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PubMed1995

Reconciling science and policy in setting federal drinking water standards--four states' perspectives.

After almost 20 years of experience with implementing the Safe Drinking Water Act and eight with Amendments to the Act, the individual states within the United States have gained valuable experience while trying to reconcile the legal mandates provided by the statutes with the science underlying them. This paper presents four different topics illustrating the problems of reconciling these two issues in the regulation of toxic chemicals in drinking waters. It presents these from the perspectives of the states of Massachusetts, Rhode Island, Connecticut, and New Jersey and offers suggestions for improved program efficiency based on considerations of comparative human health risks. The approach and schedule for controlling toxic chemicals used through 1994 are first examined and a recommendation is made for more flexibility in the rate at which chemicals are regulated. Recent U.S. EPA proposals to more stringently control radon in drinking waters are presented in the context of all sources of radon exposures, illustrating the intersection of science, laws, and economic consequences of regulatory initiatives. Inhalation and dermal exposures as a result of using chemically contaminated drinking waters are then discussed with the suggestion of the possible underprotectiveness of some present standards. Finally, the difficulty faced by the states and federal government in the control of naturally occurring arsenic exposures through drinking water is also presented and an argument is made for more local flexibility in the application of health-based standards.

Administration, Cutaneous↗
PubMed1991

The potential use of expert systems to enable physicians to order more cost-effective diagnostic imaging examinations.

Educating physicians to order diagnostic imaging examinations more cost-effectively is a difficult and time consuming task, which may be assisted significantly by the use of an expert system. This report is based on a study undertaken at the Health Sciences Centre in Winnipeg, Manitoba, to determine the feasibility of implementing an expert system to aid physicians in selecting appropriate imaging studies. The report reviews the potential benefits, requirements, and limitations of expert systems under development, and highlights the major issues to be considered in choosing such a system for implementation. An extensive literature search was done and is included to aid the reader interested in pursuing this opportunity for improving the cost-effective utilization of expensive diagnostic imaging resources.

Computer-Assisted Instruction↗
PubMed1990

Hypermedia and randomized algorithms for medical expert systems.

KNET is an environment for constructing probabilistic, knowledge-intensive systems within the axiomatic framework of decision theory. The KNET architecture defines a complete separation between the hypermedia user interface on the one hand, and the representation and management of expert opinion on the other. KNET offers a choice of algorithms for probabilistic inference. We and our coworkers have used KNET to build consultation systems for lymph-node pathology, bone-marrow transplantation therapy, clinical epidemiology, and alarm management in the intensive-care unit. Most important, KNET contains a randomized approximation scheme (RAS) for the difficult and almost certainly intractable problem of Bayesian inference. Our algorithm can, in many circumstances, perform efficient approximate inference in large and richly interconnected models of medical diagnosis. In this article, we describe the architecture of KNET, construct a randomized algorithm for probabilistic inference, and analyze the algorithm's performance. Finally, we characterize our algorithms' empiric behavior and explore its potential for parallel speedups. From design to implementation, then, KNET demonstrates the crucial interaction between theoretical computer science and medical informatics.

Algorithms↗
PubMed1992

Lee-Goldburg solid-state imaging.

A new approach to solid-state imaging (SSI) is presented. The method relies on narrowing the resonance line using the Lee-Goldburg sequence. The technique is easy to implement in practice and may find widespread applications in materials science.

Magnetic Resonance Spectroscopy↗
PubMed1976

A formative and summative evaluation model for special educational programs.

During the past two decades the problems of recruiting minority students into careers in the health fields have been addressed by many educators and various special study groups. Recent efforts by schools of medicine and allied health sciences to find viable solutions to the problem have facilitated implementation of career exploration and study-skills programs. Although the focus and sophistication of evaluation designs vary substantially among educational programs of this type, all share some common problems. The positions taken by the authors is that evaluation, both during and at the end of a program, is an essential aspect of the program and that the use of a systematic evaluation model is central to this effort. Data are presented which illustrate the utility of a systematic evaluation model when applied in a realistic test situation (an operational program for minority students). Several advantages of using this model are discussed.

Career Choice↗
PubMed1977

Subjects' rights, freedom of inquiry, and the future of research in the addictions.

Since the recent passage of regulations concerning subjects' rights and freedom on inquiry, opposition by the public and others to some areas of research in the addictions has prevented its implementation or continuation. Research investigators in the biomedical and behavioral sciences have been placed in the position of defending their work in an adversary climate. The author points out the importance of transmitting to the public, the scientific community, and legislators the investigators' concern that "subjects' rights" not be viewed only in a legalistic context, but also in the context of not harming the patient.

Advisory Committees↗
PubMed1985

Implementing change: the installation of an integrated library system at UTHSCSA.

The implementation of the Library Information System (LIS) and the distributed PHILSOM system at the University of Texas Health Science Center at San Antonio Library is described. These systems were installed over a ten-month period in 1982-1983. Aspects of the implementation, including equipment, staffing, scheduling, data preparation, and public relations, are reviewed. Evaluation of LIS and its costs are discussed.

Computers↗
PubMed1992

Collecting, communicating and using information: the educational issues. A report from the Royal College of Physicians Committee on Medical Information Technology.

Few of the major advances in information science and technology have yet been successfully introduced in health care. Their implementation could improve both quality of care and the working environment of clinicians, but this will not be achieved by investing in hardware and software alone. Investment in education is also required.

Attitude to Computers↗
PubMedDate not supplied

Organizing and implementing an Ilizarov program.

The Ilizarov external fixator has made a profound impact on orthopaedic science. With its circular design, it allows correction of three-dimensional deformities including rotation, angulation, translation, shortening, and widening, as well as lengthening and soft tissue defects. Because this device is largely patient centered and patient operated, it has presented a new challenge and career investment for the orthopaedic nurse. A comprehensive Ilizarov program is necessary to address the total patient and his multiple needs in any facility where the Ilizarov method of treatment is adopted. The Ilizarov program is a multidisciplinary team approach that provides a structure for administering and providing total patient care for the Ilizarov patient and his significant other(s).

External Fixators↗
PubMed1981

A zero-base approach to medical school planning and budgeting.

The University of Michigan Medical School has concluded that the traditional budgeting process used by it and other academic institutions fails to discriminate adequately among programs, particularly in times of level or declining resources, and that this failure could result in mediocrity. As a result, the school decided to develop a new system for managing resources and chose to explore an approach that utilizes the principles of zero-base budgeting. An important reason for selecting this technique was its requirement that managers plan, evaluate, and set priorities for all programs, existing as well as new. After a feasibility study that produced encouraging results, a test implementation of the newly developed system was carried out in all six of the school's basic science departments and in two clinical departments. While some difficulties were encountered, including those normally associated with the introduction of a new and complex system, the results of the test implementation were encouraging, and the process is undergoing further development to broaden its application in the clinical departments.

Budgets↗
PubMed2026

Clinical applications of digital twin technology in In Vitro Fertilisation.

BACKGROUND: Digital twin technology, originating from aerospace and manufacturing industries, has emerged as a transformative tool in healthcare. In vitro fertilisation (IVF) faces persistent challenges including suboptimal embryo selection, unpredictable treatment outcomes, and limited personalisation of protocols. Despite advances in assisted reproductive technology, existing literature exhibits fragmentation: artificial intelligence applications in embryo selection, ovarian stimulation, and endometrial assessment have been developed independently without systematic integration into comprehensive treatment frameworks. Digital twin technology offers unprecedented opportunities to create virtual replicas of biological systems, enabling real-time monitoring, predictive modelling, and personalised treatment strategies. AIM: This narrative review aims to critically examine the current applications of digital twin technology in IVF, evaluate its potential benefits and limitations, synthesize existing evidence into an integrative conceptual model, and identify future directions for implementation in reproductive medicine. METHOD: A comprehensive narrative review was conducted using PubMed, Scopus, Web of Science, and IEEE Xplore databases. A narrative review approach was selected over systematic review to accommodate the heterogeneity of evidence types in this emerging field, including theoretical frameworks, simulation studies, and proof-of-concept implementations that would be excluded from systematic reviews. Search terms included "digital twin," "IVF," "in vitro fertilisation," "assisted reproductive technology," "embryo selection," and "predictive modelling." Studies published between 2015 and 2025 were included, focusing on original research articles, systematic reviews, and proof-of-concept studies describing digital twin applications in reproductive medicine. RESULTS: Digital twin technology in IVF demonstrates significant potential across multiple domains including embryo development simulation, ovarian response prediction, endometrial receptivity modelling, and personalised stimulation protocols. Current applications integrate artificial intelligence, machine learning algorithms, time-lapse imaging, and omics data to create comprehensive virtual models. Early evidence suggests improvements in embryo selection accuracy, ovarian response prediction, and treatment protocol optimization, though large-scale randomized controlled trials remain limited. Implementation challenges include data integration complexity, computational requirements, regulatory considerations, and validation requirements. CONCLUSION: Digital twin technology represents a paradigm shift in IVF practice, offering personalised, predictive, and precision medicine approaches. This review synthesizes existing evidence to propose an integrative conceptual model for digital twin implementation across the IVF treatment spectrum, identifies critical knowledge gaps, and establishes research priorities to advance clinical translation. Despite current limitations, continued advancement promises improved success rates and patient outcomes.

Humans↗
PubMed2026

Systematic review of the mutations in the active antigenic site Ø of the prefusion F protein of the Respiratory Syncytial Virus (RSV) following the implementation of monoclonal antibody prophylaxis.

BACKGROUND: Monoclonal antibody (mAb) nirsevimab, which targets the antigenic site &#xd8; of the prefusion F protein (pre-F) of RSV, was introduced for RSV prophylaxis in several countries. METHODS: A systematic search was conducted between January 1, 2022, and July 31, 2026 for studies analyzing substitutions within the epitope of pre-F RSV protein, which is the target of nirsevimab, after the implementation of the mAb. We searched across PubMed, Scopus, Web of Science and ClinicalTrial.gov for studies involving children with confirmed RSV infection, that conducted genomic analysis. RESULTS: Seven studies (five observational and two randomized controlled trials) including 2156 RSV-positive samples (RSV-A: 1347, RSV-B: 809) were analyzed. RSV-A strains showed limited variability within antigenic site &#xd8;, with K65R being the most common substitution and K209E being the only intermediate-resistance RSV-A substitution. RSV-B strains demonstrated substantially higher substitution frequencies, particularly involving I206M, Q209R, and S211N. Most identified substitutions appeared to represent naturally occurring polymorphisms and retained susceptibility to nirsevimab, while multiple RSV-B substitutions and combinations involving residues 64-68 and 204-208 demonstrated reduced susceptibility or high-level resistance. Resistance-associated variants were detected in 28 of 2156 (1.3%) RSV-positive samples and exclusively among nirsevimab breakthrough infections. In a sub-analysis restricted to nirsevimab-treated individuals, resistance-associated variants were significantly more frequent among RSV-B than RSV-A (9.8% vs 0.5%; p&#xa0;<&#xa0;0.001). CONCLUSION: Most substitutions that were detected within the nirsevimab antigenic site reflect ongoing natural RSV evolution and do not significantly affect nirsevimab susceptibility. However, detection of resistance-associated variants highlights the importance of continuous genomic and phenotypic surveillance.

Humans↗
PubMed1995

Principles of clinical medicine: an interdisciplinary integrated 2-year longitudinal course.

In keeping with the Report of the Panel on the General Professional Education of the Physician (Association of American Medical Colleges 1984), Oregon Health Sciences University (OHSU) School of Medicine is in the midst of revising its curriculum. After a 4-year process, the Curriculum Committee mandated development of the Principles of Clinical Medicine course, a 2-year longitudinal course integrating input from both basic and clinical science departments. We describe the steps leading to the course's implementation, its administrative and organizational structure, the evaluation of student performance, teacher training, course curriculum, and the use of interdisciplinary teaching. This course embodies many of the changes called for in the AAMC Report and serves as a model for interdisciplinary education.

Clinical Medicine↗
PubMed1985

The book availability study as an objective measure of performance in a health sciences library.

In its search for an objective overall diagnostic evaluation, the University of Illinois Library of the Health Sciences' Program Evaluation Committee selected a book availability measure; it is easy to administer and repeat, results are reproducible, and comparable data exist for other academic and health sciences libraries. The study followed the standard methodology in the literature with minor modifications. Patrons searching for particular books were asked to record item(s) needed and the outcome of the search. Library staff members then determined the reasons for failures in obtaining desired items. The results of the study are five performance scores. The first four represent the percentage probability of a library's operating with ideal effectiveness; the last provides an overall performance score. The scores of the Library of the Health Sciences demonstrated no unusual availability problems. The study was easy to implement and provided meaningful, quantitative, and objective data.

Books↗
PubMed1983

Early outreach: career awareness for health professions.

"Early outreach" may be defined as a long-term, talent-development strategy designed to prepare a well qualified pool of disadvantaged and underrepresented minority applicants for entry into health professions schools, particularly medical schools. The concept of early outreach is to prepare, motivate, and educate talented, economically disadvantaged junior high or secondary school students to gain the necessary academic qualifications to make high school graduation, college attendance, and health careers a reality. In this paper the author defines the problem to which early outreach is addressed and discussed the contextual and historical background of the concept. A number of programs at the Health Sciences Center at the University of Illinois at Chicago designed and implemented to provide a model to achieve the concept of early outreach are described.

Career Choice↗
PubMed1995

Physicians for the 21st century: implications for medical practice, undergraduate preparation, and medical education.

Changes in medical education and the practice of medicine have resulted from the push for both education and health care reforms. Undergraduates planning application to medical school should broaden their preparation to include communications, computers, economics, and multicultural educational experiences. To prepare graduates for medical practice in the new millennium, the University of Kentucky College of Medicine has implemented a new curriculum focusing on integration of basic and clinical sciences, primary care in ambulatory sites, health promotion and disease prevention, and attention to the ethical, social, psychologic, and financial impact of disease upon the patient, family, and society.

Curriculum↗
PubMed1990

The key scientific issue of the next century: the science of addiction.

The problem of addiction is believed to be the most important scientific issue of the next century. The solution to the riddle of pharmacologic, psychological, and social addiction to nicotine, heroin, alcohol, and a high-fat diet, and the discovery and implementation of strategies for spreading healthy "addictions" will aid in solving many major public health and social science problems in the next century. All-out efforts should be expended on the comprehensive development of a science of addiction and to the wide-scale effective application of the results of such research in order to promote health, prosperity, and peace for every community in the world.

Forecasting↗