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PubMed2003

Enhancing interaural-delay-based extents of laterality at high frequencies by using "transposed stimuli".

An acoustic pointing task was used to determine whether interaural temporal disparities (ITDs) conveyed by high-frequency "transposed" stimuli would produce larger extents of laterality than ITDs conveyed by bands of high-frequency Gaussian noise. The envelopes of transposed stimuli are designed to provide high-frequency channels with information similar to that conveyed by the waveforms of low-frequency stimuli. Lateralization was measured for low-frequency Gaussian noises, the same noises transposed to 4 kHz, and high-frequency Gaussian bands of noise centered at 4 kHz. Extents of laterality obtained with the transposed stimuli were greater than those obtained with bands of Gaussian noise centered at 4 kHz and, in some cases, were equivalent to those obtained with low-frequency stimuli. In a second experiment, the general effects on lateral position produced by imposed combinations of bandwidth, ITD, and interaural phase disparities (IPDs) on low-frequency stimuli remained when those stimuli were transposed to 4 kHz. Overall, the data were fairly well accounted for by a model that computes the cross-correlation subsequent to known stages of peripheral auditory processing augmented by low-pass filtering of the envelopes within the high-frequency channels of each ear.

Adult↗

PubMed2000

Evaluation of intradialytic solute and fluid kinetics. Setting Up a predictive mathematical model.

A mathematical model of solute kinetics for the improvement of hemodialysis treatment is presented. It includes a two-compartment description of the main solutes and a three-compartment model of body fluids (plasma, interstitial and intracellular). The main model parameters can be individually assigned a priori, on the basis of body weight and plasma concentration values measured before beginning the session. Model predictions are compared with clinical data obtained in vivo during 11 different hemodialysis sessions performed on 6 patients with a profiled sodium concentration in the dialysate and a profiled ultrafiltration rate. In all cases, the agreement between the time pattern of model solute concentrations in plasma and the in vivo data proves fairly good as to urea, sodium, chloride, potassium and bicarbonate kinetics. Only in two sessions was blood volume directly measured in the patient, and in both cases the agreement with model predictions was good. In conclusion, the model allows a priori computation of the amount of sodium removed during hemodialysis, and makes it possible to predict the plasma volume changes and plasma osmolarity changes induced by a given sodium concentration profile in the dialysate and by a given ultrafiltration profile. Hence, it can be used to improve clinical tolerance to the dialysis session taking the characteristics of individual patients into account, in order to minimize intradialytic hypotension.

Bicarbonates↗

PubMed1993

Children at risk--a presentation of a Nordic project.

In 1991, money was granted by Nordisk Ministerråd to prepare a Nordic project concerning children at risk. Since then, preparations have gone forward to organize a project focussing on 10-year olds' experiences of risk and protective factors in their daily lives. The project combines data from fairly large cohorts or samples with in-depth studies concerning specific analyses of risk and protective factors, life events, children's experiences with various helping services and child welfare, children's school environment etc. A project group with participants from all the Nordic countries has been established, and three meetings have been arranged during 1992. The Nordic project as such aims to started fully 1993.

Child↗

PubMed2005

A model of impairment and functional limitation in rheumatoid arthritis.

BACKGROUND: We have previously proposed a theoretical model for studying physical disability and other outcomes in rheumatoid arthritis (RA). The purpose of this paper is to test a model of impairment and functional limitation in (RA), using empirical data from a sample of RA patients. We based the model on the disablement process framework. METHODS: We posited two distinct types of impairment in RA: 1) Joint inflammation, measured by the tender, painful and swollen joint counts; and 2) Joint deformity, measured by the deformed joint count. We hypothesized direct paths from the two impairments to functional limitation, measured by the shirt-button speed, grip strength and walking velocity. We used structural equation modeling to test the hypothetical relationships, using empirical data from a sample of RA patients recruited from six rheumatology clinics. RESULTS: The RA sample was comprised of 779 RA patients. In the structural equation model, the joint inflammation impairment displayed a strong significant path toward the measured variables of joint pain, tenderness and swelling (standardized regression coefficients 0.758, 0.872 and 0.512, P <or= 0.001 for each). The joint deformity impairment likewise displayed significant paths toward the measured upper limb, lower limb, and other deformed joint counts (standardized regression coefficients 0.849, 0.785, 0.308, P <or= 0.001 for each). Both the joint inflammation and joint deformity impairments displayed strong direct paths toward functional limitation (standardized regression coefficients of -0.576 and -0.564, respectively, P <or= 0.001 for each), and explained 65% of its variance. Model fit to data was fair to good, as evidenced by a comparative fit index of 0.975, and the root mean square error of approximation = 0.058. CONCLUSION: This evidence supports the occurrence of two distinct impairments in RA, joint inflammation and joint deformity, that together, contribute strongly to functional limitations in this disease. These findings may have implications for investigators aiming to measure outcome in RA.

Adult↗

PubMed1983

Estimated affinity of isoproterenol to cardiac chronotropic beta-receptor and of phenylephrine to vasoconstrictive alpha-receptor of the systemic resistance vessels in human borderline hypertension.

There has been yet no report, to our knowledge, which clarified the affinity ("sensitivity") of catecholamines to cardiac chronotropic beta-adrenergic receptor or to vasoconstrictive alpha-adrenergic receptor of skeletal muscle resistance vessels in human borderline hypertension (BHT), using an analysis of the kinetics of the drug-receptor interaction. In the first half of this study, isoproterenol (ISO) infusion test was performed on "normal" subjects (n = 12) and subjects with BHT (n = 10). Dose-response relation was obtained in terms of various doses of ISO and the increments of heart rate (deltaHR) produced by ISO. In the latter half of this study, phenylephrine (PHE) infusion test was carried out in the series of "normal" subjects (n = 5) and subjects with BHT (n = 6), a partly different series from the first series of subjects. Dose-response relation, again, was obtained in terms of various doses of PHE and the increments of total peripheral resistance (deltaTPR) produced by PHE. These relations were displayed on Lineweaver-Burk's plot and the "affinity" of ISO to cardiac chronotropic beta-receptor or that of PHE to vasoconstrictive alpha-receptor of skeletal muscle resistance vessels was estimated, graphically, assuming that 1) drugs were diluted by a volume of body fluid equal to the blood volume which was actually measured in each individual and 2) this concentration of drugs existed around the receptor site, i.e., there was no significant individual variations in terms of the metabolism and the distribution of the drugs. Estimated "affinity" of ISO to cardiac chronotropic beta-receptor was 0.168 +/- 0.014 x 10(4) ml X ug-1 (mean +/- SE, n = 10) in patients with BHT, while it was 0.170 +/- 0.015 x 10(4) (n = 12) in "normal" subjects. Estimated "affinity" of PHE to vasoconstrictive alpha-receptor of skeletal muscle resistance vessels was 0.171 +/- 0.011 x 10(2) ml X ug-1 (n = 6) in patients with BHT, while it was 0.183 +/- 0.012 x 10(2) (n = 5) in "normal" subjects. It is concluded from these data, almost fairly, that there is no difference in terms of the estimated "affinity" of ISO to cardiac chronotropic beta-receptor or that of PHE to vasoconstrictive alpha-receptor between "normal" subjects and patients with BHT. It was also found, in PHE infusion tests, that the plasma adrenaline concentration was significantly higher in patients with BHT than in "normal" subjects, at least at two points of time in the test: a) immediately before PHE infusion, when every individual appeared to be considerably restful and b) at the end of 1-2 min after the completion of the infusion of the largest dose of PHE used.

Adult↗

PubMed2005

Efficacy of atypical antipsychotics in bipolar disorder.

Bipolar disorder is a severe and recurrent disorder. Atypical antipsychotics have emerged as both an alternative and adjunct to conventional mood stabilisers. The manic phase of the illness is the best studied, and it appears that a class effect with regards to efficacy is present in both monotherapy and augmentation studies. Evidence for efficacy of atypical antipsychotics in depression is emerging. At this stage controlled data are available for both olanzapine and quetiapine. Maintenance data demonstrating efficacy are available for olanzapine. Atypical antipsychotics have utility in treating acute agitation and aggression in manic episodes of bipolar disorder. Subgroup analyses from trials treating manic phase bipolar disorder, and an open-label study of rapid cycling, have suggested that atypical antipsychotics may be useful for the treatment of mixed states and rapid cycling. Several studies have suggested that atypical antipsychotics may be useful in treatment-refractory episodes of bipolar disorder. The current available data suggest greater efficacy of the atypical antipsychotics in mania than in depression, although the data are fairly clear that induction of depression is not an issue with the atypical antipsychotics. A number of trials are underway that will hopefully address many of the questions still pending.

Adolescent↗

PubMed2026

AI-driven diagnostic and prognostic models for metabolic dysfunction-associated steatotic liver disease: insights from clinical, imaging, and multi-omics studies-a scoping review.

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is the most common chronic liver disease around the world, affecting 33.6% of the adult population (95% CI: 28.1%-39.5%; I 2 = 99.9%), or roughly one in three. The extent of the liver damage is variable, from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH), cirrhosis and hepatocellular carcinoma (HCC). Early diagnosis is essential to prevent serious liver damage. Traditional diagnostic techniques such as liver biopsy, imaging, and biomarker testing are all invasive, costly, reduced sensitive to early-stage disease, and they also have variability among observers. Modern diagnostic and prognostic approaches based on the principles of Artificial Intelligence (AI) and specifically on machine learning (ML) and deep learning (DL) have enabled multimodal approaches integrating clinical, imaging and molecular data. This scoping review conducted per PRISMA-ScR guidelines, synthesizes findings from 73 studies (search window 2020-2026) across three dimensions: clinical data driven models, imaging-based classifiers (ultrasound, CT and MRI), and multi-omics (genomics, transcriptomics and proteomics) techniques. Moreover, emergence of models such as U-Net and LiverNet 2.x, classification models like DeepLiverNet and BiLSTM models, as well as transformer frameworks and the identification of biomarkers models are also described. This study also investigates challenges such as data heterogeneity, data interpretability, fairness and real-world clinical application. Finally, important areas of research opportunities and future directions are highlighted to present a developing clinically applicable, explainable and ethical AI solutions to manage MASLD.

MASLD↗

PubMed1992

[Toxoplasmosis and important virus infections in pregnancy-- diagnosis and management].

Toxoplasmosis and viral infections such as rubella, cytomegaly and parvovirus B19 are much feared risk during pregnancy. The rate of connatal toxoplasmosis and of subclinically infected infants at birth with the risk of late manifestation is still unclear, whereas such data are fairly well-known for rubella-, CMV- and parvovirus-B19-infections. The respective major diagnostic issues in pregnancy, the laboratory diagnosis, and its rational use in combination with clinical information are presented. Also the value of passive prophylaxis, therapy, and prenatal diagnosis as well as the possible management for diminishing the infection problems in pregnancy are discussed.

Cytomegalovirus Infections↗

PubMedDate not supplied

Species-related differences in the stereoselective glucuronidation of oxazepam.

The concentrations of (R)-(-)- and (S)-(+)-oxazepam glucuronides in plasma and urine of several species have been measured. The relative amounts of these diastereoisomers vary among species. Thus, in the plasma and urine of rhesus monkeys the concentrations of the R-isomer are higher, whereas in man and dog more of the S-isomer is present. In plasma and urine of miniature swine the amounts of the two diastereoisomers are about equal. In the urine of rabbits the S-isomer prevails. Similar species-related differences are observed in the in vitro formation of the isomeric oxazepam glucuronides. Homogenates of dog, miniature swine, rabbit, and rat liver produce more of the S-isomer, whereas with monkey liver the formation of (R)-oxazepam glucuronide is favored. The agreement between in vivo and in vitro data is fairly good for rhesus monkey, miniature swine, and rabbit. However, for the dog the ratio of S- to R-isomers in the liver homogenate is much higher than in plasma and urine. This species-dependent stereoselective glucuronidation of oxazepam is not related to the phylogenetic or dietary grouping of these species.

Animals↗

PubMed1995

[Fibrinogen level in patients with type I diabetes with and without retinopathy].

Literature data are fairly inconsistent with regard to the plasma fibrinogen levels in type I diabetic patients, and the selection of patients was poorly standardised. We monitored plasma fibrinogen levels in type I diabetics with and without retinopathy. Regardless of the occurrence of diabetic retinopathy, diabetics with good metabolic control did not show significant difference in plasma fibrinogen levels compared to healthy controls. In the randomized group of diabetics plasma fibrinogen was significantly increased compared to diabetics with good metabolic control. This finding points to the potential role of metabolic control and/or vascular complications of diabetes in the maintaining of plasma fibrinogen levels unchanged.

Adolescent↗

PubMed1996

[Osteoporosis. Knowledge and attitudes of the Norwegian population].

In March 1994, a random sample of 1,514 Norwegians aged 16-79 years were interviewed about their knowledge of osteoporosis and their attitudes towards prevention of this disease. About 85% answered correctly that osteoporosis can be prevented, but only 57% knew that it cannot be cured. Women had better knowledge of osteoporosis than men had. Two thirds of the women were positive to the use of long-term hormone replacement therapy to prevent osteoporosis. The majority of women aged 60 years or more preferred walking to other physical activities to prevent the disease. Although the data demonstrated fairly good general knowledge of osteoporosis in the population, the oldest women, those at the highest risk of developing the disease, knew less about osteoporosis than the younger women did.

Adolescent↗

PubMed2003

Health research and the Data Protection Act 1998.

The 1998 Data Protection Act in the UK largely restates existing good practice: individuals have a right to know what data are held about them and why; and those processing data have a duty to proceed with fairness and transparency, maintain high data quality and keep data secure. Some health researchers have criticised the Act, seeing it as a legal minefield, unnecessary bureaucracy and interference from the European Union. This is largely based on misconceptions. Recent guidance from the Information Commissioner aims to assist researchers by advising how legal requirements can be met through anonymisation of data, attention to data-processing methods and fair collection of data. The Act provides a clear framework of rights and responsibilities that should be embraced with enthusiasm rather than with the reluctance of a person forced to carry out a meaningless chore.

Access to Information↗

PubMed1999

Emergency protocols in prehospital emergency medicine in Slovenia.

Emergency medicine is a branch of medicine in which prompt and accurate information is of crucial importance, because a patient's survival and the final outcome of a treatment very often depends on it. Therefore the standardization of prehospital emergency service administration with uniform documentation, methods of annotation of technical data as well as uniform gathering and data analysis are necessary. Wanting to process a fair amount of data and specially to disburden personnel, a need for computer aided processing is evident. Application that was developed in strong collaboration with EMS project team and information science engineers definitely improves data quality. Firstly when team members, especially physicians, are constrained to fulfill paper forms and secondly when data are entered into the computer, because all inconsistencies are being reconsidered and corrected if necessary. The developed application also gave the opportunity to the emergency team for prompt and accurate information.

Data Collection↗

PubMed2004

Hyperbaric oxygen therapy for traumatic brain injury: a systematic review of the evidence.

OBJECTIVE: To identify the benefits and harms of hyperbaric oxygen therapy (HBOT) to treat traumatic brain injury (TBI). DATA SOURCES: MEDLINE, EMBASE, the Cochrane Library, HealthSTAR, CINAHL, MANTIS, professional society databases, and reference lists. Databases were searched from inception through December 2003. STUDY SELECTION: We included English-language studies of patients with TBI given HBOT and evaluating functional health outcomes. DATA EXTRACTION: Data were abstracted by 1 reviewer and checked by a second. Study quality was rated as good, fair, or poor. DATA SYNTHESIS: Two fair-quality randomized controlled trials of patients with severe brain injury reported conflicting results. One found no difference in mortality (48% HBOT vs 55% control) or morbidity at 1 year. In young patients with brainstem contusion, significantly more regained consciousness at 1 month with HBOT (67%) than control (11%) (P<.03). The other found a significant decrease in mortality in the HBOT group at 1 year (17%) compared with controls (31%) (P=.037). This decrease in mortality was accompanied by an increase in proportion of patients with severe disability. Patients with intracranial pressure (ICP) greater than 20 mmHg or a Glasgow Coma Scale score of 4 to 6 had significantly lower mortality at 1 year than controls. Five observational studies did not provide better evidence of effectiveness or adverse events. Two indicated a potential for initially reducing elevated ICP in some patients. However, rebound elevations higher than pretreatment levels occurred in some patients. Adverse events, including seizures, pulmonary symptoms, and neurologic deterioration, were reported; however, no study systematically assessed adverse events, and none reported adverse events in control groups. CONCLUSIONS: The evidence for HBOT for TBI is insufficient to prove effectiveness or ineffectiveness, and more high-quality studies are needed. The evidence indicates that there is a small chance of a mortality benefit, which may depend on subgroup selection. The effect on functional status and the incidence and clinical significance of adverse effects are unclear.

Brain Injuries↗

PubMed2001

Ethnopharmacology of the Popoluca, Mexico: an evaluation.

Medicinal plants are an essential part of indigenous pharmaceutical systems. We studied the medicinal plants used by the Popoluca of the Sierra Santa Marta (Eastern Mexico). This study is part of a series on the ethnopharmacology of various Macro-Mayan groups. During 16 months of ethnobotanical fieldwork, 614 taxa used medicinally and 4488 individual use-reports were documented. The data are analysed using the concept of the "healers' consensus" in order to identify culturally important medicinal plants. The medicinal uses of the plants were grouped into 13 illness categories. The responses for each species were summarized for each of the categories and were ordered by frequency of mention. The most frequently recorded medicinal plants of the Popoluca are Hamelia patens, used to stop bleeding from wounds, and Byrsonima crassifolia, used against diarrhoea. The high-ranked medicinal species were assessed pharmacognostically using published phytochemical and pharmacological data. Popoluca medicinal uses were fairly consistent with published data on active ingredients for those plants for which such data exist. However, data is still lacking for many other species. Toxicological studies are particularly scarce. This study will be used as a basis for subsequent studies on the pharmacology and phytochemistry of medicinal plant species.

Animals↗

PubMed2004

Comparison of mathematical model predictions to experimental data of fatigue and performance.

As part of the "Fatigue and Performance Modeling Workshop," six modeling teams made predictions for temporal profiles of fatigue and performance in five different scenarios. One scenario was based on a laboratory study of fatigue and performance during 88 h of extended wakefulness with or without nap opportunities. Another scenario was based on a field study of alertness in freight locomotive engineers. Two scenarios were based on laboratory studies with various conditions of chronic sleep restriction and recovery. There was a theoretical scenario for future ultra-long-range flight operations as well. Experimental data were available for all scenarios except the latter. The model predictions were compared with the experimental data; after linear scaling using mixed-effects regression, mean square errors were computed to quantify goodness-of-fit. The six models were also compared among each other on the basis of these mean square errors. The present paper provides detailed information about the results of these comparisons. The models were capable of predicting the data for some scenarios fairly well. However, predicting the data for the two scenarios involving chronic sleep restriction was more problematic. Differences among the predictions from the six models were relatively small, suggesting that these models have a broad common basis. More experimental research is needed to yield new insights for the further development of fatigue and performance models.

Adult↗

PubMed1987

A case-control study of bladder cancer using city directories as a source of occupational data.

Commercial city directories, currently produced in 1,250 United States cities, potentially provide yearly information on occupation and employer for all city residents over age 18 years. To investigate the usefulness of these occupational data, the authors have conducted a case-control study of male bladder cancer mortality in Hamilton County, Ohio (which includes Cincinnati). A total of 731 bladder cancer cases who died during 1960-1982 were matched on age, sex, race, date-of-death, and residence at death to two controls per case. Risks of bladder cancer death were calculated by occupation, industry, and specific employer, using both city directories (multiple statements) and death certificates (single statement). Four companies showed a significant excess bladder cancer risk when using city directories. Only one would have been identified using death certificates, which ask for usual lifetime type of industry rather than a specific company name. Using city directories, significant positive associations were found between bladder cancer and occupation as an engineer, tailor, carpenter, furnace operator, blending machine operator, chemist, pressing machine operator, house cleaner, or salesman. For industry, the authors found significant positive associations for the textile, chemical, grain mill, foundry, petroleum, building service, entertainment, and advertising industries. A significant increase in risk for those with 20 or more years of employment was seen for those employed as truck drivers and furnace operators, or those employed in the railroad industry. A check of the validity of city directory data indicated that 77 per cent of the listings agreed with Social Security earnings reports for employer in any given year. One limitation of Hamilton County city directory data was the fairly large number of yearly listings without any occupational data (15 per cent for occupation, 36 per cent for employer). While city directory data do provide work history over time, unlike death certificates, such data are available only for years of residence in the city in question.

Death Certificates↗

PubMed2006

Patient expectations of fair complaint handling in hospitals: empirical data.

BACKGROUND: A common finding in several studies is patients' dissatisfaction with complaint handling in health care. The reasons why are for the greater part unknown. The key to an answer may be found in a better understanding of patients' expectations. We investigated patients' expectations of complaint handling in hospitals. METHODS: Subjects were patients who had lodged a complaint at the complaint committees of 74 hospitals in the Netherlands. A total of 424 patients (response 75%) completed a written questionnaire at the start of the complaint procedures. Derived from justice theory, we asked what they expected from fair procedures, fair communication and fair outcome of complaint handling. RESULTS: The predominant reason for complainants to lodge a complaint was to prevent the incident from happening again. Complainants expected fair procedures from the complaint committee, in particular an impartial position. This was most important to 87% of the complainants. They also expected to be treated respectfully. Furthermore, they expected the hospital and the professional involved to respond to their complaint. A change in hospital performances was the most wanted outcome of complaint handling, according to 79% of the complainants. They also expected disclosure from the professionals. Professionals should admit a mistake when it had occurred. More complainants (65%) considered it most important to get an explanation than an apology (41%). Only 32% of complainants expected the professional to make an effort to restore the doctor-patient relationship. A minority of complainants (7%) wanted financial compensation. CONCLUSION: Nearly all complainants want to prevent the incident from happening again, not out of pure altruism, but in order to restore their sense of justice. We conclude that complaint handling that does not allow for change is unlikely to meet patients' expectations. Secondly, complaint handling should not be left exclusively to complaint committees, the responses of hospital and professionals are indispensable.

Communication↗