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A microcomputer-based, net-lending interlibrary loan system.

A microcomputer-based, net-lending interlibrary loan system was developed at Lane Medical Library, Stanford University. The system, designed to generate the monthly billing invoices and all necessary statistical reports, has reduced the time required for logging-in procedures and compilation of monthly, quarterly, and annual statistics. User menus, help screens, and choice fields were developed explicitly for library staff who have little or no computer experience. The program was written using the DataEase database management software running on IBM PC, XT, AT, or compatible with a minimum of 512K RAM. Described are features of this automated interlibrary loan management system and its use in a net-lending interlibrary loan department. It focuses on data entry in the "Library Directory" and "ILL Log Sheet," details of billing invoices, and statistical reports, and flexibility in modifying tax rates, borrowing fees, and other parameters.

Accounting

Neuronal plasticity and ageing processes in the frame of the 'Red Queen Theory'.

On the basis of the morphofunctional evidence obtained in old brains of humans and mammals the present hypothesis has been introduced. This hypothesis states that neuronal plasticity can be used either to compensate for neuronal degeneration or to store new information. Thus, in pathological ageing the marked rate of degeneration has fully exhausted the already reduced plasticity capability of neural networks. In this way marked impairments of memory trace formation take place in pathological ageing conditions such as Alzheimer's disease. The essence of this hypothesis is that a competition for the available plasticity exists between the compensatory responses to ageing-induced degeneration and the processes necessary for memory trace formation. We have called this hypothesis the 'Red Queen Theory', an analogy borrowed from Lewis Carroll's book Through the Looking Glass. Thus, in ageing, processes responsible for plasticity must be forced to run at the highest possible rate to maintain the morphofunctional substrate of the existing networks as well as to allow the formation of new memory traces.

Aging

The service system at the crossroad of demography and policy making--implications for the elderly.

In many countries today, there is an ongoing debate regarding health in 'crisis'. Each country seems to experience a crisis regardless of the level of expenditures in the field of social and health services. This article discusses different influences that affect social and health service systems in relation to the elderly, and brings up the controversy concerning the elderly as a threat to available resources in society. Most examples are based on Swedish sources, but some American and British sources are used as well. Borrowing from the age stratification model, the concepts role and cohort are used as analytical concepts. The role concept is discussed in relation to the development of organizations for retired people. The analysis offered little support for the thesis that the elderly would attain a power position. Thus, a demand for societal resources by means of political strength is less feasible. When looking at the elderly from the cohort perspective, the article includes a discussion of the interdependent forms of care for the elderly; self-care, informal care and formal care. Although great challenges await social and health services systems in this respect, the article concludes that any possible crisis in health and social service systems is socially constructed and not a deterministic effect of demography as such.

Aged

Living-related kidney donors: a multicenter study of donor education, socioeconomic adjustment, and rehabilitation.

To determine the consequences of living-related kidney donation, a study was conducted of 536 donors whose nephrectomies had been performed at nine geographically dispersed centers during the past 12 years. The data demonstrated that greater than 84.0% of the donors thought they had been adequately informed regarding all aspects of donation, and less than 15.0% reported being pressured in their decision. Only two serious medical complications were directly attributable to the surgery, greater than 92.0% of the donors believed their health had not been adversely affected by donation, and 96.8% reaffirmed their decision regardless of the graft's success or the financial distress they experienced (P greater than .05). However, greater than 14.0% experienced direct pressure, particularly not to donate. Donation also appeared to stress previously troubled marriages, especially among donors without a religious affiliation, who were pressured to donate by their families, or who borrowed from family members (P less than .05). Substantial unreimbursed expenses (greater than or equal to $1,000) were incurred by 43 donors, and 23.2% of all donors reported that donation caused a financial hardship.

Adolescent

Comparing the cost of spinal MR with conventional myelography and radiculography.

All spinal magnetic resonance imaging examinations carried out during a three month period were analysed retrospectively in order to determine the clinical reasons for the scan requests. Technical details of the examinations they received and the clinical profiles formed a data set which revealed 10 separate "Clinical groups" for management purposes. Hardware, salary and expendables were costed as though the imaging unit had been sited within a National Health Service radiology department. A spread sheet was designed capable of calculating costs per patient for a variety of types of working week and of different staffing structures, sensitive to the mixture of clinical groups referred for examination. The spreadsheet also accomodated straight line depreciation for hardware value and interest rates for borrowed capital. A second, prospectively observed, sample of spinal MR examinations was used to improve the accuracy of the timing of the length of patient examinations. Costs were compared with those for patients submitted for myelography and radiculography at the adjacent hospital during the same period. The comparison indicated that spinal MR was less costly than myelography and radiculography. The most important element of the extra cost of myelography related to the need to admit patients to hospital for at least one night for this examination because of the likelihood of headache and other common (though usually minor) complications following lumbar puncture and/or the injection of contrast medium. From the limited information that it was possible to obtain in the period of follow up, it appeared that MR had either been superior or equivalent to myelography or radiculography in all the clinical groups of patients where both could be tested. There were a number of groups in which no myelograms had been requested, presumably because clinical suspicions had pointed toward conditions like tumours, developmental abnormalities and demyelinating diseases in which neurologists and neurosurgeons have already made up their minds about the superiority of MR.

Cost-Benefit Analysis

Infection of lymphocytes by a virus that aborts cytotoxic T lymphocyte activity and establishes persistent infection.

For viruses to establish persistent infections in their hosts, they must possess some mechanism for evading clearance by the immune system. When inoculated into adult immunocompetent mice, wild-type lymphocytic choriomeningitis virus (LCMV ARM) induces a CD8(+)-mediated cytotoxic T lymphocyte (CTL) response that clears the infection within 7-14 d (CTL+ [P-]). By contrast, variant viruses isolated from lymphoid tissues of persistently infected mice fail to induce a CTL response and are thus able to establish a persistent infection in adult mice (CTL- [P+]). This report compares the interaction of CTL+ (P-) and CTL- (P+) viruses with cells of the immune system. Both types of virus initially bind to 2-4% of CD4+ and CD8+ T lymphocytes and replicate within cells of both subsets. The replication of CTL- (P+) and CTL+ (P-) viruses in lymphocytes in vivo is similar for the first 5 d after initiating infection. Thereafter, in mice infected with CTL- (P+) variants, lymphocytes retain viral genetic information, and infectious virus can be recovered throughout the animals' lives. In contrast, when adult mice are infected with wild-type CTL+ (P-) LCMV ARM, virus is not recovered from lymphocytes for greater than 7 d after infection. A CD8(+)-mediated anti-LCMV CTL response is induced in such mice. Clearance of infected lymphocytes is produced by these LCMV-specific CTLs, as shown by their ability to lyse lymphocytes expressing LCMV determinants in vitro and the fact that depletion of CD8+ lymphocytes before infection with CTL+ (P-) viruses results in levels of infected lymphocytes similar to those found in undepleted CTL- (P+)-infected mice. Hence, CTL-mediated lysis of T lymphocytes carrying infectious virus is a critical factor determining whether virus persists or the infection is terminated.

Animals

miss-SNF: a multimodal patient similarity network integration approach to handle completely missing data sources.

MOTIVATION: Precision medicine leverages patient-specific multimodal data to improve prevention, diagnosis, prognosis, and treatment of diseases. Advancing precision medicine requires the non-trivial integration of complex, heterogeneous, and potentially high-dimensional data sources, such as multi-omics and clinical data. In the literature, several approaches have been proposed to manage missing data, but are usually limited to the recovery of subsets of features for a subset of patients. A largely overlooked problem is the integration of multiple sources of data when one or more of them are completely missing for a subset of patients, a relatively common condition in clinical practice. RESULTS: We propose miss-Similarity Network Fusion (miss-SNF), a novel general-purpose data integration approach designed to manage completely missing data in the context of patient similarity networks. miss-SNF integrates incomplete unimodal patient similarity networks by leveraging a non-linear message-passing strategy borrowed from the SNF algorithm. miss-SNF is able to recover missing patient similarities and is "task agnostic", in the sense that can integrate partial data for both unsupervised and supervised prediction tasks. Experimental analyses on nine cancer datasets from The Cancer Genome Atlas (TCGA) demonstrate that miss-SNF achieves state-of-the-art results in recovering similarities and in identifying patients subgroups enriched in clinically relevant variables and having differential survival. Moreover, amputation experiments show that miss-SNF supervised prediction of cancer clinical outcomes and Alzheimer's disease diagnosis with completely missing data achieves results comparable to those obtained when all the data are available. AVAILABILITY AND IMPLEMENTATION: miss-SNF code, implemented in R, is available at https://github.com/AnacletoLAB/missSNF.

Humans

A trial use of some of Reitan's neuropsychological tests to assess mild organic complications in psychiatric patients.

Several testing procedures borrowed from Reitan's extensive investigations of impairment in brain function were employed in the present study (Tactual Performance Test, Trail Making Test, Seashore Rhythm Test, Speech Sounds Perception Test, Finger Oscillation Test). These tests were administer to three groups of Ss matched for age, education, and sex distribution. All Ss were 40 years of age or older. The groups were: hospitalized psychiatric patients suspected by their psychiatrists of some degree of organic impairment; hospitalized psychiatric patients not suspected of any organic impairment; and nonhospitalized, apparently normally functioning control Ss. Four months after the beginning of the study, the psychiatrists reevaluated and reclassified the patient Ss and formed new groups of those suspected and not suspected of organic impairment. A comparison of group means that used the original S groups showed that three of nine test scores were nondiscriminating, while the remaining six discriminated the control Ss from the patients, but not the two patient groups from each other. A similar comparison that used the revised patient groups formed from the psychiatrists' re-evaluations after an additional 4 months of observation yielded four test scores that discriminated successfully between the two patient groups: Tactual Performance Test, total time; Trail Making Test, Part A and Part B; and Finger Oscillation Test, right hand. These four test scores predicted the later classification of the patients more accurately than did the psychiatrists' own original evaluations, which would be in keeping with the general function of diagnostic testing, i.e., to provide initial information about patients beyond that which can be obtained from initial psychiatric examination.

Brain Damage, Chronic