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PubMed2026

Current knowledge in pharmacogenomics and precision medicine: perspectives of the PGRN global PGx committee on improving drug therapies in underrepresented ethnic populations.

A precision medicine strategy is likely to be more impactful, when pharmacogenomics (PGx) guided selection of drugs and dosage wherever applicable is implemented across the globe. In regions where resources are disproportionately distributed, PGx implementation in routine clinical care can play a critical role in ensuring the optimal use of limited healthcare infrastructure. At present, PGx data from the majority of the distinct ethnic populations across Asia, Africa, and South America is limited. While international consortia, working groups, and scientific bodies have made significant contributions toward evaluating the evidence for PGx implementation, the majority of existing guidelines and recommendations are derived primarily from studies conducted in a limited number of ethnic groups. Precision Medicine Initiatives in countries like Korea, Taiwan, and Malaysia and PGx organizations like the African Institute of Biomedical Science and Technology (AiBST), Consortium for Genomics & Therapeutics in Africa (CGTA), implementation of pharmacogenetic testing for the effective care and treatment in Africa, Greater Middle East (GME) whole exome sequencing program, Ibero-American Network of Pharmacogenetics and Pharmacogenomics (RIBEF), Latin American Society of Pharmacogenomics and Personalized Medicine (SOLFAGEM), Latin American Network for Validation and Implementation of Pharmacogenomic Clinical Guidelines (RELIVAF), IndiGen initiative, Southeast Asian Pharmacogenomics Research Network (SEAPharm), are working toward consolidating the PGx presence in these regions.

Precision Medicine↗
PubMed2026

PanForest: predicting genes in genomes using random forests.

MOTIVATION: The presence or absence of some genes in a genome can influence whether other genes are likely to be present or absent. Understanding these gene co-occurrence and avoidance patterns reveals fundamental principles of genome organization, with applications ranging from evolutionary reconstruction to rational design of synthetic genomes. RESULTS: PanForest, presented here, uses random forest classifiers to predict the presence and absence of genes in genomes from the set of other genes present. Performance statistics output by PanForest reveal how predictable each gene's presence or absence is, based on the presence or absence of other genes in the genome. Further, PanForest produces statistics indicating the importance of each gene in predicting the presence or absence of each other gene. The PanForest software can run serially or in parallel, thereby facilitating the analysis of pangenomes at Network of Life scale.A pangenome of 12 741 accessory genes in 1000 Escherichia coli genomes was analysed in around 5 h using eight processors. To demonstrate PanForest's utility, we present a case study and show that certain genes associated with resistance to antimicrobial drugs reliably predict the presence or absence of other genes associated with resistance to the same drug. Further, we highlight several associations between those genes and others not known to be associated with antimicrobial resistance (AMR), or associated with resistance to other drugs. We envisage PanForest's use in studies from multiple disciplines concerning the dynamics of gene distributions in pangenomes ranging from biomedical science and synthetic biology to molecular ecology. AVAILABILITY AND IMPLEMENTATION: The software if freely available with a full manual and can be found with at www.github.com/alanbeavan/PanForest DOI: https://doi.org/10.5281/zenodo.17865482.

Software↗
PubMed1982

Development of on-line real-time menu management system.

An on-line, real-time menu management system was developed as a module of the integrated computer-assisted food management system implemented at the University of Missouri-Columbia Health Sciences Center Department of Nutrition and Dietetics. This system supplants a former automated form generating system and permits flexibility in menu design. The major data base in the system is the Master Menu File, which is updated using real-time processing. This file contains data about each occurrence of menu items and is interfaced with existing recipe files to produce numerous printed documents and to display the menu on a video display terminal. The major benefits of the system are flexibility and elimination of typing of worksheets. Entering a new menu or changes to the menu require only a brief amount of time; new revised documents relative to the menu can be generated on the same day. Some of the types of documents available from this system are: master menu, nutrient syllabi, menu audit, and food production forms. The menu is available on-line at all times for reference by dietitians and supervisors. The Master Menu File will be utilized more fully as new modules are designed to interface with the Menu Management System. Production forecasting, patient menu printing, and individualized diet planning are three potential enhancements to the system which will utilize data in the Master Menu File. The file was designed to accommodate additional data as the system in further matured.

Food Service, Hospital↗
PubMed1977

Undergraduate pharmacological training programs applicable to agricultural science majors.

Undergraduate training programs leading to degrees in pharmacology or toxicology do not exist on most university campuses. Agricultural science students who may ultimately use large quantities of herbicides, pesticides, and other agricultural products may obtain degrees without any exposure to the disciplines of pharmacology or toxicology; some reasons for this are discussed. The design and implementation of some courses suited to the qualifications of most undergraduate agricultural science majors are outlined. In general, a blend of lectures, discussions, and student presentations facilitates adequate presentation of the course material. Specific suggestions for student term projects are mentioned. Some of the available textbooks suitable for undergraduate courses of this type are very briefly discussed. It is suggested that in order to educate nonacademic users of agricultural chemicals, pharmacologists and toxicologists may have to work closely with both industry and those closer to the agricultural community such as county agricultural extension agents and farm youth organizations.

Agriculture↗
PubMed1983

Pediatric behavioral science in family practice.

Behavioral science is a well-accepted component of family practice, but official guidelines and proposed curricula have a predominantly adult focus. This paper describes a pediatric behavioral science curriculum for family practice residents that has been successfully integrated into the three-year family practice residency curriculum at the University of Colorado. Details of development and implementation are presented: the requisite knowledge base, skills, and attitudes; the core pediatric behavioral science topics and diagnoses; the family physician's role in handling each core diagnosis; guidelines for making management decisions; suggested approaches to teaching the curriculum; and a reference list for behavioral science faculty.

Attitude of Health Personnel↗
PubMed1995

The paradox of guideline implementation: how AHCPR's depression guideline was adapted at Kaiser Permanente Northwest Region.

BACKGROUND: To ensure implementation, the Agency for Health Care Policy and Research's (AHCPR) Guideline for the Treatment of Depression in Primary Care was recently translated into a local document by a large health maintenance organization (HMO). The guideline revision process was studied on the basis of interviews with members of the guideline revision committee and others, observation of meetings, and documents and correspondence. WHY THE GUIDELINE WAS CHANGED: The HMO changed the AHCPR guideline for reasons of convenience, credibility, audience, purpose, and context. For example, in their roles as representative consumers, committee members perceived that the AHCPR guideline, although addressed to primary care clinicians, was actually written from a psychiatric perspective and based on a psychiatric literature not relevant to primary care. COMPARISON OF THE GUIDELINES: Although the guidelines differ dramatically in length and format, coverage, emphasis, and organizing principle, substantive conflict between the two guidelines' recommendations is minimal. For example, the emphasis on medication is greater in the adaptation, which adds considerable original material of a practical nature on drugs and drug use. In addition, the original guideline has a "research literature orientation." In contrast, the adaptation is described as "clinical decision oriented", identifying the key actions and decisions that a practicing clinician must make to treat depression. DISCUSSION AND IMPLICATION: Translation of science-oriented national guidelines into user-oriented documents tailored to local audiences and settings can add great value to the guideline development process without sacrificing science-derived integrity-and is probably essential to successful implementation.

Depressive Disorder↗
PubMed1995

Staff compliance with infection control practices: application of behavioural sciences.

Microbiology and epidemiology have made significant contributions to the field of Infection Control. Most nosocomial infections which can be prevented are related to inappropriate patient care practices. However, it is extremely difficult to implement new infection control policies. To achieve staff compliance, infection control should learn from the behavioural sciences. Three related fields have been shown to be helpful in this respect: social psychology, consumer behaviour and organizational behaviour. Basic concepts from all three fields can be applied to the work of infection control for achieving staff compliance; the use of social power and the reasoned action model from the field of social psychology; the use of participatory decision-making from organizational behaviour; and the opinion leaders from consumer behaviour.

Behavioral Sciences↗
PubMed1995

Building a digital library for the health sciences: information space complementing information place.

In 1990, the University of California, San Francisco, dedicated a new library to serve the faculty, staff, and students and to meet their academic information needs for several decades to come. Major environmental changes present new and additional information management challenges, which can effectively be handled only through the widespread use of computing and computing technologies. Over the next five years, a three-pronged strategy will be followed. We are refining the current physical, paper-based library through the continuous application of technology for modernization and functional improvement. At the same time, we have begun the planning, design, and implementation of a "free-standing" Digital Library of the Health Sciences, focusing on the innovative application of technology. To ensure complementarity and product integrity where the two libraries interface, we will look to technology to transform these separate entities into an eventual, integral whole.

Computer Communication Networks↗
PubMed1980

A quality assurance process in health sciences libraries.

A goal of libraries is to assure the improvement of library services. Many organizations have attempted to use standards as a method to assure quality services, but often standards have failed through a lack of individual commitment to those standards and to the methodology used in establishing the standards. Many segments of the health care field have adopted the concept of quality assurance and are applying it to the service and care they provide. This process has the potential to raise or assure quality of service in health sciences libraries. The process involves: selecting a subject for review; developing measurable criteria; ratifying the criteria; evaluating existing services using the criteria; identifying problems; analyzing problems; developing solutions; implementing solutions; and reevaluating services. Two pilot quality assurance studies conducted in the Midwest Health Science Library Network during 1978 are described. Plans are under way to use this process on a regional basis.

Libraries, Medical↗
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↗
PubMedDate not supplied

Adaptive radiofrequency hyperthermia-phased array system for improved cancer therapy: phantom target measurements.

A computer-controlled adaptive radio-frequency hyperthermia system for improved therapeutic tumour heating is experimentally investigated. Adaptive array feedback techniques are used to modify the electric-field and temperature distribution in hyperthermia experiments with homogeneous and heterogeneous phantom targets. A commercial hyperthermia phased-array antenna system at the SUNY Health Science Center in Syracuse, New York, has been modified to implement adaptive nulling and adaptive focusing algorithms. The hyperthermia system is the BSD Medical Corporation Model BSD-2000 with Sigma-60 annular phased-array antenna applicator. The transmit phased array system is made adaptive by software modifications which invoke a gradient-search feedback algorithm. The gradient-search algorithm implements the method of steepest descent for adaptive nulling (power minimization) and the method of steepest ascent for adaptive focusing (power maximization). The feedback signals are provided by electric-field short-dipole probe antennas. With an adaptive hyperthermia array using real-time measured data, it may be possible to maximize the applied electric field at a tumour position in a complex scattering target body and simultaneously minimize or reduce the electric field at target positions where undesired high-temperature regions (hot spots) occur. The measured phantom-target data indicate that adaptive nulling can reduce the electric field at one or more target positions while simultaneously focusing the electric field at a deep-seated position within the target.

Algorithms↗
PubMed1994

HUBNET: Wide Area Network utilization of Local Area Network medical reference and communication resources.

The State University of New York at Buffalo School of Medicine and Biomedical Sciences and its associated teaching sites have developed and partially implemented a regional Wide Area Network (WAN) in Buffalo and Western New York. The school wishes to use this WAN to deliver reference and communication resources to students, residents and faculty. The richest pool of easy to use reference and communication resources are PC software programs that are intended for individual workstations or at best, client-server, Local Area Network (LAN) implementation. HUBNET (Hospitals and University at Buffalo Library Resource Network), a project of the School of Medicine and the Library Consortium of Health Institutions in Buffalo offers integrated presentation of many such LAN resources over this regional WAN. The system crosses many institutional boundaries and reaches physically remote sites in a complex mix of information systems environments with few issues related to performance. The system design provides a level of ease of use that has brought many new users into active computer use while addressing integration into diverse information systems settings and networking environments.

Computer Communication Networks↗