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A computer program for the computation of the plausibility of paternity is presented. This program gives detailed information on the genotypical possibilities for a given phenotypical constellation.
The application of output value analysis, a type of benefit/cost analysis, to a psychiatric patient population is reported. A method for discounting the value of the program if a patient was readmitted within a year after discharge was introduced. The application of this discount factor reduces the value produced by the program and thereby reduces both productivity and effectiveness indices. When applied to groups known to differ in readmission rates, such as first admissions and readmissions or voluntary and involuntary admissions, the discount factor can accentuate group differences markedly. When selected diagnostic groups were compared, the discount factor could even reverse the relative standing of the groups.
This study analyzes the relationship between program performance and workload levels. The results indicate that program effectiveness is highest under medium workloads while efficiency is greatest under high workloads. The management dilemma resulting from these findings is discussed.
We investigated the therapeutic effect of marked body weight reduction on the predominantly obstructive sleep apnea syndrome by the application of an out-patient, behaviour therapy based body weight reduction program (Optifast-program) in five of our obese apnea patients (mean overweight by Broca 53.6 +/- 24.8 kg). Mean body weight reduction was 32.7 +/- 15.8 kg after six months. The mean apnea-index of 34.5 +/- 23.1/h prior to the weight reduction dropped to 7.8 +/- 6.1/h after therapy. The mean apnea-hypopnea-index (so called "respiratory disturbance index", RDI) could be reduced from 45,7 +/- 26.0/h to 14.0 +/- 11.4/h. The best therapeutic effect on the sleep related respiratory parameters was seen in patients who reached their normal weight whereas the absolute weight reduction itself seems to be less important. Our results should encourage this causal therapy in appropriate patients.
An export module was developed for transferring primary relational pedigree data directly from a widely used pedigree program and relational database to the BRCAPRO program for calculation of BRCA gene mutation probability estimation.
OBJECTIVE: To investigate the effect of repeated feedback-controlled and programmed "intelligent" stretching of the ankle plantar- and dorsiflexors to treat subjects with ankle spasticity and/or contracture in stroke. DESIGN: Noncontrolled trial. SETTING: Institutional research center. PARTICIPANTS: Subjects with spasticity and/or contracture after stroke. INTERVENTIONS: Stretching of the plantar- and dorsiflexors of the ankle 3 times a week for 45 minutes during a 4-week period by using a feedback-controlled and programmed stretching device. MAIN OUTCOME MEASURES: Passive and active range of motion (ROM), muscle strength, joint stiffness, joint viscous damping, reflex excitability, comfortable walking speed, and subjective experiences of the subjects. RESULTS: Significant improvements were found in the passive ROM, maximum voluntary contraction, ankle stiffness, and comfortable walking speed. The visual analog scales indicated very positive subjective evaluation in terms of the comfort of stretching and the effect on their involved ankle. CONCLUSIONS: Repeated feedback-controlled or intelligent stretching had a positive influence on the joint properties of the ankle with spasticity and/or contracture after stroke. The stretching device may be an effective and safe alternative to manual passive motion treatment by a therapist and has potential to be used to repeatedly and regularly stretch the ankle of subjects with spasticity and/or contracture without daily involvement of clinicians or physical therapists.
In previous papers, several approaches to programming of the resulting force field in GFFF were described and investigated. The experiments were dealing with flow-velocity and channel thickness, i.e. factors influencing hydrodynamic lift forces (HLF). The potential of density and viscosity of carrier liquid for field programming was predicted and demonstrated by preliminary experiments. This work is devoted to experimental verification of the influence of carrier liquid density and viscosity. Several carrier liquid density and simultaneously viscosity gradients using water-methanol mixtures are in this work implemented in the separation of a model silica mixture. Working with the water-methanol gradients, one is not able to separate the influence of density from the contribution of viscosity. However, we found experimental conditions to show the isolated effect of carrier liquid density (two water-methanol mixtures of equal viscosity differing in their densities). In order to demonstrate the isolated effect of viscosity, we implemented in this work a new system of (hydroxypropyl)methyl cellulose (HPMC) carrier liquids. Three different HPMC compositions enabled to vary the viscosity more than two times at almost constant density. With increasing carrier liquid viscosity, the focusing and elevating trend was clearly pronounced for 5 and 10 microm silica particles. By the isolated effect of increased viscosity, the centre of the 10 microm particle zone was elevated to the streamline at 16% of the channel height. These experiments have shown that the influence of carrier liquid viscosity on HLF should be taken into account even at higher levels above the channel bottom, i.e. beyond the near-wall region. Further, it is shown that higher value of carrier liquid viscosity improves the separation of the model mixture in terms of time and resolution.
The OPTAMA (Optimizing Pharmacodynamic Target Attainment using the MYSTIC [Meropenem Yearly Susceptibility Test Information Collection] Antibiogram) Program provides insight into the appropriate antibiotic options for empiric therapy for common nosocomial pathogens. In this report, South America is represented by Brazil, Colombia, Peru, and Venezuela. A 5000-subject Monte Carlo Simulation estimated pharmacodynamic target attainment for meropenem, imipenem, ceftazidime, cefepime, piperacillin/tazobactam, and ciprofloxacin against Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. Pharmacokinetic parameter variability was derived from existing healthy volunteer data, and minimum inhibitory concentration (MIC) data came from the 2002 MYSTIC program. Piperacillin/tazobactam and ciprofloxacin displayed the lowest target attainment against all bacterial species (14% to 24% for A. baumannii, 26% to 37% for P. aeruginosa, and 48% to 66% for the Enterobacteriaceae). Overall, the carbapenems had the highest probabilities of attainment against the Enterobacteriaceae (98% to 100%) and A. baumannii (73% to 74%), whereas cefepime obtained the greatest target attainment against P. aeruginosa (65%). Because no single regimen had high target attainment against A. baumannii and P. aeruginosa, the use of combination therapy to treat these pathogens in South America may be justified. Because of the lack of agreement with percent susceptibility for certain antimicrobial regimens, the use of pharmacodynamic target attainment may be a more accurate predictor of microbiologic success.
The National Diabetes Education Program is a joint initiative of the National Institutes of Health and the Centers for Disease Control and Prevention. This article outlines the program, points out implications for dietetics professionals, and offers suggestions as to how they may become involved.
Gravitational field-flow fractionation (GFFF) utilizes the Earth's gravitational field as an external force that causes the settlement of particles towards the channel accumulation wall. Hydrodynamic lift forces oppose this action by elevating particles away from the channel accumulation wall. These two counteracting forces enable modulation of the resulting force field acting on particles in GFFF. In this work, force-field programming based on modulating the magnitude of hydrodynamic lift forces was implemented via changes of flow-rate, which was accomplished by a programmable pump. Several flow-rate gradients (step gradients, linear gradients, parabolic, and combined gradients) were tested and evaluated as tools for optimization of the separation of a silica gel particle mixture. The influence of increasing amount of sample injected on the peak resolution under flow-rate gradient conditions was also investigated. This is the first time that flow-rate gradients have been implemented for programming of the resulting force field acting on particles in GFFF.
Gravitational field-flow fractionation utilises the Earth's gravitational field as an external force that causes the settlement of particles towards the channel accumulation wall. Hydrodynamic lift forces oppose this action by elevating of particles from the channel accumulation wall. Therefore there are several possibilities to modulate the resulting force field acting on particles in gravitational field-flow fractionation. Regarding the force field programming in gravitational field-flow fractionation, this work focused on two topics: changes of the difference between particle density and carrier liquid density in Brownian and focusing elution modes and influencing of lift forces achieved by changing the flow-rate in focusing elution mode. We have found and described the experimental conditions applicable to force field programming in the case of separations of silica gel particles by gravitational field-flow fractionation. It was shown that the effect of carrier liquid viscosity in the water-methanol system is implemented as an additional factor enhancing the desired effect of carrier liquid density. Some other forces influencing the retention behaviour of the model particles are discussed.
The Systolic Hypertension in the Elderly Program (SHEP) staff contacted 447,921 screenees, of whom 11,919 (2.7%) were originally eligible and 4,736 (1.1%) maintained eligibility and were randomized. The total number of participants enrolled at the 16 clinical centers ranged from 133 to 559. The low yield of screenees to randomizations resulted from the study design, not from low levels of agreement to participate, and required the employment of a variety of recruitment strategies in a prudent overall plan. SHEP was one of the first clinical trials to use mass mailing as a primary strategy of recruitment. The study used mailing lists from seven generic sources. More than 3.4 million letters of invitation were mailed; they yielded an overall response rate of 4.3%. Motor vehicle and voter registration lists provided the greatest numbers of names. Mailings to members of health maintenance organizations (HMOs) and registrants of the Health Care Finance Administration (HCFA) provided the greatest response rates. Considerable variability in response rates existed among clinical centers using generically similar mailing lists. Generally, the number of hours spent on recruitment showed a positive, but not statistically significant, association with randomization yields. The recruitment yield was statistically significantly higher in clinics with experienced recruitment coordinators than in clinics with inexperienced ones (p = 0.0008). From these findings we conclude that mass mailing is an important strategy in an overall recruitment program, that the involvement of experienced recruitment staff is important, and that although the total time spent by staff on recruitment may also improve results, it matters less than the staff's level of recruiting experience.
A group of 13 men and women in substance abuse treatment participated in a 3-day residential program experience based on integrated principles from adventure therapy, therapeutic camping, and relapse prevention. The experimental group is compared to a group of 18 men and women who received the usual and customary relapse prevention program. Both groups completed pre- and postintervention questionnaires. There were no differences in drinking-related locus of control, stress, or problem-solving between groups at postinterview, but there were significant improvements in autonomic arousal, frequency of negative thoughts, and alcohol craving. Participants in both groups were interviewed 10 months after the 3-day intervention. Considering individuals who were unreachable as relapsed, the 10-month follow-up relapse rate was 31% for the experimental group and 58% for the comparison group. These results add to the limited body of research supporting outdoor adventure and therapeutic camping experiences integrated with traditional relapse prevention activities as an adjunct to substance abuse treatment.
In this paper we present a method for converting general nonlinear programming (NLP) problems into separable programming (SP) problems by using feedforward neural networks (FNNs). The basic idea behind the method is to use two useful features of FNNs: their ability to approximate arbitrary continuous nonlinear functions with a desired degree of accuracy and their ability to express nonlinear functions in terms of parameterized compositions of functions of single variables. According to these two features, any nonseparable objective functions and/or constraints in NLP problems can be approximately expressed as separable functions with FNNs. Therefore, any NLP problems can be converted into SP problems. The proposed method has three prominent features. (a) It is more general than existing transformation techniques; (b) it can be used to formulate optimization problems as SP problems even when their precise analytic objective function and/or constraints are unknown; (c) the SP problems obtained by the proposed method may highly facilitate the selection of grid points for piecewise linear approximation of nonlinear functions. We analyze the computational complexity of the proposed method and compare it with an existing transformation approach. We also present several examples to demonstrate the method and the performance of the simplex method with the restricted basis entry rule for solving SP problems.
OBJECTIVE: To delay or discourage the use of alcohol by seventh-grade students through peer-led education. Peer-Led Alcohol Education (PLAE) program objectives were to: (1) educate students about alcohol use and (2) assess the differences between pharmacy student presenters and high school student (peer) presenters. SETTING: Middle schools in rural Nebraska. DESIGN: PLAE focuses on normative beliefs, personal values, and pledging. Pharmacy students and high school students were trained to deliver alcohol education presentations to seventh-grade students. Evaluation results were compared among groups of seventh-grade students who received PLAE presentations from peer presenters and from pharmacy student presenters. RESULTS: PLAE presentations were made to 342 seventh-grade students at 11 schools. Evaluation results suggest that pharmacy students projected more confidence in their presentations, used more creative prop selections, and were more effective communicators. High-school presenters had a greater ability to "relate" to the seventh-graders and thus were deemed more on-target with the information. CONCLUSION: Evaluation findings suggest that rural seventh-grade students in Nebraska perceived that the PLAE program provides useful information to aid them in their decisions regarding alcohol use.
Cycloheximide (CHX), long recognized for its ability to inhibit protein synthesis, has been widely employed in studies of cell death to the extent that prevention of cell death by CHX has been used as prima facie evidence for a subtype of apoptosis called 'programmed cell death'. However, very rarely have investigators determined the effects of CHX on protein synthesis in their particular cell death paradigms. Recent findings are revealing alternative mechanisms of action of CHX that involve, ironically, stimulation of cytoprotective signalling pathways. For example, in embryonic rat hippocampal cell cultures CHX protects neurons against oxidative insults by a mechanism involving induction of neuroprotective gene products including Bcl-2. CHX induces increases in immediate early gene mRNA levels, and can activate several different kinases and transcription factors that are also activated by various insults and in response to anti-apoptotic growth factors. Concentrations of CHX that cause only a modest and/or transient decrease in over-all protein synthesis may prevent cell death by inducing cytoprotective signalling pathways ('programmed cell life'), whereas higher concentrations of CHX may prevent cell death by blocking the expression of 'death genes'. Establishing which of these anti-apoptotic mechanisms of action of CHX is operative in each cell death paradigm is clearly essential for proper interpretation of experimental results.
The progress in artificial intelligence enables us to conceive adaptive systems whose characteristics are nearer and nearer to those of living beings. These characteristics though depend on ingenious choices by the designer of these systems: Initial conditions, parameters, optimisation functions, gradient and measure of fitness within the environment. Nevertheless, in living systems which are non-finalist, there are no programmers or designers to conceive of such ingenious choices. Our paper "Self-Programming Machines (I)" presents a non-finalist model since initial states and functions are randomly chosen at the beginning and once and for all. In spite of the fact that they are non-finalist, these machines always stabilise at fixed points when they are connected to an external process. This paper studies the dynamics of a mono-layered network of self-programming machines driving a real device. "the Ashby homeostat", and shows the striking properties of such networks. This system stabilises only at fixed points even if it is subjected to small perturbations or intentional breakdowns such as a reversal of power supply or disconnection of one or several motors. Real and simulated experiences are compared and theoretical results are demonstrated.
This article presents an experimental evaluation of the Family Bereavement Program (FBP), a 2-component group intervention for parentally bereaved children ages 8-16. The program involved separate groups for caregivers, adolescents, and children, which were designed to change potentially modifiable risk and protective factors for bereaved children. The evaluation involved random assignment of 156 families (244 children and adolescents) to the FBP or a self-study condition. Families participated in assessments at pretest, posttest, and 11-month follow-up. Results indicated that the FBP led to improved parenting, coping, and caregiver mental health and to reductions in stressful events at posttest. At follow-up, the FBP led to reduced internalizing and externalizing problems, but only for girls and those who had higher problem scores at baseline.