[Simplification of an examination method for investigation of the work capacity of elderly workers].
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Aged↗
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Results for “Work Simplification”
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CHESS classification of bladder-outflow obstruction. A consequence in the discussion of current concepts.
The present discussion on the natural history, growth rate pathophysiology, morbidity, and possible treatment of benign prostatic hyperplasia (BPH) reinforces the need to objectify mechanical BPH-induced obstruction with pressure-flow study. Different methods for the quantification of BPH-induced obstruction exist and the grade of simplification depends on their working mechanism. To review the limitations of the current concepts, 118 BPH patients were selected for computerized pressure-flow data analysis according to quadratic passive urethral resistance relation (PURR) function. The CHESS classification differs from all other concepts due to its two-dimensional character and was developed as a result of the following way of thinking: (1) the whole individual pressure-flow plot is the most accurate basis for further analysis; (2) PURR as the true low-pressure flank of the individual plot is the most favorable definition for mechanical obstruction; (3) PURR quantification requires at least two parameters, footpoint and curvature/slope, with regard to the documented missing significant correlation of both; and (4) a two-parameter-based classification is two-dimensional (CHESS classification).
Aged↗
How to (or not to) communicate science.
Protagonists for 'the public understanding of science' still sometimes fail to recognize that there is also a need for 'the scientists' understanding of the public' and that for most of science most of the time we are all public. 'Science' is communicated to 'the public' through popular books, museums, TV, the Internet, but far too often the present state of scientific belief is presented uncritically as the onward march of truth as discovered by Euro-American males. This has contributed to a widespread public concern, if not mistrust, in many areas of science, not least genetics and neuroscience. Although researchers often criticize the media for misrepresenting their work, the hype and simplifications often begin with the press releases put out by the researchers, their institutions and the scientific journals themselves. I conclude by looking more optimistically at the ways in which, by bringing natural science into theatre, novels and other art forms, the fragmentation of our culture may be diminished.
Communication↗
Patient-focused care.
The trend away from a departmental focus and toward "patient-focused" care in hospitals is described; advantages of and barriers to such a change and its effects on pharmacy are discussed. Patient-focused care is characterized by decentralization of services, cross-training of personnel from different departments to provide basic care, interdisciplinary collaboration, various degrees of organizational restructuring, use of "clinical pathways"--recommended components of care for patients with a particular diagnosis, simplification and redesign of work to eliminate steps and save time (e.g., providing care according to predetermined protocols and charting only exceptions to the protocol), and increased involvement of patients in their own care. Its objectives are to use nonclinical and clinical staff more effectively and to improve patients' perceptions of the quality of care and staff members' job satisfaction. It is unrealistic to expect quick reductions in hospital costs through patient-focused care, and workers will worry about job security if an institution overemphasizes this aspect. A 1993 survey of 311 hospitals found that almost half had or planned to have patient-focused care projects. Adoption of patient-focused care projects may be slowed by workers' fear of new responsibilities and new reporting relationships. However, not all patient-focused care models involve radical organizational changes, and reorganizations can be such that pharmacy staff members are still connected to the pharmacy department even if they are supervised by a nonpharmacist. In some institutions patient-focused care projects have given pharmacy its first opportunity for decentralization.(ABSTRACT TRUNCATED AT 250 WORDS)
Hospital-Patient Relations↗
[Experience in developing devices for medical use exemplified by the electronic stethophonoendoscope].
The paper describes the use of the expert's error technique to provide evidence and pool medical specifications for an electron amplifying stethophonoendoscope, a medical diagnostic device. It illustrates the impact of variations in amplitude-frequency responses (AFR) on the auscultation properties of the devise. An AFR variation of only 10-12 dB can distort sound perception at auscultation. The results of development of the electron stethophonoendoscope indicate that the correct choice of criteria for expert's estimates allows the device's specifications to be worked out with simultaneous simplification of testing procedures.
Artifacts↗
Estimating the prevalence of protein sequences adopting functional enzyme folds.
Proteins employ a wide variety of folds to perform their biological functions. How are these folds first acquired? An important step toward answering this is to obtain an estimate of the overall prevalence of sequences adopting functional folds. Since tertiary structure is needed for a typical enzyme active site to form, one way to obtain this estimate is to measure the prevalence of sequences supporting a working active site. Although the immense number of sequence combinations makes wholly random sampling unfeasible, two key simplifications may provide a solution. First, given the importance of hydrophobic interactions to protein folding, it seems likely that the sample space can be restricted to sequences carrying the hydropathic signature of a known fold. Second, because folds are stabilized by the cooperative action of many local interactions distributed throughout the structure, the overall problem of fold stabilization may be viewed reasonably as a collection of coupled local problems. This enables the difficulty of the whole problem to be assessed by assessing the difficulty of several smaller problems. Using these simplifications, the difficulty of specifying a working beta-lactamase domain is assessed here. An alignment of homologous domain sequences is used to deduce the pattern of hydropathic constraints along chains that form the domain fold. Starting with a weakly functional sequence carrying this signature, clusters of ten side-chains within the fold are replaced randomly, within the boundaries of the signature, and tested for function. The prevalence of low-level function in four such experiments indicates that roughly one in 10(64) signature-consistent sequences forms a working domain. Combined with the estimated prevalence of plausible hydropathic patterns (for any fold) and of relevant folds for particular functions, this implies the overall prevalence of sequences performing a specific function by any domain-sized fold may be as low as 1 in 10(77), adding to the body of evidence that functional folds require highly extraordinary sequences.
Amino Acid Sequence↗
Optimizing initial plasmid copy number distribution for improved protein activity in a recombinant fermentation.
Recombinant bacterial cells in a fermentation broth rarely contain the same number of plasmids, even though this simplification is often used. Recent work has however indicated limitations of the simplified approach. Based on these studies, the distribution of plasmid copy numbers per cell has been represented macroscopically here in a Gaussian form for the fraction of biomass as a function of the copy number. Applying this distribution and an experimentally validated kinetic model to glyceraldehyde-3-phosphate dehydrogenase (GAPDH) synthesis by Escherichia coli containing the plasmid pBR Eco gap, it is seen that GAPDH production in a batch fermentation is maximized by a particular initial (non-zero) copy number variance and an optimal duration. To implement this distribution in a bioreactor, it is suggested that the profile may be discretized, inocula corresponding to the mean copy number of each fraction prepared, and then combined to obtain the seed culture.
Journal Article↗
[Psychological aspects of treatment compliance in the insulin- dependent diabetic child].
Cognitions (conceptual constructs) concerning treatment and compliance with treatment were investigated in 39 children with insulin-dependent diabetes mellitus (mean age, 13.8 +/- 3.0 years; duration of diabetes mellitus, 5.1 +/- 3.2 years). A structured interview and a scale exploring diabetes-related cognitions were administered to each child. Results were as follows: the complexity of treatment of IDDM was perceived as the main obstacle to compliance by 90% of subjects; despite adequate knowledge of the prescribed treatment regimen, the children had created a mental representation of what their treatment should be and were highly compliant to this subjective construction. Most of the complex elements of therapy (urine and blood glucose monitoring, diet) were partly eliminated, with the child developing an idiosyncratic therapeutic regimen with which he or she complied scrupulously. The impact of patient education could be improved by taking this tendency towards simplification into account and by working out with the child the most acceptable regimen capable of ensuring optimal metabolic control.
Adolescent↗
Laparoscopic appendectomy (LA) with a new technique.
UNLABELLED: The technique of LA has evolved during the past decade. We describe a simplification using a scope with work channel. TECHNIQUE: A 1.2 cm paraumbilical trocar enters the CO2(-)-inflated peritoneum. The 1 cm scope with work channel is introduced. If the view confirms the diagnosis of appendicitis we place a 1-cm trocar in the midline 2 cm above the symphysis pubis. The scope is switched to the 1 cm trocar. The appendix is immobilized through the work channel. Through the paraumbilical site the appendiceal artery is clipped or coagulated as necessary. The stump is closed by Roeder loops or stapler. The specimen is removed through the larger site. The wounds are closed with single sutures. CONCLUSION: This technique has the advantage of being less invasive on the abdominal wall. The sum of the stab wounds is 2.2 cm, requires only one surgeon and the assistance of a scrub nurse. If necessary, the operation it can be converted to 3- or 4-trocar technique or an open one.
Adult↗
Shifts in the immunocompetence of lymphoid tissue in guinea pigs containing a limited microflora.
Many authors have demonstrated simplification of the species composition of the normal microflora in animals long kept in a closed environment. The purpose of the present work is to reveal the effect of such simplification (without reduction of the total number of bacteria) on the immunocompetent system of the animals. Three months old germ-free, monocontaminated (Staph. albus) and conventional guinea pigs with reduced fecal microflora were used in this study. Guinea pigs of the second group were fed a sterile diet but were kept in an ordinary vivarium. Two groups of control animals were: 1) conventionals fed regular diets; 2) conventionals fed the diet contaminated with fecal microflora of guinea pigs after sterilization. The fecal microflora was examined. The total number of bacteria in faeces of monocontaminated and microflora-reduced conventional animals was approximately the same as in conventional controls. Various lymphoid organs were examined. Their weight, size, number and activity of germinal centres, amount of globulin-producing cells, their differentiation and amount of globulins in single cells were determined. The lymphoid tissue in microflora-reduced animals and especially in monocontaminated guinea pigs was found to be underdeveloped. These changes were, however, less pronounced than in germ-free animals. It is suggested that simplification of the microflora in a macro-organism during long-term enclosure reduces the lymphoid tissue; such a macro-organism may develop severe reactions of the microbial shock, when occurring in a normal microbial environment.
Animals↗
Simplified quantification of dopamine transporters in humans using [99mTc]TRODAT-1 and single-photon emission tomography.
Quantification of dopamine transporters (DAT) using [99mTc]TRODAT-1 and single-photon emission tomography (SPET) requires full kinetic modeling of the data, using complex and invasive arterial blood sampling to provide an input function to the model. We have shown previously that a simpler reference tissue model provides accurate quantitative results, using a reference region devoid of DAT as the input to the model and thereby obviating the need for blood sampling. We now extend this work into humans, and develop further simplifications to make the imaging protocol much more practical as a routine procedure. Fourteen healthy subjects (age 29.8 +/- 8.4 years, range 18.7-45.5 years) underwent dynamic SPET for 6 h following injection of 752 +/- 28 MBq [99mTc]TRODAT-1. The kinetic data were analyzed using nonlinear regression analysis (NLRA) and Logan-Patlak graphical analysis. In addition, simple average ratios of striatal-to-background counts were obtained for three 1-h periods (3-4 h, 4-5 h, 5-6 h), and compared against the kinetic models. All methods gave an index of specific binding, proportional to the binding potential, known as the distribution volume ratio (DVR). The reference tissue NLRA gave mean values of k3=0.013 +/- 0.003 min(-1), k4=0.011 +/- 0.002 min(-1), and DVR=2.29 +/- 0.17. Graphical analysis gave a value of DVR=2.28 +/- 0. 16, and the three ratio values of DVR were: 3-4 h, 2.18 +/- 0.15; 4-5 h, 2.34 +/- 0.13; and 5-6 h, 2.46 +/- 0.19. Graphical analysis was highly correlated with NLRA (R2=0.91, slope=0.90 +/- 0.08). The ratio methods correlated well with NLRA (3-4 h, R2=0.71, slope= 0.73 +/- 0.13; 4-5 h, R2=0.86, slope=0.73 +/- 0.09; 5-6 h, R2=0.80, slope=1.00 +/- 0.15), and also with graphical analysis (3-4 h, R2=0.65, slope=0.74 +/- 0.16; 4-5 h, R2=0.85, slope=0.78 +/- 0.09; 5-6 h, R2=0.88, slope=1.11 +/- 0.12). The optimum equilibrium time point for obtaining a simple ratio was approximately 4.5-5.5 h. In conclusion, the simple ratio techniques for obtaining a quantitative measure of specific binding correlated well with the reference tissue kinetic models, using both NLRA and graphical analysis. The optimum time for obtaining a ratio appeared to be in the range 4.5-5.5 h. Earlier time points, while still relatively accurate, had a lower sensitivity and may not be optimized for measuring small changes in DAT concentrations.
Adolescent↗
Study of arterial blood pressure by a Windkessel-type model: influence of arterial functional properties.
OBJECTIVE: To analyse the performance of a Windkessel blood pressure (BP) modeling of arterial compliance adjusted in a dynamic fashion according to a non-linear relationship between the arterial compliance (AC) and BP. Non invasive measurements of the radial BP waveform (MILLAR tonometry) were compared to those constructed by an electric simulator reproducing the model in a symmetrical network subdivided into 121 segments. We introduced at cardiac level the aortic stroke volume (Doppler echocardiography) and the dynamic values of compliance (relation of compliance-to pressure, constant or variable) whether the model was linear or non linear, measured by high resolution Doppler (NIUS 02) for each subject. RESULTS: At the radial artery segment the modelled BP obtained by the non linear model of AC was not significantly different from the measured BP wave, while in the linear model (AC constant at mean BP level) the systolic BP was significantly underestimated. (*P < 0.05). CONCLUSION: This work shows the limits inherent in simplification of arterial compliance in the Windkessel model using constant parameters. This demonstrates the influence of the dynamic properties of the arterial wall in a conduction artery on the level of systolic and diastolic BP.
Blood Pressure↗
A graphical method to simplify the application of the linear-quadratic dose-effect equation to fractionated radiotherapy.
The linear-quadratic (LQ) dose-effect equation has been shown to be capable of providing a number of new insights into clinical radiotherapy. However, even in the most straightforward application of the formalism, i.e. to fractionated radiotherapy, the level of mathematics required to solve the associated equations could be a significant barrier to the wider application of the LQ method. In this paper it is shown that a wide range of problems arising in fractionated radiotherapy are capable of being analysed with the aid of one basic graph. It is further demonstrated that the extrapolated response dose, which forms the conceptual fulcrum of the LQ method is an additive quantity, and that the analysis of treatments involving several component parts can be simplified by using this property. The main features of these simplifications are demonstrated using some representative worked examples.
Brachytherapy↗
[Economic simplification in the pharmaceutical service. I. Analysis of the current situation and motivation of suggested work reorganization].
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Community Pharmacy Services↗
Multihost, multiparasite systems: an application of bifurcation theory.
The local analysis of multihost multiparasite models has been hampered by algebraic intractability. There have been two responses to this difficulty: extensive numerical investigation, and simplification to a level where analytical techniques work. In this paper we describe another approach, based on bifurcation theory, in which the qualitative properties of the model equilibrium structure are realized on an array of maps drawn in parameter space. This approach is described in the context of two models: the basic two-host shared microparasite S-I model and the single-host two-microparasite S-I (susceptible-infective) model. The procedure involved does not require model simplification through a reduction in dimensionality. It can handle intraspecific as well as parasite-mediated competition and, in the second model, single-host parasite coexistence. The map arrays provide a concise catalogue of the possible modes of behaviour of a system and an explanation for changes in that behaviour. In particular, the reasons why the conjectures made about the behaviour of the first of these models do not hold throughout parameter space are immediately clear from the map structure, as are the conditions for collusive and competitive behaviour between the two types of parasite in the second model.
Animals↗
Factors affecting survival rates of in vitro produced bovine embryos after vitrification and direct in-straw rehydration.
The aim of this work was to investigate the possibilities of simplification, and to outline the limits of application, of a vitrification method for cow embryos. Morulae and blastocysts were produced by in vitro fertilization of slaughterhouse-derived, in vitro matured oocytes with frozen-thawed bull semen, and subsequent culture on a granulosa cell monolayer. Vitrification was performed by equilibration of embryos with 12.5% ethylene glycol and 12.5% dimethylsulphoxide at 20-22 degrees C for 60 s, then with 25% ethylene glycol and 25% dimethylsulphoxide at 4 degrees C for another 60 s. Embryos were then loaded in straws, placed in liquid nitrogen vapour for 2 min, and then plunged. Straws were thawed in a 22 degrees C water-bath, the embryos were directly rehydrated and further incubated in straw, and were then expelled and cultured in vitro for 72 h. In the first experiment, embryos of different age and developmental stage (Day 5 compacted morulae, Day 6 early blastocysts, Days 6 and 7 blastocysts, Day 7 expanded blastocysts and Day 8 hatched blastocysts) as well as Days 7 and 5 blastocysts previously subjected to partial zone dissection were vitrified. After thawing, the re-expansion rates of blastocysts and zona-dissected embryos did not differ (67 and 87%, respectively), and hatching was more frequent for blastocysts frozen in advanced developmental stages (34, 47 and 63% for early blastocysts, blastocysts and expanded blastocysts, respectively). The re-expansion rate of morulae was lower (10%) and no hatching of these embryos was observed. In the second experiment, Day 7 expanded blastocysts were vitrified using PBS, PBS+albumin, TCM199 and TCM199+calf serum as holding media. No differences in re-expansion and hatching rates were seen. However, when incubation with the concentrated cryoprotectant solution was performed at 20-22 degrees C, the embryo survival rate decreased (PBS+albumin) or no embryo survived (TCM199+calf serum) the vitrification procedure. In the third experiment, Day 7 expanded blastocysts were vitrified, thawed, cultured for 1 day, and then re-expanded embryos were again vitrified and thawed. Out of the 87% that survived the first cycle, 73% re-expanded and 47% hatched following the second vitrification and thawing. These observations prove that the vitrification procedure described is relatively harmless, that it can be used for blastocysts of different developmental stages and that an intact zona is not required to obtain high survival rates.
Animals↗
Description of the third-order optical aberrations of near-circular pupil optical systems without symmetry.
Many authors, dating back to at least the 1950s, have presented mathematical expansions of the wave-front aberration function for optical systems without symmetry, typically based on limiting assumptions and simplifications, with some of the most recent work being done by Howard and Stone [Appl. Opt. 39, 3232 (2000)]. This paper reveals that in fact there are no new aberrations in imaging optical systems with near-circular aperture stops but otherwise without symmetry. What does occur is that the field dependence of an aberration often changes when symmetry is abandoned. Each aberration type develops a characteristic field behavior in a system without symmetry. Specifically, for example, astigmatism, develops a binodal field dependence; e.g., there are typically two points in the field with zero astigmatism, and typically neither point is on axis. This construct, nodal aberration theory, for understanding the aberrations in systems without symmetry becomes a direct extension of an optical designer's knowledge base. Through the use of real ray-based analysis methods, such as Zernike coefficients, it is possible to understand completely the aberrations of optical systems without symmetry in terms of rotationally symmetric aberration theory with the simple addition of the concept of field nodes.
Journal Article↗
Ceramic shade prescriptions for work authorizations.
The basic application provides essential data for ceramic veneer fabrication. Three-dimensional information divides the space for body and enamel components. The second body shade selection improves shade matching in the middle one-third of the tooth and enhances the appearance of the enamel component. Dentists are encouraged to recognize the influence each component has upon the total shade composition. A format is established for recording clinical information. The use of available ceramic systems is seemingly unlimited. The method presented provides flexibility for recording the most detailed shade information in simple graphic and verbal terms. Technical simplification is a by-product of complete, precise work information. Clinical judgements based on color and ceramic knowledge, as well as experience, can be conveniently converted into concise component descriptions. Using the suggested guidelines with reasonable care, a comfortable experience base for prescribing difficult shades can quickly develop.
Ceramics↗