Basic Training Program in Medical Pedagogy: a 1-year program for medical faculty.

In 1979 université de Montréal developed the Basic Training Program in Medical Pedagogy; the program has since been offered at two other Canadian medical schools. The learning activities are spread over an academic year so that the teachers are able to continue their clinical or research duties. The program, which follows a model of systematic instruction, comprises 17 self-instructional modules on basic educational topics adapted to medical teaching. The topics are related to four components of an integrated system: student needs and learning objectives, instructional methods, student evaluation and program evaluation. The instructional format is aimed at three levels--understanding, analysis and application--to which assignments and assessments are related. In addition to the modules, the program offers 15 half-day sessions for small groups (five participants and one instructor) to discuss aspects of the program, especially home assignments and the application of personal educational projects. A minimum of 100 hours of personal time is requested. The program''s main goal is that students be placed at the centre of the educational process. Of 215 participants since 1979, 171 (80%) have completed the program and reported high satisfaction. Issues related to any faculty development program are discussed.     

基于全外显子组数据的ABO血型的基因判定

全外显子组测序研究已经应用在疾病、药物等方面,是临床研究中一种辅助分子诊断方法。该方法也逐步应用在临床ABO血型的判定中,由于目前临床血型判定的主要方法是血清学,疑难样本判定等问题无法解决,因此分子水平的基因测序方法提高了血型判定的准确性,比如PCR方法和基因芯片方法。为进一步提高ABO血型精细分型的准确性,通过分析全外显子组测序数据,开发了相关的VBA程序,能够快速自动化判定ABO精细分型,并且初步判定结果与临床判定结果一致,可以作为临床血型精确判定的辅助手段。     

THE ELECTROENCEPHALOGRAM IN PEDIATRICS—The Indications for Use and the Limitations

Electroencephalograms normally undergo pronounced serial changes during maturation of the brain.Many physiological and nonphysiological influences may alter the EEG tracing.As regards EEG''s, appraisal of cerebral function is based on comparison with normal standards of frequency, rhythm, wave configuration and amplitude, bilateral synchrony, and response to various physiological stimuli.Various abnormal EEG patterns are fairly constantly related to concomitant clinical disease.A laboratory tool which may be used to supplement clinical data but not to make a clinical diagnosis, the EEG may also sometimes be of value in helping to suggest prognosis and in helping with evaluation of a therapeutic program.     

EIAV与HIV分子生物学相关性研究进展

马传染性贫血病毒 (equineinfectiousanemiavirus,EIAV)与人类免疫缺陷病毒(humanimmunodeficiencyvirus ,HIV)同属逆转录病毒科、慢病毒属成员。两者在形态结构、抗原特性、基因组构成以及病毒与宿主的持续作用等方面极为相似 ,且EIAV具有独特的快速发病进程和明显的病程分界 ,使其成为研究HIV的基因变异与临床症状之间相互关系的理想动物模型。EIAV疫苗是我国拥有自立知识产权的世界上唯一的慢病毒疫苗 ,以该疫苗为基础 ,开发新型HIV疫苗将成为今后的发展策略。近年国内外学者对EIAV及HIV的分子生物学进行了深入研究 ,确定了与病毒毒力相关的某些基因及编码蛋白 ,并在疫苗的研究上取得了一定进展。     

Prevention of type 2 diabetes--lessons we have learnt for implementation.

The challenge today is to implement successful diabetes prevention programs in general health care. Even if not all questions for the prevention of diabetes are answered, we have today overwhelming evidence that diabetes can be prevented or delayed in high risk population through lifestyle modification or pharmacological interventions. This information has to be translated now into well-defined strategies for screening and treating high risk population in daily practice. It is necessary then to develop and implement prevention programs into clinical practice considering scientific aspects and practical requirements during implementation. While translating the scientific evidence into population based intervention strategies more and more questions arise, mostly related to economic and structural requirements during implementation. At the end, giving the right answers to these questions will decide about the success of implemented prevention strategies. Here, we will try to answer some of the questions which arose during the implementation of a prevention management concept into clinical practice. We focus on the development of a structured prevention management program which will enable implementation of diabetes prevention into clinical practice.     

Exercise reduces circulating biomarkers of cellular senescence in humans

Cellular senescence has emerged as a significant and potentially tractable mechanism of aging and multiple aging‐related conditions. Biomarkers of senescent cell burden, including molecular signals in circulating immune cells and the abundance of circulating senescence‐related proteins, have been associated with chronological age and clinical parameters of biological age in humans. The extent to which senescence biomarkers are affected by interventions that enhance health and function has not yet been examined. Here, we report that a 12‐week structured exercise program drives significant improvements in several performance‐based and self‐reported measures of physical function in older adults. Impressively, the expression of key markers of the senescence program, including p16, p21, cGAS, and TNFα, were significantly lowered in CD3⁺ T cells in response to the intervention, as were the circulating concentrations of multiple senescence‐related proteins. Moreover, partial least squares discriminant analysis showed levels of senescence‐related proteins at baseline were predictive of changes in physical function in response to the exercise intervention. Our study provides first‐in‐human evidence that biomarkers of senescent cell burden are significantly lowered by a structured exercise program and predictive of the adaptive response to exercise.     

CLONE 3: plasmid drawing and clone management software program for microcomputers

CLONE 3 is a microcomputer software program which draws circular and linear plasmid maps, facilitates cloning operations and performs related sequence analysis and information retrieval functions. This article describes the use of the CLONE 3 program to streamline the flow of information in the research laboratory doing genetic engineering applications.     

"Blood and guts": one component of an integrated program in biologic sciences as applied to medicine.

The 3-year medical school program at McMaster University encourages an approach to learning a physician can apply throughout his or her career. The program has four phases and provides early exposure to relevant clinical material. In phase 3, the basic science phase, the structure and function of organ systems in health and disease are studied. Understanding the mechanisms of disease in order to be able to relate clinical symptoms and signs to physiologic and pathologic processes is emphasized. The four 10-week units deal with groups of organ systems. The "blood and guts" unit teaches the student hematology and gastroenterology through a variety of problem-based methods. Specialists in the relevant scientific disciplines influence selection and construction of the problems presented. The students are evaluated by the faculty tutor on their accomplishment of specific objectives related to their competence in solving biomedical problems.     

MedBlast: searching articles related to a biological sequence

In the genomic era, researchers often want to know more information about a biological sequence by retrieving its related articles. However, there is no available tool yet to achieve conveniently this goal. Here we developed a new literature-mining tool MedBlast, which uses natural language processing techniques, to retrieve the related articles of a given sequence. An online server of this program is also provided. AVAILABILITY: Both online server and the program are available freely at http://medblast.sibsnet.org     

Neural interfaces for upper-limb prosthesis control: opportunities to improve long-term reliability

Building on a long history of innovation in neural-recording interfaces, the Defense Advanced Research Projects Agency (DARPA) has launched a program to address the key challenges related to transitioning advanced neuroprosthesis technology to clinical use for amputated service members. The goal of the Reliable Neural Technology (RE-NET) Program is to develop new technology to extract information from the nervous system at a scale and rate needed to reliably control modern robotic prostheses over the lifetime of the amputee. The RE-NET program currently encompasses three separate efforts: histology for interface stability over time (HIST), reliable peripheral interfaces (RPIs), and reliable central nervous system (CNS) interfaces (RCIs).     

Breaking out of the biomed box: an audit assessment and recommendations for an in-house biomedical engineering program

In order to assess the current performance and to identify future growth opportunities of an in-house biomedical engineering (BME) program, senior management of Lehigh Valley Hospital (Allentown, Penn) engaged (in July 2001) the services of a clinical engineering consultant. Although the current in-house program was both functionally and financially sound, an independent audit had not been performed in over 4 years, and there were growing concerns by the BME staff related to the department's future leadership and long-term support from senior management. After an initial 2-month audit of the existing program, the consultant presented 41 separate recommendations for management's consideration. In order to refine and implement these recommendations, 5 separate committees were established to further evaluate a consolidated version of them, with the consultant acting as the facilitator for each group. Outcomes from each of the committees were used in the development of a formal business plan, which, upon full implementation, would not only strengthen and refine the current in-house service model but could also result in a substantial 3-year cost savings for the organization ($1,100,000 from existing operations, $500,000 in cost avoidance by in-sourcing postwarranty support of future capital equipment acquisitions). Another key outcome of the project was related to the development of a new master policy, titled the "Medical Equipment Management Program," complete with a newly defined state-of-the-art equipment scheduled inspection frequency model.     

PC-based system for an objective quantification of manual movement disability for clinical and scientific purposes

In clinical management and research of movement disorders exact knowledge about the extent of motor impairment is essential. This paper presents a computer program which allows for an objective measurement of manual movement disability. The program was developed for standard hardware and can easily be used in a variety of clinical and research environments. The program runs on MS-DOS computers and uses a Microsoft computer mouse as the only input device. The temporal resolution is 100 Hz, the spatial resolution 400 dots per inch. The user may choose between standard test sets or he may design sets according to his individual needs from a pool of available protocols which includes tracking tasks, ballistic tasks, complex sequential tasks, and finger tapping. All tasks are implemented in a similar way in order to keep the test environment as consistent as possible for the patient. The patient must usually carry out movements which correspond to the movements of a target symbol on the computer screen. This entails the manipulation of a follower symbol, also visible on the computer screen, via the computer mouse. The program itself and the theoretical background of the protocols are described in the paper. Additionally, preliminary results from pilot experiments are presented.     

EEG data acquisition and preprocessing by microcomputer satellite system

Recent development in computer technology allows already medium scale EEG data processing to be performed within the clinical neurophysiology department, if a fast minicomputer with adequate mass storage and graphical output facilities is used. Data acquisition, however, should be delegated to a microcomputer which also should take over as much preprocessing as possible. A system is presented, where one or several microcomputer-based satellite units perform analog-digital conversion, Fourier transformation (FFT), calculation of power spectra and crossproducts, as well as event related averaging or other preprocessing procedures. The units are connected to a fast central minicomputer, where a supervisor program loads the microprocessors with their programs, supervises their activity, receives preprocessed data and activates appropriate postprocessing programs to produce the final results.     

A computer program for characterizing root system branching patterns

A computer program is presented which measures the length, branching patterns and distribution of link length within a root system. The program skeletonizes digitized images of root systems, loads these images into a binary tree data structure and uses this data structure to characterize the root systems. Measurements of the root length and topological parameters of root systems of Senecio vulgaris made by hand and by computer program were linearly related, with r² values greater than 0.99 in all cases.     

Réflexions cliniques sur le premier épisode psychotique: vers une intervention spécifique de plus en plus précoce

The present article is based on the experience we had between 1997 and 2002 with theProgramme Spécifique d’Intervention — Premier Épisode (PSI), a first episode psychosis program developed at the hospital Hôtel-Dieu de Lévis, in relation with the current literature. It discusses the importance of a specific program for first episode psychosis and the factors implicated in the development of such a program. The nature and the impact of the different modalities of evaluation and treatment used by the PSI are examined through a clinical case. The article comments on the difficulties met and the modifications that have been made to the original form of the PSI or which could be suggested in the development of a similar program. A second clinical case emphasizes the pertinence of a specific intervention at the time of the psychotic prodrome, and the possible integration of this intervention in a program for first psychotic episodes.     

The genetic risk screening, education, and referral program: a model program for training of health professionals.

This report describes a statewide program which trains family-planning personnel to provide genetic risk screening, to educate clients about potential genetic risks, and to make appropriate referrals to genetics centers. The program is unique in that training and service delivery are all done within the structure and agencies of the family-planning councils of Pennsylvania. Through the collaboration of the Pennsylvania Department of Health, the family-planning councils, and trainers from clinical genetics centers, a uniform and comprehensive program for training and service delivery has evolved. This program now provides genetic risk screening for nearly 100,000 women/year, many of whom are from groups typically underserved by genetics services.     

Dragon Gene Start Finder identifies approximate locations of the 5' ends of genes

Recognition of gene starts is a difficult and yet unsolved problem. We present a program, Dragon Gene Start Finder (DGSF), which assesses the gene start in mammalian genomes and predicts a region which should overlap with the first exon of the gene or be in its proximity. The program has been rigorously tested on human chromosomes 4, 21 and 22, and in a strand specific search achieves an overall sensitivity of approximately 65% and a positive predictive value of approximately 78%. The sensitivity for the CpG-island related promoters is >88%. DGSF is free for academic and non-profit users at http://sdmc.lit.org.sg/promoter/dragonGSF1_0/genestart.htm; the download version of the program integrated within the TRANSPLORER package can be obtained from Biobase GmbH, at http://www.biobase.de/.     

Prélèvements à coeur arrêté : problèmes organisationnels

Non heart beating donor is now available in France. Pilots hospitals have tested the organisation in the french environment, and confirmed an increase of 20% of renal transplant. Educational program is necessary, as a good synchronisation between between medical emergency service (SAMU) which include not paramedics but french doctors. The last problems concern financial aspect, and probably the need to change the surgical teams to a multiorgan approach. A last ethical problem due to the developpement of therapeutical ECMO program is probably related to wrong informations.     

An application of multivariate ratio methods for the analysis of a longitudinal clinical trial with missing data.

This paper presents an analysis of a longitudinal multi-center clinical trial with missing data. It illustrates the application, the appropriateness, and the limitations of a straightforward ratio estimation procedure for dealing with multivariate situations in which missing data occur at random and with small probability. The parameter estimates are computed via matrix operators such as those used for the generalized least squares analysis of catetorical data. Thus, the estimates may be conveniently analyzed by asymptotic regression methods within the same computer program which computes the estimates, provided that the sample size is sufficiently computer program which computes the estimates, provided that the sample size is sufficiently large.