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At least 163 records · Page 9Linked to original sources

An algorithm for MR angiography image enhancement.

This study describes a three-dimensional (3D) filtering algorithm for magnetic resonance angiography (MRA) image enhancement. Based on the properties of 3D MRA data, the algorithm uses the dispersion range of the 13 outputs of a 3D directional low-pass filter bank to identify the vessel structure and control the processing of MRA data. Vascular structures in the data are preserved while the components of static tissues and isolated noise impulses are reduced by the processing. As a result, the small vessels have been enhanced and visibility of vessels in the projected image has been improved.

Algorithms↗

[Microsatellite DNA analysis as a tool for forensic paternity testing (DNA paternity testing)].

UNLABELLED: MICROSATELLITE ANALYSIS: By using serological or HLA-testing, the alleged father can be excluded as the biological father, but, regardless of the degree of probability, positive paternity results cannot be obtained without DNA testing. According to the results of the National Human Genome Project, human genome consists of approximately 30.000 genes. The vast majority of human DNA is not organized in genes and has no genetic expression or visible function. Non-coding DNA contains genetic markers important for human identification. Short tandem repeats, or STRs, are a class of microsatellites consisting of tandemly repeated sequences of 2 to 6 base pair length monomers. Most of the microsatellites show a high degree of polymorphism, which can be evaluated by PCR technique, and used in criminalistics, forensic identification and parentage testing. A source of DNA in parentage testing are blood samples or buccal swabs which are routinelly used. Amplification of isolated DNA can be performed in 25-30 cycles by PCR, and fragments are separated by capillary electrophoresis. CONCLUSION: The probability of paternity of 99.99% or higher corresponds to the paternity "practically proven", indicating that the alleged father is the biological father. Such results can be obtained only by DNA testing. DNA-testing laboratories are required to conduct validation of laboratory facilities, equipment and staff and are subject to permanent control by the society.

DNA↗

Intrinsic dual-energy processing of myocardial perfusion images.

UNLABELLED: We have developed a software-based method for processing dual-energy 201TI SPECT emission projection data with the goal of calculating a spatially dependent index of the local impact of gamma-ray attenuation. We refer to this method as intrinsic dual-energy processing (IDEP). METHODS: IDEP exploits the differential attenuation of lower energy emissions (69-83 keV) and higher energy emissions (167 keV) resulting from the decay of 201TI to characterize the relative degree of low-energy gamma-ray attenuation throughout the myocardium. In particular, IDEP can be used to estimate the relative probability that a low-energy gamma-ray emitted from a particular region of the myocardium is detected during the acquisition of SPECT projection data. Studies on phantoms and healthy human volunteers were performed to determine whether the IDEP method yielded detection probability images with systematic structure visible above the noise of these images and whether the systematic structure in the detection probability images could be rationalized physically. In patient studies, the relative regional detection probabilities were applied qualitatively to determine the likely effects of attenuation on the distribution of mapped photon emissions. RESULTS: Measurements of the detection probability in uniform phantoms showed excellent agreement with those obtained from computer simulations for both 180 degrees and 360 degrees acquisitions. Additional simulations with digital phantoms showed good correlation between IDEP-estimated detection probabilities and calculated detection probabilities. In patient studies, the IDEP-derived detection probability maps showed qualitative agreement with known nonuniform attenuation characteristics of the human thorax. When IDEP data were integrated with the findings on the emission scan, the correlation with coronary anatomy (known in 6 patients and hypothesized on the basis of clinical and electrocardiographic parameters in 5 patients) was improved compared with evaluating the mapped emission image alone. CONCLUSION: The IDEP method has the potential to characterize the attenuation properties of an object without use of a separate transmission scan. Coupled with the emission data, it may aid coronary diagnosis.

Aged↗

Advanced practice nurses: a study of client satisfaction.

PURPOSE: To describe the satisfaction of clients with care provided by advanced practice nurses (APNs) in the Wright State University (WSU) Pilot Project. The Pilot Project was created through state legislation that recognized APNs associated with three universities in Ohio for the purpose of granting the APNs title protection, prescriptive authority, and recognition leading to reimbursement. DATA SOURCES: The Interactional Model of Client Health Behavior (Cox, 1982), which proposes that client characteristics and interactions with health professionals determine health outcomes, served as the framework for this descriptive study. The study measured client (n = 506) satisfaction with care delivered by 36 APNs at 26 different practice sites using an adapted Client Satisfaction Tool (CST). The internal consistency of the adapted CST was 0.935. CONCLUSIONS: Client (n = 506) satisfaction scores ranged from 28 to 50, with a mean score of 47.15 (SD = 4.00). Findings suggest that clients are very satisfied with APNs in the WSU Pilot Project. IMPLICATIONS FOR NURSING PRACTICE: Client satisfaction is one indicator used to determine quality of care. Consumer satisfaction benefits the individual client and provides important information for the health care payer. Measuring and reporting client satisfaction with care provided by APNs may increase the visibility and marketability of APNs.

Humans↗

[Environmental health promotion in municipalities--resources, organization and activities].

The Municipal Health Services Act with amendments from 1988 defines environmental health promotion activities directed at physical, chemical, biological and social factors as mandatory for the local Norwegian health authorities. In addition, the municipal health services are responsible for health surveillance and for initiating cross-sectorial preventive measures. In 1991, we undertook a national survey among the Norwegian municipal health services to monitor planning activities, manpower resources, cross-sectorial cooperation, and project-oriented activities within the field of environmental health promotion. Less than one-third of the municipalities employed technically trained hygienic personnel. However, three of four municipalities had carried out some environmental health promotion projects within the last two years. The following factors were all independently related to level of environmental health promotion activity: the availability of technical assistance, the level of cross-sectorial cooperation and the size of the population in the municipality. We conclude that this area of health promotion should be improved by better planning, a higher level of technical hygienic competence within the municipal health services, more inter-sectorial cooperation and greater emphasis on visible projects of limited duration.

Environmental Health↗

[HIV/AIDS competence network research group presents first results].

Germany's clinical HIV research efforts are underrepresented on an international level. This deficit is primarily due to a lack of clinical studies involving patients from across the country and the fact that no national patient cohort system exists in Germany which could provide a basis for such clinical studies. The competence network HIV/AIDS is filling this shortcoming by serving as a comprehensive, nationwide research alliance. The establishment of a patient cohort is linked to 20 projects. The success of this new structure is becoming visible.

Acquired Immunodeficiency Syndrome↗

Reflective topical autobiography: an under utilised interpretive research method in nursing.

Reflective topical autobiography (an autobiographical method) belongs to the genre of testimonial research and is located within the postpositivist interpretive research paradigm. Despite the (reflective) topical autobiographical method enjoying a 'rebirth' in recent years and being utilised by a range of researchers in the human and literary disciplines, it remains largely unknown and under utilised in nursing research domains. In this article it is proposed that reflective topical autobiography is an important research method in its own right, and one which promises to make a substantive contribution to the overall project of advancing nursing inquiry and knowledge. This is particularly so where nursing research shares in the affirming projects of interpretive research generally and the relatively new sociology of the emotions in particular apropos: (i) increasing understanding of subjectivity and making subjective experiences more visible and intelligible, (ii) the search for meaning and increasing understanding of the commonality of existential human experience, and (iii) decentring the detached observer and his/her privileging the objectivist illusion in the hierarchy of research discourses, paving the way for the admission of multiple realities and interpretations of lived experience. In this article, a coherent reflective topical autobiographical research method is advanced for use in nursing education and research contexts.

Autobiographies as Topic↗

Reversal of photodamage with topical growth factors: a pilot study.

BACKGROUND: Interest in the reversal of facial photodamage has increased significantly among patients and physicians in the past decade. Though surgical procedures may be very effective, the associated healing time and potential risks have spurred the development of non-surgical treatments. There has also been an increasing depth of knowledge regarding wound healing and its control by growth factors as well as its modulation by the topical application of growth factors. Bioengineered tissue cultures have resulted in the ability to collect naturally occurring human growth factors in their tissue concentrations. OBJECTIVE: The objective of this study is to determine if the twice daily application of a combination of multiple growth factors to photodamaged facial skin results in any evidence of improvement after 60 days. METHODS: Fourteen patients applied a gel containing a mixture of eight different growth factors (Nouricel-MD) to photodamaged facial skin twice daily. Prior to the study and at days there were clinical evaluations of photodamage (Fitzpatrick scale), 3 mm punch biopsies and optical profilometry. Patient questionnaires were answered at 60 days. RESULTS: Eleven of 14 patients showed clinical improvement in at least one facial area. The peri-orbital region showed a statistically significant improvement (p = 0.0003). Optical profilometry showed a statistically significant reduction in Ra measurement (p=0.0075) and shadowing (p=0.02), both indicating a decrease in the depth and number of textural irregularities or fine lines. Biopsies revealed new collagen formation in the Grenz zone (37% increase in thickness) and thickening of the epidermis by 27%. Eight of 14 patients felt their wrinkles were improved, while 12 of 14 felt their skin texture was improved. CONCLUSIONS: The application of a mixture of topical growth factors may stimulate the repair of facial photodamage resulting in new collagen formation, epidermal thickening and the clinical appearance of smoother skin with less visible wrinkling.

Biopsy↗

Bisensory augmentation: a speechreading advantage when speech is clearly audible and intact.

Reisberg, McLean, and Goldfield (1987) have shown that vision plays a part in the perception of speech even when the auditory signal is clearly audible and intact. Using an alternative method the present study replicated their finding. Clearly audible spoken messages were presented in audio-only and audio-visual conditions, and the adult participants' resulting comprehension was measured. Stories were presented in French (Expt 1), in a Glaswegian accent (Expt 2), and by presenting spoken information that was semantically and syntactically complex (Experiment 3). Three separate groups of 16 adult female participants aged 19-21 participated in the three experiments. In all three experiments, comprehension improved significantly when the speaker's face was visible.

Acoustic Stimulation↗

Ambulatory care pharmacy services: has the agenda changed?

OBJECTIVE: To provide an extensive review of ambulatory care clinical pharmacy services and evaluate the services and research data in the field. DATA SOURCES: MEDLINE was searched from January 1992 through July 1999. Search terms included pharmacy, clinical pharmacy, and pharmaceutical care, cross-referenced with ambulatory care, primary care, family medicine, and managed care. STUDY SELECTION: Relevant peer-reviewed studies and reports since our previous article in 1992 were selected and described. Literature prior to 1992 was briefly reviewed. DATA SYNTHESIS: The relevant literature was reviewed and some examples from the authors' institutions are provided. Much research has continued to be published documenting the value of clinical pharmacy services in ambulatory care, including in community pharmacy, anticoagulation services, family medicine, primary care clinics, Veterans Affairs Medical Centers, and managed care. However, these innovative services are underrepresented in the community at large. The vast majority of the public does not have access to these types of services. CONCLUSIONS: There will be continued and dramatic expansion of ambulatory care pharmacy services in the new decade beginning in the year 2000. It will be critical that standards of practice be very high. We believe there is a critical need for visible demonstration projects and large multicenter research projects that demonstrate the value of these services.

Ambulatory Care Facilities↗

Visibility of trabecular structures in oral radiographs.

OBJECTIVES: To determine whether alveolar trabecular bone is visible and quantifiable in projection radiographs. Radiographic changes in oral trabecular bone have been studied as possible indications of bone loss, but in some previous studies, observed structures have been attributed entirely to the endosteal surface. METHODS: Computed radiography (CR) images of human mandibles in molar and pre-molar regions were compared with simulations calculated from high-resolution computed-tomography (CT) and micro-CT volumes. By digitally editing the CT volumes, the simulations were separated into trabecular and cortical components. High-pass-filtered CR images revealed structural details of cortical and trabecular bone. RESULTS: Trabecular bone constitutes as much as 38% of the total alveolar bone, and accounts for most of the observed alveolar fine structure. Several morphological types of fine structure can be distinguished. The noise in filtered images appears to be a meaningful measure of trabecular bone. CONCLUSION: Trabecular bone is highly visible in intraoral radiographs.

Alveolar Process↗

Dermatofibrosarcoma protuberans of the vulva. A case report.

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a cutaneous malignancy that is uncommon anywhere on the body but is especially uncommon on the vulva. This cancer rarely metastasizes but has a high incidence of local recurrence because of its tendency to grow in fingerlike projections away from the primary tumor. CASE: A 36-year-old, black woman was the 10th and youngest patient with DFSP of the vulva to be reported. Treatment of the 5-cm, mobile, well-circumscribed lesion consisted of local excision. Several adjacent microscopic lesions showing DFSP were found in the pathologic specimen, however, so an even wider excision was performed. Twenty-seven months following removal, there was no evidence of recurrence. CONCLUSION: Survival rates for DFSP of the skin range from 91% to 100% in reported series, but local recurrence rates of 20-49% have also been noted. The reported deaths from the disease have resulted from extensive local spread due to inadequate excision and, only rarely, metastases. Because DFSP tends to spread to microscopic projections away from the visible lesions, very wide local excision is required for tumor control.

Adult↗

Removal of MAP4 from microtubules in vivo produces no observable phenotype at the cellular level.

Microtubule-associated protein 4 (MAP4) promotes MT assembly in vitro and is localized along MTs in vivo. These results and the fact that MAP4 is the major MAP in nonneuronal cells suggest that MAP4's normal functions may include the stabilization of MTs in situ. To understand MAP4 function in vivo, we produced a blocking antibody (Ab) to prevent MAP4 binding to MTs. The COOH-terminal MT binding domain of MAP4 was expressed in Escherichia coli as a glutathione transferase fusion protein and was injected into rabbits to produce an antiserum that was then affinity purified and shown to be monospecific for MAP4. This Ab blocked > 95% of MAP4 binding to MTs in an in vitro assay. Microinjection of the affinity purified Ab into human fibroblasts and monkey epithelial cells abolished MAP4 binding to MTs as assayed with a rat polyclonal antibody against the NH2-terminal projection domain of MAP4. The removal of MAP4 from MTs was accompanied by its sequestration into visible MAP4-Ab immunocomplexes. However, the MT network appeared normal. Tubulin photoactivation and nocodazole sensitivity assays indicated that MT dynamics were not altered detectably by the removal of MAP4 from the MTs. Cells progressed to mitosis with morphologically normal spindles in the absence of MAP4 binding to MTs. Depleting MAP4 from MTs also did not affect the state of posttranslational modifications of tubulin subunits. Further, no perturbations of MT-dependent organelle distribution were detected. We conclude that the association of MAP4 with MTs is not essential for MT assembly or for the MT-based functions in cultured cells that we could assay. A significant role for MAP4 is not excluded by these results, however, as MAP4 may be a component of a functionally redundant system.

Animals↗

Ensuring quality Website redesign: the University of Maryland's experience.

The Web Redesign Committee at the Health Sciences and Human Services Library (HS/HSL) of the University of Maryland was formed to evaluate its site and oversee the site's redesign. The committee's goal was to design a site that would be functional, be usable, and provide the library with a more current image. Based on a literature review and discussions with colleagues, a usability study was conducted to gain a better understanding of how the Website was used. Volunteers from across the campus participated in the study. A Web-based survey was also used to gather feedback. To complement user input, library staff were asked to review the existing site. A prototype site was developed incorporating suggestions obtained from the evaluation mechanisms. The usability study was particularly useful because it identified problem areas, including terminology, which would have been overlooked by library staff. A second usability study was conducted to refine the prototype. The new site was launched in the spring of 2000. The usability studies were valuable mechanisms in designing the site. Users felt invested in the project, and the committee received valuable feedback. This process led to an improved Website and higher visibility for the library on campus.

Computer Communication Networks↗

Planning and drawing complex shapes.

Arm and hand movements are generally controlled using a combination of sensory-based and memory-based guidance mechanisms. This study examined similarities and differences in visually-guided and memory-guided arm movements, and sought to determine as to what extent certain control principles apply to each type of movement. In particular, the 2/3 power law is a principle that appears to govern the formation of complex, curved hand trajectories; it specifies that the tangential velocity should be proportional to the radius of curvature raised to an exponent of 1/3. A virtual reality system was used to project complex target paths in three-dimensional (3D) space. Human subjects first tracked (with the tip of a handheld pen) a single target moving along an unseen path. The entire target path then became visible and the subject traced the shape. Finally, the target shape disappeared and the subject was to draw it, in the same 3D space, from memory. Most aspects of the movements (speed, path size, shape and arm postures) were very similar across the three conditions. However, subjects adhered to the 2/3 power law most closely in the tracing condition, when the entire target path was visible. Also, only within the tracing condition, there were significant differences in the value of the exponent depending on the size and the spatial orientation of the trajectory. In the tracking and drawing conditions, the exponent was greater than 1/3, indicating that subjects spent more time in areas of tight curvature. This may represent a strategy for learning and remembering the complex shape.

Adult↗

Significance of a visible major fissure on the frontal chest radiograph.

In this series of 80 patients, five factors are found to contribute to a visible major fissure. Volume changes in either the lower or upper lobes may cause fissural rotation from a coronal to a sagittal plane (26 patients). An incomplete or variant fissure with fluid abutting it (20 patients), or combinations of these factors (16 patients) will make the fissure visible. With either an incomplete fissure or a normal fissure in variant position, pleural thickening (seven patients) or adjacent consolidation (five patients) may make it possible to see the fissure. In normal patients, due to variation in fissural course, the fissure may be visible (six patients). In all of these situations, technical factors such as the divergent beam, position (lordotic), or projection (anteroposterior), may have contributory roles.

Humans↗