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Common errors in evaluating chest radiographs.

Chest radiographs that are correctly obtained and interpreted provide valuable diagnostic information. However, some radiographs are not taken at total lung capacity, and the appearance of the lungs on film may mimic certain lung disorders. Most common interpretive pitfalls in chest radiography can be avoided by physicians who are familiar with the film appearance of varying degrees of lung inflation, technical limitations of portable radiography, and common chest abnormalities. When further definition is necessary, additional projections should be obtained. Chest fluoroscopy and computed tomography can offer further clarification, if needed.

Adipose Tissue↗

Research use of the AIDA www.2aida.org diabetes software simulation program: a review-part 1. decision support testing and neural network training.

The purpose of this two-part review is to overview research use of the AIDA diabetes software simulator. AIDA is a diabetes computer program that permits the interactive simulation of plasma insulin and blood glucose profiles for teaching, demonstration, and self-learning purposes. It has been made freely available, without charge, on the Internet as a noncommercial contribution to continuing diabetes education. Since its launch in 1996 over 300,000 visits have been logged at the main AIDA Website-www.2aida.org-and over 60,000 copies of the AIDA program have been downloaded free-of-charge. This review describes research projects and ventures, undertaken for the most part by other research workers in the diabetes computing field, that have made use of the freeware AIDA software. Relevant research work was identified in three main ways: (i) by personal (e-mail/written) communications from researchers, (ii) via the ISI Web of Science citation database to identify published articles that referred to AIDA-related papers, and (iii) via searches on the Internet. In a number of cases research students who had sought advice about AIDA, and diabetes computing in general, provided copies of their research dissertations/theses upon the completion of their projects. The two reviews highlight some of the many and varied research projects that have made use of the AIDA diabetes simulation software to date. A wide variety of diabetes computing topics have been addressed. In Part 1 of the review, these range from testing decision support prototypes to training artificial neural networks. In Part 2 of the review, issues surrounding dietary assessments, developing new diabetes models, and performance monitoring of closed-loop insulin delivery devices are considered. Overall, research projects making use of AIDA have been identified in Australia, Italy, South Korea, the United Kingdom, and the United States. These reviews confirm an unexpected but useful benefit of distributing medical software, like AIDA, for free via the Internet-demonstrating how it is possible to have a synergistic benefit with other researchers-facilitating their own research projects in related medical fields. The reviews highlight a variety of these projects that have benefited from the free availability of the AIDA diabetes software simulator. In a number of cases these other research projects simply would not have been possible without unrestricted access to the AIDA software and/or technical descriptions of its workings. In addition, some specific common themes begin to emerge from the research ventures that have been reviewed. These include the use of simulated blood glucose data from the AIDA program for preliminary computerlab-based testing of other decision support prototypes. Issues surrounding such use of simulated data for separate prototype testing are discussed further in Part 2 of the review.

Computer Simulation↗

Creating integrated service systems for homeless persons with mental illness: the ACCESS Program. Access to Community Care and Effective Services and Supports.

The Access to Community Care and Effective Services and Supports (ACCESS) demonstration program was initiated in 1993 by the U.S. Department of Health and Human Services as part of a national agenda to end homelessness among persons with serious mental illness. Demonstration projects have been established in nine states to develop integrated systems of care for this population. This paper provides an overview of the ACCESS program and presents definitions of services integration and systems integration. Evaluating the effectiveness of integration strategies is a critical aspect of the program. The authors describe the evaluation design and the integration strategies being evaluated and summarize findings from a formative evaluation of the project's first two years. The evaluation revealed several problems that were addressed by providing technical assistance to the states. States were helped to articulate a broader mission of addressing system-level barriers, develop an expanded plan, strengthen the authority of interagency councils, involve leaders at the state and agency levels, and develop joint funding strategies.

Adult↗

The influence of different technique factors on image quality of lumbar spine radiographs as evaluated by established CEC image criteria.

In this study we have investigated the image quality of lumbar spine radiographs taken after recording technical and physical parameters. Two technical parameters were altered, tube voltage (70 kV and 90 kV for the anteroposterior (AP) projection and 77 kV and 95 kV for the lateral projection) and sensitivity of the film-screen system (sensitivity class 400 and 600). In total, 85 images were included in the study. Entrance surface dose (ESD) was measured using thermoluminescent dosemeters. The mean value of ESD for the different technique groups varied between 1.9 mGy (90 kV, sensitivity class 400) and 4.6 mGy (70 kV, sensitivity class 400) for the AP projection, and between 6.4 mGy (95 kV, sensitivity class 600) and 20.4 mGy (70 kV, sensitivity class 400) for the lateral projection. Image criteria given in the "European Guidelines on Quality Criteria for Radiographic Images" were used to assess image quality. Two evaluation methods have been employed. A straightforward scoring of fulfilled image criteria, and visual grading analysis using the structures defined in the image criteria. The latter method provided a sharper distinction between groups of images taken using different radiographic techniques. The average number of fulfilled image criteria for the AP projections varied between 0.74 (90 kV, sensitivity class 400) and 0.87 (70 kV, sensitivity class 400). For the lateral projection this number varied between 0.79 (95 kV, sensitivity class 600) and 0.84 (77 kV, sensitivity class 600). This study shows that image criteria are useful tools in clinical studies of image quality.

Adolescent↗

New radiographic programs for transverse conventional tomograms in the dentomaxillofacial region.

Using only 7 programs, Orthophos Plus permits transverse conventional tomograms of all maxillomandibular regions. The precision of the magnification factors of these programs is very high. Factors influencing the image quality of the 7 programs were assessed. Image quality depends on technical precision and on correct patient positioning, i.e., jaw axis alignment to the direction of projection. This procedure with 7 programs is more demanding than the procedure for x-ray units that use many programs for the different projections. Especially for implantology, it is important that the patient's jaw be positioned in accordance with the projection to avoid oblique cuts and incorrect information about the jaw dimensions. The correct region is best selected by positioning a cast in the positioning aids prior to exposure and using the same setting for the patient's exposures. For correct implant planning, it is helpful to digitize the tomograms with Friacom so that, despite different magnification factors of the programs, the correct implant dimensions are determined. If these suggestions are followed, use of these programs in dental practice can be recommended.

Alveolar Process↗

Design of a patient-centered, multi-institutional healthcare information network using peer-to-peer communication in a highly distributed architecture.

OBJECTIVE: to design a community healthcare information network for all 450,000 citizen in the State of Geneva, Switzerland, connecting public and private healthcare professionals. Requirements include the decentralized storage of information at the source of its production, the creation of a virtual patient record at the time of the consultation, the control by the patient of the access rights to the information, and the interoperability with other similar networks at the national and european level. METHODS: a participative approach and real-world pilot projects are used to design, test and validate key components of the network, including its technical architecture and the strategy for the management of access rights by the patients. RESULTS: a distributed architecture using peer-to-peer communication of information mediators can implement the various requirements while limiting to an absolute minimum the amount of centralized information. Access control can be managed by the patient with the help of a medical information mediator, the physician of trust.

Community Networks↗

The SUCOZOMA program: results and challenges.

The research program Sustainable Coastal Zone Management (SUCOZOMA), which was started in 1996 by the Swedish Foundation of Strategic Environmental Research, was motivated by the recognition of increasingly severe global, regional and national coastal problems. The program approached the complex issues of coastal eutrophication, fishing practices, and overexploited coastal resources, with a concerted effort involving multidisciplinarity, stakeholder cooperation, and a focus on the problems perceived as most serious by the public and decision-makers. As the program was concluded in 2004 it had resulted in the completion or near-completion of 22 doctoral dissertations and approximately one hundred publications. More than 40 scientists were involved in the program. Göteborg University was the host university, but important research teams have also been located at Stockholm University, the Beijer Institute, and the Kristineberg Marine Research Station of the Royal Swedish Academy of Sciences, and within the National Board of Fisheries. During the program, networks of stakeholders were established and SUCOZOMA had contributed to numerous political and administrative processes relevant for integrated coastal zone management (ICZM). SUCOZOMA program results can be grouped into different categories. Many of the projects in the two phases of the program produced results which can be defined as technical or practical and available for direct implementation in, e.g. mussel cultivation, restoration and safeguarding of spawning areas, seal-safe fishing gear or sustainable fishing of underexploited species. Other results can be characterized as policy oriented, and the impact of these can only be fairly evaluated as new policies are put into effect. SUCOZOMA resulted in important new knowledge regarding coastal science and management, but also concerning the organization required to conduct an end-user oriented multidisciplinary program effectively.

Animals↗

[Planning the pathological departments of modern large clinics].

With the increasing importance of pathomorphological research as an integral element of optimization of therapeutic-diagnostic service of a modern hospital, it is important to improve the structure and technical basis of the pathology departments. The experience of pathological service and the analysis of projects of pathology departments included in the current type projects of clinical and other hospitals reveal some unsatisfactory features in architectural planning and in medico-technological aspects. This handicaps the improvement of the pathological service as an element of medical service and the subject of teaching. Recommendations on these problems are presented.

Hospital Bed Capacity, 500 and over↗

Department of the Environment (DOE) household projections.

"This article briefly describes the basis of the method of household projections developed by the Department of the Environment and touches on some of the problems and shortcomings." The projections concern England and Wales only.

Developed Countries↗

[Books from the Arco do Cego in colonial Brazil].

Between 1799 and 1801, the friar José Mariano da Conceição Veloso, a Minas Gerais native, headed Lisbon's Casa Literária do Arco do Cego, which in a brief three-year span published at least eighty works on topics that included agriculture, navigation, and medicine. This editorial project must be understood within the context of Dom Rodrigo de Souza Coutinho's enlightened government program. Meant to modernize the Empire, it included dissemination of technical and practical knowledge in lands under Portuguese dominion, especially in the Americas. As a contribution to an understanding of the Enlightenment in Brazil , this article presents elements form my research on the development of the project and how it was received.

Agriculture↗

[How to write a scientific paper].

To write a paper and to succeed in getting it published in a highly renowned scientific journal represent the last but not the least of the difficulties that a researcher has to face before being able to consider a given research project fully accomplished. While writing a manuscript, it is important to put a consistent effort in designing its structure, paying attention to a few technical guidelines. It is worth keeping in mind, however, that the editorial success of a manuscript is related not only to the writer skills and experience but also to the attention previously dedicated to the design and conduction of the research project from which data are derived. On the other hand, the probability for a well designed and carefully performed study (yielding data relevant from a clinical viewpoint), to have its results accepted for publication in an important journal is very low if they are poorly summarized in a low quality paper. In the light of these considerations, the aim of this concise review was to provide the researcher with a few simple tips on how to prepare a scientific article, ranging from its early drafting to its final publication. We have also dealt in some detail with the problems related to the selection of the journal and manuscript format, with the procedures related to manuscript submission, and with the approach to follow in order to prepare a proper answering to the reviewers' and editors' comments.

Periodicals as Topic↗

The PDA as a reference tool: libraries' role in enhancing nursing education.

"The PDA as a Reference Tool: The Libraries' Role in Enhancing Nursing Education" is a pilot project funded by the University of Massachusetts President's Office Information Technology Council through their Professional Development Grant program in 2004. The project's goal is to offer faculty and students in nursing programs at two University of Massachusetts campuses access to an array of medical reference information, such as handbooks, dictionaries, calculators, and diagnostic tools, on small handheld computers called personal digital assistants. Through exposure to the variety of information resources in this digital format, participants can discover and explore these resources at no personal financial cost. Participants borrow handhelds from the University Library's circulation desks. The libraries provide support in routine resynchronizing of handhelds to update information. This report will discuss how the projects were administered, what we learned about what did and did not work, the problems and solutions, and where we hope to go from here.

Advertising↗

Family planning: the unfinished revolution.

This is a general overview of family planning programs in developing countries, with a focus on east and southeast Asia and Sub-Saharan Africa. The author concludes that "by the year 2000, the number of contraceptive users in developing countries will have to be 40 percent higher if fertility declines are to match projections." Suggestions for program improvement are included.

Africa↗

[Are children properly classified within the scope of expert assessment to determine need for services?].

This project deals with assessment directives issued by the leading statutory care insurance companies to define the need for care of children at certain ages in coping with the activities of daily life specified by the German Social Legislation. The ages in question relate to healthy, normally developed children. They are used as a measure of comparison for the assessment of diseased children. Besides, they have a decisive significance in defining the need for care. Only if a child is not able to perform a certain activity, although it is meant to be able to do so at that age, can we define the need for help and assistance, i.e. care. The project is divided into two sections. 1. Comparison of age mentioned in the assessment directives for each of the daily life activities of healthy and normally developed children aged 1 to 12 years with the age mentioned in technical literature. 2. Comparison of age mentioned in the assessment directives for each ot the daily life activities of healthy and normally developed children at the age of 1 to 12 years with those mentioned in retrospective interviews with the same group of children. In the first part of the project, an analysis of the literature dealing with the subject was done. The literature included the stock of technical literature in the German language. Studying the literature, ages for children could be isolated, that could be classed with the activities of daily life mentioned in the German Social Code. These ages were compared with those in the assessment directives. In a second part of the project, 81 mothers and fathers of healthy, normally developed children aged 1 to 12 years were asked via a questionnaire. They were asked to estimate retrospectively from what age on their child had been able to perform certain activities of daily life without any help. The comparison of ages mentioned in the assessment directives with those of the analysis of literature conformed only regarding daily life activity. Regarding the other activities of daily life the age for children was set higher in the assessment directives than in the literature. Comparing the age of children in the assessment directives with the results of the questionnaires the age was also set higher in the directives than shown by the results of the questionnaires. The results of the literature analysis and the inquiry by questionnaires show that the ages mentioned in the assessment directives for an independent performance of daily life activities do not correspond to the development according to the age of healthy normally developed children aged 1 to 12 years. As a result of this project it seems to be justified to be doubtful about an adequate assessment of children who are in the need of care. Due to this reason it would be desirable to reexamine the data of the assessment directives by means of a new representative prospective study.

Activities of Daily Living↗

[Correction of five different types of errors of model REFSEQs appeared in NCBI human gene database only by using two novel human genes C17orf32 and ZNF362].

Found that there exist many mistakes in the REFSEQ issued in the genome annotation project of NCBI, the result of which indicates that people be cautious in using REFSEQ database in NCBI. By adopting the technical route combining bioinformatics analysis and experimental verification, through the comparison of the cloned genes in the non-redundant database, we found that there were many mistakes in the computer annotation human genome coding sequences that were issued on the internet. First we quoted nine wrong types of novel human genes anticipated by NCBI GENOME Annotation Project. Here we give one example in detail: (1) Comparison of the sequences between novel human gene C17orf32 and hypothetical human gene LOC124919. LOC123722 is a modified sequence of C17orf32 cDNA with an inserted G between 406 -407 nucleotides. The base G in the 401 position of LOC123722 cDNA is a redundant insert, which causes a reading frame shift in the translation of an alternative protein. This inserted G has not been found in our experimental clone, and is fully rejected by human EST alignment, and is shown as a redundance by genomic GT/AG organization analysis. (2) Comparison of the sequences between novel human gene C17orf32 and hypothetical human gene LOC147007. C17orf32 gene (ORF from 31 to 657 nucleotides) is located on human chromosome 17(Accession No. NT_010808.7), and is only linked with a hypothetical human gene LOC147007 (ORF from 55 to 435 nucleotides) at present. This hypothetical human gene sequence has not been verified by experiment, and is a wrong form of our verified C17orf32 gene. The full-length 1 679 bp cDNA sequence of C17orf32 exhibits overall homology to that of LOC147007 of 625 bp mRNA, with matching percentage of 37% in 36% of total window over the full-length nucleotide, especially 121 approximately 366 bp of LOC147007 is just the same as 316 approximately 561 bp of C17orf32. Thus, the 126 aa protein encoded by XP_097165 of LOC147007 exhibits overall homology to the 208 aa protein encoded by C17orf32, with matching percentage of 50% in 48% of total window over the full-length protein, especially 23 approximately 104 aa of XP_097165 is just the same as 96 approximately 177 aa of C17orf32 protein. Both flanking regions of LOC147007 outside the same ORF central part are wrong assembly of non-relative cDNA. In addition, we have in silico cloned a novel mouse gene, ORF32 (open reading frame 32) with TPA accession number of BK000258, which is the mouse ortholog of human C17orf32. Our strategy is helpful in both finding out more novel human genes and correcting the mistakes in the REFSEQs issued by NCBI genome annnotation project. For example, we adopted the gene anticipating method, through automatic calculation and analysis, anticipated two modes reference sequences (LOC124919 and LOC147007) from NCBI contig NT_ 010808. Both of them should be C17orf32, but the fact is that both of them are various wrong forms of C17orf32, respectively are the first type and second type of mistakes. Another example, we adopted gene anticipation method, through automatic calculation and analysis, anticipated three modes reference sequences (LOC14907, LOC200084 and LOC91126) from NCBI contig NT_004511 which really are one type of gene of ZNF362, but submitted three different wrong forms of ZNF362, respectively are: the fourth, fifth, and seventh type of mistakes. We can correct or avoid the currently wrong human genome coding sequence by using in silico clone and combining experimental verification. People should be cautious in treating the computer's annotation which may exist all type of wrong human genome coding sequences. The correct identification and annotation of the novel human genes still remain to be a long and arduous task.

Amino Acid Sequence↗