An epidemiologic approach to computerized medical diagnosis—AEDMI program

A program called “An Epidemiological Approach to Computerized Medical Diagnosis” (AEDMI) is presented. Using an interactive questionnaire, physician-patient interviews are conducted and a summary of the relevant clinical data is provided. Standard items, obained on a multi-centre basis, form a large-scale data base. Simultaneously, the reasoning of clinical experts in each real case is analyzed to obtain a knowledge-rules data base. The methodology of the program combines Bayesian systems, expert systems, and other new lines of researcg such as neural networks or case-based reasoning. The general concepts of clinical decision making aid systems are reviewed. This publication is aimed at obtaining international cooperation.     

Levels of quality management of blood transfusion services in Europe

The European blood legislation has defined several key quality elements to achieve Good Manufacturing Practice (GMP) in the field of blood transfusion. During the recent years, the blood legislation is in the process of implementation throughout its member states. Following the Directive 2002/98/EC, Directive 2005/62/EC has given further requirements for quality-management systems to be fulfilled by blood establishments. In addition, GMP/Good Laboratory Practice (GLP) and ISO standards are used inter alia by blood establishments. In order to support the implementation of the blood legislation, the European Public Health Work Plan (2005/2007) has cofunded two projects, led by the German Red Cross and supported by the European Blood Alliance, delivering a common European Standard Operating Procedure (SOP) methodology (EU-Q-Blood-SOP) and criteria and standards for the inspection of blood establishments (EUBIS). The EU-SOP manual will assist blood establishments in preparing for the inspection of their services related to the implementation of quality relevant elements required by the EU Directive 2002/98/EC and its technical annexes. The standards and criteria for inspection of blood establishments will cross-reference existing quality standards to the directive requirements and define requirements for the structure of quality-management systems based on the directive 2002/98/EC and its technical annexes. Based on these requirements, inspection standards and criteria are developed to assist in the independent assessment of quality systems established by individual blood establishments. These assessments are done in relation to the requirements defined by the European Union legislation on blood, in order to safeguard the quality of blood and to achieve continuous improvement of its quality throughout Europe.     

Improvement of Accuracy in a High-Capacity, Six Degree-of-freedom Load Cell: Application to Robotic Testing of Musculoskeletal Joints

This study investigated a previously unaccounted for source of error in a high-capacity, six degree-of-freedom load cell used in multi-degree-of-freedom robotic testing of musculoskeletal joints, an application requiring a load cell with high accuracy in addition to high load capacity. A method of calibration is presented for reducing the error caused by changes in universal force-moment sensor (UFS) orientation within a gravitational field. Uncorrected, this error can exceed a magnitude of 1% of the full-scale load capacity—the manufacturer-stated accuracy of the UFS. Implementation of the calibration protocol reduced this error by approximately 75% for a variety of loading conditions. This improvement in load cell accuracy (while maintaining full load capacity) should improve both the measurement and control of specimen kinetics by robotic/UFS and other biomechanical testing systems. © 1999 Biomedical Engineering Society. PAC99: 8719Rr, 8780Vt, 0620Fn, 0620Dk, 8719Ff     

ACE Genotype May Have an Effect on Single versus Multiple Set Preferences in Strength Training

A polymorphic variant of the human angiotensin converting enzyme (ACE) gene was identified. The 'D' (rather than 'I') variant was associated with improvements in strength related to physical training. We set out to determine whether the response to different patterns of strength training might also differ. Ninty-nine Caucasian male non-elite athletes were randomly allocated into one of three groups: 31 non-training/control (CG: 31), single-set (SSG: 35) and multiple-set (MSG: 33). SSG and MSG trained three times a week for 6 weeks. Both training groups were underwent a strength-training program with two mesocycles (12-15 repetition maximum (RM) and 8-12 RM mesocycles). One RM loads in half squat and bench press were assessed before training and after the first and second mesocycles. ACE polymorphisms analysed by polymerase chain reaction (PCR) methods. Subjects with ACE II genotype in the MST group had improved strength development in 12-15 RM, while SST and MST groups had similar gains in 8-12 RM. Subjects with ACE DD genotype in both the SSG and the MSG had similar benefits from both 12-15 RM and 8-12 RM. Strength gains for subjects with ACE ID genotype in the SSG were similar to MSG gains in response to 8-12 RM loads but not with 12-15 RM loads. Additionally, subjects with DD genotype had superior strength gains in both strength training groups. Tailoring strength training programmes (single-set vs. multiple set) according to the athlete's ACE genotype may be advantageous.     

A systemic perspective on children’s emotional insecurity in relation to father: links to parenting,interparental conflict and children’s social well-being

ABSTRACT

Focusing on the father-child-relationship in a family systems perspective, this paper investigates longitudinal links of parenting, interparental conflict, and positive regard by both parents, to their emotional insecurity with father and mother. Furthermore, to clarify fathers’ contribution to children’s social development, aspects of the relationship to both parents are jointly considered. The sample was drawn from the German family panel pairfam and included 372 family triads with parents’ and children’s self-reports. Findings revealed consistent associations between interparental conflict and lack of positive regard and emotional insecurity, while parenting had no independent links with children’s emotional insecurity or social adjustment. Controlling for the stability of child outcomes, interparental conflict predicted children’s lower prosocial behavior and higher peer rejection. In addition, peer rejection was predicted by children’s emotional insecurity with father. The findings are in line with the emotional security hypothesis and highlight the importance of the father-child-relationship for developing positive peer relationships.     

动物实验模型中多极导管心室除颤系统电除颤对心脏功能的影响

评价新型的双极和三极导管自动心室除颤系统电除颤对左心室收缩和舒张功能的影响。动物麻醉后,在X光机指导下,分别在10只犬心脏内装置双极导管自动除颤系统（组Ⅰ）;在10只猪心脏内装置三极导管自动除颤系统（组Ⅱ）;并行电除颤试验。使用食管超声心动图在电除颤前后记录二维、M型和多谱勒超声图像。组I动物接受4次电除颤,电量为64J;组Ⅱ接受平均8次电除颤,电量为210J。结果显示：左室收缩面积分数、左室等容舒张时间和二尖瓣血流E波与A波速度比值以及时间-流速积分比值等反映左室舒缩功能的指标在两组动物除颤后均无显著改变。研究表明：两种经静脉导管自动心室除颤系统中反复低能量心内膜电除颤对左室舒缩功能无明显损伤作用;研究结果为经静脉多极导管自动心室除颤系统在临床的应用和电生理研究提供了可靠的实验数据。     

Evaluation of the WIDER I system for antimicrobial susceptibility testing of clinical isolates of Haemophilus influenzae and Streptococcus pneumoniae

The aim of this study was to evaluate the WIDER I system for susceptibility testing of Haemophilus influenzae and Streptococcus pneumoniae . MICs of 12 antimicrobials against 42 H. influenzae and 58 S. pneumoniae strains were determined using 1W MIC panels and compared with those obtained by microdilution. Overall essential agreements were >99%. Very major errors were not detected. Major errors occurred with ampicillin (1.7% H. influenzae ). Minor errors were 2.3% (amoxicillin–clavulanate, cefuroxime, chloramphenicol), 7.1% (ampicillin) and 16.7% (clarithromycin) for H. influenzae , and 1.7% (chloramphenicol, erythromycin, meropenem), 3.4% (amoxicillin–clavulanate, cefuroxime, tetracycline) and 8.6% (levofloxacin) for S. pneumoniae . The WIDER I system is a reliable method for susceptibility testing of H. influenzae and S. pneumoniae .     

Assessing graduate programs for healthcare information management/technology (HIM/T) executives

This paper describes a methodology to assess health/medical informatics graduate-level education curricula. The authors used the Certified Professional in Healthcare Information Management Systems (CPHIMS) exam objectives published by the Healthcare Information and Management Systems Society (HIMSS) as the basis for their assessment. The authors compared the 69 CPHIMS exam objectives against four health/medical informatics program course objectives as stated in the selected program's online graduate catalog. Results showed that the two programs with management as a focus addressed the majority (67 and 59%) of the CPHIMS objectives within core and elective courses combined. Overall, the other two programs addressed closer to a third of the CPHIMS objectives (36 and 32%). This methodology could prove to be useful in assisting students interested in graduate-level training programs with a tool by which to measure the congruence of the curricula of different programs with the mission of the programs and with their own professional interests.     

Genetics,systems, and alcohol

Under a variety of rubrics (e.g., complexity, self-constructing systems, dissipative structures), interest has recently burgeoned in applying principles of complex systems to a wide variety of scientific issues. A major concern is with emergent properties of systems not derivable from the properties of components of the systems. In this paper, some elementary aspects of systems considerations are applied to phenomena of alcohol pharmacogenetics. It is likely that whole new families of informative phenotypes can be generated by this approach.     

Two Methods for Identifying Wiener Cascades Having Noninvertible Static Nonlinearities

Two methods are proposed for identifying the component elements of a Wiener cascade that is comprised of a dynamic linear element (L) followed by a static nonlinearity (N). Both methods avoid potential problems of instability in a procedure presented by Paulin [M. G. Paulin, Biol. Cybern. 69: 67–76, 1993], which itself is a modification of a method described earlier by Hunter and Korenberg [I. W. Hunter and M. J. Korenberg, Biol. Cybern. 55: 135–144, 1996]. The latter method is a rapidly convergent iterative procedure that produces accurate estimates of the L and N elements from short data records, provided that the static nonlinearity N is invertible. Subsequently, Paulin introduced a modification that removed this limitation and enabled identification of Wiener cascades with nonmonotonic static nonlinearities. However, Paulin presented his modification employing an autoregressive moving average (ARMA) model representation for the dynamic linear element. To remove the possibility that the estimated ARMA model could be unstable, we recast the procedure by utilizing instead a rapid method for finding an impulse response representation for the dynamic linear element. However, in this form the procedure did not have good convergence properties, so we introduced two key ideas, both of which provide effective alternatives for identifying Wiener cascades whether or not the static nonlinearities therein are invertible. The new procedures are illustrated on challenging examples involving high-degree polynomial static nonlinearities, of odd or even symmetry, a high-pass linear element, and output noise corruption of 50%. © 1999 Biomedical Engineering Society. PAC99: 8710+e, 0210Nj, 0250-r