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PubMed2003

[Outpatient geriatric rehabilitation: an evaluation of two models assessing trends of medical outcomes].

In Germany, complex and intensified outpatient geriatric rehabilitation is currently scarcely practised, mainly in model projects. The evaluation of these projects is exclusively conducted in uncontrolled studies. In our project "AMBRA", two different organisational models of geriatric rehabilitation are compared: a mobile rehabilitation team based at a geriatric hospital department and an outpatient rehabilitation centre run by GPs trained in geriatrics. Outcomes were assessed in terms of capability of self-care (Barthel-Index), mobility (Tinetti-Test, Timed "Up & Go"-Test, TUG), and depression (Geriatric Depression Scale, GDS). They were documented at three points in time (start of rehabilitation, end of rehabilitation, 6 months after end of rehabilitation) and analysed by multivariate analyses of variance (repeated measurements). 162 complete patients histories were taken in the first 18 months of the project. They show significant improvements in capability of self-care and mobility (both Tinetti-Test and TUG) between the beginning and the end of rehabilitation (adjusted for age, sex, cognitive function, diagnosis, rehabilitation model). On a medium-term basis, these results remained stable (TUG declined, however). Average GDS values did not change significantly. There were no significant sex- or age-related effects. The patients' cognitive function influenced changes in the results of the Barthel-Index and the Tinetti-Test. Patients with skeletal diseases showed less favourable trends in the Barthel-Index as did patients with cognitive impairments caused by vascular disease in the TUG, but these patients also benefited in the course of the model rehabilitation procedures. Differences in trends between patient groups of the two models were observed in the Barthel-Index. 96 % of patients previously living at home were still living there at the end of rehabilitation, 91 % were still living there 6 months after the end of rehabilitation. At the end of rehabilitation, 67 % of patients described an improvement of their personal situation associated with the rehabilitation procedure. Six months later, 82 % described an improvement or a stabilisation of their personal situation. Our results show positive medium-term rehabilitation trends concerning medical and subjective outcomes. In order to analyse effectiveness, we will have to wait for the results of a regional control group which is being recruited.

Activities of Daily Living↗
PubMed2006

Exogean: a framework for annotating protein-coding genes in eukaryotic genomic DNA.

BACKGROUND: Accurate and automatic gene identification in eukaryotic genomic DNA is more than ever of crucial importance to efficiently exploit the large volume of assembled genome sequences available to the community. Automatic methods have always been considered less reliable than human expertise. This is illustrated in the EGASP project, where reference annotations against which all automatic methods are measured are generated by human annotators and experimentally verified. We hypothesized that replicating the accuracy of human annotators in an automatic method could be achieved by formalizing the rules and decisions that they use, in a mathematical formalism. RESULTS: We have developed Exogean, a flexible framework based on directed acyclic colored multigraphs (DACMs) that can represent biological objects (for example, mRNA, ESTs, protein alignments, exons) and relationships between them. Graphs are analyzed to process the information according to rules that replicate those used by human annotators. Simple individual starting objects given as input to Exogean are thus combined and synthesized into complex objects such as protein coding transcripts. CONCLUSION: We show here, in the context of the EGASP project, that Exogean is currently the method that best reproduces protein coding gene annotations from human experts, in terms of identifying at least one exact coding sequence per gene. We discuss current limitations of the method and several avenues for improvement.

Amino Acid Sequence↗
PubMed1992

Scan time reduction in snapshot FLASH MRI.

We describe the speeding up of snapshot FLASH MRI by placing a slice selection experiment before the whole imaging sequence. In conventional snapshot FLASH slice selection is made in every projection, thus consuming a great deal of experimental time. This problem can be overcome by applying only one slice-selective procedure before starting the imaging. The idea is to make a selective saturation of the outer volume and to interrogate the unaffected slice by a train of rapid, hard, low-angle pulses. By this new method the measuring times of snapshot FLASH can be further reduced.

Abdomen↗
PubMed2005

[Networking and integrated disease management. Advantages and disadvantages from the medical point of view].

At the moment the terms "networking", "cost reduction" and "integrated disease management" are frequently discussed in all branches of the German health care system. Unfortunately there are different interpretations of these terms. "Integrated disease management" in the meaning of communication between clinical and outpatient health care has al ready existed for years now. Traditional ways of communication lead to information loss. Losing information is a reason for low cost effectiveness and a prolonged healing process directly harming the patient. A computer network may prevent information loss and may in crease the performance of data transfer. Different sides have al ready started networking, and it is now necessary to bundle the interests. This necessity has been recognized by the German legislative. To lead this project to success it is important to know and to fulfil some medical criteria. Defining and describing these conditions is the topic of this paper. Our special intent is to show that digital technique is necessary to improve cooperation among physicians.

Computer Communication Networks↗
PubMed1987

Recovery of regenerating goldfish retinal ganglion cells is slowed in the absence of the topographically correct synaptic target.

When the axons of goldfish retinal ganglion cells are severed the cell bodies undergo a series of changes as the axons regenerate. These changes begin to reverse when the axons start to innervate the tectum and by 3 months after the lesion the cell bodies have nearly returned to normal. When the axons projecting to the caudal tectum were severed by a mediolateral transection of the tectum, only retinal ganglion cells in the nasal portion of the contralateral retina underwent the changes normally associated with regeneration, followed by a speedy return to normal. Because the injured fibers probably did not fully retract from the tectum, these results indicated that: (1) the complete removal of the axons from the tectal milieu was not essential for initiating the cell body changes, and (2) close proximity to the target sites would speed the recovery of the cells. When the caudal portion of the tectum was ablated the retinal ganglion cells of the nasal retina remained enlarged significantly longer than after tectal transection. During the time the cells remained enlarged the electrophysiological projection onto the remaining rostral part of the tectum revealed no significant 'compression' of the visual field. Compression of the visual field onto the rostral portion of the tectum can be accelerated if the caudal tectal ablation is accompanied by an optic nerve crush. However, under this condition the recovery of ganglion cells in the nasal retina was significantly slower than the recovery of cells in the temporal retina. This may reflect an element of topographical specificity in the regulation of the recovery of the cell body from axonal injury.

Animals↗
PubMed1995

Vaccine development from a commercial point of view.

The development of a commercial vaccine comprises distinct stages. Initiation of a research project is triggered by demands from the market. If commercial and technical requirements are met, a feasibility study is carried out. Research is started, and aimed at formulating the product profile (what the product looks like). The product profile is subject to requirements set by the market (e.g. whether the product will fit into existing vaccination schedules) and very often technical aspects affect the product profile (e.g. whether the freeze-dried product is easy to reconstitute). Only after a cost-profit analysis is positive, the development phase is entered. During this phase, experiments are carried out to obtain registration. After the product has been registered it is ready for production and marketing. Only few vaccines for hemoparasitic diseases have reached the market. These comprise: attenuated parasites (Toxoplasma gondii, Eimeria species); killed vaccines (Anaplasma marginale) and subunit vaccines (Babesia canis). Factors relating to the product potential of these vaccines are discussed.

Animals↗
PubMed2005

Estimation and projection of nitrous oxide (N2O) emissions from anthropogenic sources in Taiwan.

Taiwan is a densely populated and developed country with more than 97% of energy consumption supplied by imported fuels. Greenhouse gas emissions are thus becoming significant environmental issues in the country. Using the Intergovernmental Panel on Climate Change (IPCC) recommended methodologies, anthropogenic emissions of nitrous oxide (N2O) in Taiwan during 2000-2003 were estimated to be around 41 thousand metric tons annually. About 87% of N2O emissions come from agriculture, 7% from the energy sector, 3% from industrial processes sector, 3% from waste sector. On the basis of N2O emissions in 2000, projections for the year 2010 show that emissions were estimated to decline by about 6% mainly due to agricultural changes in response to the entry of WTO in 2002. In contrast to projections for the year 2020, N2O emissions were projected to grow by about 17%. This is based on the reasonable scenario that a new adipic acid/nitric acid plant will be probably started after 2010.

Agriculture↗
PubMed1997

An evaluation of crystal structure of mannan I by X-ray powder diffraction and molecular mechanics studies.

The present study reports the re-examination of the crystal structure of mannan I by the X-ray powder diffraction study combined with the miniature crystal model simulation. A primary objective of this study was to investigate an adequate chain staggering position along the fiber axis. Among the several crystal structure models proposed for mannan I, that derived from the electron diffraction study of the single crystals was adopted as a starting model. The X-ray crystallographic residuals were calculated for the single crystal structure at different chain staggering positions, while the ab projection was kept invariant. In a similar fashion, the miniature crystal models consisting of seven mannotetraoses were constructed, each having different chain staggering values and the three-dimensional structures of all the models were subsequently optimized by using the MM3(92) program without introducing any constraint. Both the X-ray residual and lattice energy plots with respect to the chain staggering position showed the common minima around the -0.25 x c chain staggering. The minimum models were subjected to a search for preferred orientations of O2 and O6 hydroxyl groups. It was found that the hydroxyl groups present inside the minicrystal tended to rotate into particular orientations during the structure optimizations to form the O5-H-O2 and O3-H-O6 intermolecular hydrogen bonds between the adjacent oligomers in an alternative direction.

Cell Wall↗
PubMed1990

Global energy minimization by rotational energy embedding.

Given a sufficiently good empirical potential function for the internal energy of molecules, prediction of the preferred conformations is nearly impossible for large molecules because of the enormous number of local energy minima. Energy embedding has been a promising method for locating extremely good local minima, if not always the global minimum. The algorithm starts by locating a very good local minimum when the molecule is in a high-dimensional Euclidean space, and then it gradually projects down to three dimensions while allowing the molecule to relax its energy throughout the process. Now we present a variation on the method, called rotational energy embedding, where the descent into three dimensions is carried out by a sequence of internal rotations that are the multidimensional generalization of varying torsion angles in three dimensions. The new method avoids certain kinds of difficulties experienced by ordinary energy embedding and enables us to locate conformations very near the native for avian pancreatic polypeptide and apamin, given only their amino acid sequences and a suitable potential function.

Apamin↗
PubMed2003

Early perfluorodecalin lung distension in infants with congenital diaphragmatic hernia.

BACKGROUND/PURPOSE: Pulmonary hypoplasia contributes to mortality in infants with severe congenital diaphragmatic hernia (CDH). Accelerated postnatal lung growth with perfluorocarbon lung distension has been demonstrated in animals. The authors present a study measuring perfluorodecalin distension in neonates with severe CDH on extracorporeal membrane oxygenation (ECMO) support. METHODS: Six consecutive neonates with CDH requiring ECMO support were recruited. The lungs were filled with perfluorodecalin, and continuous positive airway pressure was applied for 6 to 10 days (mean, 7.7 days +/- 0.7). The perfluorodecalin was exchanged 4 times a day. Radiographic lung projections were measured, and from 2-dimensional measurements an estimated lung volume was calculated using the ECMO cannula as reference. RESULTS: Perfluorodecalin instillation started soon after starting ECMO support (mean, 13.5 +/- 5.3 hours). The volume required to fill the lungs increased significantly (P <.02). The radiographic dimension of the affected lung increased significantly (mean percentage increase, 272%; P <.02). The contralateral lung dimension also increased (mean percentage increase 51%; P <.02). CDH repair was undertaken on ECMO in all cases. All patients survived (follow-up, 3 to 42 months). CONCLUSIONS: This protocol of early perfluorodecalin lung distension in infants with severe CDH on ECMO support resulted in significant radiographic lung enlargement. Clinical outcomes are encouraging. Possible mechanisms include alveolar recruitment, alveolar dilatation, and accelerated postnatal lung growth.

Extracorporeal Membrane Oxygenation↗
PubMed2000

A neurobehavioral treatment for unilateral complex partial seizure disorders: a comparison of right- and left-hemisphere patients.

This study looked at the efficacy of a multi-disciplinary neurobehavioral approach for treating patients with complex partial seizure disorders. Patients with a seizure focus in either the left or right hemisphere were compared for overall effectiveness of this approach in achieving control of complex partial seizures. Patients in this study received short-term treatment based on a model of self-control developed by the Andrews/Reiter Epilepsy Research Program. This research selected all patients who met the lateralization criterion from among cases receiving short-term treatment between 1992 and 1996. Forty-four patients were identified, a group of 21 right-hemisphere subjects and a second group of 23 left-hemisphere subjects. These patients were treated in a short-term (5 consecutive days) treatment protocol and then released, with weekly phone contact for 6 months following treatment. They were then followed for an additional 19 months through the continued submission of their seizure logs and journals. Subjects in both groups kept seizure records throughout the study starting with a two-month baseline period. Other data collected allowed study of the interaction of emotional states with seizure occurrence. This project produced valuable and relevant information regarding neurobehavioral management interventions as an effective adjunctive or alternative treatment for obtaining seizure control in epilepsy patients. Overall, 79% of patients treated achieved seizure control. More than 64% identified a recognizable emotional state that triggered seizures. The emotional trigger was specific for either the right or left hemisphere.

Adult↗
PubMed1987

A reassessment of the accuracy of reinnervation by motoneurons following crushing or freezing of the sciatic or lumbar spinal nerves of rats.

The accuracy of reinnervation in peripheral nerves following second degree injuries, which do not disrupt the longitudinal continuity of the endoneurial sheaths, has been studied in rats. The sciatic nerve or lumbar spinal nerves (that is the extraspinal nerves before their fusion in the sciatic plexus) were crushed with fine watchmakers' forceps in neonatal and adult rats. In addition, the lumbar spinal nerves were frozen in a group of 5 adult rats. After allowing reinnervation to occur for 5 to 9 weeks, the motoneurons whose axons ran in the plantar nerve were labelled retrogradely with horseradish peroxidase. Their positions in the grey matter of the lumbar spinal cord were recorded and compared with those labelled from the contralateral unoperated plantar nerve. Very few errors of projection occurred after a crush lesion of the adult sciatic nerve but all the other lesions produced significant numbers of errors. The order, starting with the preparations with fewest errors was as follows (numbers in brackets = percentage of neurons misplaced): sciatic crush in adult (3%), sciatic crush in neonate (23%), spinal nerve freeze in adult (23%), spinal nerve crush in adult (35%), and spinal nerve crush in neonate (72%). It seems that a significant number of axonal growth cones cross endoneurial sheaths after crush or cryoinjuries. Explanations for the difference in observed reinnervation accuracy between young and old rats and between lesions in peripheral nerves and spinal nerves are discussed. The first is that axons in peripheral nerves in older rats have a less penetrable endoneurial membrane encasing them. The second is that the amount of misrouting is the same at all lesion sites but is much less easily detectable after sciatic lesions than spinal nerve lesions. This is because axons are organized in a 'musculotopic' manner in peripheral nerves and exchange of axon positions will occur largely between axons destined for the same peripheral target. In contrast, exchange of positions of axons in spinal nerves will lead to more overt errors because at this site axons destined for particular muscles do not lie side by side but are intermingled with axons innervating other peripheral targets.

Animals↗
PubMed2002

Quantification of heart rate variability by discrete nonstationary non-Markov stochastic processes.

We develop the statistical theory of discrete nonstationary non-Markov random processes in complex systems. The objective of this paper is to find the chain of finite-difference non-Markov kinetic equations for time correlation functions (TCF) in terms of nonstationary effects. The developed theory starts from careful analysis of time correlation through nonstationary dynamics of vectors of initial and final states and nonstationary normalized TCF. Using the projection operators technique we find the chain of finite-difference non-Markov kinetic equations for discrete nonstationary TCF and for the set of nonstationary discrete memory functions (MF's). The last one contains supplementary information about nonstationary properties of the complex system on the whole. Another relevant result of our theory is the construction of the set of dynamic parameters of nonstationarity, which contains some information of the nonstationarity effects. The full set of dynamic, spectral and kinetic parameters, and kinetic functions (TCF, short MF's statistical spectra of non-Markovity parameter, and statistical spectra of nonstationarity parameter) has made it possible to acquire the in-depth information about discreteness, non-Markov effects, long-range memory, and nonstationarity of the underlying processes. The developed theory is applied to analyze the long-time (Holter) series of RR intervals of human ECG's. We had two groups of patients: the healthy ones and the patients after myocardial infarction. In both groups we observed effects of fractality, standard and restricted self-organized criticality, and also a certain specific arrangement of spectral lines. The received results demonstrate that the power spectra of all orders (n=1,2, ...) MF m(n)(t) exhibit the neatly expressed fractal features. We have found out that the full sets of non-Markov, discrete and nonstationary parameters can serve as reliable and powerful means of diagnosis of the cardiovascular system states and can be used to distinguish healthy data from pathologic data.

Adolescent↗
PubMed2006

Behavioral management at the Phoenix Zoo: new strategies and perspectives.

It all started with a seemingly simple decision to re-evaluate and document the Phoenix Zoo's behavioral management protocol. The purpose of this project was to present proactive standards for the care and psychological well-being of our living collection, while meeting or exceeding the guidelines of the Animal Welfare Act (U. S. Department of Agriculture Animal and Plant Health and Inspection Service, Animal Care, 1999). Preparing the protocol was a catalyst to re-evaluate the zoo's philosophy and application of behavioral management. It suggested a restructuring of collection management and the rethinking of future goals and practices. Gradually, the process became more focused and organized. Behavioral enrichment, training, animal behavior issues, and exhibit architecture were embraced as essential components for providing quality of life. Staff from all levels worked side-by-side on assignments. Our way of thinking and working was changing.

Animal Husbandry↗