PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Optimization”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,171 records · Page 65Linked to original sources

[Optimization in planning and application of 60 Co gamma irradiations - analysis of the problem (author's transl)].

As an aspect of the complex problem of optimization in therapeutical transmission of radiation energy to Man, the dose distribution within a cross-sectional area of the body is considered. For the judgement on optimal dose distributions, involving judgement on irradiation technique, boundary conditions are needed which encompass important parameters of a dose distribution (= criterion for optima). For computer-assisted optimization the boundary conditions are to be scheduled by an appropriate algorithm. The parameters describing a dose distribution are indicated. Practical utilization of computer-assisted optimization of dose is represented by means of two optimization schedules.

Cobalt Radioisotopes↗

Optimal screening for patients with hyperparathyroidism with use of serum calcium observations. A decision-theoretical analysis.

The conventional upper 95 percentile references limit of serum calcium does not necessarily constitute an optimal decision limit in screening for patients with hyperparathyroidism. The design of optimal screening procedures has to consider (a) the prevalence of disease; (b) the relative importance of making correct classifications of patients; and (c) the influence of analytical imprecision and inaccuracy. Based on serum calcium determinations from three reference sample groups (healthy individuals, patients with hyperparathyroidism, and patients with hypercalcaemia due to malignant disease) optimal decision limits were calculated for different screening situations. Optimum was defined in terms of estimated 'costs' due to misclassification. Different values for disease prevalence were used, as well as different weighting factors reflecting the importance related to correct classification of healthy and pathological patients. For a disease prevalence of 5% the optimal decision limit varies between 2.59 and 2.65 mmol/l for a weighting ratio false positives to false negatives of between 1:5 to 5:1. For a prevalence of 0.1% the corresponding range was 2.67-2.72 mmol/l. Compared to classification on the basis of the conventional upper reference limit, the application of optimal decision limits means significantly lower costs due to misclassification. Analytical bias then has to be kept stable within +/- 0.01 mmol/l. Inter-laboratory analytical variation also has to be reduced to the same level in order to make it possible to transfer reference values, decision limits and single patient values to other laboratories.

Adolescent↗

Optimization of enzyme-based assays in coagulation testing.

Optimized assays for antithrombin III and plasminogen have been developed based on a study of the kinetic parameters Km and Kcat for four commercially available substrates: the p-nitroanilide derivatives of D-Phe-pipecolyl-Arg (S-2238), and toluenesulfonyl-Gly-Pro-Arg (Chromozym TH), which are thrombin substrates; D-Val-Leu-Lys (S-2251), a plasminogen/streptokinase substrate; and alpha-N-carbobenzoxy-L-lysine thiobenzyl ester, a substrate for both enzymes. We used a centrifugal analyzer system for rapid data acquisition and interactive analysis. Optimized conditions for assay of a particular enzyme are not constant for different substrates in the same buffering agent. For example, in 1,4-piperazine diethanesulfonic acid buffer at 37 degrees C, thrombin-catalyzed hydrolysis of Chromozym TH is optimal at 125 mmol/L buffer, 100 mmol/L NaCl, and pH 8.2, whereas substitution of S-2238, also a tripeptide p-nitroanilide, yields optimal hydrolysis at 85 mmol/L buffer, 300 mmol/L NaCl, and pH 7.2. We conclude that optimized assay conditions are best obtained by an extensive survey of available buffers and a detailed investigation of the effects of variation in pH and in the concentrations of the buffer and auxiliary reagents through use of both one-factor-at-a-time and multivariate response surface experimentation.

Blood Coagulation Tests↗

A new optimization based approach to experimental combination chemotherapy.

A new approach towards the design of optimal multiple drug experimental cancer chemotherapy is presented. Once an adequate model is specified, an optimization procedure is used in order to achieve an optimal compromise between after treatment tumor size and toxic effects on healthy tissues. In our approach we consider a model including cancer cell population growth and pharmacokinetic dynamics. These elements of the model are essential in order to allow less empirical relationships between multiple drug delivery policies, and their effects on cancer and normal cells. The desired multiple drug dosage schedule is computed by minimizing a customizable cost function subject to dynamic constraints expressed by the model. However, this additional dynamic wealth increases the complexity of the problem which, in general, cannot be solved in a closed form. Therefore, we propose an iterative optimization algorithm of the projected gradient type where the Maximum Principle of Pontryagin is used to select the optimal control policy.

Drug Therapy, Combination↗

Optimal filtering and quality control of the signal-averaged ECG. High-fidelity 1-minute recordings.

BACKGROUND: The clinical performance of the signal-averaged ECG (SAECG) for prediction of ventricular tachycardia (VT) depends on its quality, or final noise level. However, signal averaging is a statistical estimation procedure that is time-consuming and vulnerable to noise-induced error. The optimally filtered SAECG is proposed as a simple, quality-assured procedure requiring only 1 minute of data. METHODS AND RESULTS: The optimally filtered SAECG is based on measures of signal variance and time-frequency representations. Forty subjects were studied to compare a 0.3-microV root-mean-square (RMS) noise endpoint SAECG with an optimally filtered 64-beat ensemble. Eight SAECGs were computed with noise endpoints of 1.0-through 0.3-microV RMS. Noise measurements were also made directly from the filtered SAECG. From these and previously published data, sensitivity was predicted as a function of noise endpoint. Measured QRS parameters and final noise were highly similar between the optimally filtered SAECG and the 0.3-microV RMS noise endpoint SAECG. CONCLUSIONS: The optimally filtered 64-beat SAECG achieves a performance (equivalent noise reduction, signal definition, and mathematically predicted sensitivity for VT) similar to a 0.3-microV RMS noise endpoint average. Testing in a large clinical database is required to validate the method for routine clinical use. SAECGs terminated by use of different noise measurement techniques are not directly comparable because of measurement technique dependence. However, a formula is presented for comparison of statistics between studies that have used the most popular noise measurement techniques.

Electrocardiography↗

Prevalence of fluorosis and other enamel defects related to caries among adults in communities with optimal and low water fluoride concentrations.

The aim of this Swedish study, performed in 1982, was to determine the prevalence of fluorotic and nonfluorotic enamel defects among adults in areas with optimal and low fluoride concentrations in water. The fluorosis prevalence was also related to caries prevalence in these areas. The study was based on clinical examinations of subjects born between 1939-1951 who had been drinking water with a fluoride content representative of their area of residence all their lives. This water was the only appreciable source of fluoride during tooth formation. Two hundred and sixty individuals living in the optimal fluoride area were included in the study and 236 individuals from the low fluoride area. The results showed first, a low prevalence of mild dental fluorosis in the area with optimal fluoride content in its drinking water; secondly, a low prevalence of non-fluorotic enamel defects, which was, however, higher in the low fluoride area than in the optimal fluoride area; thirdly, that caries prevalence was lower among those with fluorotic enamel defects in the optimal fluoride area; and lastly, caries prevalence was not influenced by non-fluorotic enamel defects.

Adult↗

[Experience and results of application of remote afterloading system (RALS) optimization program for intracavitary treatment of squamous cell carcinoma of the uterine cervix].

An optimization program for a remote after-loading system (RALS) for intracavitary treatment of cancer of the uterine cervix was established in 1982 by Tabushi and his co-workers. This system has been used in our hospital since 1986, using MODULEX. Seventy-three cases of untreated squamous cell carcinoma of the uterine cervix have been treated under RALS, 29 under conventional RALS and 44 under the RALS optimization program. The cumulative 5-year survival rates were obtained for the groups treated under each system by the Kaplan-Meier method. The 5-year survival rate of stage II cases treated under the RALS optimization program was 68.2%, and that of stage III cases 58.5%. On the other hand, that of stage II cases treated under conventional RALS was 56.3%, and that of stage III cases 44.9%. There was no significant difference between these two groups. Local control rates for stage II and III cases were higher than 5 year-survival rates. Among complications, the frequency of grade 2 radiation colitis was 15.9% with the RALS optimization program cases, and that of grade 2 radiation cystitis was 4.5%. We consider the RALS optimization program to be a clinically useful method for the intracavitary treatment of squamous cell carcinoma of the uterine cervix.

Adult↗

[Quantification of visual EEG evaluation by using the concept of optimality (author's transl)].

For the visual evaluation of the EEG in children (awake) 17 items are formulated and defined. They are to be examined and determined as beeing either optimal or non-optimal, as it is easier to define what is optimal, than what is normal. The non-optimal items are summed up for a total score. It could be shown that this score discriminates between sample groups of 50 children each, one with "minimal brain dysfunction" and another with normal controls of the same age and sex. There are also several distinct differences within the particular items. The objectivity of the items was proved by fourfold examination of the same sample group. The concept of optimality therefore offers a valid and objective method of quantifying the visual EEG evaluation, thus improving the interpretation of minor abnormalities in the EEG.

Attention Deficit Disorder with Hyperactivity↗

[Method of calculating TDF biological equivalent for optimal treatment dose in fractionated intracavitary irradiation of carcinoma of the uterine cervix].

Intracavitary irradiation therapy for carcinoma of the uterine cervix used with high or low dose rate irradiation is fractionated in Japan. The optimal treatment dose is determined according to the biological effect on both diseased and healthy tissues. The equations of modified NSD and TDF biological equivalents were recalculated from Arai's clinical data, which were used to examine the optimal time-dose-fractionation relationship for high and low dose rate intracavitary irradiation on squamous cell carcinoma of the cervix uteri. The optimal time-dose-fractionation relationship at point A is expressed as follows: D = NSD N0.26 T0.06 where NSD is 17.75 get for high dose rate and 31.78 get for low dose rate. TDF = K n d1.47 x-0.09 where K is 1.46 for high dose rate and 0.62 for low dose rate. The range of the optimal total dose to point A given by one fraction per week was 30.7 Gy for 4 fractions and 38.3 Gy for 8 fractions in high dose rate irradiation. In the case of low dose rate irradiation, the optimal total dose given by one fraction per week and the dose rate of 75.0 cGy/h was 55.0 Gy for 4 fractions. The maximum dose difference between our result and Arai's was about +/- 10%. The dose modification ratio for high dose rate and low dose rate is 1.79.

Brachytherapy↗

[Establishment of the optimal conditions for detecting anti-M2 by western blotting in primary biliary cirrhosis].

Anti-mitochondrial antibodies(AMA) are serodiagnostic markers for primary biliary cirrhosis(PBC) but heterogenous in antigen molecules which they recognize. A disease-specific AMA for PBC is anti-M2. The conventional examination methods are indirect immunofluorescence and ELISA. However, there are some problems in specificity, because the antigen preparations used are crude. Thus, analysis with Western-blotting(W-B) is needed, because it allows the identification of a molecule which the antibody reacts with. In this report, we established the optimal conditions for detecting anti-M2 with W-B in PBC. As antigen, we used mitochondrial fractions derived from beef hearts. Because a positive band at 74 kDa became negative after absorbing sera with PDH purified from porcine hearts, this band corresponded to major antigeneity of anti-M2. Titration experiments with SDS-PAGE showed that the optimal concentration of this antigen preparation for loading is 0.04 mg/ml. We also performed titration experiments to determine the optimal dilutions for second antibodies and serum samples. The results showed that the optimal dilution for second antibodies, anti-IgG and anti-IgM, were 1:3000 and 1:1000, respectively. The optimal dilution for serum samples was shown to be 1:10(2). Moreover, the W-B technique gave a positive result even for sera from AMA-negative PBC patients which had tested negative with conventional methods, if undiluted sera were examined or if anti-IgG or anti-IgM was used as a second antibody. Thus, the W-B technique is more sensitive than conventional methods of analysis. Based on these results, we will be able to detect anti-M2 with maximum efficiency, thus improving our ability to study the relationship between anti-M2 and the pathological conditions in PBC.

Autoantibodies↗

Two optimal prefilter cutoff frequencies needed for SPECT images of myocardial perfusion in a one-day protocol.

OBJECTIVE: The purpose of this study was to determine if cutoff frequencies of two-dimensional Butterworth filters need to be changed, depending upon the amount of radiopharmaceutical administered in one-day protocols for reconstructing SPECT images of myocardial perfusion. METHODS: A scintilation camera and a phantom were used with 2.2 MBq and 10.6 MBq 99mTc. These activities corresponded to the approximate amounts used in our one-day myocardial perfusion imaging protocol. The projection data were collected in 30 positions spread over 180 degrees. Thirty- and 150-sec acquisitions per position were performed to obtain the study and the high-quality reference images. Thirteen cutoff frequencies of the filter were used to reconstruct the SPECT images. Optimal cutoff frequencies were determined by visual assessment and by calculating the normalized mean square error (n.m.s.e). These results were then compared. The same protocol was used to image three volunteers with no heart disease and the images were evaluated visually. RESULTS: In the phantom study, the optimal cutoff frequencies were 0.225 cycles/pixel for 2.2 MBq, and 0.275 cycles/pixel and 0.25 cycles/pixel for 10.6 MBq by visual inspection, and were 0.225 cycles/pixel and 0.275 cycles/pixel by calculating the n.m.s.e., respectively. In the patient study, the lower cutoff frequency of 0.20 cycles/pixel was optimal for the exercise study (low dose), while the higher cutoff frequencies of 0.275 cycles/pixel was optimal for the resting study (high dose). CONCLUSION: The optimal cutoff frequencies differed for the two activity levels. Cutoff frequencies should be changed according to the amounts of radiopharmaceuticals used for the first and the second examinations in one-day protocols.

Heart↗

Optimization of the human factor VIII complementary DNA expression plasmid for gene therapy of hemophilia A.

While the gene delivery vehicle is critical for the efficacy of human factor VIII gene therapy, optimization of the potency and duration of the factor VIII gene that is delivered is equally important in light of the poor transcription and translation characteristics of this gene. We discuss here a systematic approach to optimization of factor VIII complementary DNA expression by analysis of specific elements engineered into the transcription unit and other positions in the expression plasmid. Within the transcription unit we have engineered different 5' and 3' sequence modifications and tested them for factor VIII expression in human liver cells. These changes incorporate liver-specific promoter and enhancer sequences and regulatory elements affecting RNA export. Specifically, the thyroid hormone-binding globulin promoter and alpha 1 microglobulin/bikunin enhancer were tested and a synthetic 5' intron was compared to a 3' post-transcriptional regulatory element on factor VIII expression levels. For translation optimization, a leader sequence was designed to be of optimum length, have no RNA secondary structure and contain the optimal translation initiation sequence. Finally, we discuss areas for plasmid optimization, which include removal of near-consensus splicing sequences, the inclusion of strong transcription termination elements and the use of autonomous replicating plasmid sequences for episomal maintenance and enhanced plasmid retention for duration of gene expression.

Carcinoma, Hepatocellular↗

Optimized PCR labeling in mutational and microsatellite analysis.

To optimize the labeling and visualization of PCR products we tested different variables, including deoxynucleotide concentration and ratio, dilution of labeled product, number of PCR cycles, and use of one-step or nested labeling protocols. Labeling was achieved using a fixed amount of labeled dATP, whose relative specific activity was varied by adding increasing amounts of cold dATP. Optimal PCR-labeling intensity was reached at dATP concentrations between 0.9 and 7.0 micromol/L, with a peak at 1.8 micromol/L. This concentration corresponded to an optimal ratio between the increase in specific activity and the decrease in DNA yield. Nucleotide imbalances >1:2 were not advantageous. Mutational analysis by single-strand conformational polymorphism (SSCP) was used to validate PCR-labeling protocols. The limiting nucleotide concentrations did not affect SSCP. Clear SSCP patterns were obtained using DNA templates of different sizes derived from several genes. SSCP patterns obtained using one-step or nested PCR-labeling protocols were equivalent and were visualized after overnight exposure, using [alpha35S]dATP as the label. Dilutions of labeled products ranging between 1:10 and 1:2.5 influenced SSCP patterns, and the lowest dilution tested produced better-defined and more-intense signals. Optimized SSCP conditions allowed the detection of novel and previously characterized nucleotide variants. Clear microsatellite typing was also obtained using optimized protocols and [alpha35S]dATP as the label.

Colorectal Neoplasms, Hereditary Nonpolyposis↗

Optimal sampling strategies for bayesian estimation of docetaxel (Taxotere) clearance.

Docetaxel activity has been documented in many solid tumors, including metastatic breast cancer and non-small cell lung cancer. However, as clinical studies in other tumor types are now being conducted, the validation of an optimal sampling strategy would allow the performance of pharmacokinetics/pharmacodynamics studies with minimum inconvenience for the patient. Six optimal sampling strategies with one to six sampling times were computed, based on the D-optimality theory, using population pharmacokinetic parameters estimated from a large pharmacokinetic database of 547 patients treated in previous Phase II studies. Validation of these sampling strategies was performed on a set of 35 patients, from two Phase I studies, who received docetaxel as a 1-h infusion at doses ranging from 50 to 100 mg/m2. Validation consisted of comparing clearance assessed by maximum likelihood estimation obtained using complete plasma concentration-time data (considered as the reference) and clearance determined by Bayesian estimation with an optimal design. For all of the optimal sampling strategies tested, clearance was found to be well estimated when at least two samples were taken. Bayesian estimation with two measured levels (at the end of infusion and at 6 h after the start of infusion) can be selected, because it allows adequate estimation of clearance with a nonsignificant bias of +1.37% and a precision of 12.3%.

Antineoplastic Agents, Phytogenic↗

Yoga MAT: A factorial randomized study using the Multiphase Optimization Strategy to develop a multicomponent yoga intervention for people with chronic pain taking medications for opioid use disorder.

BACKGROUND: People taking medications for opioid use disorder (MOUD) commonly experience chronic pain. Yoga interventions show promise for decreasing pain-related disability in other populations. More time spent in yoga practice may improve pain-related outcomes. METHODS: The Multiphase Optimization Strategy (MOST) provided the framework for developing an optimized yoga intervention package. In a 2x2x2x2 factorial experiment, we evaluated four candidate intervention components which, when added to a weekly yoga class, might increase yoga engagement. The primary outcome was minutes per week of yoga practice (classes and other yoga practice) over the 12-week intervention period. We sought to determine which combination of intervention components was associated with the most yoga practice for people with chronic pain taking buprenorphine or methadone as MOUD. RESULTS: We enrolled 192 adults. There was a significant main effect for Component "B" (having two private sessions with a yoga teachers; IRR = 1.10, 90%CI 1.02; 1.18), and a synergistic interaction between Components "B" and "D" (D was financial incentives for attending class; IRR = 1.11, 90%CI 1.02; 1.19). This combination of these two components (without other potential components) was associated with the second highest model-predicted mean minutes of yoga per week (157.1min; 90% CI = 120.1-194.0) which was only 4min less than the combination including all four components. CONCLUSIONS: We identified a combination of intervention components as the optimized intervention. A next step will be to test the effect of this optimized intervention on pain and substance use outcomes in a randomized controlled clinical trial.

Humans↗

Optimized GMP-grade production of non-viral Sleeping Beauty-generated CARCIK cells for enhanced fitness and clinical scalability.

BACKGROUND: Strict adherence to GMP guidelines and regulatory compliance is crucial when transitioning from research to clinical-grade production of ATMPs like CAR T cells. The success of CAR T cell therapy in treating hematological malignancies highlights the need for closed or automated systems to ensure quality and efficacy. Recent evidence also suggests that ex vivo culture conditions can significantly impact CAR T cell functionality. METHODS: We present our optimized methodology for expanding Sleeping Beauty transposon-engineered Chimeric Antigen Receptor-Cytokine-Induced Killer (CARCIK) cells using G-Rex devices and evaluate its impact on CARCIK cell phenotype and T cell fitness. RESULTS: Building on our previously validated protocol, we introduced key simplifications to optimize the CARCIK differentiation process. Delaying the nucleofection step eliminated the need for feeder cells while maintaining efficient CAR expression and high cell viability. Transitioning from T-flasks to G-Rex bioreactors reduced operator hands-on time from 21 to 28 days to 14-17 days and resulted in a less differentiated CARCIK cell product. Metabolic and transcriptional analyses showed that the novel protocol improves CARCIK cell fitness and in vivo efficacy against B-cell lymphoma. The novel method was validated in Good Manufacturing Practices (GMP) conditions at our two Cell Factories and yielded enough numbers of CARCIK-CD19 cells for clinical use. CONCLUSIONS: Optimizing non-viral CARCIK cell production using G-Rex bioreactors and refined timing adjustments has streamlined the workflow, enhanced cell fitness, and resulted in a highly effective therapeutic product with demonstrated in vivo efficacy in mice. These improvements reduced manipulation and contamination risks, while optimizing logistics and space efficiency, facilitating allogeneic CARCIK generation for a current phase I/II clinical trial (NCT05869279) in patients with R/R CD19 + non-Hodgkin Lymphoma (B-cell NHL) and Chronic Lymphocytic Leukemia (CLL), confirming the approach's scalability and clinical potential.

Humans↗

Alternative criteria for optimal designs of limiting dilution assays.

It is well known that criteria for optimal non-linear designs usually depend on the unknown value of parameters. An approximate Bayesian approach imposes a prior on these values and optimizes the expectation of the criterion over this distribution. While this method produces designs that perform well on average, the design may perform badly in some parts of the parameter space, and if the true parameter appears to fall in one of these regions, then the good average performance will be little compensation. Several alternative criteria are introduced in the context of deriving designs for limiting dilution assays. These include constrained optimization of a familiar criterion, a minimax criterion and designs to optimize prespecified centiles of the variance under the prior distribution. The latter are shown to offer a useful compromise between good overall performance and possible poor performance.

Analysis of Variance↗

Medium optimization for spore production of coniothyrium minitans using statistically-based experimental designs

Statistically-based experimental designs were used to optimize a chemically defined solid medium for the spore production of Coniothyrium minitans. In the first optimization step the influence of starch, urea, phosphate, magnesium, calcium, thiamin and trace elements on spore production was evaluated using a fractional factorial design. Starch and trace elements influenced spore production positively while urea affected spore production negatively. The other components had no significant influence on spore production. In the second and third steps the concentrations of starch, urea and trace elements were further optimized using central composite designs and response surface analysis. This optimization strategy allowed the spore production to be increased by a factor 7 from 4 x 10(9) to almost 3 x 10(10) spores per Petri dish of 9 cm diameter. Copyright 1999 John Wiley & Sons, Inc.

Journal Article↗