stochastic images characterized by equally probable spatial distributions of the nitrate concentration across the area. Post-processing of many simulations allowed the mapping of contaminated and uncontaminated areas and provided a model for the uncertainty in the spatial distribution of nitrate concentrations.

Agriculture↗
PubMed2005

Residential instability in socioeconomically deprived neighbourhoods, good or bad?

Previously, both positive and negative effects of residential instability on various health outcomes have been described. The present study tests these effects in a European context, using two different data-sources (1) neighbourhood level data on socioeconomic deprivation and residential instability, and (2) individual-level community survey data to assess quality of life. Multilevel regression analyses showed that socioeconomic deprivation was negatively associated with several dimensions of quality of life, in stable neighbourhoods, while no such effect was observed in average or unstable neighbourhoods. Thus, when accounting for interaction effects, residential instability appeared to protect against negative effects of neighbourhood poverty and, therefore, may be beneficial for residents' quality of life.

Adult↗
PubMed2005

Impact of school-based health centers on children with asthma.

PURPOSE: To quantitatively assess the impact of school-based health centers (SBHCs) on hospitalization and emergency department (ED) visits for children with asthma. METHODS: The study was conducted at four SBHC intervention school districts and two comparable non-SBHC school districts in Greater Cincinnati, Ohio. A longitudinal quasi-experimental time-series repeated measures design was used with a study period from 1997 to 2003. Children with asthma with at least 2 years of continuous enrollment who had medical claims for asthma diagnosis and antiasthmatic medications were selected. The primary data sources were student enrollment data from the schools and the Ohio Medicaid claims database. Generalized estimating equation (GEE) analysis and analysis of covariance were used to assess the intervention effect before and after the SBHC program. RESULTS: Asthma was one of the major diseases for SBHC encounters. Major prescription drugs that SBHC staff managed for children with asthma included albuterol, montelukast, fluticasone, budesonide, and triamcinolone. Of 273 children (196 in SBHC schools and 77 in non-SBHC schools), 42% were female, 41.7% African-Americans, and the average age was 8.2 years. After the opening of the SBHC, relative risks of hospitalization and ED visits in the SBHC group decreased 2.4-fold and 33.5%, respectively. The cost of hospitalization per child decreased significantly over time for children in SBHC schools (F = 4.115, p = .044). After SBHCs opened, cost of hospitalization decreased for African-American children (F = 5.198, p = .023). Costs of ED visits for children in SBHC schools were significantly lower than children in non-SBHC schools (F = 19.8, p < .0001). CONCLUSIONS: The risk of hospitalization and ED visits for children with asthma decreased significantly with SBHC programs. The potential cost-savings for hospitalization was estimated as 970 dollars per child.

Anti-Asthmatic Agents↗
PubMed2004

Comparison of a commercially available clinical information system with other methods of measuring critical care outcomes data.

PURPOSE: To compare the quality of data recorded by a commercially available clinical information system (CIS) to other commonly used methods for obtaining large amounts of patient data. MATERIALS AND METHODS: Five sets of clinical patient data were chosen as a cross-section of all the data collected by a CIS in our intensive care unit (ICU): 1) Length of stay in the ICU, 2) Vital signs, 3) Days of mechanical ventilation, 4) medications, and 5) diagnoses. Data generated by our ICU CIS was compared with other parallel data sets commonly used to obtain the same data for clinical research. RESULTS: When compared with our CIS, the hospital database recorded a length of stay at least 1 day longer than the actual length of stay 53% of the time. A search of 139,387 sets of vital signs showed less than 0.1% rate of suspected artifact. When compared to direct observation, our CIS correctly recorded days of mechanical ventilation in 23 of 26 patients (88%). Two other data sets, medical diagnoses and medications given showed significant differences with other commonly used databases of the same information collected outside the ICU (billing codes and pharmacy records respectively CONCLUSIONS: Compared to other commonly used data sources for clinical research, a commercially available CIS is an acceptable source of ICU patient data.

Decision Support Systems, Clinical↗
PubMed2003

Quality assurance experience with the randomized neuropathic bone pain trial (Trans-Tasman Radiation Oncology Group, 96.05).

BACKGROUND AND PURPOSE: Trans-Tasman Radiation Oncology Group 96.05 is a prospective randomized controlled trial comparing a single 8 Gy with 20 Gy in five fractions of radiotherapy (RT) for neuropathic pain due to bone metastases. This paper summarizes the quality assurance (QA) activities for the first 234 patients (accrual target 270). MATERIALS AND METHODS: Independent audits to assess compliance with eligibility/exclusion criteria and appropriateness of treatment of the index site were conducted after each cohort of approximately 45 consecutive patients. Reported serious adverse events (SAEs) in the form of cord/cauda equina compression or pathological fracture developing at the index site were investigated and presented in batches to the Independent Data Monitoring Committee. Finally, source data verification of the RT prescription page and treatment records was undertaken for each of the first 234 patients to assess compliance with the protocol. RESULTS: Only one patient was found conclusively not to have genuine neuropathic pain, and there were no detected 'geographical misses' with RT fields. The overall rate of detected infringements for other eligibility criteria over five audits (225 patients) was 8% with a dramatic improvement after the first audit. There has at no stage been a statistically significant difference in SAEs by randomization arm. There was a 22% rate of RT protocol variations involving ten of the 14 contributing centres, although the rate of major dose violations (more than +/-10% from protocol dose) was only 6% with no statistically significant difference by randomization arm (P=0.44). CONCLUSIONS: QA auditing is an essential but time-consuming component of RT trials, including those assessing palliative endpoints. Our experience confirms that all aspects should commence soon after study activation.

Bone Neoplasms↗
PubMed1989

Farm equipment injuries in a rural county, 1980 through 1985: the emergency department as a source of data for prevention.

Incidence rates of injury related to farm machinery were estimated for Athens County, Ohio, using data generated as part of the National Electronic Injury Surveillance System (NEISS) of the Consumer Product Safety Commission. The study period was 1980 through 1985. The service area of the principal hospital in the county, which participates in NEISS, closely approximates the population of the county. The population of the entire county and the rural farm population, based on US Census data, were used as denominators in calculation of rates. There were 147 injuries related to farm machinery over a six-year period, 14 of which were coded as occupational. One hundred twelve (84.2%) of these injury victims were men. The annual incidence rate per 1,000 rural farm resident population was 25.6 per 1,000 for children under the age of 14 years and was 55.6 per 1,000 for adults age 25 to 34 years. Annual rates for adults age 35 and up ranged from 13 to 19 per 1,000 rural farm residents. The annual number of tractor rollover injuries decreased during this study period, while the annual numbers of other tractor injuries did not change. Hospital emergency department visits can be used to document the need for and to evaluate injury prevention measures.

Accidents, Occupational↗
PubMed2005

[Systematic review of group educational interventions in type-2 diabetes patients].

OBJECTIVES: To evaluate the effect of group educational interventions in type-2 diabetes patients. To analyse what kind of group intervention has the best long-term effects. DESIGN: Systematic review. DATA SOURCES: Review of electronic data bases: CENTRAL, MEDLINE, EMBASE, CINAHL, and PASCAL, and of the bibliographic references of the studies selected. Contacts with experts to locate non-published articles. Selection of studies. Randomised clinical studies with controls and quasi-experimental studies that evaluate group education interventions aimed at type-2 diabetes patients over 18 years old. These interventions were of any length and in any context, and their target was to improve quality of life, self-control, or metabolic control. The comparison group included individual educational interventions and non-interventions. VARIABLES RESULT: Quality of life, self-control, and diabetes control (HbA1c, cholesterol, triglycerides, blood pressure, and smoking). REVIEW METHODS: Trial selection by 3 groups with 3 researchers in each, who independently reviewed headings, abstracts and key words of all the identified trials to decide on their eligibility. The quality of trials was evaluated by the criteria defined by the Cochrane Metabolic and Endocrine Disorders Group. Researchers assessed the articles independently; and discrepancies were resolved by discussion and consensus.

Diabetes Mellitus, Type 2↗
PubMed1998

Firearm-related injury surveillance in California.

CONTEXT: Although firearms are the leading cause of injury death in California, no staff resources were devoted to surveillance of firearm-related injuries until 1995, when The California Wellness Foundation funded the Firearm Injury Surveillance Program (FISP). OBJECTIVE: To develop and evaluate surveillance of serious firearm-related injuries and risk factors. DESIGN: Passive surveillance using several data sources: death records, homicide data, hospital discharge data, and Behavioral Risk Factor Surveys. To evaluate FISP, we follow the Centers for Disease Control and Prevention's Guidelines for Evaluating Surveillance Systems. SETTING: State of California. PARTICIPANTS: California Department of Health Services, Epidemiology and Prevention for Injury Control Branch. MAIN OUTCOME MEASURES: Deaths and hospitalizations resulting from firearm-related injuries and presence and storage of firearms in the home. We evaluated FISP's utility, simplicity, flexibility, acceptability, representativeness, and timeliness. RESULTS: Firearm-related injuries were the leading cause of death among children as young as 13 or 14 years of age. In 1994, more than 13,000 California residents died or were hospitalized as a result of firearm-related injuries. Except among whites, most of these serious firearm-related injuries were from assaults. The predominance of handguns as murder weapons increased with time and was more marked among younger and racial/ethnic minority victims. FISP provides data needed for setting policy and preventing firearm-related injuries. The system is acceptable and represents the serious firearm-related injury problem well, but lacks flexibility, timeliness, and detail. CONCLUSIONS: Despite the limitations inherent in passive surveillance, FISP serves many of our surveillance needs well.

Adolescent↗
PubMed1998

[Cholinesterases].

OBJECTIVE: To review current data on butyrylcholinesterase. DATA SOURCES: Search through Medline data bases of articles in French or English. STUDY SELECTION: Original articles and case reports were selected. Letters to editor were excluded. DATA EXTRACTION: The articles were analyzed in order to obtain current data on biochemical structure, action, major pathological variations, especially with regard to the recent informations obtained by molecular biology concerning the identification of genetic variants. DATA SYNTHESIS: Butyrylcholinesterase must be differentiated from acetylcholinesterase, which cannot hydrolyse succinylcholine. The physiological action of butyrylcholinesterase remains unknown, although it can hydrolyse many drugs. Excluding genetical mutations, several physiopathological situations alter butyryl-cholinesterase activity. Butyrylcholinesterase activity assessment does not allow the diagnosis of genetic variants. Whatever the origin, only deficits of more than 50% modify significantly the metabolism of succinylcholine or mivacurium. The diagnosis of a prolonged neuromuscular blockade is obtained with systematic monitoring of the neuromuscular function in case of administration of mivacurium or succinylcholine. Mivacurium should only be re-injected when one response at train of four is obtained. In case of prolonged neuromuscular blockade, the anticholinesterasic agent should not be administered when no response at train of four is obtained. The biochemical methods using inhibitors (dibucaine, fluoride) of the butyrylcholinesterase and a familial study lead to the diagnosis in most cases because the atypical and fluoride variants are the most frequent. When results are doubtful, genetic molecular methods with the use of PCR and restriction enzymes allow a rapid diagnosis.

Acetylcholinesterase↗
PubMed2003

Uses and sources of data on long-term survival after blood transfusion.

Several public policy decisions in transfusion medicine require information on the long-term (> or =10-year) survival of transfused patients. This information is needed (1) to estimate the number of surviving transfusion recipients who have contracted a particular infection through transfusion, (2) to assess the cost-effectiveness of measures introduced to further improve the safety of the allogeneic blood supply, (3) to estimate the total anticipated number of transfusion-transmitted cases of disease when a novel transfusion-transmitted infection with a long incubation period emerges, and (4) determine the scope of any proposed lookback investigation in terms of the length of time that should be covered retrospectively by the lookback effort. Although the probabilities of survival of Olmsted County, MN, residents transfused in 1981 were often used previously when input data on long-term posttransfusion survival were needed in the United States, these data most likely do not reflect the survival of patients transfused in the 1990s. Recent data from Sweden, Northern England, and New York City suggest that the short-term (up to 5 years posttransfusion) probabilities of survival reported from Olmsted County may have to be reduced by up to 20% before they can be used for making public policy decisions in the future, and that probabilities of survival of 66%, 60%, and 47%, respectively, at 1, 2, and 5 years posttransfusion may reflect the life expectancy of subjects transfused in the 1990s. No empirical data on the 10-year probability of survival of such patients are currently available from population-based studies, but some data suggest that the 10-year survival of an unselected population transfused in 1988 to 1990 may be 40%. A population-based study that includes several US counties has to be undertaken to generate the information needed for public policy decisions in the future.

Blood Transfusion↗
PubMed1998

Streptomyces species isolated from potato scabs in France: numerical analysis of "Biotype-100" carbon source assimilation data.

Thirty one strains of Streptomyces isolated from common and netted scabs in France were characterized using "Biotype-100" strips and 14 conventional tests. Numerical analysis showed that S. scabiei was the single causal agent of common scab in France. However the strains clustered among S. scabiei were phenotypically heterogeneous, since 3 subphenons were delineated. The strains clustered in subphenons 1a and 1c and one strain of subphenon 1b were associated with common scab. On the other hand, a group of strains clustered in phenon 2, distinct from S. scabiei, S. acidiscabies and S. caviscabies, was often associated with symptoms of netted scab. None of the French strains thus far pathogenic to potato belonged to the already described species S. acidiscabies and S. caviscabies from Japan and North America. Phenotypic characteristics clearly differentiated all the various groups of strains described.

Bacterial Typing Techniques↗