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Sample records for integrative medicine advancing

  1. Holistic integrative medicine: toward a new era of medical advancement.

    PubMed

    Fan, Daiming

    2017-03-01

    Medicine has encountered unprecedented problems associated with changes in nature, society, and environment, as well as with new human quests for survival, longevity, and health. In the meantime, the development of medicine is facing challenges that resulted from the over-division and specialization of disciplines and the fragmentation of medical knowledge. To construct a new medical system that is more suitable for human health and disease treatment, holistic integrative medicine (HIM), which regards the human body as a holistic entity, organically integrates the most advanced knowledge and theories in each medical field and the most effective practices in various clinical specialties to revise and adjust on the basis of social, environmental, and psychological conditions. HIM is the inevitable and necessary direction for the future development of medicine. In this article, we illustrated the connotation of HIM, the differences between HIM and other medical conceptions, and the practice of HIM in recent years.

  2. Complementary and Integrative Medicine

    MedlinePlus

    ... medical treatments that are not part of mainstream medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine. Complementary medicine is used together with mainstream medical ...

  3. Integration of an Introductory Pharmacy Practice Experience With an Advanced Pharmacy Practice Experience in Adult Internal Medicine

    PubMed Central

    Bird, Matthew L.; Vesta, Kimi S.; Harrison, Donald L.; Dennis, Vincent C.

    2012-01-01

    Objective. To describe the development, implementation, and assessment of an internal medicine introductory pharmacy practice experience (IPPE) that was integrated with an existing advanced pharmacy practice experience (APPE) in internal medicine. Design. A structured IPPE was designed for first-, second-, and third-year pharmacy (P1, P2, and P3) students. Activities for the IPPE were based on the established APPE and the individual learner's educational level. Assessment. Students reported a greater understanding of clinical pharmacists’ roles, increased confidence in their clinical skills, and better preparation for APPEs. Peers viewed the approach as innovative and transferable to other practice settings. Participating faculty members provided a greater number of contact hours compared to traditional one-time site visits. Conclusions. Integrating an IPPE with an existing APPE is an effective and efficient way to provide patient care experiences for students in the P1-P3 years in accordance with accreditation standards. PMID:22544969

  4. [Holistic integrative medicine: the road to the future of the development of burn medicine].

    PubMed

    Fan, D M

    2017-01-20

    Holistic integrative medicine is the road to the future of the development of burn medicine. Not only burn medicine, but also human medicine gradually enters the era of holistic integrative medicine. Holistic integrative medicine is different from translational medicine, evidence-based medicine or precision medicine, which integrates the most advanced knowledge and theories in medicine fields with the most effective practices and experiences in clinical specialties to form a new medical system.

  5. Pediatric Integrative Medicine.

    PubMed

    McClafferty, Hilary; Vohra, Sunita; Bailey, Michelle; Brown, Melanie; Esparham, Anna; Gerstbacher, Dana; Golianu, Brenda; Niemi, Anna-Kaisa; Sibinga, Erica; Weydert, Joy; Yeh, Ann Ming

    2017-09-01

    The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care. Related to this mission, the American Academy of Pediatrics recognizes the increasing use of complementary and integrative therapies for children and the subsequent need to provide reliable information and high-quality clinical resources to support pediatricians. This Clinical Report serves as an update to the original 2008 statement on complementary medicine. The range of complementary therapies is both extensive and diverse. Therefore, in-depth discussion of each therapy or product is beyond the scope of this report. Instead, our intentions are to define terms; describe epidemiology of use; outline common types of complementary therapies; review medicolegal, ethical, and research implications; review education and training for select providers of complementary therapies; provide educational resources; and suggest communication strategies for discussing complementary therapies with patients and families. Copyright © 2017 by the American Academy of Pediatrics.

  6. Advances in rehabilitation medicine.

    PubMed

    Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He

    2013-10-01

    Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.

  7. Bilateral Integrative Medicine, Obviously

    PubMed Central

    Stumpf, Steven H.; Shapiro, Simon J.

    2006-01-01

    Unstated and unacknowledged bias has a profound impact on the nature and implementation of integrative education models. Integrative education is the process of training conventional biomedical and traditional Chinese medicine practitioners in each tradition such that patient care may be effectively coordinated. A bilateral education model ensures that students in each tradition are cross-taught by experts from the ‘other’ tradition, imparting knowledge and values in unison. Acculturation is foundational to bilateral integrative medical education and practice. Principles are discussed for an open-minded bilateral educational model that can result in a new generation of integrative medicine teachers. PMID:16786060

  8. Integrated traditional Chinese medicine.

    PubMed

    Robinson, Nicola

    2006-05-01

    To experience the integration of traditional Chinese medicine (TCM) in China was 'the chance of a lifetime; thanks to the support of the Winston Churchill Memorial Trust. The scale and range of TCM available in terms of health care provision, education and research is unique in the world. This holistic integrative medicine is part of Chinese culture. Regulation and training of practitioners has similarities with current structures emerging in the UK in preparation for the statutory regulation for acupuncture and herbal medicine. China's research activity is a critical component of informing the debate on evidence-based practice and now real opportunities for collaboration and dissemination are beginning to emerge.

  9. Integrative Medicine in Preventive Medicine Education

    PubMed Central

    Jani, Asim A.; Trask, Jennifer; Ali, Ather

    2016-01-01

    During 2012, the USDHHS’s Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center established a multidisciplinary steering committee, versed in integrative medicine, whose primary aim was to develop integrative medicine core competencies for incorporation into preventive medicine graduate medical education training. The competency development process was informed by central integrative medicine definitions and principles, preventive medicine’s dual role in clinical and population-based prevention, and the burgeoning evidence base of integrative medicine. The steering committee considered an interdisciplinary integrative medicine contextual framework guided by several themes related to workforce development and population health. A list of nine competencies, mapped to the six general domains of competence approved by the Accreditation Council of Graduate Medical Education, was operationalized through an iterative exercise with the 12 grantees in a process that included mapping each site’s competency and curriculum products to the core competencies. The competencies, along with central curricular components informed by grantees’ work presented elsewhere in this supplement, are outlined as a roadmap for residency programs aiming to incorporate integrative medicine content into their curricula. This set of competencies adds to the larger efforts of the IMPriME initiative to facilitate and enhance further curriculum development and implementation by not only the current grantees but other stakeholders in graduate medical education around integrative medicine

  10. Integrative medicine in america.

    PubMed

    2012-07-01

    2011 年,致力于改善医护服务的 慈善组织 Bravewell Collaborative 委托进行了一项调查,以确定目前 美国的综合医学实施情况。29 个 发展完善的综合医学中心参与了本 调 查,本调查旨在了解患者人数 及最常诊治的病症、所采用的核心 实践及护理模式、服务的付费方 式、护理所包含的价值和原则以及 推动成功实施的主要因素。本调查(美国的综合医学:综 合医学在美国临床中心的实施情 况)刊发于本期《Global Advances in Health and Medicine》中,于 2012 年 2 月首次发布。多数相关 研究调查的是所使用的补充康复 手段的类型以及使用者,而不是 使用原因,最重要的是,没有调 查与之共同使用的手段。这是首 次深入调查实际综合临床实践, 就此而言,数据揭示了患者的整 体(身体、心智及精神)治疗情 况、协同使用传统与补充干预治 疗的方法、不同医生之间的合作 方式以及核心价值的实施方法。 我们非常高兴能与全球观众分享 这份调查。2012 年 3 月,Bravewell Collaborative召开了一项会议,参 加这项旨在了解现况的调查的 29 个中心的负责人一同到 会。Bravewell 的初衷是,让临床 与管理负责人互通有无,分享最 佳实践以及探讨深入采用综合医 学的方法。每年慢性健康问题造成美国经 济损失超过 10,000 亿美元,所以 我们有必要找出最有效的方法治疗 和预防最普遍的病症。综合医学能 多方面地迎合这一诉求。加利福尼 亚拉荷亚的斯可普斯综合医学中心 (Scripps Center for Integrative Medicine) 医学博士 Mimi Guarneri 在会上进行主旨发言时说得很中 肯:“ά们不可能照搬对心脏病病 发患者的治疗模式,来治疗试图防 止突发心脏病的患者。 这完全行 不通。应该摒弃这种做法。”

  11. Finding a sustainable prototype for integrative medicine

    PubMed Central

    Pillai, Geetha Krishnan Gopalakrishna; Sharma, Pooja

    2014-01-01

    Mainstreaming traditional systems of medicine and integrating them with the established health delivery mechanisms is an important step in accelerating advancement of health sciences to achieve current global health care goals. This paper proposes the “axial-model” of Integrative Medicine (IM). A replicable model, viable across multiple IM possibilities, which are clinically beneficial, supports evidence-based evolution and is socially acceptable. Axial model may be implemented to integrate two or more systems of medicines, provided they are legally regulated and approved for clinical administration. It proposes three consecutively phased clinical processes, named parallel, complementary and protocol, respectively. The model supports translational medicine by mainstreaming beneficial practices of traditional medicine as a part of its process of execution. PMID:25336841

  12. Integrative Medicine and Case Management.

    PubMed

    Powell, Suzanne K

    2016-01-01

    The evolution of the integration of health care modalities has changed. The National Institutes of Health founded office of the National Center for Complementary and Alternative Medicine in the early 1990s to investigate integrative therapies through scientific research. In December 2014, the name and mission were updated to the National Center for Complementary and Integrative Health. Case managers, the coordinators of health care, must understand the changes to "integrative medicine" and the allure of the alternative modalities.

  13. Integrative holistic medicine in Minnesota.

    PubMed

    Torkelson, Carolyn J; Manahan, Bill

    2009-05-01

    Minnesota has played a leading role in the integrative holistic medicine movement in the United States for more than 2 decades. This article defines integrative holistic medicine and describes how it is practiced. It also discusses the reasons why institutions and providers here and elsewhere in the country have embraced this approach to patient care.

  14. Advancing medical education: connecting interprofessional collaboration and education opportunities with integrative medicine initiatives to build shared learning.

    PubMed

    Templeman, Kate; Robinson, Anske; McKenna, Lisa

    2016-12-01

    BackgroundImproved teamwork between conventional and complementary medicine (CM) practitioners is indicated to achieve effective healthcare. However, little is known about interprofessional collaboration and education in the context of integrative medicine (IM). MethodsThis paper reports the findings from a constructivist-grounded theory method study that explored and highlighted Australian medical students' experiences and opportunities for linking interprofessional collaboration and learning in the context of IM. Following ethical approval, in-depth semi-structured interviews were conducted with 30 medical students from 10 medical education faculties across Australian universities. Results Medical students recognised the importance of interprofessional teamwork between general medical practitioners and CM professionals in patient care and described perspectives of shared responsibilities, profession-specific responsibilities, and collaborative approaches within IM. While students identified that limited interprofessional collaboration currently occurred in the medical curriculum, interprofessional education was considered a means of increasing communication and collaboration between healthcare professionals, helping coordinate effective patient care, and understanding each healthcare team members' professional role and value. Conclusions The findings suggest that medical curricula should include opportunities for medical students to develop required skills, behaviours, and attitudes for interprofessional collaboration and interprofessional education within the context of IM. While this is a qualitative study that reflects theoretical saturation from a selected cohort of medical students, the results also point to the importance of including CM professionals within interprofessional collaboration, thus contributing to more person-centred care.

  15. Implementation of an Integrative Medicine Curriculum for Preventive Medicine Residents.

    PubMed

    Chiaramonte, Delia R; D'Adamo, Christopher; Amr, Sania

    2015-11-01

    The University of Maryland Department of Epidemiology and Public Health collaborated with the Center for Integrative Medicine at the same institution to develop and implement a unique integrative medicine curriculum within a preventive medicine residency program. Between October 2012 and July 2014, Center for Integrative Medicine faculty provided preventive medicine residents and faculty, and occasionally other Department of Epidemiology and Public Health faculty, with comprehensive exposure to the field of integrative medicine, including topics such as mind-body medicine, nutrition and nutritional supplements, Traditional Chinese Medicine, massage, biofield therapies, manual medicine, stress management, creative arts, and the use of integrative medicine in the inpatient setting. Preventive medicine residents, under the supervision of Department of Epidemiology and Public Health faculty, led integrative medicine-themed journal clubs. Resident assessments included a case-based knowledge evaluation, the Integrative Medicine Attitudes Questionnaire, and a qualitative evaluation of the program. Residents received more than 60 hours of integrative medicine instruction, including didactic sessions, experiential workshops, and wellness retreats in addition to clinical experiences and individual wellness mentoring. Residents rated the program positively and recommended that integrative medicine be included in preventive medicine residency curricula. The inclusion of a wellness-focused didactic, experiential, and skill-based integrative medicine program within a preventive medicine residency was feasible and well received by all six preventive medicine residents. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Alternative and Integrative Medicine

    MedlinePlus

    ... government and regulatory agencies. In conventional medicine, effective cancer treatment is defined as one that causes a tumor to reduce in size or remain stable. Description Many alternative therapies seek to treat illness by helping the body ...

  17. Medicinal electrochemistry: integration of electrochemistry, medicinal chemistry and computational chemistry.

    PubMed

    Almeida, M O; Maltarollo, V G; de Toledo, R A; Shim, H; Santos, M C; Honorio, K M

    2014-01-01

    Over the last centuries, there were many important discoveries in medicine that were crucial for gaining a better understanding of several physiological processes. Molecular modelling techniques are powerful tools that have been successfully used to analyse and interface medicinal chemistry studies with electrochemical experimental results. This special combination can help to comprehend medicinal chemistry problems, such as predicting biological activity and understanding drug action mechanisms. Electrochemistry has provided better comprehension of biological reactions and, as a result of many technological improvements, the combination of electrochemical techniques and biosensors has become an appealing choice for pharmaceutical and biomedical analyses. Therefore, this review will briefly outline the present scope and future advances related to the integration of electrochemical and medicinal chemistry approaches based on various applications from recent studies.

  18. Project ASPIRE: Incorporating Integrative Medicine Into Residency Training

    PubMed Central

    Nawaz, Haq; Via, Christina M.; Ali, Ather; Rosenberger, Lisa D.

    2016-01-01

    Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents’ attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period. PMID:26477907

  19. Integrative Medicine for Insomnia.

    PubMed

    Zhou, Eric S; Gardiner, Paula; Bertisch, Suzanne M

    2017-09-01

    Difficulty initiating and/or maintaining sleep is a common issue. Patients experiencing insomnia symptoms frequently self-treat their symptoms with sleep medications. However, there remains concern regarding the short- and long-term health impacts of sleep medications. This article discusses the evidence supporting integrative approaches to insomnia treatment, including cognitive-behavioral therapy and mind-body therapies (mindfulness meditation, yoga, tai chi), as well as emerging data for use of other less well supported approaches (dietary supplements, acupuncture). Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Latest advances in antiaging medicine.

    PubMed

    Grossman, Terry

    2005-06-01

    Rapid progress is being made in our ability to modify the aging process. Rather than serving as a period of debility and decreasing health, for many people, the later years of life are becoming a period of continued productivity, independence and good health. Progress is also being made in increasing average lifespan. The leading causes of death (cardiovascular disease, cancer, lung disease, diabetes) are the end result of decades-long processes. With current knowledge, it is possible to delay the onset of these diseases. This can be assisted by lifestyle choices incorporating healthful diet, exercise, stress management, and nutritional supplementation. Emerging genomics technology will allow individuals to establish personalized programs, while early detection of heart disease and cancer will contribute to longevity. Biotechnological therapies involving stem cells, recombinant DNA, proteomics, therapeutic cloning and gene-based therapies are expected to play major roles in promoting successful aging. We are at the threshold of artificial intelligence (AI) and nanotechnology (NT). AI will allow for a merging of our biological thinking with advanced forms of non-biological intelligence to vastly expand our ability to think, create and experience. NT will ultimately allow us to build devices able to build molecules much like our current cellular machinery does, one atom at a time. It is the goal of today's antiaging medicine to forestall disease and aging long enough for people to utilize the powerful biotechnology and nanotechnology therapies that will be developed over the decades ahead. These future therapies have the potential to greatly extend longevity.

  1. Recent advances in tropical medicine.

    PubMed

    Solomon, Anthony W; Nayagam, Shevanthi; Pasvol, Geoffrey

    2009-07-01

    There have been significant advances in both the classical and neglected tropical diseases, with Guinea worm looking set to be the next disease after smallpox to be eradicated. Aided by a combination of enhanced understanding of the biology of the pathogens, intensification of immunisation activities or mass drug administration, together with the development of synergies with control programmes for co-endemic tropical diseases, polio, lymphatic filariasis, trachoma and onchocerciasis all appear to be in global decline, with good prospects for eventual successful elimination. While the global incidence of new cases of leprosy continues to decrease, the focus of leprosy control efforts has shifted following more widespread recognition that cure of infection does not necessarily prevent disability. Expansion in funding for HIV/AIDS and malaria provides some grounds for optimism about the control of these diseases. However, ongoing education and access remain essential to increasing the uptake of HIV testing and decreasing transmission. Meanwhile, the rise of drug-resistant tuberculosis and malaria is concerning, and the emergence of the highly pathogenic avian influenza A and re-emergence of viruses such as chikungunya and West Nile virus, without significant recent progress in vaccine development, pose additional ongoing challenges to tropical medicine physicians worldwide.

  2. Integrative medicine for chronic pain

    PubMed Central

    Saha, Felix J.; Brüning, Alexander; Barcelona, Cyrus; Büssing, Arndt; Langhorst, Jost; Dobos, Gustav; Lauche, Romy; Cramer, Holger

    2016-01-01

    Abstract Introduction: Integrative medicine inpatient treatment has been shown to improve physical and mental health in patients with internal medicine conditions. The aim of this study was to investigate the effectiveness of a 2-week integrative medicine inpatient treatment in patients with chronic pain syndromes and the association of treatment success with patient-related process variables. Methods: Inpatients with chronic pain syndromes participating in a 2-week integrative medicine inpatient program were included. Patients’ pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were measured on admission, discharge, and 6 months after discharge. Likewise process variables including ability and will to change, emotional/rational disease acceptance, mindfulness, life and health satisfaction, and easiness of life were assessed. Results: A total of 310 inpatients (91% female, mean age 50.7 ± 12.4 year, 26.5% low back pain, and 22.9% fibromyalgia) were included. Using mixed linear models, significant improvements in pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were found (all P < 0.05). Ability to change and implementation, disease acceptance, mindfulness, life and health satisfaction, and light heartedness/easiness likewise improved (all P < 0.05). Improved outcomes were associated with increases in process variables, mainly ability to change and implementation, disease acceptance, life and health satisfaction, and light heartedness/easiness (R2 = 0.03–0.40). Conclusions: Results of this study suggest that a 2-week integrative medicine inpatient treatment can benefit patients with chronic pain conditions. Functional improvements are associated with improved ability to change and implementation, disease acceptance, and satisfaction. PMID:27399133

  3. Developing and implementing core competencies for integrative medicine fellowships.

    PubMed

    Ring, Melinda; Brodsky, Marc; Low Dog, Tieraona; Sierpina, Victor; Bailey, Michelle; Locke, Amy; Kogan, Mikhail; Rindfleisch, James A; Saper, Robert

    2014-03-01

    The Consortium of Academic Health Centers for Integrative Medicine defines integrative medicine as "the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health and healing." Over the past three decades, the U.S. public increasingly has sought integrative medicine approaches. In an effort to train medical professionals to adequately counsel patients on the safe and appropriate use of these approaches, medical schools and residencies have developed curricula on integrative medicine for their trainees. In addition, integrative medicine clinical fellowships for postresidency physicians have emerged to provide training for practitioners interested in gaining greater expertise in this emerging field. Currently, 13 clinical fellowships in integrative medicine exist in the United States, and they are predominantly connected to academic medical centers or teaching affiliate hospitals. In 2010, the Consortium of Academic Health Centers for Integrative Medicine, represented by 56 member academic health care institutions with a shared commitment to advance the principles and practices of integrative medicine, convened a two-year task force to draft integrative medicine fellowship core competencies. These competencies would guide fellowship curriculum development and ensure that graduates possessed a common body of knowledge, skills, and attitudes. In this article, the authors discuss the competencies and the task force's process to develop them, as well as associated teaching and assessment methods, faculty development, potential barriers, and future directions.

  4. Interprofessional Integrative Medicine Training for Preventive Medicine Residents.

    PubMed

    Cowen, Virginia S; Thomas, Pauline A; Gould-Fogerite, Susan E; Passannante, Marian R; Mahon, Gwendolyn M

    2015-11-01

    Integrative medicine training was incorporated into the Rutgers New Jersey Medical School Preventive Medicine residency at the Rutgers Biomedical and Health Sciences Newark Campus as a collaboration between the Rutgers New Jersey Medical School and the School of Health Related Professions. Beginning in 2012, an interdisciplinary faculty team organized an Integrative Medicine program in a Preventive Medicine residency that leveraged existing resources across Rutgers Biomedical and Health Sciences. The overarching aim of the programs was to introduce residents and faculty to the scope and practice of integrative medicine in the surrounding Newark community and explore evidence-based research on integrative medicine. The faculty team tapped into an interprofessional network of healthcare providers to organize rotations for the preventive medicine residents that reflected the unique nature of integrative medicine in the greater Newark area. Residents provided direct care as part of interdisciplinary teams at clinical affiliates and shadowed health professionals from diverse disciplines as they filled different roles in providing patient care. The residents also participated in research projects. A combination of formal and informal programs on integrative medicine topics was offered to residents and faculty. The Integrative Medicine program, which ran from 2013 through 2014, was successful in exposing residents and faculty to the unique nature of integrative medicine across professions in the community served by Rutgers Biomedical and Health Sciences. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Pharmacogenomics and Nanotechnology Toward Advancing Personalized Medicine

    NASA Astrophysics Data System (ADS)

    Vizirianakis, Ioannis S.; Amanatiadou, Elsa P.

    The target of personalized medicine to achieve major benefits for all patients in terms of diagnosis and drug delivery can be facilitated by creating a sincere multidisciplinary information-based infrastructure in health care. To this end, nanotechnology, pharmacogenomics, and informatics can advance the utility of personalized medicine, enable clinical translation of genomic knowledge, empower healthcare environment, and finally improve clinical outcomes.

  6. Integration of Chinese medicine with Western medicine could lead to future medicine: molecular module medicine.

    PubMed

    Zhang, Chi; Zhang, Ge; Chen, Ke-ji; Lu, Ai-ping

    2016-04-01

    The development of an effective classification method for human health conditions is essential for precise diagnosis and delivery of tailored therapy to individuals. Contemporary classification of disease systems has properties that limit its information content and usability. Chinese medicine pattern classification has been incorporated with disease classification, and this integrated classification method became more precise because of the increased understanding of the molecular mechanisms. However, we are still facing the complexity of diseases and patterns in the classification of health conditions. With continuing advances in omics methodologies and instrumentation, we are proposing a new classification approach: molecular module classification, which is applying molecular modules to classifying human health status. The initiative would be precisely defining the health status, providing accurate diagnoses, optimizing the therapeutics and improving new drug discovery strategy. Therefore, there would be no current disease diagnosis, no disease pattern classification, and in the future, a new medicine based on this classification, molecular module medicine, could redefine health statuses and reshape the clinical practice.

  7. Evidence-Based Advances in Rabbit Medicine.

    PubMed

    Summa, Noémie M; Brandão, João

    2017-09-01

    Rabbit medicine has been continuously evolving over time with increasing popularity and demand. Tremendous advances have been made in rabbit medicine over the past 5 years, including the use of imaging tools for otitis and dental disease management, the development of laboratory testing for encephalitozoonosis, or determination of prognosis in rabbits. Recent pharmacokinetic studies have been published, providing additional information on commonly used antibiotics and motility-enhancer drugs, as well as benzimidazole toxicosis. This article presents a review of evidence-based advances for liver lobe torsions, thymoma, and dental disease in rabbits and controversial and new future promising areas in rabbit medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Epigenetic Mechanisms of Integrative Medicine

    PubMed Central

    Kanherkar, Riya R.; Stair, Susan E.; Bhatia-Dey, Naina; Mills, Paul J.; Chopra, Deepak

    2017-01-01

    Since time immemorial humans have utilized natural products and therapies for their healing properties. Even now, in the age of genomics and on the cusp of regenerative medicine, the use of complementary and alternative medicine (CAM) approaches represents a popular branch of health care. Furthermore, there is a trend towards a unified medical philosophy referred to as Integrative Medicine (IM) that represents the convergence of CAM and conventional medicine. The IM model not only considers the holistic perspective of the physiological components of the individual, but also includes psychological and mind-body aspects. Justification for and validation of such a whole-systems approach is in part dependent upon identification of the functional pathways governing healing, and new data is revealing relationships between therapies and biochemical effects that have long defied explanation. We review this data and propose a unifying theme: IM's ability to affect healing is due at least in part to epigenetic mechanisms. This hypothesis is based on a mounting body of evidence that demonstrates a correlation between the physical and mental effects of IM and modulation of gene expression and epigenetic state. Emphasis on mapping, deciphering, and optimizing these effects will facilitate therapeutic delivery and create further benefits. PMID:28316635

  9. Epigenetic Mechanisms of Integrative Medicine.

    PubMed

    Kanherkar, Riya R; Stair, Susan E; Bhatia-Dey, Naina; Mills, Paul J; Chopra, Deepak; Csoka, Antonei B

    2017-01-01

    Since time immemorial humans have utilized natural products and therapies for their healing properties. Even now, in the age of genomics and on the cusp of regenerative medicine, the use of complementary and alternative medicine (CAM) approaches represents a popular branch of health care. Furthermore, there is a trend towards a unified medical philosophy referred to as Integrative Medicine (IM) that represents the convergence of CAM and conventional medicine. The IM model not only considers the holistic perspective of the physiological components of the individual, but also includes psychological and mind-body aspects. Justification for and validation of such a whole-systems approach is in part dependent upon identification of the functional pathways governing healing, and new data is revealing relationships between therapies and biochemical effects that have long defied explanation. We review this data and propose a unifying theme: IM's ability to affect healing is due at least in part to epigenetic mechanisms. This hypothesis is based on a mounting body of evidence that demonstrates a correlation between the physical and mental effects of IM and modulation of gene expression and epigenetic state. Emphasis on mapping, deciphering, and optimizing these effects will facilitate therapeutic delivery and create further benefits.

  10. Integrative methods for analyzing big data in precision medicine.

    PubMed

    Gligorijević, Vladimir; Malod-Dognin, Noël; Pržulj, Nataša

    2016-03-01

    We provide an overview of recent developments in big data analyses in the context of precision medicine and health informatics. With the advance in technologies capturing molecular and medical data, we entered the area of "Big Data" in biology and medicine. These data offer many opportunities to advance precision medicine. We outline key challenges in precision medicine and present recent advances in data integration-based methods to uncover personalized information from big data produced by various omics studies. We survey recent integrative methods for disease subtyping, biomarkers discovery, and drug repurposing, and list the tools that are available to domain scientists. Given the ever-growing nature of these big data, we highlight key issues that big data integration methods will face. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. [To see the future development of burn medicine from the view of holistic integrative medicine].

    PubMed

    Hu, D H; Tao, K

    2017-04-20

    The therapeutic methods and effects have been improved greatly in the past few decades for burn care and management with several important advancements which have resulted in more effective patient stabilization and significantly decreased mortality in China. However, the challenges still exist, such as how to further improve the recovery of the patients' appearance and function, and how to advance the treatment of severe deep extensive burn injury, etc. The theory of holistic integrative medicine (HIM) provides a new opportunity for the development of clinical medicine. This article emphasizes the important roles of HIM in exploration of burn medicine, considering the advanced development of modern life sciences and relevant techniques.

  12. Advancing the Integration of Population Medicine into Medical Curricula at The Warren Alpert Medical School of Brown University: A New Master's Degree Program.

    PubMed

    Mello, Michael J; Feller, Edward; George, Paul; Borkan, Jeffrey

    2015-09-01

    Additional knowledge, attitudes and skills are required for the next generation of medical students as they expand the traditional focus on individual patients to include population-based health and scholarly investigation. The Warren Alpert Medical School of Brown University (AMS) is initiating a master's degree program as a key component of the new Primary Care-Population Medicine program at AMS leading to both a Doctorate in Medicine (MD) and Master of Science in Population Medicine (ScM) degrees in four years. The ScM is composed of a series of nine courses, integrated into the four-year MD curriculum, as well as a thesis. Additional attention will be given to leadership and quality improvement training. The goal is to produce graduates competent in the care of individual patients, panels, communities, and populations.

  13. Advanced Integrated Traction System

    SciTech Connect

    Greg Smith; Charles Gough

    2011-08-31

    The United States Department of Energy elaborates the compelling need for a commercialized competitively priced electric traction drive system to proliferate the acceptance of HEVs, PHEVs, and FCVs in the market. The desired end result is a technically and commercially verified integrated ETS (Electric Traction System) product design that can be manufactured and distributed through a broad network of competitive suppliers to all auto manufacturers. The objectives of this FCVT program are to develop advanced technologies for an integrated ETS capable of 55kW peak power for 18 seconds and 30kW of continuous power. Additionally, to accommodate a variety of automotive platforms the ETS design should be scalable to 120kW peak power for 18 seconds and 65kW of continuous power. The ETS (exclusive of the DC/DC Converter) is to cost no more than $660 (55kW at $12/kW) to produce in quantities of 100,000 units per year, should have a total weight less than 46kg, and have a volume less than 16 liters. The cost target for the optional Bi-Directional DC/DC Converter is $375. The goal is to achieve these targets with the use of engine coolant at a nominal temperature of 105C. The system efficiency should exceed 90% at 20% of rated torque over 10% to 100% of maximum speed. The nominal operating system voltage is to be 325V, with consideration for higher voltages. This project investigated a wide range of technologies, including ETS topologies, components, and interconnects. Each technology and its validity for automotive use were verified and then these technologies were integrated into a high temperature ETS design that would support a wide variety of applications (fuel cell, hybrids, electrics, and plug-ins). This ETS met all the DOE 2010 objectives of cost, weight, volume and efficiency, and the specific power and power density 2015 objectives. Additionally a bi-directional converter was developed that provides charging and electric power take-off which is the first step

  14. Holistic Medicine: Advances and Shortcomings

    PubMed Central

    Gordon, James S.

    1982-01-01

    Holistic medicine is an attitudinal approach to health care rather than a particular set of techniques. It addresses the psychological, familial, societal, ethical and spiritual as well as biological dimensions of health and illness. The holistic approach emphasizes the uniqueness of each patient, the mutuality of the doctor-patient relationship, each person's responsibility for his or her own health care and society's responsibility for the promotion of health. As holism has become an increasingly popular concept, it has been distorted by both proponents and critics. Tendencies to equate holism with particular therapeutic modalities, to neglect public health for a one-sided emphasis on individual responsibility and to reject rather than elaborate on the scientific method have hampered the movement's progress. In the future orthodox and alternative approaches and techniques must all be seen as complementary parts of a larger synthesis that will genuinely deserve the name of holism. PMID:7113200

  15. Integrative Medicine in Head and Neck Cancer.

    PubMed

    Matovina, Chloe; Birkeland, Andrew C; Zick, Suzanna; Shuman, Andrew G

    2017-02-01

    Objective Complementary and alternative medicine, or integrative medicine, has become increasingly popular among patients with head and neck cancer. Despite its increasing prevalence, many patients feel uncomfortable discussing such therapies with their physicians, and many physicians are unaware and underequipped to evaluate or discuss their use with patients. The aim of this article is to use recent data to outline the decision making inherent to integrative medicine utilization among patients with head and neck cancer, to discuss the ethical implications inherent to balancing integrative and conventional approaches to treatment, and to highlight available resources to enhance head and neck cancer providers' understanding of integrative medicine. Data Sources Randomized controlled trials involving integrative medicine or complementary and alternative medicine treatment for cancer patients. Review Methods Trials were drawn from a systematic PubMed database search categorized into cancer prevention, treatment, and symptom management. Conclusions Integrative medicine is gaining popularity for the management of cancer and is most commonly used for symptom management. A number of randomized controlled trials provide data to support integrative therapies, yet physicians who treat head and neck cancer may be faced with ethical dilemmas and practical barriers surrounding incorporation of integrative medicine. Implications for Practice In the management of head and neck cancer, there is an increasing demand for awareness of, dialogue about, and research evaluating integrative medicine therapies. It is important for otolaryngologists to become aware of integrative therapy options, their risks and benefits, and resources for further information to effectively counsel their patients.

  16. Precision medicine for advanced prostate cancer.

    PubMed

    Mullane, Stephanie A; Van Allen, Eliezer M

    2016-05-01

    Precision cancer medicine, the use of genomic profiling of patient tumors at the point-of-care to inform treatment decisions, is rapidly changing treatment strategies across cancer types. Precision medicine for advanced prostate cancer may identify new treatment strategies and change clinical practice. In this review, we discuss the potential and challenges of precision medicine in advanced prostate cancer. Although primary prostate cancers do not harbor highly recurrent targetable genomic alterations, recent reports on the genomics of metastatic castration-resistant prostate cancer has shown multiple targetable alterations in castration-resistant prostate cancer metastatic biopsies. Therapeutic implications include targeting prevalent DNA repair pathway alterations with PARP-1 inhibition in genomically defined subsets of patients, among other genomically stratified targets. In addition, multiple recent efforts have demonstrated the promise of liquid tumor profiling (e.g., profiling circulating tumor cells or cell-free tumor DNA) and highlighted the necessary steps to scale these approaches in prostate cancer. Although still in the initial phase of precision medicine for prostate cancer, there is extraordinary potential for clinical impact. Efforts to overcome current scientific and clinical barriers will enable widespread use of precision medicine approaches for advanced prostate cancer patients.

  17. Precision medicine for advanced prostate cancer

    PubMed Central

    Mullane, Stephanie A.; Van Allen, Eliezer M.

    2016-01-01

    Purpose of review Precision cancer medicine, the use of genomic profiling of patient tumors at the point-of-care to inform treatment decisions, is rapidly changing treatment strategies across cancer types. Precision medicine for advanced prostate cancer may identify new treatment strategies and change clinical practice. In this review, we discuss the potential and challenges of precision medicine in advanced prostate cancer. Recent findings Although primary prostate cancers do not harbor highly recurrent targetable genomic alterations, recent reports on the genomics of metastatic castration-resistant prostate cancer has shown multiple targetable alterations in castration-resistant prostate cancer metastatic biopsies. Therapeutic implications include targeting prevalent DNA repair pathway alterations with PARP-1 inhibition in genomically defined subsets of patients, among other genomically stratified targets. In addition, multiple recent efforts have demonstrated the promise of liquid tumor profiling (e.g., profiling circulating tumor cells or cell-free tumor DNA) and highlighted the necessary steps to scale these approaches in prostate cancer. Summary Although still in the initial phase of precision medicine for prostate cancer, there is extraordinary potential for clinical impact. Efforts to overcome current scientific and clinical barriers will enable widespread use of precision medicine approaches for advanced prostate cancer patients. PMID:26909474

  18. Advances in internal medicine. Volume 30

    SciTech Connect

    Stollerman, G.H.

    1984-01-01

    This book discusses the recent advances made in medicine. Topics discussed are--pathogenesis of T-cell Leukemia Virus; Immunosuppression; Acquired immune deficiency syndrome (AIDS)--organs affected and etiology; molecular biology of bacterial infections; pneumonia; patterns of aspergillosillosis infections; leukotrienes; cardiovascular action of beta-blockers; toxicity of drugs and biological effects of metals; and carcinogenesis of various carcinogens.

  19. Integrative Medicine Distance-Learning Program

    DTIC Science & Technology

    2005-10-01

    manual medicine, spirituality, Chinese medicine, homeopathy , medicine and culture and clinical integration. o Sixty physicians, nurse...rec’d from curriculum sent in December •Web development of December content •Develop proposal for additional funding Phase II • Homeopathy x 4 and

  20. Current advances in perinatal medicine.

    PubMed

    Stern, L

    1979-01-01

    The enhancement of pulmonary maturation with the resultant ability to prevent hyaline membrane disease has given rise to the use of a number of drugs experimentally including corticosteroids, thyroxine, aminophylline, heroin, and several suggested others for this purpose. In clinical use to date only the corticosteroids have been widely utilized in man but it is clear that these agents are capable of effecting an advancement in the maturation of the surfactant system of the lung and a subsequent reduction in the incidence of severity of hyaline membrane disease. However, all agents which act by the enhancement of maturation also carry with them a resultant arrest to replication of tissues and there have been demonstrable effects on both the lung and possibly the brain of the organisms to whom these agents have been administreted. In this connection it is, therefore, important to realize that the advantages gained from these agents may be counterbalanced by disadvantages from their usage and that a reasoned and careful approach in each individual case is mandatory when use of such agents is considered. Experimental and clinical studies suggest the possibility that Vitamin E acting as a free radical scavenger may be important in the prevention of oxygen toxicity both to the eye (retrolental fibroplasia) as well as ameliorating the oxygen component of the destructive effects of respirator lung disease (bronchopulmonary dysplasia). The action of Vitamin E under these circumstances is not dependent upon its actual quantitative level in the plasma of premature infants but in utilization to its excess. Although phototherapy has been universally and widely used since 1958, precise studies of its mechanism of action have not been revealing. Recent work has suggested that following exposure to photoirradiation, bilirubin in its unconjugated form can be seen to appear in the excretory bile ducts suggesting the transport of unconjugated bilirubin through the liver. More recent

  1. Toward the integration of cytomics and medicine.

    PubMed

    Leif, Robert C

    2009-09-01

    The integration of cytomics research and healthcare informatics will facilitate technology transfer and reduce medical costs. The CytometryML prototype of the Advanced Cytometry Standard (ACS) has the benefits of including microscopic image and flow list-mode data, being based on XML and thus is compatible with existing medical and scientific informatics standards, such as HL7, and employing a design based upon the Digital Imaging and Communications in Medicine (DICOM) standard. The reuse of the well tested DICOM model resulted in a great decrease in the design and documentation effort and increased probability of reliability. Schemas for flow cytometers and microscopes have been created. XML schemas for two related types of container (ZIP) files have been specified for a set of measurements. The series and instance containers respectively include the metadata that is constant and the metadata that is specific to an individual or small closely related group of measurements.

  2. Attempts to utilize and integrate traditional medicine in North Korea.

    PubMed

    Lim, Byungmook; Park, Jongbae; Han, Changyon

    2009-03-01

    To summarize the way North Korea attempted to modernize its system of traditional medicine and integrate it with Western biomedicine. We reviewed clinical textbooks and periodicals of traditional Korean medicine published in North Korea, research reports on North Korean health and medicine published elsewhere, and conducted interviews of defectors from North Korea who were students or clinicians of traditional medicine. Key findings of this study are: (1) North Korea has attempted several ways of integrating traditional medicine into education and clinical practices; (2) North Korea's communist government provided the main driving force for an integration policy; (3) school curricula of both Western and traditional Korean medicine incorporated knowledge of both disciplines, yet more weight was placed on traditional Korean medicine; (4) a combination of Western diagnosis and Korean therapeutics was the most frequent example of integration, while the dual system approach with reciprocal practice was also explored; (5) several forms of integrative therapeutic mixture were practiced including concurrent medication, injection on acupuncture points, and intramuscular or intravenous injection of extracts from medicinal plants; and (6) limited resources for research and the underdeveloped level of clinical research failed to secure rigorous scientific advancement. Despite the government-driven attempt to create an ideal integrative system of medicine, according to our findings, the actual introduction of an integrative system into practice was far from the North Korean government's anticipated outcome in regards to clinical practice. We hypothesize this was due to famine, economic crisis, and political isolation from the international realm. Traditional Korean medicine seems to have served the population, which is in desperate need of treatment amid difficulties in health, while North Korea's Western biomedicine-based health delivery system has been badly affected.

  3. Big data is essential for further development of integrative medicine.

    PubMed

    Li, Guo-zheng; Liu, Bao-yan

    2015-05-01

    To give a short summary on achievements, opportunities and challenges of big data in integrative medicine (IM) and explore the future works on breaking the bottleneck to make IM develop rapidly, this paper presents the growing field of big data from IM, describes the systems of data collection and the techniques of data analytics, introduces the advances, and discusses the future works especially the challenges in this field. Big data is increasing dramatically as the time flies, whatever we face it or not. Big data is evolving into a promising way for deep insight IM, the ancient medicine integrating with modern medicine. We have great achievements in data collection and data analysis, where existing results show it is possible to discover the knowledge and rules behind the clinical records. Transferring from experience-based medicine to evidence-based medicine, IM depends on the big data technology in this great era.

  4. Recent Advances of Metallocenes for Medicinal Chemistry.

    PubMed

    Santos, Miguel M; Bastos, Pedro; Catela, Isabelle; Zalewska, Karolina; Branco, Luis C

    2017-01-01

    The recent advances for the synthesis and application of different metallocenes for Medicinal Chemistry is reviewed. This manuscript presents the different metallocene scaffolds, with special emphasis on ferrocene derivatives, and their potential pharmaceutical application. Over the last years, the synthesis of new metallocene compounds and their biological and medicinal effects against some types of diseases (e.g. anti-tumoral, antibiotics, anti-viral) have been reported. From the medicinal point of view, the attractive properties of metallocene derivatives, such as their high stability, low toxicity and appealing redox behaviors are particularly relevant. This area has attracted many researchers as well as the pharmaceutical industry due to the promising results of some metallocenes, in particular ferrocene compounds, in breast cancer and malaria. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. Advanced integrated safeguards at Barnwell

    SciTech Connect

    Bambas, K.J.; Barnes, L.D.

    1980-06-01

    The development and initial performance testing of an advanced integrated safeguards system at the Barnwell Nuclear Fuel Plant (BNFP) is described. The program concentrates on the integration and coordination of physical security and nuclear materials control and accounting at a single location. Hardware and software for this phase have been installed and are currently being evaluated. The AGNS/DOE program is now in its third year of development at the BNFP.

  6. Integrative medicine for cancer treatment

    MedlinePlus

    ... it is used with standard anti-nausea medicines. Yoga . This ancient mind-body practice may help relieve stress, anxiety, and depression. Before doing yoga, be sure to check with your health care ...

  7. Advancing and Translating Knowledge in Vascular Medicine

    PubMed Central

    Husmann, Marc; Barton, Matthias

    2014-01-01

    For centuries, physicians have depended on the use of written information to gain knowledge. Book printing and binding introduced by Gutenberg in the fifteenth century revolutionized and accelerated the distribution of information. Advancing medical knowledge and progress is not only linked to the scientific quality of a discovery determining it will be accepted by the peers but also by its communication and sharing of new findings with the medical community. All these factors determine whether new knowledge will advance and improve clinical practice, medical education, and ultimately, patient care, and human health. In the past decade medical publishing has witnessed a revolution with regard to the instant, online availability of published “open access” information, which can be accessed and printed from any computer connected to the internet. As an example, how language and availability of printed information may affect distribution of knowledge, we discuss the publication of the first results of balloon angioplasty in patients with peripheral vascular disease 40 years ago by Andreas Grüntzig, M.D. at the University of Zürich. Vascular Medicine, as part of Frontiers in Cardiovascular Medicine, will provide open access provided to all published content for sharing and distributing new and most up-to-date information on clinical practice and medical knowledge in vascular medicine. We anticipate that the ongoing transformation of scientific publishing through open access will further accelerate this process and make new knowledge available even faster. Immediate, unrestricted, and rapid access to the most current knowledge published will play a role in maintaining and advancing human vascular health across the globe. PMID:26664857

  8. Integrative medicine approach to chronic pain.

    PubMed

    Teets, Raymond Y; Dahmer, Stephen; Scott, Emilie

    2010-06-01

    Chronic pain can be a frustrating condition for patient and clinician. The integrative medicine approach to pain can offer hope, adding safe complementary and alternative medical (CAM) therapies to mitigate pain and suffering. Such CAM therapies include nutrition, supplements and herbs, manual medicine, acupuncture, yoga, and mind-body approaches. The evidence is heterogeneous regarding these approaches, but some evidence suggests efficacy and confirms safety. The integrative medicine approach can be beneficial in a patient with chronic pain. Copyright 2010 Elsevier Inc. All rights reserved.

  9. Integrative medicine in allergy and immunology.

    PubMed

    Chang, Christopher; Gershwin, M Eric

    2013-06-01

    Integrative medicine is a relatively new discipline which attempts to combine allopathic medicine with alternative or complementary medicine, to reap the benefits of both forms of medicine in optimizing the care of patients. Integrative medicine concentrates on treating the patient as a whole, both in body and mind. While the scientific method and "evidence-based" clinical research drives the management and treatment of diseases in conventional Western medicine, alternative or complementary medicine is based on unproven yet potentially beneficial techniques that have been developed throughout history, dating back to the ancient cultures in the Middle East, Africa, and China. In spite of the lack of evidence of most alternative medicine techniques, these methodologies have been practiced for centuries with great acceptance in many countries. It is in the Western world, where "modern" medicine is dictated by the scientific method, that the most controversy in the use of these alternative modes of therapy exists. Since the science behind alternative medicine is incomplete or non-existent, it is difficult for those trained in Western medicine to accept or adopt this approach. But perhaps it is the failure of Western medicine to adequately guarantee our well being and good health that have led to the ongoing debate between the medical profession and the general public as to the benefits of these alternative treatments. In one sense, integrative medicine may be a futile attempt to coin a new term in the hope of legitimizing alternative medicine. On the other hand, there is a wealth of historical experience in the use of the techniques. Studies to evaluate the scientific basis behind ancient medical techniques are ongoing, and it is to be expected that the results will neither be uniformly positive nor negative. Of particular interest is the effect of traditional medicine, herbal formulations, and manipulative techniques on the immune system, and its application in the

  10. Integrative Medicine Selects Best Practice from Public Health and Biomedicine

    PubMed Central

    Ryan, Terence J

    2013-01-01

    The meaning of terms Integrated and Integrative are described variously by an amalgam of latest scientific advances with ancient healing systems, of complementary medicine and biomedicine, and sexually transmitted infections and HIV/AIDS. It means seamless good quality care between hospital and primary care. They provoke approval mostly from patients and disapproval mostly from advocates of science and evidence-based medicine. The Institute of Applied Dermatology in Kasaragod, Kerala, India has championed a mix of Biomedicine, Yoga and herbals from Ayurvedic medicine, partly based on publications from the Department of Dermatology of the University of Oxford. In Oxford dermatology, acceptance of value of integrative medicine (IM) is demonstrated, especially in wound healing and the skin's blood supply. This has long featured in the university's research program. A variety of approaches to the practice of medicine are illustrated with reference to Osler, Garrod, and Doll. IM is believed to underlie contemporarily best practice. Particular emphasis is given to the control of heat, pain, redness, and swelling, all manifestations of inflammation, and the importance of emotion as a stimulus or inhibitor carried by neural pathways. These may explain some unbelievable Asian practices and one of the many roles of Yoga. The concept of Integrative is expanded to include care of the earth and nutrition, the hazards of climate change, Gardens for Health, do (k) no (w) harm as a key to good practice. PMID:23716803

  11. Integrative medicine selects best practice from public health and biomedicine.

    PubMed

    Ryan, Terence J

    2013-03-01

    The meaning of terms Integrated and Integrative are described variously by an amalgam of latest scientific advances with ancient healing systems, of complementary medicine and biomedicine, and sexually transmitted infections and HIV/AIDS. It means seamless good quality care between hospital and primary care. They provoke approval mostly from patients and disapproval mostly from advocates of science and evidence-based medicine. The Institute of Applied Dermatology in Kasaragod, Kerala, India has championed a mix of Biomedicine, Yoga and herbals from Ayurvedic medicine, partly based on publications from the Department of Dermatology of the University of Oxford. In Oxford dermatology, acceptance of value of integrative medicine (IM) is demonstrated, especially in wound healing and the skin's blood supply. This has long featured in the university's research program. A variety of approaches to the practice of medicine are illustrated with reference to Osler, Garrod, and Doll. IM is believed to underlie contemporarily best practice. Particular emphasis is given to the control of heat, pain, redness, and swelling, all manifestations of inflammation, and the importance of emotion as a stimulus or inhibitor carried by neural pathways. These may explain some unbelievable Asian practices and one of the many roles of Yoga. The concept of Integrative is expanded to include care of the earth and nutrition, the hazards of climate change, Gardens for Health, do (k) no (w) harm as a key to good practice.

  12. Integrative Medicine in Preventive Medicine Education: Implementation Analysis.

    PubMed

    Burton, Dee; Trask, Jennifer; Sandvold, Irene; Amr, Sania; Chaudry, Sajida S; Debay, Marc

    2015-11-01

    In September 2012, the Health Resources and Services Administration funded 12 preventive medicine residency programs to participate in a 2-year project aimed at incorporating integrative medicine (IM) into their residency training programs. The grantees were asked to incorporate competencies for IM into their respective preventive medicine residency curricula and to provide for faculty development in IM. The analysis conducted in 2014-2015 used the following evidence to assess residency programs' achievements and challenges in implementation: progress and performance measures reports, curriculum mapping of program activities to IM competencies, records of webinar participation, and post-project individual semi-structured phone interviews with the 12 grantee project leaders. Key findings are: (1) IM activities offered to residents increased by 50% during the 2 years; (2) Accessing IM resources already in existence at local grantee sites was the primary facilitator of moving the integration of IM into preventive medicine residencies forward; (3) Among all activities offered residents, rotations were perceived by grantees as by far the most valuable contributor to acquiring IM competencies; (4) Online training was considered a greater contributor to preventive medicine residents' medical knowledge in IM than faculty lectures or courses; (5) Faculty were offered a rich variety of opportunities for professional development in IM, but some programs lacked a system to ensure faculty participation; and (6) Perceived lack of evidence for IM was a barrier to full program implementation at some sites. Grantees expect implemented programs to continue post-funding, but with decreased intensity owing to perceived faculty and curriculum time constraints. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

  13. Advanced Integration Matrix Education Outreach

    NASA Technical Reports Server (NTRS)

    Paul Heather L.

    2004-01-01

    The Advanced Integration Matrix (AIM) will design a ground-based test facility for developing revolutionary integrated systems for joint human-robotic missions in order to study and solve systems-level integration issues for exploration missions beyond Low Earth Orbit (LEO). This paper describes development plans for educational outreach activities related to technological and operational integration scenarios similar to the challenges that will be encountered through this project. The education outreach activities will provide hands-on, interactive exercises to allow students of all levels to experience design and operational challenges similar to what NASA deals with everyday in performing the integration of complex missions. These experiences will relate to and impact students everyday lives by demonstrating how their interests in science and engineering can develop into future careers, and reinforcing the concepts of teamwork and conflict resolution. Allowing students to experience and contribute to real-world development, research, and scientific studies of ground-based simulations for complex exploration missions will stimulate interest in the space program, and bring NASA's challenges to the student level. By enhancing existing educational programs and developing innovative activities and presentations, AIM will support NASA s endeavor to "inspire the next generation of explorers.. .as only NASA can."

  14. Advanced Integration Matrix Education Outreach

    NASA Technical Reports Server (NTRS)

    Paul Heather L.

    2004-01-01

    The Advanced Integration Matrix (AIM) will design a ground-based test facility for developing revolutionary integrated systems for joint human-robotic missions in order to study and solve systems-level integration issues for exploration missions beyond Low Earth Orbit (LEO). This paper describes development plans for educational outreach activities related to technological and operational integration scenarios similar to the challenges that will be encountered through this project. The education outreach activities will provide hands-on, interactive exercises to allow students of all levels to experience design and operational challenges similar to what NASA deals with everyday in performing the integration of complex missions. These experiences will relate to and impact students everyday lives by demonstrating how their interests in science and engineering can develop into future careers, and reinforcing the concepts of teamwork and conflict resolution. Allowing students to experience and contribute to real-world development, research, and scientific studies of ground-based simulations for complex exploration missions will stimulate interest in the space program, and bring NASA's challenges to the student level. By enhancing existing educational programs and developing innovative activities and presentations, AIM will support NASA s endeavor to "inspire the next generation of explorers.. .as only NASA can."

  15. Complementary and alternative medicine. Integrative medicine: business risks and opportunities.

    PubMed

    Berndtson, K

    1998-01-01

    Much of the buzz over integrative medicine is well deserved. The opportunities seem to outweigh the risks, but superior management skills are needed to guide these programs through adolescence into clinical and business maturity. By carefully considering the staffing, team building, compensation methods, marketing, and program evaluation and development issues explored in this article, health care and physician executives should be able to steer between the rocks on their way to integrative medicine decisions that are right for their organizations. Many claim that integrative medicine has the potential to reshape health care delivery in a more patient-centered direction. While this may be true, such programs must prove themselves from financial and clinical operational perspectives in order to achieve this potential. Luminary clinical skills are not enough to guarantee the survival of such programs--a strong clinical base of expertise in alternative therapies is a key success factor. As with any health care venture, there are no substitutes for clinical excellence or sound management.

  16. Recent advances in personalized lung cancer medicine

    PubMed Central

    Okimoto, Ross A; Bivona, Trever G

    2014-01-01

    The identification of molecular subtypes of non-small-cell lung cancer has transformed the clinical management of this disease. This is best exemplified by the clinical success of targeting the EGFR or ALK with tyrosine kinase inhibitors in the front-line setting. Our ability to further improve patient outcomes with biomarker-based targeted therapies will depend on a more comprehensive genetic platform that can rationally interrogate the cancer genome of an individual patient. Novel technologies, including multiplex genotyping and next-generation sequencing are rapidly evolving and will soon challenge the oncologist with a wealth of genetic information for each patient. Although there are many barriers to overcome, the integration of these genetic platforms into clinical care has the potential to transform the management of lung cancer through improved molecular categorization, patient stratification, and drug development, thereby, improving clinical outcomes through personalized lung cancer medicine. PMID:25506379

  17. European regulatory tools for advanced therapy medicinal products.

    PubMed

    Flory, Egbert; Reinhardt, Jens

    2013-12-01

    Increasing scientific knowledge and technical innovations in the areas of cell biology, biotechnology and medicine resulted in the development of promising therapeutic approaches for the prevention and treatment of human diseases. Advanced therapy medicinal products (ATMPs) reflect a complex and innovative class of biopharmaceuticals as these products are highly research-driven, characterised by innovative manufacturing processes and heterogeneous with regard to their origin, type and complexity. This class of ATMP integrates gene therapy medicinal products, somatic cell therapy medicinal products and tissue engineering products and are often individualized and patient-specific products. Multiple challenges arise from the nature of ATMPs, which are often developed by micro, small and medium sized enterprises, university and academia, for whom regulatory experiences are limited and regulatory requirements are challenging. Regulatory guidance such as the reflection paper on classification of ATMPs and guidelines highlighting product-specific issues support academic research groups and pharmaceutical companies to foster the development of safe and effective ATMPs. This review provides an overview on the European regulatory aspects of ATMPs and highlights specific regulatory tools such as the ATMP classification procedure, a discussion on the hospital exemption for selected ATMPs as well as borderline issues towards transplants/transfusion products.

  18. European Regulatory Tools for Advanced Therapy Medicinal Products

    PubMed Central

    Flory, Egbert; Reinhardt, Jens

    2013-01-01

    Summary Increasing scientific knowledge and technical innovations in the areas of cell biology, biotechnology and medicine resulted in the development of promising therapeutic approaches for the prevention and treatment of human diseases. Advanced therapy medicinal products (ATMPs) reflect a complex and innovative class of biopharmaceuticals as these products are highly research-driven, characterised by innovative manufacturing processes and heterogeneous with regard to their origin, type and complexity. This class of ATMP integrates gene therapy medicinal products, somatic cell therapy medicinal products and tissue engineering products and are often individualized and patient-specific products. Multiple challenges arise from the nature of ATMPs, which are often developed by micro, small and medium sized enterprises, university and academia, for whom regulatory experiences are limited and regulatory requirements are challenging. Regulatory guidance such as the reflection paper on classification of ATMPs and guidelines highlighting product-specific issues support academic research groups and pharmaceutical companies to foster the development of safe and effective ATMPs. This review provides an overview on the European regulatory aspects of ATMPs and highlights specific regulatory tools such as the ATMP classification procedure, a discussion on the hospital exemption for selected ATMPs as well as borderline issues towards transplants/transfusion products. PMID:24474890

  19. Integrative medicine and patient-centered care.

    PubMed

    Maizes, Victoria; Rakel, David; Niemiec, Catherine

    2009-01-01

    Integrative medicine has emerged as a potential solution to the American healthcare crisis. It provides care that is patient centered, healing oriented, emphasizes the therapeutic relationship, and uses therapeutic approaches originating from conventional and alternative medicine. Initially driven by consumer demand, the attention integrative medicine places on understanding whole persons and assisting with lifestyle change is now being recognized as a strategy to address the epidemic of chronic diseases bankrupting our economy. This paper defines integrative medicine and its principles, describes the history of complementary and alternative medicine (CAM) in American healthcare, and discusses the current state and desired future of integrative medical practice. The importance of patient-centered care, patient empowerment, behavior change, continuity of care, outcomes research, and the challenges to successful integration are discussed. The authors suggest a model for an integrative healthcare system grounded in team-based care. A primary health partner who knows the patient well, is able to addresses mind, body, and spiritual needs, and coordinates care with the help of a team of practitioners is at the centerpiece. Collectively, the team can meet all the health needs of the particular patient and forms the patient-centered medical home. The paper culminates with 10 recommendations directed to key actors to facilitate the systemic changes needed for a functional healthcare delivery system. Recommendations include creating financial incentives aligned with health promotion and prevention. Insurers are requested to consider the total costs of care, the potential cost effectiveness of lifestyle approaches and CAM modalities, and the value of longer office visits to develop a therapeutic relationship and stimulate behavioral change. Outcomes research to track the effectiveness of integrative models must be funded, as well as feedback and dissemination strategies

  20. Advanced integrated enhanced vision systems

    NASA Astrophysics Data System (ADS)

    Kerr, J. R.; Luk, Chiu H.; Hammerstrom, Dan; Pavel, Misha

    2003-09-01

    In anticipation of its ultimate role in transport, business and rotary wing aircraft, we clarify the role of Enhanced Vision Systems (EVS): how the output data will be utilized, appropriate architecture for total avionics integration, pilot and control interfaces, and operational utilization. Ground-map (database) correlation is critical, and we suggest that "synthetic vision" is simply a subset of the monitor/guidance interface issue. The core of integrated EVS is its sensor processor. In order to approximate optimal, Bayesian multi-sensor fusion and ground correlation functionality in real time, we are developing a neural net approach utilizing human visual pathway and self-organizing, associative-engine processing. In addition to EVS/SVS imagery, outputs will include sensor-based navigation and attitude signals as well as hazard detection. A system architecture is described, encompassing an all-weather sensor suite; advanced processing technology; intertial, GPS and other avionics inputs; and pilot and machine interfaces. Issues of total-system accuracy and integrity are addressed, as well as flight operational aspects relating to both civil certification and military applications in IMC.

  1. Pediatric integrative medicine: pediatrics' newest subspecialty?

    PubMed Central

    2012-01-01

    Background Integrative medicine is defined as relationship-centered care that focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing, including evidence-based complementary and alternative medicine. Pediatric integrative medicine (PIM) develops and promotes this approach within the field of pediatrics. We conducted a survey to identify and describe PIM programs within academic children’s hospitals across North America. Key barriers and opportunities were identified for the growth and development of academic PIM initiatives in the US and Canada. Methods Academic PIM programs were identified by email and eligible for inclusion if they had each of educational, clinical, and research activities. Program directors were interviewed by telephone regarding their clinical, research, educational, and operational aspects. Results Sixteen programs were included. Most (75%) programs provided both inpatient and outpatient services. Seven programs operated with less than 1 FTE clinical personnel. Credentialing of complementary and alternative medicine (CAM) providers varied substantially across the programs and between inpatient and outpatient services. Almost all (94%) programs offered educational opportunities for residents in pediatrics and/or family medicine. One fifth (20%) of the educational programs were mandatory for medical students. Research was conducted in a range of topics, but half of the programs reported lack of research funding and/or time. Thirty-one percent of the programs relied on fee-for-service income. Conclusions Pediatric integrative medicine is emerging as a new subspecialty to better help address 21st century patient concerns. PMID:22894682

  2. Linking Ayurveda and Western medicine by integrative analysis.

    PubMed

    Fauzi, Fazlin Mohd; Koutsoukas, Alexios; Lowe, Robert; Joshi, Kalpana; Fan, Tai-Ping; Glen, Robert C; Bender, Andreas

    2013-04-01

    In this article, we discuss our recent work in elucidating the mode-of-action of compounds used in traditional medicine including Ayurvedic medicine. Using computational ('in silico') approach, we predict potential targets for Ayurvedic anti-cancer compounds, obtained from the Indian Plant Anticancer Database given its chemical structure. In our analysis, we observed that: (i) the targets predicted can be connected to cancer pathogenesis i.e. steroid-5-alpha reductase 1 and 2 and estrogen receptor-β, and (ii) predominantly hormone-dependent cancer targets were predicted for the anti-cancer compounds. Through the use of our in silico target prediction, we conclude that understanding how traditional medicine such as Ayurveda work through linking with the 'western' understanding of chemistry and protein targets can be a fruitful avenue in addition to bridging the gap between the two different schools of thinking. Given that compounds used in Ayurveda have been tested and used for thousands of years (although not in the same approach as Western medicine), they can potentially be developed into potential new drugs. Hence, to further advance the case of Ayurvedic medicine, we put forward some suggestions namely: (a) employing and integrating novel analytical methods given the advancements of 'omics' and (b) sharing experimental data and clinical results on studies done on Ayurvedic compounds in an easy and accessible way.

  3. Integration of traditional Chinese medicine and Western medicine in the era of precision medicine.

    PubMed

    Wang, Wen-Jian; Zhang, Teng

    2017-01-01

    Precision medicine has received growing recognition from clinicians, health systems, and the pharmaceutical industry, as well as patients and policymakers, which will leave a major impact on the practice of medicine. Interestingly, traditional Chinese medicine (TCM) provides personalized medical treatment based on the theory of TCM characterized by holistic concept and pattern differentiation. This, to some extent, is similar to the personalized medical treatment of precision medicine. In China, TCM as well as Western medicine (WM) plays an important role in healthcare. In this article, the authors summarized the influence of precision medicine on current medical directions, the advantages of TCM in disease treatment, further development of precision medicine and the strategies for integration of TCM and WM under this new treatment approach. In addition, the authors discuss the perspective of precise medical diagnosis and treatment, precise prevention, and the complementary advantages of the integration of TCM and WM. Finally, the authors give their perspectives on the challenges and opportunities presented by precision medicine, in the context of further research toward the integration of TCM and WM.

  4. Advances by the Integral Fast Reactor Program

    SciTech Connect

    Lineberry, M.J.; Pedersen, D.R.; Walters, L.C.; Cahalan, J.E.

    1991-01-01

    The advances by the Integral Fast Reactor Program at Argonne National Laboratory are the subject of this paper. The Integral Fast Reactor (IFR) is an advanced liquid-metal-cooled reactor concept being developed at Argonne National Laboratory. The advances stressed in the paper include fuel irradiation performance, improved passive safety, and the development of a prototype fuel cycle facility. 14 refs.

  5. Advanced integrated solvent extraction systems

    SciTech Connect

    Horwitz, E.P.; Dietz, M.L.; Leonard, R.A.

    1997-10-01

    Advanced integrated solvent extraction systems are a series of novel solvent extraction (SX) processes that will remove and recover all of the major radioisotopes from acidic-dissolved sludge or other acidic high-level wastes. The major focus of this effort during the last 2 years has been the development of a combined cesium-strontium extraction/recovery process, the Combined CSEX-SREX Process. The Combined CSEX-SREX Process relies on a mixture of a strontium-selective macrocyclic polyether and a novel cesium-selective extractant based on dibenzo 18-crown-6. The process offers several potential advantages over possible alternatives in a chemical processing scheme for high-level waste treatment. First, if the process is applied as the first step in chemical pretreatment, the radiation level for all subsequent processing steps (e.g., transuranic extraction/recovery, or TRUEX) will be significantly reduced. Thus, less costly shielding would be required. The second advantage of the Combined CSEX-SREX Process is that the recovered Cs-Sr fraction is non-transuranic, and therefore will decay to low-level waste after only a few hundred years. Finally, combining individual processes into a single process will reduce the amount of equipment required to pretreat the waste and therefore reduce the size and cost of the waste processing facility. In an ongoing collaboration with Lockheed Martin Idaho Technology Company (LMITCO), the authors have successfully tested various segments of the Advanced Integrated Solvent Extraction Systems. Eichrom Industries, Inc. (Darien, IL) synthesizes and markets the Sr extractant and can supply the Cs extractant on a limited basis. Plans are under way to perform a test of the Combined CSEX-SREX Process with real waste at LMITCO in the near future.

  6. [Reflection on treatment of acquired immunodeficiency syndrome by integrative medicine].

    PubMed

    Wang, Dan-Ni

    2012-02-01

    The current situation of Chinese medicine and Western medicine treatment of acquired immunodeficiency syndrome (AIDS) has made the integrative medicine treatment of AIDS an important treatment strategy. Integrative medicine treatment of AIDS has made certain achievements in clinical research, basic research, and other aspects. It has good mass foundation and curative efficacy, as well as insufficiency. I hope integrative medicine can be brought into full play in the treatment of AIDS and make breakthrough progress.

  7. Integrative Genomics and Computational Systems Medicine

    SciTech Connect

    McDermott, Jason E.; Huang, Yufei; Zhang, Bing; Xu, Hua; Zhao, Zhongming

    2014-01-01

    The exponential growth in generation of large amounts of genomic data from biological samples has driven the emerging field of systems medicine. This field is promising because it improves our understanding of disease processes at the systems level. However, the field is still in its young stage. There exists a great need for novel computational methods and approaches to effectively utilize and integrate various omics data.

  8. Advanced optical manufacturing digital integrated system

    NASA Astrophysics Data System (ADS)

    Tao, Yizheng; Li, Xinglan; Li, Wei; Tang, Dingyong

    2012-10-01

    It is necessarily to adapt development of advanced optical manufacturing technology with modern science technology development. To solved these problems which low of ration, ratio of finished product, repetition, consistent in big size and high precision in advanced optical component manufacturing. Applied business driven and method of Rational Unified Process, this paper has researched advanced optical manufacturing process flow, requirement of Advanced Optical Manufacturing integrated System, and put forward architecture and key technology of it. Designed Optical component core and Manufacturing process driven of Advanced Optical Manufacturing Digital Integrated System. the result displayed effective well, realized dynamic planning Manufacturing process, information integration improved ratio of production manufactory.

  9. Time for new guidelines in advanced healthcare: the mission of The EPMA Journal to promote an integrative view in predictive, preventive and personalized medicine

    PubMed Central

    2012-01-01

    Changing long-held beliefs is never easy. As a consequence of the accumulating clinical data and knowledge about the epidemiology and pathological mechanisms of the most frequent causes of morbidity and mortality, we are currently reconsidering our view of the origins and progression of cardiovascular, oncologic and neurodegenerative diseases. Optimistic versus pessimistic prognosis for healthcare sector depends much on diagnostic, preventive and treatment approaches, which healthcare systems will preferably adopt in the near future. PPPM offers great promise for the future practice of medicine. We are pleased to announce this first open access volume of The EPMA Journal following its transfer to BioMed Central two years after publication of the first article in the journal. PMID:22901436

  10. Integrative Medicine in a Preventive Medicine Residency: A Program for the Urban Underserved.

    PubMed

    Berz, Jonathan P B; Gergen Barnett, Katherine A; Gardiner, Paula; Saper, Robert B

    2015-11-01

    The Preventive Medicine Residency Program collaborated with the Department of Family Medicine's Program for Integrative Medicine and Health Disparities at Boston Medical Center to create a new rotation for preventive medicine residents starting in autumn 2012. Residents participated in integrative medicine group visits and consults, completed an online curriculum in dietary supplements, and participated in seminars all in the context of an urban safety net hospital. This collaboration was made possible by a federal Health Resources and Services Administration grant for integrative medicine in preventive medicine residencies and helped meet a need of the program to increase residents' exposure to clinical preventive medicine and integrative health clinical skills and principles. The collaboration has resulted in a required rotation for all residents that continues after the grant period and has fostered additional collaborations related to integrative medicine across the programs. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Advances on Bioactive Polysaccharides from Medicinal Plants.

    PubMed

    Xie, Jian-Hua; Jin, Ming-Liang; Morris, Gordon A; Zha, Xue-Qiang; Chen, Han-Qing; Yi, Yang; Li, Jing-En; Wang, Zhi-Jun; Gao, Jie; Nie, Shao-Ping; Shang, Peng; Xie, Ming-Yong

    2016-07-29

    In recent decades, the polysaccharides from the medicinal plants have attracted a lot of attention due to their significant bioactivities, such as anti-tumor activity, antioxidant activity, anticoagulant activity, antidiabetic activity, radioprotection effect, anti-viral activity, hypolipidemic and immunomodulatory activities, which make them suitable for medicinal applications. Previous studies have also shown that medicinal plant polysaccharides are non-toxic and show no side effects. Based on these encouraging observations, most researches have been focusing on the isolation and identification of polysaccharides, as well as their bioactivities. A large number of bioactive polysaccharides with different structural features and biological effects from medicinal plants have been purified and characterized. This review provides a comprehensive summary of the most recent developments in physiochemical, structural features and biological activities of bioactive polysaccharides from a number of important medicinal plants, such as polysaccharides from Astragalus membranaceus, Dendrobium plants, Bupleurum, Cactus fruits, Acanthopanax senticosus, Angelica sinensis (Oliv.) Diels, Aloe barbadensis Miller, and Dimocarpus longan Lour. Moreover, the paper has also been focused on the applications of bioactive polysaccharides for medicinal applications. Recent studies have provided evidence that polysaccharides from medicinal plants can play a vital role in bioactivities. The contents and data will serve as a useful reference material for further investigation, production, and application of these polysaccharides in functional foods and therapeutic agents.

  12. Advances in optics for biotechnology, medicine and surgery

    PubMed Central

    Fitzmaurice, Maryann; Pogue, Brian W.; Tearney, Guillermo J.; Tunnell, James W.; Yang, Changhuei

    2014-01-01

    The guest editors introduce a Biomedical Optics Express feature issue that includes contributions from participants at the 2013 conference on Advances in Optics for Biotechnology, Medicine and Surgery XIII. PMID:24575348

  13. Recent Advances in Integrated Photonic Sensors

    PubMed Central

    Passaro, Vittorio M. N.; de Tullio, Corrado; Troia, Benedetto; La Notte, Mario; Giannoccaro, Giovanni; De Leonardis, Francesco

    2012-01-01

    Nowadays, optical devices and circuits are becoming fundamental components in several application fields such as medicine, biotechnology, automotive, aerospace, food quality control, chemistry, to name a few. In this context, we propose a complete review on integrated photonic sensors, with specific attention to materials, technologies, architectures and optical sensing principles. To this aim, sensing principles commonly used in optical detection are presented, focusing on sensor performance features such as sensitivity, selectivity and rangeability. Since photonic sensors provide substantial benefits regarding compatibility with CMOS technology and integration on chips characterized by micrometric footprints, design and optimization strategies of photonic devices are widely discussed for sensing applications. In addition, several numerical methods employed in photonic circuits and devices, simulations and design are presented, focusing on their advantages and drawbacks. Finally, recent developments in the field of photonic sensing are reviewed, considering advanced photonic sensor architectures based on linear and non-linear optical effects and to be employed in chemical/biochemical sensing, angular velocity and electric field detection. PMID:23202223

  14. Recent advances in integrated photonic sensors.

    PubMed

    Passaro, Vittorio M N; de Tullio, Corrado; Troia, Benedetto; La Notte, Mario; Giannoccaro, Giovanni; De Leonardis, Francesco

    2012-11-09

    Nowadays, optical devices and circuits are becoming fundamental components in several application fields such as medicine, biotechnology, automotive, aerospace, food quality control, chemistry, to name a few. In this context, we propose a complete review on integrated photonic sensors, with specific attention to materials, technologies, architectures and optical sensing principles. To this aim, sensing principles commonly used in optical detection are presented, focusing on sensor performance features such as sensitivity, selectivity and rangeability. Since photonic sensors provide substantial benefits regarding compatibility with CMOS technology and integration on chips characterized by micrometric footprints, design and optimization strategies of photonic devices are widely discussed for sensing applications. In addition, several numerical methods employed in photonic circuits and devices, simulations and design are presented, focusing on their advantages and drawbacks. Finally, recent developments in the field of photonic sensing are reviewed, considering advanced photonic sensor architectures based on linear and non-linear optical effects and to be employed in chemical/biochemical sensing, angular velocity and electric field detection.

  15. Introduction to the history and current status of evidence-based korean medicine: a unique integrated system of allopathic and holistic medicine.

    PubMed

    Yin, Chang Shik; Ko, Seong-Gyu

    2014-01-01

    Objectives. Korean medicine, an integrated allopathic and traditional medicine, has developed unique characteristics and has been active in contributing to evidence-based medicine. Recent developments in Korean medicine have not been as well disseminated as traditional Chinese medicine. This introduction to recent developments in Korean medicine will draw attention to, and facilitate, the advancement of evidence-based complementary alternative medicine (CAM). Methods and Results. The history of and recent developments in Korean medicine as evidence-based medicine are explored through discussions on the development of a national standard classification of diseases and study reports, ranging from basic research to newly developed clinical therapies. A national standard classification of diseases has been developed and revised serially into an integrated classification of Western allopathic and traditional holistic medicine disease entities. Standard disease classifications offer a starting point for the reliable gathering of evidence and provide a representative example of the unique status of evidence-based Korean medicine as an integration of Western allopathic medicine and traditional holistic medicine. Conclusions. Recent developments in evidence-based Korean medicine show a unique development in evidence-based medicine, adopting both Western allopathic and holistic traditional medicine. It is expected that Korean medicine will continue to be an important contributor to evidence-based medicine, encompassing conventional and complementary approaches.

  16. Advancements in medicine from aerospace research

    NASA Technical Reports Server (NTRS)

    Wooten, F. T.

    1971-01-01

    A program designed to find ways of transferring space technology to non-space medicine is discussed. The methodology used to attack the problem and several illustrative examples of the results are given.

  17. Chinese medicine and integrative medicine in the United States.

    PubMed

    Bauer, Brent A

    2015-08-01

    Health wellness is a state of the homeostasis. Chinese medicine incorporate many concept including holistic medicine and individualized medicine to promote health wellness. Different domains of Chinese medicine were exclusively adopted after the first introduction of acupuncture to USA. Mayo as one of the best USA hospital created a foundation for the more widespread introduction of Chinese medicine into the US especially on the health wellness promotion.

  18. Complementary, alternative, integrative, or unconventional medicine?

    PubMed

    Penson, R T; Castro, C M; Seiden, M V; Chabner, B A; Lynch, T J

    2001-01-01

    Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded the Kenneth B. Schwartz Center. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and sustenance to the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Interest in complementary and alternative medicine (CAM) has grown exponentially in the past decade, fueled by Internet marketing, dissatisfaction with mainstream medicine, and a desire for patients to be actively involved in their health care. There is a large discordance between physician estimates and reported prevalence of CAM use. Many patients do not disclose their practices mainly because they believe CAM falls outside the rubric of conventional medicine or because physicians do not ask. Concern about drug interactions and adverse effects are compounded by a lack of Food and Drug Administration regulation. Physicians need to be informed about CAM and be attuned to the psychosocial needs of patients.

  19. Recent advances in nuclear medicine in endocrine oncology.

    PubMed

    Luster, Markus; Pfestroff, Andreas; Verburg, Frederik A

    2017-01-01

    The purpose is to review recent advances concerning the role of nuclear medicine in endocrine oncology. For I therapy of thyroid cancer a thyrotropin (TSH) more than 30 mU/l has for many years been deemed a condition sine qua non. However, new data show that patients with lower TSH levels at the time of ablation have the same rate of successful ablation as those with TSH more than 30 mU/l.I-124 combined integrated positron emission tomography and computed X-ray tomography was shown to be highly accurate in predicting findings on posttherapy radioiodine scanning and was shown to have a high prognostic power.In neuroendocrine tumors, long-term complication rates of peptide receptor radionuclide therapy were reported. Furthermore first preclinical and clinical results of peptide receptor radionuclide therapy with somatostatin receptor antagonists were published.In nuclear medicine, prostate-specific membrane antigen (PSMA)-targeted radionuclide imaging and therapy is of interest. PSMA was shown to also be expressed in neoplasms of the thyroid, the adrenal glands and neuroendocrine tumors. Further individualization of thyroid cancer patient care by means of I-124-positron emission tomography and computed X-ray tomography-based selection of the therapeutic strategy is possible. I therapy might not require as intensive TSH stimulation as thought previously. For endocrine-related malignancies PSMA targeting deserves further investigation.

  20. Trailblazing healthcare: institutionalizing and integrating complementary medicine.

    PubMed

    Sharf, Barbara F; Geist Martin, Patricia; Cosgriff-Hernández, Kevin-Khristián; Moore, Julia

    2012-12-01

    This study examines three integrative health centers to understand their (1) historical development, organizational goals, and modalities, (2) the processes and challenges of integrating complementary and allopathic medicine, while encouraging staff collaboration, and (3) how each center becomes institutionalized within their community. We focus on three organizational case studies that reflect varying forms of integrative health care practices in three U.S. cities. Participant-observation and in-depth interviews with center directors were analyzed qualitatively. Important patterns found within the three cases are (1) the critical role of visionary biomedical practitioners who bridge complementary and allopathic practices, (2) communicating integration internally through team interaction, and (3) communicating integration externally through spatial location, naming, and community outreach. IM centers continue to blaze new trails toward mainstream access and acceptance by gathering evidence for IM, encouraging team collaboration within organizational contexts, constructing organizational identity, and negotiating insurance reimbursements. IM is not the enactment of specific modalities, but rather a philosophy of healing. Though scheduling conflicts, skepticism, and insurance coverage may be obstacles toward IM, collaboration among specialists and with patients should be the ultimate goal. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Integrating family medicine and complementary medicine in cancer care: a cross-cultural perspective.

    PubMed

    Ben-Arye, Eran; Israely, Pesi; Baruch, Erez; Dagash, Jamal

    2014-10-01

    In this paper, we describe the case study of a 27 year-old Arab female patient receiving palliative care for advanced breast cancer who was referred to complementary medicine (CM) consultation provided within a conventional oncology department. We explore the impact of the integrative CM practitioners' team of three family physicians and one Chinese medicine practitioner on the patient's well-being and specifically on the alleviation of her debilitating hot flashes and insomnia. This quality of life improvement is also affirmed by comparing the Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Well-being (MYCAW) questionnaires administered at the initial and follow-up assessment sessions. In conclusion, we suggest that family physicians trained in evidence-based complementary medicine are optimal integrators of holistic patient-centered supportive care. The inclusion of trained CM practitioners in a multi-disciplinary integrative team may enhance the bio-psycho-social-spiritual perspective, and provide additional practical therapies that improve the quality of life of patients confronting cancer.

  2. Evidence-Based Advances in Ferret Medicine.

    PubMed

    Huynh, Minh; Chassang, Lucile; Zoller, Graham

    2017-09-01

    This literature review covers approximately 35 years of veterinary medicine. This article develops the current state of knowledge in pet ferret medicine regarding the most common diseases according to evidence-based data and gives insight into further axis of research. Literature review was conducted through identification of keywords (title + ferret) with Web-based database searching. To appreciate the methodological quality and the level of evidence of each article included in the review, full-text versions were reviewed and questions addressed in the articles were formulated. Analysis of the articles' content was performed by the authors, and relevant clinical information was extracted. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Advancements in medicine from aerospace research.

    NASA Technical Reports Server (NTRS)

    Wooten, F. T.

    1971-01-01

    Discussion of a NASA-sponsored medical program under which work is done by multidiscipline teams to provide an interface between aerospace and medicine. A prosthetic urethral valve, an ear oximeter for measurement of oxygen content in the blood, a radiation dosimeter and an electromyographic muscle trainer are noted as the products of this program.

  4. Advancements in medicine from aerospace research.

    NASA Technical Reports Server (NTRS)

    Wooten, F. T.

    1971-01-01

    Discussion of a NASA-sponsored medical program under which work is done by multidiscipline teams to provide an interface between aerospace and medicine. A prosthetic urethral valve, an ear oximeter for measurement of oxygen content in the blood, a radiation dosimeter and an electromyographic muscle trainer are noted as the products of this program.

  5. Incorporating pattern identification of Chinese medicine into precision medicine: An integrative model for individualized medicine.

    PubMed

    Li, Jin-gen; Xu, Hao

    2015-11-01

    On 20 January, 2015, U.S. President Obama announced an ambitious plan called "Precision Medicine (PM) Initiative", aiming to deliver genetics-based medical treatments. PM has shown a promising prospect by tailoring disease treatments and preventions to individuals. However, a predominantly genetics-based method restricts its benefit and applicability in most chronic and complex diseases. Pattern identification (PI) is one of the representative characteristics of Chinese medicine implying the concept of holism and individualized treatment. It is another classification method taking environmental, psychosocial and other individual factors into account. Integrating PI with disease diagnosis of Western medicine will provide a strong complement to genetics-based PM, thus establish an integrative model for individualized medicine. PI provides new perspectives for PM, not only in clinical practice, but also in new drug development and clinical trial design. It is for sure that the integrative approach will ultimately lead to a safer, more convenient and effective patient-centered healthcare and most patients will benefit in the era of PM.

  6. A pluralist challenge to "integrative medicine": Feyerabend and Popper on the cognitive value of alternative medicine.

    PubMed

    Kidd, Ian James

    2013-09-01

    This paper is a critique of 'integrative medicine' as an ideal of medical progress on the grounds that it fails to realise the cognitive value of alternative medicine. After a brief account of the cognitive value of alternative medicine, I outline the form of 'integrative medicine' defended by the late Stephen Straus, former director of the US National Centre for Complementary and Alternative Medicine. Straus' account is then considered in the light of Zuzana Parusnikova's recent criticism of 'integrative medicine' and her distinction between 'cognitive' and 'opportunistic' engagement with alternative medicine. Parusnikova warns that the medical establishment is guilty of 'dogmatism' and proposes that one can usefully invoke Karl Popper's 'critical rationalism' as an antidote. Using the example of Straus, I argue that an appeal to Popper is insufficient, on the grounds that 'integrative medicine' can class as a form of cognitively-productive, critical engagement. I suggest that Parusnikova's appeal to Popper should be augmented with Paul Feyerabend's emphasis upon the role of 'radical alternatives' in maximising criticism. 'Integrative medicine' fails to maximise criticism because it 'translates' alternative medicine into the theories and terminology of allopathic medicine and so erodes its capacity to provide cognitively-valuable 'radical alternatives'. These claims are then illustrated with a discussion of 'traditional' and 'medical' acupuncture. I conclude that 'integrative medicine' fails to exploit the cognitive value of alternative medicine and so should be rejected as an ideal of medical progress.

  7. Evidence-based integrative medicine in clinical veterinary oncology.

    PubMed

    Raditic, Donna M; Bartges, Joseph W

    2014-09-01

    Integrative medicine is the combined use of complementary and alternative medicine with conventional or traditional Western medicine systems. The demand for integrative veterinary medicine is growing, but evidence-based research on its efficacy is limited. In veterinary clinical oncology, such research could be translated to human medicine, because veterinary patients with spontaneous tumors are valuable translational models for human cancers. An overview of specific herbs, botanics, dietary supplements, and acupuncture evaluated in dogs, in vitro canine cells, and other relevant species both in vivo and in vitro is presented for their potential use as integrative therapies in veterinary clinical oncology.

  8. [Advances in the application of smart phones in modern medicine].

    PubMed

    Wang, Lin; Hu, Jie; Li, Fei; Wei, Huilin; Li, Ying; Lu, Tianjian; Wang, Shuqi; Xu, Feng

    2014-02-01

    Since smart phones have been developed, significant advances in the function of mobile phone due to the development of software, hardware and accessories have been reached. Till now, smart phones have been engaged in daily life with an increasing impact. As a new medical model, mobile phone medicine is emerging and has found wide spread applications in medicine, especially in diagnosing, monitoring and screening various diseases. In addition, mo bile phone medical application shows great potential trend to improve healthcare in resource-limited regions due to its advantageous features of portability and information communication capability. Nowadays, the scientific and technological issues related to mobile phone medicine have attracted worldwide attention. In this review, we summarize state-of-the-art advances of mobile phone medicine with focus on its diagnostics applications in order to expand the fields of their applications and promote healthcare informatization.

  9. Advancements in medicine from aerospace research

    NASA Technical Reports Server (NTRS)

    Wooten, F. T.

    1971-01-01

    NASA has taken the lead in implementing the concept of technology utilization, and the Technology Utilization Program is the first vital step in the goal of a technological society to insure maximum benefit from the costs of technology. Experience has shown that the active approach to technology transfer is unique and is well received in the medical profession when appropriate problems are tackled. The problem solving approach is a useful one at the precise time when medicine is recognizing the need for new technology.

  10. Advanced Integrated Power Systems (AIPS)

    DTIC Science & Technology

    2012-10-08

    These devices were super-capacitor banks, flywheels, superconducting magnetic energy storage, and advanced batteries (such as Li- ion ). Their test system...Xantrex XW Hybrid Inverter/ Charger is a true sine-wave, 120/240 VAC, initial split-phase inverter/ charger incorporating a DC to AC inverter, battery ...9 Figure 6. Xantrex XW Hybrid Inverter/ Charger

  11. [Research advances of fat embolism syndrome in forensic medicine].

    PubMed

    Fang, Jun-Jie; Chen, Yang

    2009-06-01

    Fat embolism syndrome (FES) is a common and life-threatening clinical syndrome, which is a difficult problem frequently encountered in medical science, especially in forensic medicine and orthopaedics. FES would be easily mistaken or missed by forensic examiner due to the lack of the specific symptoms and signs. This article reviews the etiology, pathogenesis, pathology, the mechanism of death, as well as the advances of the forensic medicine diagnosis of FES with current literatures update.

  12. Recent advances of perinatal medicine in China.

    PubMed

    Zhou, Z

    1995-05-01

    Perinatal medicine has been practiced for only 30 years. The basis for such medicine is perinatal health care and the main theme is systemic monitoring and management of high-risk pregnancies. China has offered such practice since 1979, with the perinatal health care system derived from the former health care system for pregnant women. The rate of maternal mortality in China had fallen to 94.7/100,000 by 1989, while the perinatal mortality rate was 51.8/1000 as of 1986. Comparable rates for 1993 in the Shanghai area were 19.95/100,000 and 10.6/1000, respectively. A group of Baby Friendly Hospitals was formally approved by the Ministry of Health and the WHO-UNICEF joint committee. In Shanghai, 11 such maternity hospitals received this status in 1993, and 27 more in 1994. Recently, the social model of perinatal health care, as proposed by WHO-EURO, has been adopted in Shanghai, providing the mother the rights and freedom to choose appropriate health care management on her own. It is gaining emphasis in Shanghai that both medical and social models are mandatory in perinatal health care.

  13. Integrative Medicine in Preventive Medicine Education: Competency and Curriculum Development for Preventive Medicine and Other Specialty Residency Programs.

    PubMed

    Jani, Asim A; Trask, Jennifer; Ali, Ather

    2015-11-01

    During 2012, the USDHHS's Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center established a multidisciplinary steering committee, versed in integrative medicine, whose primary aim was to develop integrative medicine core competencies for incorporation into preventive medicine graduate medical education training. The competency development process was informed by central integrative medicine definitions and principles, preventive medicine's dual role in clinical and population-based prevention, and the burgeoning evidence base of integrative medicine. The steering committee considered an interdisciplinary integrative medicine contextual framework guided by several themes related to workforce development and population health. A list of nine competencies, mapped to the six general domains of competence approved by the Accreditation Council of Graduate Medical Education, was operationalized through an iterative exercise with the 12 grantees in a process that included mapping each site's competency and curriculum products to the core competencies. The competencies, along with central curricular components informed by grantees' work presented elsewhere in this supplement, are outlined as a roadmap for residency programs aiming to incorporate integrative medicine content into their curricula. This set of competencies adds to the larger efforts of the IMPriME initiative to facilitate and enhance further curriculum development and implementation by not only the current grantees but other stakeholders in graduate medical education around integrative medicine training.

  14. Advancing pig cloning technologies towards application in regenerative medicine.

    PubMed

    Nagashima, H; Matsunari, H; Nakano, K; Watanabe, M; Umeyama, K; Nagaya, M

    2012-08-01

    Regenerative medicine is expected to make a significant contribution by development of novel therapeutic treatments for intractable diseases and for improving the quality of life of patients. Many advances in regenerative medicine, including basic and translational research, have been developed and tested in experimental animals; pigs have played an important role in various aspects of this work. The value of pigs as a model species is being enhanced by the generation of specially designed animals through cloning and genetic modifications, enabling more sophisticated research to be performed and thus accelerating the clinical application of regenerative medicine. This article reviews the significant aspects of the creation and application of cloned and genetically modified pigs in regenerative medicine research and considers the possible future directions of the technology. We also discuss the importance of reproductive biology as an interface between basic science and clinical medicine. © 2012 Blackwell Verlag GmbH.

  15. Advance modern medicine with clinical case reports

    PubMed Central

    2014-01-01

    Randomized clinical trial (RCT) can fail to demonstrate the richness of individual patient characteristics. Given the unpredictable nature of medicine, a patient may present in an unusual way, have a strange new pathology, or react to a medical intervention in a manner not seen before. The publication of these novelties as case reports is a fundamental way of conveying medical knowledge. Throughout history there have been famous case studies that shaped the way we view health and disease. Case reports can have the following functions: (I) descriptions of new diseases; (II) study of mechanisms; (III) discovery new therapies; (IV) recognition of side effects; and (V) education. Before submitting a case report, it is worthwhile to refer to the Case Report Check Sheet described by Green and Johnson [2006]. PMID:25525572

  16. Technological advances in precision medicine and drug development

    PubMed Central

    Maggi, Elaine; Patterson, Nicole E; Montagna, Cristina

    2016-01-01

    New technologies are rapidly becoming available to expand the arsenal of tools accessible for precision medicine and to support the development of new therapeutics. Advances in liquid biopsies, which analyze cells, DNA, RNA, proteins, or vesicles isolated from the blood, have gained particular interest for their uses in acquiring information reflecting the biology of tumors and metastatic tissues. Through advancements in DNA sequencing that have merged unprecedented accuracy with affordable cost, personalized treatments based on genetic variations are becoming a real possibility. Extraordinary progress has been achieved in the development of biological therapies aimed to even further advance personalized treatments. We provide a summary of current and future applications of blood based liquid biopsies and how new technologies are utilized for the development of biological therapeutic treatments. We discuss current and future sequencing methods with an emphasis on how technological advances will support the progress in the field of precision medicine. PMID:27622214

  17. Advanced Wireless Integrated Navy Network

    DTIC Science & Technology

    2005-03-01

    Basing visualization of wireless technologies, Ad Hoc networks , network protocols, real-time resource allocation, Ultra Wideband (UWB) communications...4.1 TIP #1: Distributed MIMO UWB sensor networks incorporating software radio 67 4.2 TIP #2: Close-in UWB wireless with applications to Sea- Basing 68...4.3 TIP #3: Secure Ad Hoc Networks 73 4.4 TIP #4: Integration of Close-in UWB wireless with ESM crane for Sea Basing applications 75 5. FINANCIAL REPORT

  18. Advanced Studies of Integrable Systems.

    DTIC Science & Technology

    1986-12-18

    Fluctuations in Magnetized Plasmas (Phys. Fluids 27, 1169-75 (1984)] (coauthored with S.N. Antani) The nonlinear interactions of whistler waves with density... Dynamica Problems in Soliton Systems, pp 12-22. ed. S. Takeno, Springer-Verlag, NY (1985)]. S 11. Forced Integrable Systems - An Overview, D. J. Kaup...Kaup, P.J. Hansen, S. Roy Choudhury and Gary E. Thomas (accepted for publication in Phys. Fluids ). A singular perturbation method is used to solve this

  19. Rejuvenation: an integrated approach to regenerative medicine.

    PubMed

    Kang, Y James; Zheng, Lily

    2013-12-01

    The word "rejuvenate" found in the Merriam-Webster dictionary is (1) to make young or youthful again: give new vigor to, and (2) to restore to an original or new state. Regenerative medicine is the process of creating living, functional tissues to repair or replace tissue or organ function lost due to age, disease, damage, or congenital defects. To accomplish this, approaches including transplantation, tissue engineering, cell therapy, and gene therapy are brought into action. These all use exogenously prepared materials to forcefully mend the failed organ. The adaptation of the materials in the host and their integration into the organ are all uncertain. It is a common sense that tissue injury in the younger is easily repaired and the acute injury is healed better and faster. Why does the elder have a diminished capacity of self-repairing, or why does chronic injury cause the loss of the self-repairing capacity? There must be some critical elements that are involved in the repair process, but are suppressed in the elder or under the chronic injury condition. Rejuvenation of the self-repair mechanism would be an ideal solution for functional recovery of the failed organ. To achieve this, it would involve renewal of the injury signaling, reestablishment of the communication and transportation system, recruitment of the materials for repairing, regeneration of the failed organ, and rehabilitation of the renewed organ. It thus would require a comprehensive understanding of developmental biology and a development of new approaches to activate the critical players to rejuvenate the self-repair mechanism in the elder or under chronic injury condition. Efforts focusing on rejuvenation would expect an alternative, if not a better, accomplishment in the regenerative medicine.

  20. [DGSMP - Interdisciplinarity to Advance Social Medicine and Prevention of Illness].

    PubMed

    Gaertner, T; Mittelstaedt, G v

    2016-02-01

    The German Society for Social Medicine and Prevention (DGSMP) refers back to a tradition of over more than 100 years, nevertheless having a critical look at it. As a scientific medical society the DGSMP promotes cross-sectoral configuration of contemporary social medicine to the benefit of both, general welfare and individual health in form of prevention, rehabilitation, re-integration, palliation and long-term care. Human medicine is the lead discipline in the interdisciplinary approach by the DGSMP in order to create - facing the dynamics in the health care system - professional prerequisites to maintain and update solidarity and equity in medical services on a scientific basis.

  1. Complementary and Integrative Medicine at Mayo Clinic.

    PubMed

    Pang, Ran; Wang, Shihan; Tian, Lin; Lee, Mark C; Do, Alexander; Cutshall, Susanne M; Li, Guangxi; Bauer, Brent A; Thomley, Barbara S; Chon, Tony Y

    2015-01-01

    Complementary and alternative medicine (CAM) has gained acceptance throughout the industrialized world. The present study was performed to provide information about the use of CAM at Mayo Clinic, an academic medical center in Northern Midwest of the US. We retrospectively reviewed the electronic medical records of 2680 patients visiting the CAM program at Mayo Clinic, Rochester, between 1 July 2006 and 31 March 2011. Services provided included acupuncture, massage, integrative medical consultations and executive stress management training. Data including age, gender, race, diagnosis and the number of treatment/consultation sessions were collected to describe the use of CAM in our institute over the last several years. It was found that the mean (standard deviation) age of patient was 52.6 (15.5) years. Of those, 73.1% were female and 26.9% were male. Most patients were white. The number of patients referred to CAM increased significantly from 2007 to 2010. The three most common diagnostic categories were back pain (12.9%), psychological disorders (11.8%), and joint pain (9.6%). Back pain was the most common diagnosis for patients receiving acupuncture, and fibromyalgia was the most common for patients receiving massage therapy. Psychological disorders (i.e., stress) were the major diagnosis referred to both integrative medical consults and executive stress management training. These results suggest that the diseases related to pain and psychological disorders are the main fields of CAM use. It also shows the increasing trend of the use of CAM at an academic medical center in the US.

  2. Integrated optics approach for advanced semiconductor lasers

    NASA Astrophysics Data System (ADS)

    Suematsu, Yasuharu; Arai, Shigehisa

    1987-11-01

    Recent advances in the field of semiconductor integrated optics are reviewed from the point of view of monolithic integration of semiconductor lasers and other optical components and/or devices. Emphasis is placed on dynamic-single-mode (DSM) lasers, such as DFB and DBR lasers, intended for highly stable single-wavelength light sources for such monolithic integration. The realization of high-performance DSM lasers and the fabrication techniques of monolithically integrated optical devices and circuits are briefly reviewed. A variety of potential applications is discussed.

  3. Integration of traditional Chinese medicine with Western medicine--right or wrong?

    PubMed

    Cai, J F

    1988-01-01

    The presence of a dualistic medical system in most Asian, African and Latin American countries results from specific historical events. In China, traditional medicine and Western medicine exist side by side during the last century. Through Chinese medicine suffered from discrimination which retarded its development for several decades, under the protection and encouragement of New China's policy, it develops steadily and flourishes. Moreover, a new policy of integrating Chinese with Western medicine is a right orientation for development in China. Yet this is not the only way of development for traditional medicine. New achievements in traditional Chinese medicine prove that this new field is worthy of further exploration.

  4. Integrative Medicine System Based on Music.

    PubMed

    Balasubramanian, Sai Venkatesh; Balasubramanian, Gomathi; Ramanathan, Ganapathy

    2016-04-01

    Today, the world's ever-changing lifestyles demand a reliable, comprehensive system of integrative medicine with minimal side effects. One of the most prominent candidates for such a system is music, an enjoyable health care approach, and in response to the need for that system, the present article formulates one that is music based. Specifically, the authors have explored the physician-patient interaction, developing a model of that interaction within the context of music therapy. That model is based on ancient Ayurvedic principles and on research from modern physics and biology, such as that on quantum consciousness, chaos theory, the statistical theory of communication, information theory, and neurodynamics. The authors formulated 6 dimensions for that model: (1) physiological-Tridoshas, (2) emotional-Trigunas, (3) sociological-temperament, (4) psychological-brain waves, (5) spiritual-Chakras, and (6) informational-landscape. The connections between music and those dimensions are explored in the current article. The model opens the doors for a reliable, enjoyable, holistic health care, using music, with minimal side effects.

  5. The business of palliative medicine--part 6: clinical operations in a comprehensive integrated program.

    PubMed

    Lagman, Ruth L; Walsh, Declan; LeGrand, Susan B; Davis, Mellar P

    2011-03-01

    The medical care of individuals with advanced disease is complex and has historically been fragmented and suboptimal. Palliative medicine attempts to address these needs. The Harry R. Horvitz Center for Palliative Medicine at the Cleveland Clinic is an established comprehensive integrated program. Structured and seamless clinical operations are important to ensure the best delivery of high-quality medical care and continuity for those affected by life-limiting illness.

  6. Advancing the science of medicines regulation: the role of the 21st-century medicines regulator.

    PubMed

    Lumpkin, M M; Eichler, H-G; Breckenridge, A; Hamburg, M A; Lönngren, T; Woods, K

    2012-10-01

    The history of medicines regulation is punctuated with sudden swings in focus mandated by a public injured by medicines and skeptical of regulators' abilities to protect them. As stakeholder communities and the science that undergirds medicines have both grown more sophisticated, seemingly conflicting mission equities, such as public health protection vs. promotion or population vs. individual patient product development focus, have created new challenges to defining the mission and role of twenty-first-century medicines regulators. The role of medicines regulators as a nationally focused, retrospective assessor of data is rapidly shifting to that of a prospective generator of public data and tools to help drive what has now become a global product development and regulatory enterprise that is fast gaining recognition as an integral part of any truly effective twenty-first-century health-care system. This article discusses this evolution and describes how regulatory science will help to both drive and define it.

  7. Recent Advances in Traditional Chinese Medicine for Kidney Disease.

    PubMed

    Zhong, Yifei; Menon, Madhav C; Deng, Yueyi; Chen, Yiping; He, John Cijiang

    2015-09-01

    Because current treatment options for chronic kidney disease (CKD) are limited, many patients seek out alternative therapies such as traditional Chinese medicine. However, there is a lack of evidence from large clinical trials to support the use of traditional medicines in patients with CKD. Many active components of traditional medicine formulas are undetermined and their toxicities are unknown. Therefore, there is a need for research to identify active compounds from traditional medicines and understand the mechanisms of action of these compounds, as well as their potential toxicity, and subsequently perform well-designed, randomized, controlled, clinical trials to study the efficacy and safety of their use in patients with CKD. Significant progress has been made in this field within the last several years. Many active compounds have been identified by applying sophisticated techniques such as mass spectrometry, and more mechanistic studies of these compounds have been performed using both in vitro and in vivo models. In addition, several well-designed, large, randomized, clinical trials have recently been published. We summarize these recent advances in the field of traditional medicines as they apply to CKD. In addition, current barriers for further research are also discussed. Due to the ongoing research in this field, we believe that stronger evidence to support the use of traditional medicines for CKD will emerge in the near future.

  8. Out of the wilderness: flipping the classroom to advance scholarship in an internal medicine residency program.

    PubMed

    Vincent, Dale S

    2014-11-01

    Residents in an internal medicine residency program "flipped the classroom" in a series of learner-centered activities which included the creation of a medical student interest group, a continuing medical education symposium, and a journal supplement focused on wilderness medicine topics in Hawai'i and Asia Pacific. The project encompassed both scholarly activities (discovery, integration, application, and teaching) as well as scholarship (writing for publication). The project advanced the professional formation of residents by developing competencies and producing outcomes that are key features of the ACGME Next Accreditation System.

  9. [Recognizing prevention and treatment of burn sepsis with the concept of holistic integrative medicine].

    PubMed

    Huan, J N

    2017-04-20

    Sepsis remains a major cause of death in severe burns. The effect of sepsis management is influenced by its complicated pathophysiologic changes. In order to improve the outcome of burn sepsis, the predisposing factor of sepsis after burn analyzed by advanced technology, the early prevention, antibiotics therapy, and combined treatment in severe burns with sepsis are discussed using the concept of holistic integrative medicine.

  10. Fully Integrated Biochip Platforms for Advanced Healthcare

    PubMed Central

    Carrara, Sandro; Ghoreishizadeh, Sara; Olivo, Jacopo; Taurino, Irene; Baj-Rossi, Camilla; Cavallini, Andrea; de Beeck, Maaike Op; Dehollain, Catherine; Burleson, Wayne; Moussy, Francis Gabriel; Guiseppi-Elie, Anthony; De Micheli, Giovanni

    2012-01-01

    Recent advances in microelectronics and biosensors are enabling developments of innovative biochips for advanced healthcare by providing fully integrated platforms for continuous monitoring of a large set of human disease biomarkers. Continuous monitoring of several human metabolites can be addressed by using fully integrated and minimally invasive devices located in the sub-cutis, typically in the peritoneal region. This extends the techniques of continuous monitoring of glucose currently being pursued with diabetic patients. However, several issues have to be considered in order to succeed in developing fully integrated and minimally invasive implantable devices. These innovative devices require a high-degree of integration, minimal invasive surgery, long-term biocompatibility, security and privacy in data transmission, high reliability, high reproducibility, high specificity, low detection limit and high sensitivity. Recent advances in the field have already proposed possible solutions for several of these issues. The aim of the present paper is to present a broad spectrum of recent results and to propose future directions of development in order to obtain fully implantable systems for the continuous monitoring of the human metabolism in advanced healthcare applications. PMID:23112644

  11. [Exploration of regulating blood lipids metabolism by integrative medicine].

    PubMed

    Liu, Shan-shan; Wu, Wei; Qing, Li-jin

    2015-02-01

    Hyperlipidemia is an important risk factor of cardio-/cerebrovascular disease, and reducing lipids has become an important project for itsclinical preventing and treating. Western medicine, with its confirmative efficacy and clear mechanism, has played an irreplaceable role. Along with the development of modern medicine, integrative medicine has gradually become a growing trend in regulating blood lipids metabolism. It not only could make up the insufficient power for Chinese medicine in lowering lipids, but also could reduce adverse reactions and economic costs brought by long-term administration of Western medicine. As a modern practitioner of Chinese medicine, we should keep clear that integrative medicine regulating blood lipids metabolism does not mean a simple combination of traditional Chinese medicine and Western medicine. We should treat it guided by systematic theories. We combine disease identification and syndrome differentiation, guide lipids lowering by integrative medicine including selecting Western drugs for blood lipids lowering, Chinese medical prescriptions for syndrome typing, and effective Chinese herbs based on modern pharmacologies.

  12. [Integrative pharmacology: new paradigm of modernization of Chinese medicine].

    PubMed

    Xu, Hai-Yu; Yang, Hong-Jun

    2014-02-01

    Chinese medicinal formulae( CMF) were often used in the clinics of traditional Chinese medicine (TCM) which were critical for modernization of Chinese medicine to shed light on the interaction between CMF and biological organisms. In current studies, correlation between system and part, macroscopic actions and microcosmic mechanism, ADME process and pharmacologic actions were often neglected. Thus, we put forward integrative pharmacology, which could integrate the correlation between CMF and biological organisms from multi-levels and multi-dimensional views. Integrative pharmacology would reveal the molecular mechanism of CMF for ailments treatment and screen out effective material systematically, which would be the new paradigm of TCM research.

  13. Oxetanes: Recent Advances in Synthesis, Reactivity, and Medicinal Chemistry.

    PubMed

    Bull, James A; Croft, Rosemary A; Davis, Owen A; Doran, Robert; Morgan, Kate F

    2016-10-12

    The four-membered oxetane ring has been increasingly exploited for its contrasting behaviors: its influence on physicochemical properties as a stable motif in medicinal chemistry and its propensity to undergo ring-opening reactions as a synthetic intermediate. These applications have driven numerous studies into the synthesis of new oxetane derivatives. This review takes an overview of the literature for the synthesis of oxetane derivatives, concentrating on advances in the last five years up to the end of 2015. These methods are clustered by strategies for preparation of the ring and further derivatization of preformed oxetane-containing building blocks. Examples of the use of oxetanes in medicinal chemistry are reported, including a collation of oxetane derivatives appearing in recent patents for medicinal chemistry applications. Finally, examples of oxetane derivatives in ring-opening and ring-expansion reactions are described.

  14. Recent advances on integrated quantum communications

    NASA Astrophysics Data System (ADS)

    Orieux, Adeline; Diamanti, Eleni

    2016-08-01

    In recent years, the use of integrated technologies for applications in the field of quantum information processing and communications has made great progress. The resulting devices feature valuable characteristics such as scalability, reproducibility, low cost and interconnectivity, and have the potential to revolutionize our computation and communication practices in the future, much in the way that electronic integrated circuits have drastically transformed our information processing capacities since the last century. Among the multiple applications of integrated quantum technologies, this review will focus on typical components of quantum communication systems and on overall integrated system operation characteristics. We are interested in particular in the use of photonic integration platforms for developing devices necessary in quantum communications, including sources, detectors and both passive and active optical elements. We also illustrate the challenges associated with performing quantum communications on chip, by using the case study of quantum key distribution—the most advanced application of quantum information science. We conclude with promising perspectives in this field.

  15. Pediatric Integrative Medicine Approaches to Attention Deficit Hyperactivity Disorder (ADHD).

    PubMed

    Esparham, Anna; Evans, Randall G; Wagner, Leigh E; Drisko, Jeanne A

    2014-08-27

    Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder in children and is increasing in prevalence. There has also been a related increase in prescribing stimulant medication despite some controversy whether ADHD medication makes a lasting difference in school performance or achievement. Families who are apprehensive about side effects and with concerns for efficacy of medication pursue integrative medicine as an alternative or adjunct to pharmacologic and cognitive behavioral treatment approaches. Integrative medicine incorporates evidence-based medicine, both conventional and complementary and alternative therapies, to deliver personalized care to the patient, emphasizing diet, nutrients, gut health, and environmental influences as a means to decrease symptoms associated with chronic disorders. Pediatric integrative medicine practitioners are increasing in number throughout the United States because of improvement in patient health outcomes. However, limited funding and poor research design interfere with generalizable treatment approaches utilizing integrative medicine. The use of research designs originally intended for drugs and procedures are not suitable for many integrative medicine approaches. This article serves to highlight integrative medicine approaches in use today for children with ADHD, including dietary therapies, nutritional supplements, environmental hygiene, and neurofeedback.

  16. Pediatric Integrative Medicine Approaches to Attention Deficit Hyperactivity Disorder (ADHD)

    PubMed Central

    Esparham, Anna; Evans, Randall G.; Wagner, Leigh E.; Drisko, Jeanne A.

    2014-01-01

    Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder in children and is increasing in prevalence. There has also been a related increase in prescribing stimulant medication despite some controversy whether ADHD medication makes a lasting difference in school performance or achievement. Families who are apprehensive about side effects and with concerns for efficacy of medication pursue integrative medicine as an alternative or adjunct to pharmacologic and cognitive behavioral treatment approaches. Integrative medicine incorporates evidence-based medicine, both conventional and complementary and alternative therapies, to deliver personalized care to the patient, emphasizing diet, nutrients, gut health, and environmental influences as a means to decrease symptoms associated with chronic disorders. Pediatric integrative medicine practitioners are increasing in number throughout the United States because of improvement in patient health outcomes. However, limited funding and poor research design interfere with generalizable treatment approaches utilizing integrative medicine. The use of research designs originally intended for drugs and procedures are not suitable for many integrative medicine approaches. This article serves to highlight integrative medicine approaches in use today for children with ADHD, including dietary therapies, nutritional supplements, environmental hygiene, and neurofeedback. PMID:27417475

  17. Recent advances of nanotechnology in medicine and engineering

    SciTech Connect

    Nobile, Lucio; Nobile, Stefano

    2016-05-18

    The aim of this paper is to give an overview of some advances of nanotechnology in medicine and engineering, exploring typical applications of these emerging technologies. The mechanical properties of such small structures determine their utility and are therefore of considerable interest. Based on nanometer scale tests, a theoretical model to predict the bending strength of a nanobeam is proposed. A fracture approach which takes into account imperfections on the beam surface and crack growth is employed.

  18. Recent advances of nanotechnology in medicine and engineering

    NASA Astrophysics Data System (ADS)

    Nobile, Lucio; Nobile, Stefano

    2016-05-01

    The aim of this paper is to give an overview of some advances of nanotechnology in medicine and engineering, exploring typical applications of these emerging technologies. The mechanical properties of such small structures determine their utility and are therefore of considerable interest. Based on nanometer scale tests, a theoretical model to predict the bending strength of a nanobeam is proposed. A fracture approach which takes into account imperfections on the beam surface and crack growth is employed.

  19. Integrating traditional Chinese medicine into mainstream healthcare system in Hong Kong, China-A model of integrative medicine in the HKU-SZ Hospital.

    PubMed

    Lao, Lixing; Ning, Zhipeng

    2015-11-01

    The European Congress for Integrative Medicine 2015 Global Summit on Integrative Medicine and Healthcare in Greater Copenhagen has successfully promoted integrative medicine to the public once again. Integrative medicine, which is called the art and science of healthcare by Nordic Integrative Medicine, has been widely used in the world. In Hong Kong, integrated traditional Chinese and Western medicine, which is also known as the Chinese version of integrative medicine, provides a valuable reference for the development of integrative medicine in the world. In this article, we introduce the development of traditional Chinese medicine in Hong Kong and an integrated traditional Chinese and Western medicine model in the University of Hong Kong-Shenzhen Hospital.

  20. Integrative Medicine and Complementary and Alternative Therapies

    MedlinePlus

    ... effective. Because of the emotional and physical toll cancer and its treatment takes, many people are turning to complementary and alternative medicine (CAM) therapies to provide relief and increase their sense of ...

  1. Complementary and Integrative Medicine for Neurologic Conditions.

    PubMed

    Wells, Rebecca Erwin; Baute, Vanessa; Wahbeh, Helané

    2017-09-01

    Although many neurologic conditions are common, cures are rare and conventional treatments are often limited. Many patients, therefore, turn to complementary and alternative medicine (CAM). The use of selected, evidence-based CAM therapies for the prevention and treatment of migraine, carpal tunnel syndrome, and dementia are presented. Evidence is growing many of modalities, including nutrition, exercise, mind-body medicine, supplements, and acupuncture. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Clinical holistic health: advanced tools for holistic medicine.

    PubMed

    Ventegodt, Søren; Clausen, Birgitte; Nielsen, May Lyck; Merrick, Joav

    2006-02-24

    According to holistic medical theory, the patient will heal when old painful moments, the traumatic events of life that are often called "gestalts", are integrated in the present "now". The advanced holistic physician's expanded toolbox has many different tools to induce this healing, some that are more dangerous and potentially traumatic than others. The more intense the therapeutic technique, the more emotional energy will be released and contained in the session, but the higher also is the risk for the therapist to lose control of the session and lose the patient to his or her own dark side. To avoid harming the patient must be the highest priority in holistic existential therapy, making sufficient education and training an issue of highest importance. The concept of "stepping up" the therapy by using more and more "dramatic" methods to get access to repressed emotions and events has led us to a "therapeutic staircase" with ten steps: (1) establishing the relationship; (2) establishing intimacy, trust, and confidentiality; (3) giving support and holding; (4) taking the patient into the process of physical, emotional, and mental healing; (5) social healing of being in the family; (6) spiritual healing--returning to the abstract wholeness of the soul; (7) healing the informational layer of the body; (8) healing the three fundamental dimensions of existence: love, power, and sexuality in a direct way using, among other techniques, "controlled violence" and "acupressure through the vagina"; (9) mind-expanding and consciousness-transformative techniques like psychotropic drugs; and (10) techniques transgressing the patient's borders and, therefore, often traumatizing (for instance, the use of force against the will of the patient). We believe that the systematic use of the staircase will greatly improve the power and efficiency of holistic medicine for the patient and we invite a broad cooperation in scientifically testing the efficiency of the advanced holistic

  3. [Psychiatric advance directives--medical models into psychiatric medicine].

    PubMed

    Mautner, Sigal; Lachman, Max; Kaplan, Zeev; Shalev, Anat

    2014-01-01

    Since the year 2005, in the field of general medicine, the legislature in Israel determined ways to implement medically advanced directives according to the power of the law. Different states in the world had implemented parallel legislation for patients who suffer from mental illness. Psychiatric Advance Directives is a legitimate document which is valid in Australia, New Zealand, Scotland, England and in 25 countries in the U.S.A. Psychiatric advance directives (PAD's) allow competent persons, through advance instructions, to state their preferences for future mental health treatment in the event of an incapacitating psychiatric crisis. Self Determination Theory, Self Care and Autonomy are dominant supportive approaches in the creation of Psychiatric Advance Directives. Research conducted on psychiatric advance directives shows positive potential benefits for mental health clients, therapists and psychiatrists. More research in that area must be conducted. Psychiatric advance directives are currently developed and implemented with the cooperation of the Tauber Foundation and the Beer Sheva Mental Health Center. This is the first step in learning of effective ways to use this intervention in Israel and change perceptions toward a positive connection between medical efficiency and client preferences.

  4. Medicinal mushroom science: Current perspectives, advances, evidences, and challenges.

    PubMed

    Wasser, Solomon P

    2014-01-01

    The main target of the present review is to draw attention to the current perspectives, advances, evidences, challenges, and future development of medicinal mushroom science in the 21 st century. Medicinal mushrooms and fungi are thought to possess approximately 130 medicinal functions, including antitumor, immunomodulating, antioxidant, radical scavenging, cardiovascular, anti-hypercholesterolemic, antiviral, antibacterial, anti-parasitic, antifungal, detoxification, hepatoprotective, and antidiabetic effects. Many, if not all, higher Basidiomycetes mushrooms contain biologically active compounds in fruit bodies, cultured mycelium, and cultured broth. Special attention is paid to mushroom polysaccharides. The data on mushroom polysaccharides and different secondary metabolites are summarized for approximately 700 species of higher hetero- and homobasidiomycetes. Numerous bioactive polysaccharides or polysaccharide-protein complexes from the medicinal mushrooms described appear to enhance innate and cell-mediated immune responses, and exhibit antitumor activities in animals and humans. Whilst the mechanism of their antitumor actions is still not completely understood, stimulation and modulation of key host immune responses by these mushroom compounds appear central. Polysaccharides and low-molecular-weight secondary metabolites are particularly important due to their antitumor and immunostimulating properties. Several of the mushroom compounds have been subjected to Phase I, II, and III clinical trials, and are used extensively and successfully in Asia to treat various cancers and other diseases. Special attention is given to many important unsolved problems in the study of medicinal mushrooms.

  5. The business of palliative medicine - part 5: service utilization in a comprehensive integrated program.

    PubMed

    Estfan, Bassam; Davis, Mellar P; Walsh, Declan; Heintz, Jessica; Shaheen, Philip E; Cheema, Bushra; LeGrand, Susan B; Lagman, Ruth L

    2007-01-01

    The aim of palliative medicine is to provide multidisciplinary comprehensive care in advanced illness. Patient and family utilization of various product service lines offered by the Harry R Horvitz Center for Palliative Medicine at the Cleveland Clinic Foundation was studied. Newly referred patients were followed up prospectively until 85% had either died or been lost to follow-up. Demographic, clinical, and referral data were recorded; subsequent product service line utilization was updated daily. The total study period was 171 days, and 238 patients entered. Acute care inpatient unit, outpatient clinic visits, and 24-hour phone contacts were the most frequently used product service lines. Patients had a median of 3 contacts (range, 1 to 27) with individual service lines. Multiple palliative medicine product service lines were utilized often, with repeated use of the individual service lines. A comprehensive integrated palliative medicine program is necessary to fully meet the complex needs of those with advanced disease.

  6. Integrating Advanced Molecular Technologies into Public Health.

    PubMed

    Gwinn, Marta; MacCannell, Duncan R; Khabbaz, Rima F

    2017-03-01

    Advances in laboratory and information technologies are transforming public health microbiology. High-throughput genome sequencing and bioinformatics are enhancing our ability to investigate and control outbreaks, detect emerging infectious diseases, develop vaccines, and combat antimicrobial resistance, all with increased accuracy, timeliness, and efficiency. The Advanced Molecular Detection (AMD) initiative has allowed the Centers for Disease Control and Prevention (CDC) to provide leadership and coordination in integrating new technologies into routine practice throughout the U.S. public health laboratory system. Collaboration and partnerships are the key to navigating this transition and to leveraging the next generation of methods and tools most effectively for public health.

  7. Integrative Medicine Preferences Among Coccidioidomycosis (Valley Fever) Patients.

    PubMed

    Short, Jack H; Bradley, Constance; Blair, Janis E; Stewart, Terry D; Burns, Mark W; Patron, Roberto L; Millstine, Denise M

    2017-02-01

    To understand the extent and modalities of integrative medicine strategies that patients with coccidioidomycosis (valley fever) have incorporated into their treatment regimens. A direct patient survey was distributed, with 100 unique responses, at a single infectious diseases clinic at an academic medical center in Arizona. Eligible patients, defined as those with confirmed coccidioidomycosis or currently under evaluation, were polled on their personal use of 36 integrative medicine modalities. Patients were also asked to indicate their level of fatigue on a 10-point scale in an attempt to correlate levels of fatigue to use of specific integrative medicine modalities. Of the patients surveyed, 64% had used at least one integrative medicine modality, and 53% used two or more, along with conventional medical therapy. The top three modalities were nutrition (39%), massage (27%), and breathing exercises (26%). The mean reported fatigue level was 4.7 on a 10-point scale, with a standard deviation of 3.0. There was no statistically significant association between use of a specific modality and reported level of fatigue. Nearly two thirds of patients (64%) surveyed had used at least one integrative medicine modality throughout the course of their therapy. Clinicians are probably unaware of the extent to which many patients, including this population, have embraced integrative medicine. Awareness of patients' goal and preferences is valuable in shared clinical decision making.

  8. Naturopathic physicians: holistic primary care and integrative medicine specialists.

    PubMed

    Litchy, Andrew P

    2011-12-01

    The use of Complimentary and Alternative Medicine (CAM) is increasing in the United States; there is a need for physician level practitioners who possess extensive training in both CAM and conventional medicine. Naturopathic physicians possess training that allows integration of modern scientific knowledge and the age-old wisdom of natural healing techniques. Naturopathic philosophy provides a framework to implement CAM in concert with conventional therapies. The naturopathic physician's expertise in both conventional medicine and CAM allows a practice style that provides excellent care through employing conventional and CAM modalities while utilizing modern research and evidence-based medicine.

  9. BioMEMS –Advancing the Frontiers of Medicine

    PubMed Central

    James, Teena; Mannoor, Manu Sebastian; Ivanov, Dentcho V.

    2008-01-01

    Biological and medical application of micro-electro-mechanical-systems (MEMS) is currently seen as an area of high potential impact. Integration of biology and microtechnology has resulted in the development of a number of platforms for improving biomedical and pharmaceutical technologies. This review provides a general overview of the applications and the opportunities presented by MEMS in medicine by classifying these platforms according to their applications in the medical field. PMID:27873858

  10. Recent advances in PLC hybrid integration technology

    NASA Astrophysics Data System (ADS)

    Ogawa, Ikuo; Kitagawa, Takeshi

    2003-07-01

    Opto-electronic hybrid integraiton using a silica-based planar lightwave circuit (PLC) platform is an attractive way to realize the various kinds of opto-electronic components required for future photonic networks. This paper briefly introduces the concept and basic techniques used for PLC hybrid integration, and describes recent advances in this field. We also report on several high-performance optical devices that we recently developed using this technology.

  11. Anthroposophic Medicine: An Integrative Medical System Originating in Europe

    PubMed Central

    Albonico, Hans-Ulrich; Baars, Erik; Hamre, Harald J.; Zimmermann, Peter; Kiene, Helmut

    2013-01-01

    Anthroposophic medicine is an integrative multimodal treatment system based on a holistic understanding of man and nature and of disease and treatment. It builds on a concept of four levels of formative forces and on the model of a three-fold human constitution. Anthroposophic medicine is integrated with conventional medicine in large hospitals and medical practices. It applies medicines derived from plants, minerals, and animals; art therapy, eurythmy therapy, and rhythmical massage; counseling; psychotherapy; and specific nursing techniques such as external embrocation. Anthroposophic healthcare is provided by medical doctors, therapists, and nurses. A Health-Technology Assessment Report and its recent update identified 265 clinical studies on the efficacy and effectiveness of anthroposophic medicine. The outcomes were described as predominantly positive. These studies as well as a variety of specific safety studies found no major risk but good tolerability. Economic analyses found a favorable cost structure. Patients report high satisfaction with anthroposophic healthcare. PMID:24416705

  12. Anthroposophic medicine: an integrative medical system originating in europe.

    PubMed

    Kienle, Gunver S; Albonico, Hans-Ulrich; Baars, Erik; Hamre, Harald J; Zimmermann, Peter; Kiene, Helmut

    2013-11-01

    Anthroposophic medicine is an integrative multimodal treatment system based on a holistic understanding of man and nature and of disease and treatment. It builds on a concept of four levels of formative forces and on the model of a three-fold human constitution. Anthroposophic medicine is integrated with conventional medicine in large hospitals and medical practices. It applies medicines derived from plants, minerals, and animals; art therapy, eurythmy therapy, and rhythmical massage; counseling; psychotherapy; and specific nursing techniques such as external embrocation. Anthroposophic healthcare is provided by medical doctors, therapists, and nurses. A Health-Technology Assessment Report and its recent update identified 265 clinical studies on the efficacy and effectiveness of anthroposophic medicine. The outcomes were described as predominantly positive. These studies as well as a variety of specific safety studies found no major risk but good tolerability. Economic analyses found a favorable cost structure. Patients report high satisfaction with anthroposophic healthcare.

  13. Sleep medicine care under one roof: a proposed model for integrating dentistry and medicine.

    PubMed

    Sharma, Sunil; Essick, Greg; Schwartz, David; Aronsky, Amy J

    2013-08-15

    Integrating oral appliance therapy into the delivery of care for sleeprelated breathing disorders has been a challenge for dental and medical professionals alike. We review the difficulties that have been faced and propose a multidisciplinary care delivery model that integrates dental sleep medicine and sleep medicine under the same roof with educational and research components. The model promises to offer distinct advantages to improved patient care, continuity of treatment, and the central coordination of clinical and insurance-related benefits.

  14. [Integration of Internal and Clinical Laboratory Medicine].

    PubMed

    Hirokawa, Makoto

    2015-03-01

    The mission of our department is to contribute to diagnostic improvement in medicine in order to promote better outcomes. We have clinical expertise in internal medicine including primary care medicine, hematology, allergy, rheumatology, and nephrology. We also have expertise in clinical laboratory medicine and hospital infection control. Specific areas of academic interest include immune-mediated hematological diseases, allergic diseases, autoimmune diseases, and chronic kidney disease. Immune recovery following hematopoietic stem cell transplantation and the immunopathophysiology of bone marrow failure syndrome have been our main topics of interest, and we have been applying our knowledge of T-cell receptor diversity to these areas in order to explore the mechanisms of immunodeficiency and autoimmunity in hematological disorders. We have found that the peripheral expansion of mature T cells in grafts plays an important role in immune reconstitution after stem cell transplantation in humans, and have also found altered T-cell repertoires in immune-mediated chronic acquired pure red cell aplasia. Thus, quantitative and qualitative analyses of immune receptors could be a promising method for assessing immunocompetence and exploring the pathophysiology of autoimmune diseases. Research and development of novel approaches in this field should be intensively conducted.

  15. Regenerative medicine: advances in new methods and technologies.

    PubMed

    Park, Dong-Hyuk; Eve, David J

    2009-11-01

    The articles published in the journal Cell Transplantation - The Regenerative Medicine Journal over the last two years reveal the recent and future cutting-edge research in the fields of regenerative and transplantation medicine. 437 articles were published from 2007 to 2008, a 17% increase compared to the 373 articles in 2006-2007. Neuroscience was still the most common section in both the number of articles and the percentage of all manuscripts published. The increasing interest and rapid advance in bioengineering technology is highlighted by tissue engineering and bioartificial organs being ranked second again. For a similar reason, the methods and new technologies section increased significantly compared to the last period. Articles focusing on the transplantation of stem cell lineages encompassed almost 20% of all articles published. By contrast, the non-stem cell transplantation group which is made up primarily of islet cells, followed by biomaterials and fetal neural tissue, etc. comprised less than 15%. Transplantation of cells pre-treated with medicine or gene transfection to prolong graft survival or promote differentiation into the needed phenotype, was prevalent in the transplantation articles regardless of the kind of cells used. Meanwhile, the majority of non-transplantation-based articles were related to new devices for various purposes, characterization of unknown cells, medicines, cell preparation and/or optimization for transplantation (e.g. isolation and culture), and disease pathology.

  16. Advanced strategies for quality control of Chinese medicines.

    PubMed

    Zhao, Jing; Ma, Shuang-Cheng; Li, Shao-Ping

    2017-06-19

    Quality control is always the critical issue for Chinese medicines (CMs) with their worldwide increasing use. Different from western medicine, CMs are usually considered that multiple constituents are responsible for the therapeutic effects. Therefore, quality control of CMs is a challenge. In 2011, the strategies for quantification, related to the markers, reference compounds and approaches, in quality control of CMs were reviewed (Li, et al., J. Pharm. Biomed. Anal., 2011, 55, 802-809). Since then, some new strategies have been proposed in these fields. Therefore, the review on the strategies for quality control of CMs should be updated to improve the safety and efficacy of CMs. Herein, novel strategies related to quality marker discovery, reference compound development and advanced approaches (focused on glyco-analysis) for quality control, during 2011-2016, were summarized and discussed. Copyright © 2017. Published by Elsevier B.V.

  17. Glycotherapy: New Advances Inspire a Reemergence of Glycans in Medicine

    PubMed Central

    Hudak, Jason E.; Bertozzi, Carolyn R.

    2014-01-01

    The beginning of the 20th century marked the dawn of modern medicine with glycan-based therapies at the forefront. However, glycans quickly became overshadowed as DNA- and protein-focused treatments became readily accessible. The recent development of new tools and techniques to study and produce structurally defined carbohydrates has spurred renewed interest in the therapeutic applications of glycans. This review focuses on advances within the past decade that are bringing glycan-based treatments back to the forefront of medicine and the technologies that are driving these efforts. These include the use of glycans themselves as therapeutic molecules as well as engineering protein and cell surface glycans to suit clinical applications. Glycan therapeutics offer a rich and promising frontier for developments in the academic, biopharmaceutical, and medical fields. PMID:24269151

  18. Changing academic medicine: strategies used by academic leaders of integrative medicine-a qualitative study.

    PubMed

    Witt, Claudia M; Holmberg, Christine

    2012-01-01

    In Western countries, complementary and alternative medicine (CAM) is more and more provided by practitioners and family doctors. To base this reality of health care provision on an evidence-base, academic medicine needs to be included in the development. In the study we aimed to gain information on a structured approach to include CAM in academic health centers. We conducted a semistructured interview study with leading experts of integrative medicine to analyze strategies of existing academic institutions of integrative medicine. The study sample consisted of a purposive sample of ten leaders that have successfully integrated CAM into medical schools in the USA, Great Britain, and Germany and the Director of the National Center for Alternative and Complementary Medicine. Analysis was based on content analysis. The prerequisite to foster change in academic medicine was a strong educational and professional background in academic medicine and research methodologies. With such a skill set, the interviewees identified a series of strategies to align themselves with colleagues from conventional medicine, such as creating common goals, networking, and establishing well-functioning research teams. In addition, there must be a vision of what should be needed to be at the center of all efforts in order to implement successful change.

  19. Advanced therapy medicinal products: current and future perspectives.

    PubMed

    Hanna, Eve; Rémuzat, Cécile; Auquier, Pascal; Toumi, Mondher

    2016-01-01

    Advanced therapy medicinal products (ATMPs) are innovative therapies that encompass gene therapy, somatic cell therapy, and tissue-engineered products. These therapies are expected to bring important health benefits, but also to substantially impact the pharmaceuticals budget. The aim of this study was to characterise the ATMPs in development and discuss future implications in terms of market access. Clinical trials were searched in the following databases: EudraCT (EU Drug Regulating Authorities Clinical Trials), ClinicalTrials.gov, and ICTRP (International Clinical Trials Registry Platform of the World Health Organization). Trials were classified by category of ATMP as defined by European regulation EC No. 1394/2007, as well as by development phase and disease area. The database search identified 939 clinical trials investigating ATMPs (85% ongoing, 15% completed). The majority of trials were in the early stages (Phase I, I/II: 64.3%, Phase II, II/III: 27.9%, Phase 3: 6.9%). Per category of ATMP, we identified 53.6% of trials for somatic cell therapies, 22.8% for tissue-engineered products, 22.4% for gene therapies, and 1.2% for combined products (incorporating a medical device). Disease areas included cancer (24.8%), cardiovascular diseases (19.4%), musculoskeletal (10.5%), immune system and inflammation (11.5%), neurology (9.1%), and others. Of the trials, 47.2% enrolled fewer than 25 patients. Due to the complexity and specificity of ATMPs, new clinical trial methodologies are being considered (e.g., small sample size, non-randomised trials, single-arm trials, surrogate endpoints, integrated protocols, and adaptive designs). Evidence generation post-launch will become unavoidable to address payers' expectations. ATMPs represent a fast-growing field of interest. Although most of the products are in an early development phase, the combined trial phase and the potential to cure severe chronic conditions suggest that ATMPs may reach the market earlier than

  20. Advanced therapy medicinal products: current and future perspectives

    PubMed Central

    Hanna, Eve; Rémuzat, Cécile; Auquier, Pascal; Toumi, Mondher

    2016-01-01

    Background Advanced therapy medicinal products (ATMPs) are innovative therapies that encompass gene therapy, somatic cell therapy, and tissue-engineered products. These therapies are expected to bring important health benefits, but also to substantially impact the pharmaceuticals budget. Objective The aim of this study was to characterise the ATMPs in development and discuss future implications in terms of market access. Methods Clinical trials were searched in the following databases: EudraCT (EU Drug Regulating Authorities Clinical Trials), ClinicalTrials.gov, and ICTRP (International Clinical Trials Registry Platform of the World Health Organization). Trials were classified by category of ATMP as defined by European regulation EC No. 1394/2007, as well as by development phase and disease area. Results The database search identified 939 clinical trials investigating ATMPs (85% ongoing, 15% completed). The majority of trials were in the early stages (Phase I, I/II: 64.3%, Phase II, II/III: 27.9%, Phase 3: 6.9%). Per category of ATMP, we identified 53.6% of trials for somatic cell therapies, 22.8% for tissue-engineered products, 22.4% for gene therapies, and 1.2% for combined products (incorporating a medical device). Disease areas included cancer (24.8%), cardiovascular diseases (19.4%), musculoskeletal (10.5%), immune system and inflammation (11.5%), neurology (9.1%), and others. Of the trials, 47.2% enrolled fewer than 25 patients. Due to the complexity and specificity of ATMPs, new clinical trial methodologies are being considered (e.g., small sample size, non-randomised trials, single-arm trials, surrogate endpoints, integrated protocols, and adaptive designs). Evidence generation post-launch will become unavoidable to address payers’ expectations. Conclusion ATMPs represent a fast-growing field of interest. Although most of the products are in an early development phase, the combined trial phase and the potential to cure severe chronic conditions suggest

  1. Sleep Medicine Care Under One Roof: A Proposed Model for Integrating Dentistry and Medicine

    PubMed Central

    Sharma, Sunil; Essick, Greg; Schwartz, David; Aronsky, Amy J.

    2013-01-01

    Integrating oral appliance therapy into the delivery of care for sleeprelated breathing disorders has been a challenge for dental and medical professionals alike. We review the difficulties that have been faced and propose a multidisciplinary care delivery model that integrates dental sleep medicine and sleep medicine under the same roof with educational and research components. The model promises to offer distinct advantages to improved patient care, continuity of treatment, and the central coordination of clinical and insurance-related benefits. Citation: Sharma S; Essick G; Schwartz D; Aronsky AJ. Sleep medicine care under one roof: a proposed model for integrating dentistry and medicine. J Clin Sleep Med 2013;9(8):827-833. PMID:23946715

  2. Cardiovascular and Hematological Medicine in 2013 - Advances and Insights.

    PubMed

    Mukherjee, Debabrata

    2012-12-11

    Welcome to the first issue of Cardiovascular & Hematological Agents in Medicinal Chemistry (CHAMC) for 2013. I hope everyone has had an enjoyable holiday season and I want to wish everyone a wonderful New Year. As you know, our journal (CHAMC) aims to cover the latest and outstanding developments in medicinal chemistry, rational drug design for the discovery of novel cardiovascular and hematological Agents and discusses such therapies in clinical practice. Each issue contains a series of timely in-depth reviews, original research articles and drug clinical trial studies written by leaders in the field covering a range of current topics in cardiovascular and hematological sciences. I feel that CHAMC is an essential journal for every medicinal chemist, clinician and healthcare provider who wishes to be kept informed and up-to-date with the latest and most important developments in cardiovascular and hematological drug discovery and their clinical uses. In the coming issues of the journal, we will discuss several important topics pertinent to chemists and clinicians in the cardiovascular and hematology fields such as curcumin and resveratrol as alternative medicinal agents against metabolic syndrome, interrelationship between chronic kidney disease and risk of cardiovascular diseases and effects of direct renin inhibitor, aliskiren, on arterial hypertension, chronic kidney disease and cardiovascular disease among others. The journal also delves into hot topics such as genetic testing and personalized medicine, use of literature-based discovery to identify novel therapeutic approaches, pharmacologic mechanism and clinical relevance of P2Y12 inhibitors and intracoronary injection of glycoprotein IIb/IIIa, abciximab, as adjuvant therapy in primary coronary intervention. Cardiovascular medicine and hematology are both very dynamic fields with rapid advances and we will continue to work to keep you up to date on new advances and therapies. I would also take this

  3. Latest Advances Towards Ras Inhibition: A Medicinal Chemistry Perspective.

    PubMed

    Sautier, Brice; Nising, Carl F; Wortmann, Lars

    2016-12-23

    Owing to their high occurrence rate across many human cancers and their lack of druggability so far, mutant forms of the signaling protein Ras are currently among the most attractive (and elusive) oncology targets. This strong appeal explains the sustained effort in the field, and the ensuing progress has rekindled optimism regarding the discovery of Ras inhibitors. In this Minireview, we discuss the most recent advances towards irreversible inhibitors, and highlight approaches to inhibitors of Ras-effector interactions that have been overshadowed by the current focus on direct Ras inhibition. At the same time, we provide a critical assessment from a medicinal chemistry perspective.

  4. Response to a proposal for an integrative medicine curriculum.

    PubMed

    Benjamin, Patricia J; Phillips, Reed; Warren, Don; Salveson, Catherine; Hammerschlag, Richard; Snider, Pamela; Haas, Mitchell; Barrett, Richard; Chapman, Timothy; Kaneko, Robert; Martin, Morgan; Myer, Suzzanne Nelson; Nedrow, Anne; Niemiec, Catherine; O'Bryon, David; Ochoa, Sonia; Peterson, David; Weeks, John

    2007-11-01

    A paper entitled "Core Competencies in Integrative Medicine for Medical School Curricula: A proposal," published in Academic Medicine, stimulated a broad discussion among complementary and alternative medicine (CAM) educators. This discussion led to a formal process for responding to the issues raised by the paper. Representatives from the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) and the Oregon Collaborative for Complementary and Integrative Medicine (OCCIM) formed the ACCAHC/OCCIM Task Force to participate in a Delphi process of consultation and deliberation. This process led to a broad, cross-discipline agreement on important points to include in a response to the integrative medicine (IM) curriculum proposal. Five key areas of concern emerged: (1) the definition of IM as presented in the paper; (2) lack of clarity about the goals of the proposed IM curriculum; (3) lack of recognition of the breadth of whole systems of health care; (4) omission of competencies related to collaboration between MDs and CAM professionals in patient care; and (5) omission of potential areas of partnership in IM education. A major overall theme emerging from the Delphi process was a desire for closer collaboration between conventional medical schools and CAM academic institutions in developing IM curricula. Several cross-disciplinary venues for addressing the Delphi Task Force themes include the National Center for Complementary and Alternative Medicine's R-25 Initiatives, and the National Education Dialogue. OCCIM is presented as an example of a successful lateral integration approach.

  5. INTEGRATED PLASMA CONTROL FOR ADVANCED TOKAMAKS

    SciTech Connect

    HUMPHREYS,D.A; FERRON,J.R; JOHNSON,R.D; LEUER,J.A; PENAFLOR,B.G; WALKER,M.L; WELANDER,A.S; KHAYRUTDINOV,R.R; DOKOUKA,V; EDGELL,D.H; FRANSSON,C.M

    2003-10-01

    OAK-B135 Advanced tokamaks (AT) are distinguished from conventional tokamaks by their high degree of shaping, achievement of profiles optimized for high confinement and stability characteristics, and active stabilization of MHD instabilities to attain high values of normalized beta and confinement. These high performance fusion devices thus require accurate regulation of the plasma boundary, internal profiles, pumping, fueling, and heating, as well as simultaneous and well-coordinated MHD control action to stabilize such instabilities as tearing modes and resistive wall modes. Satisfying the simultaneous demands on control accuracy, reliability, and performance for all of these subsystems requires a high degree of integration in both design and operation of the plasma control system in an advanced tokamak. The present work describes the approach, benefits, and progress made in integrated plasma control with application examples drawn from the DIII-D tokamak. The approach includes construction of plasma and system response models, validation of models against operating experiments, design of integrated controllers which operate in concert with one another as well as with supervisory modules, simulation of control action against off-line and actual machine control platforms, and iteration of the design-test loop to optimize performance.

  6. Advanced integrated life support system update

    NASA Technical Reports Server (NTRS)

    Whitley, Phillip E.

    1994-01-01

    The Advanced Integrated Life Support System Program (AILSS) is an advanced development effort to integrate the life support and protection requirements using the U.S. Navy's fighter/attack mission as a starting point. The goal of AILSS is to optimally mate protection from altitude, acceleration, chemical/biological agent, thermal environment (hot, cold, and cold water immersion) stress as well as mission enhancement through improved restraint, night vision, and head-mounted reticules and displays to ensure mission capability. The primary emphasis to date has been to establish garment design requirements and tradeoffs for protection. Here the garment and the human interface are treated as a system. Twelve state-off-the-art concepts from government and industry were evaluated for design versus performance. On the basis of a combination of centrifuge, thermal manikin data, thermal modeling, and mobility studies, some key design parameters have been determined. Future efforts will concentrate on the integration of protection through garment design and the use of a single layer, multiple function concept to streamline the garment system.

  7. Advanced integrated life support system update

    NASA Technical Reports Server (NTRS)

    Whitley, Phillip E.

    1994-01-01

    The Advanced Integrated Life Support System Program (AILSS) is an advanced development effort to integrate the life support and protection requirements using the U.S. Navy's fighter/attack mission as a starting point. The goal of AILSS is to optimally mate protection from altitude, acceleration, chemical/biological agent, thermal environment (hot, cold, and cold water immersion) stress as well as mission enhancement through improved restraint, night vision, and head-mounted reticules and displays to ensure mission capability. The primary emphasis to date has been to establish garment design requirements and tradeoffs for protection. Here the garment and the human interface are treated as a system. Twelve state-off-the-art concepts from government and industry were evaluated for design versus performance. On the basis of a combination of centrifuge, thermal manikin data, thermal modeling, and mobility studies, some key design parameters have been determined. Future efforts will concentrate on the integration of protection through garment design and the use of a single layer, multiple function concept to streamline the garment system.

  8. Advancing Alternative Analysis: Integration of Decision Science.

    PubMed

    Malloy, Timothy F; Zaunbrecher, Virginia M; Batteate, Christina M; Blake, Ann; Carroll, William F; Corbett, Charles J; Hansen, Steffen Foss; Lempert, Robert J; Linkov, Igor; McFadden, Roger; Moran, Kelly D; Olivetti, Elsa; Ostrom, Nancy K; Romero, Michelle; Schoenung, Julie M; Seager, Thomas P; Sinsheimer, Peter; Thayer, Kristina A

    2017-06-13

    Decision analysis-a systematic approach to solving complex problems-offers tools and frameworks to support decision making that are increasingly being applied to environmental challenges. Alternatives analysis is a method used in regulation and product design to identify, compare, and evaluate the safety and viability of potential substitutes for hazardous chemicals. We assessed whether decision science may assist the alternatives analysis decision maker in comparing alternatives across a range of metrics. A workshop was convened that included representatives from government, academia, business, and civil society and included experts in toxicology, decision science, alternatives assessment, engineering, and law and policy. Participants were divided into two groups and were prompted with targeted questions. Throughout the workshop, the groups periodically came together in plenary sessions to reflect on other groups' findings. We concluded that the further incorporation of decision science into alternatives analysis would advance the ability of companies and regulators to select alternatives to harmful ingredients and would also advance the science of decision analysis. We advance four recommendations: a) engaging the systematic development and evaluation of decision approaches and tools; b) using case studies to advance the integration of decision analysis into alternatives analysis; c) supporting transdisciplinary research; and d) supporting education and outreach efforts. https://doi.org/10.1289/EHP483.

  9. Advancing Alternative Analysis: Integration of Decision Science.

    PubMed

    Malloy, Timothy F; Zaunbrecher, Virginia M; Batteate, Christina; Blake, Ann; Carroll, William F; Corbett, Charles J; Hansen, Steffen Foss; Lempert, Robert; Linkov, Igor; McFadden, Roger; Moran, Kelly D; Olivetti, Elsa; Ostrom, Nancy; Romero, Michelle; Schoenung, Julie; Seager, Thomas; Sinsheimer, Peter; Thayer, Kristina

    2016-10-28

    Decision analysis-a systematic approach to solving complex problems-offers tools and frameworks to support decision making that are increasingly being applied to environmental challenges. Alternatives analysis is a method used in regulation and product design to identify, compare, and evaluate the safety and viability of potential substitutes for hazardous chemicals. Assess whether decision science may assist the alternatives analysis decision maker in comparing alternatives across a range of metrics. A workshop was convened that included representatives from government, academia, business, and civil society and included experts in toxicology, decision science, alternatives assessment, engineering, and law and policy. Participants were divided into two groups and prompted with targeted questions. Throughout the workshop, the groups periodically came together in plenary sessions to reflect on other groups' findings. We conclude the further incorporation of decision science into alternatives analysis would advance the ability of companies and regulators to select alternatives to harmful ingredients, and would also advance the science of decision analysis. We advance four recommendations: (1) engaging the systematic development and evaluation of decision approaches and tools; (2) using case studies to advance the integration of decision analysis into alternatives analysis; (3) supporting transdisciplinary research; and (4) supporting education and outreach efforts.

  10. Integration of molecular pathology, epidemiology and social science for global precision medicine.

    PubMed

    Nishi, Akihiro; Milner, Danny A; Giovannucci, Edward L; Nishihara, Reiko; Tan, Andy S; Kawachi, Ichiro; Ogino, Shuji

    2016-01-01

    The precision medicine concept and the unique disease principle imply that each patient has unique pathogenic processes resulting from heterogeneous cellular genetic and epigenetic alterations and interactions between cells (including immune cells) and exposures, including dietary, environmental, microbial and lifestyle factors. As a core method field in population health science and medicine, epidemiology is a growing scientific discipline that can analyze disease risk factors and develop statistical methodologies to maximize utilization of big data on populations and disease pathology. The evolving transdisciplinary field of molecular pathological epidemiology (MPE) can advance biomedical and health research by linking exposures to molecular pathologic signatures, enhancing causal inference and identifying potential biomarkers for clinical impact. The MPE approach can be applied to any diseases, although it has been most commonly used in neoplastic diseases (including breast, lung and colorectal cancers) because of availability of various molecular diagnostic tests. However, use of state-of-the-art genomic, epigenomic and other omic technologies and expensive drugs in modern healthcare systems increases racial, ethnic and socioeconomic disparities. To address this, we propose to integrate molecular pathology, epidemiology and social science. Social epidemiology integrates the latter two fields. The integrative social MPE model can embrace sociology, economics and precision medicine, address global health disparities and inequalities, and elucidate biological effects of social environments, behaviors and networks. We foresee advancements of molecular medicine, including molecular diagnostics, biomedical imaging and targeted therapeutics, which should benefit individuals in a global population, by means of an interdisciplinary approach of integrative MPE and social health science.

  11. Providing a navigable route for acute medicine nurses to advance their practice: a framework of ascending levels of practice.

    PubMed

    Lees-Deutsch, Liz; Christian, Jan; Setchfield, Ian

    2016-01-01

    This article conveys concerns raised by delegates at the International SAM Conference (Manchester, 2015) regarding how to advance nursing practice in acute medicine. It endeavors to capture the essence of 'how to advance practice' and 'how to integrate advanced practice' within the workforce structures of an acute medicine unit (AMU). It addresses the production of tacit knowledge and the recognition and integration of this to developing the nursing workforce. The current context of NHS efficiencies and recruitment issues emphasize the value of retaining tacit knowledge. Uniquely, this article offers an early conceptual framework through which levels of advancement and potential transition points to advance nursing practice in acute medicine are articulated. Determining how to advance requires identification of prior accomplishments such as, tacit knowledge, experiential learning, CPD, specialist courses and management experience. This requires nurses to make judicious decisions to advance their practice and the distinction between 'amassing experience' and 'career progression'. It aims to stimulate thinking around the practicalities of advancement, the value of tacit knowledge and potential realization through the framework trajectory.

  12. [General integral medicine: the strategic direction for complex health interventions].

    PubMed

    Hou, Zheng-kun; Liu, Feng-bin; Yang, Yun-ying; Chen, Xin-lin; Li, Li-juan; Li, Pei-wu; Liu, Yuan-peng

    2014-06-01

    Nowadays, the simple combination of Western medicine (WM) and complementary and alternative medicine (CAM) cannot resolve all the health problems and various requirements. This article proposed the general integral medicine (GIM) theoretical model, which declares the disease causes analysis, clinical intervention and outcomes assessment should be recognized, managed and evaluated both from physiological, psychological, and spiritual status, and all the four dimensions: orthodox medicine (WM, Chinese medicine, etc.), individual inherent characteristics (emotion, attitude, psychology, etc.), cultural influences (doctors, caregivers, groups care, etc.), and natural environment and social systems (economic status, social security system, environmental pollution, etc). As for health outcomes assessment, a more comprehensive system including biological, doctors, patients, health intimate, social and environmental evaluations were required. The GIM model has individualized, dynamic, standardized, objective, systematic inherent characteristics, and opening and compatible external characteristics. It aims to provide the new theoretical guidance and strategic development direction for complex health interventions, and solve various medical related psychological and social problems.

  13. Vaccination Attitudes and Practices of Integrative Medicine Physicians.

    PubMed

    Buehning, Laura Jean; Peddecord, Kenneth Michael

    2017-01-01

    Context • The growth of Internet-based information and social networking has increased the accessibility and importance of antivaccine information. That information has led to a questioning of vaccination schedules and policies by many individuals. Although the attitudes of complementary and alternative practitioners, such as homeopaths and chiropractic students, toward vaccination have been assessed, despite the growth of integrative medicine, no assessment of the attitudes and practices regarding vaccination of these physicians has been performed. Objective • The study intended to evaluate the attitudes and practices regarding vaccination of members of the American Board of Integrative and Holistic Medicine (ABIHM). Design • The research team conducted a survey of practitioners. Setting • The administration and evaluation of the survey took place at San Diego State University (San Diego, CA, USA). Participants • Prospective participants were 1419 diplomats of the ABIHM on June 19, 2013. Outcome Measures • The survey assessed members' (1) use of and confidence in the vaccination recommendations of the Centers for Disease Control and Prevention (CDC) and of medical-specialty associations, (2) confidence in the manufacturing safety of vaccines and in manufacturer's surveillance of adverse events, and (3) attitudes toward vaccination mandates. The questionnaire included 33 items, with 5 open-ended questions that provided a space for comments. Results • The survey was completed by 290 of 1419 diplomats (20%). The survey showed a diversity of opinions in many vaccination issues. Integrative medicine physicians were less likely to administer vaccinations than physicians in traditional allopathic medicine. Among the 44% who provide vaccinations, 35% used alternative schedules regularly. Integrative medicine physicians showed a greater support of vaccination choice, were less concerned about maintaining herd immunity, and were less supportive of school, day

  14. [Mind-body medicine as a part of German integrative medicine].

    PubMed

    Dobos, G; Altner, N; Lange, S; Musial, F; Langhorst, J; Michalsen, A; Paul, A

    2006-08-01

    Mind-body medicine (MBM) as a holistic approach to health and healing has been shaped by research into stress physiology and stress psychology, by psychoneuro(endocrino)immunology and by Antonovsky's salutogenetic paradigm. MBM seeks to acknowledge physical, psychological as well as social and spiritual aspects of human beings. MBM constitutes one of the traditions, which the emerging field of integrative medicine in Germany draws upon, others being mainstream medicine, traditional European naturopathy and non-European methods like traditional Chinese medicine. The article outlines historical aspects of MBM, gives a brief review of research evidence, and introduces clinical MBM institutes in Germany. Especially the Clinic and Chair of Complementary and Integrative Medicine, Alfried Krupp von Bohlen und Halbach Foundation at the University Duisburg-Essen has been integrating MBM into the concept of integrative medicine. Considering that a growing number of health issues arises due to maladaptive lifestyles, MBM is being identified as a development that supports a shift from increasingly expensive treatments to more cost-effective preventive approaches.

  15. SEU In An Advanced Bipolar Integrated Circuit

    NASA Technical Reports Server (NTRS)

    Zoutendyk, John A.; Secrest, Elaine C.; Berndt, Dale F.

    1989-01-01

    Report summarizes investigation of single-event upsets (SEU) in bipolar integrated-circuit set of flip-flops (memory cells). Device tested made by advanced digital bipolar silicon process of Honeywell, Inc. Circuit chip contained 4 cells. Construction enabled study of effect of size on SEU behavior. Each cell externally biased so effect of bias current on SEU behavior. Results of study provides important information for optimal design of devices fabricated using buried-layer bipolar process operating in heavy-ion SEU environments. Designers use information to provide required levels of suppression of SEU in specific applications via combinations of size and/or cell-current scaling.

  16. Integration of Palliative Medicine Into Routine Oncological Care: What Does the Evidence Show Us?

    PubMed Central

    Debono, David J.

    2011-01-01

    Palliative medicine is now a recognized medical subspecialty. The goal of palliative medicine is to prevent and relieve suffering, and to support the best possible quality of life for patients and their families, regardless of the stage of their illness.1 Typically, palliative medicine teams consist of multiple disciplines (such as physicians, advanced practice nurses, social workers, and chaplains) to address several domains of the patient experience. Medical oncologists have routinely provided palliative care to their patients along with antineoplastic therapy. Nevertheless, there is a recognized need for an improvement in palliative care delivery to the patient with advanced cancer. This narrative review outlines recent clinical trials of palliative care being integrated into routine oncological care. PMID:22379414

  17. Incubating Integrative Medicine in India through PMO's Atal Incubator Scheme of Niti Aayog

    PubMed Central

    Anand, Akshay; Tyagi, Rahul; Kaur, Paramvir

    2017-01-01

    Background Incubation centers are considered important tools to advance in a field of activity with multidisciplinary approach. The idea of incubation emerged long time back but it is actively pursued by funding agencies as a medium to propel community development. India's fast developing economy had limited tryst with Integrative Medicine until Indian Prime Minister, Narendra Modi, role modelled for Yoga in Chandigarh on the occasion of International Yoga Day. Integrative Medicine is a growing field and widely accepted as a cost-effective problem solving method that simplifies the management of incurable and complex disorders where modern medicine has little to offer. Summary Development of integrative medicine health incubator is the key to development of multidisciplinary program that offers to reduce the cost of healthcare, out of pocket expenses and emphasizes on preventive healthcare as means to achieve a healthy population in a developing country like India. Key Message Incubation center may become practical solution for many health problems in singular platform for healthier society by integrating traditional and modern medicine. PMID:28867893

  18. Incubating Integrative Medicine in India through PMO's Atal Incubator Scheme of Niti Aayog.

    PubMed

    Anand, Akshay; Tyagi, Rahul; Kaur, Paramvir

    2017-07-01

    Incubation centers are considered important tools to advance in a field of activity with multidisciplinary approach. The idea of incubation emerged long time back but it is actively pursued by funding agencies as a medium to propel community development. India's fast developing economy had limited tryst with Integrative Medicine until Indian Prime Minister, Narendra Modi, role modelled for Yoga in Chandigarh on the occasion of International Yoga Day. Integrative Medicine is a growing field and widely accepted as a cost-effective problem solving method that simplifies the management of incurable and complex disorders where modern medicine has little to offer. Development of integrative medicine health incubator is the key to development of multidisciplinary program that offers to reduce the cost of healthcare, out of pocket expenses and emphasizes on preventive healthcare as means to achieve a healthy population in a developing country like India. Incubation center may become practical solution for many health problems in singular platform for healthier society by integrating traditional and modern medicine.

  19. The University of Maryland experience in integrating preventive medicine into the clinical medicine curriculum.

    PubMed Central

    Havas, S; Rixey, S; Sherwin, R; Zimmerman, S I; Anderson, S

    1993-01-01

    Lifestyle risk factors play a major role in the etiology of premature mortality, morbidity, and disability in the United States. Numerous professional groups as well as the Surgeon General of the Public Health Service have recommended that increased attention be devoted to training medical students and physicians to improve their knowledge and skills in health promotion and disease prevention. Such training is critical for attaining many of the "Healthy People 2000" objectives. For a variety of reasons, however, most medical schools have had difficulty in successfully integrating preventive medicine into their clinical curriculums. This article describes the critical elements that allowed the faculty at the University of Maryland School of Medicine to accomplish this goal through its fourth year clinical preventive medicine course. The strategies employed in this course may serve as a model for other institutions to achieve the integration of preventive medicine into their clinical curriculums. PMID:8497571

  20. The value of Avicenna's heritage in development of modern integrative medicine in Uzbekistan.

    PubMed

    Buranova, Dilfuza Djamaldinovna

    2015-12-01

    The heritage of Abu Ali al-Husayn ibn Abd Allah ibn Sina (known in Europe as Avicenna, hereinafter referred to as Avicenna; around 980-1037 ce)has been used in the practice of doctors of various specialties in the treatment of various diseases for many centuries. Extensive clinical experience accumulated over a long time is actively used in modern medicine. Avicenna has had an invaluable contribution to world medicine. He is the largest representative of advanced sociohumanitarian ideas among the peoples of Central Asia. He was a philosopher and physician, scientist and mathematician, poet, and specialist in literature. The rich heritage of the scientist takes a worthy place in the history of medicine in particular, and world civilization in general. Avicenna introduced the main contribution to the treasury of the universal culture by his work in medicine. Avicenna brought together the achievements of Hippocrates (c. 460-370 bce),Galen (c. 130-200 ce),and healers of Egypt, Persia, and India, and he supplemented them with own research results, brilliant discoveries, and hypotheses. Avicenna left many works, among them the especially popular Canon of Medicine. He paid great attention to the prevention of diseases rather than their treatment, which is important today. In his works he gives advice on the use of herbal medicines and biologically active points for various diseases. This article highlights some topical issues of multifaceted heritage of Avicenna for modern medicine and identified promising areas for the development of integrative medicine in Uzbekistan.

  1. Advanced Integrated Optical Signal Processing Components.

    NASA Astrophysics Data System (ADS)

    Rastani, Kasra

    This research was aimed at the development of advanced integrated optical components suitable for devices capable of processing multi-dimensional inputs. In such processors, densely packed waveguide arrays with low crosstalk are needed to provide dissection of the information that has been partially processed. Waveguide arrays also expand the information in the plane of the processor while maintaining its coherence. Rib waveguide arrays with low loss, high mode confinement and highly uniform surface quality (660 elements, 8 μm wide, 1 μm high, and 1 cm long with 2 mu m separations) were fabricated on LiNbO _3 substrates through the ion beam milling technique. A novel feature of the multi-dimensional IO processor architecture proposed herein is the implementation of large area uniform outcoupling (with low to moderate outcoupling efficiencies) from rib waveguide arrays in order to access the third dimension of the processor structure. As a means of outcoupling, uniform surface gratings (2 μm and 4 μm grating periods, 0.05 μm high and 1 mm long) with low outcoupling efficiencies (of approximately 2-18%/mm) were fabricated on the nonuniform surface of the rib waveguide arrays. As a practical technique of modulating the low outcoupling efficiencies of the surface gratings, it was proposed to alter the period of the grating as a function of position along each waveguide. Large aperture (2.5 mm) integrated lenses with short positive focal lengths (1.2-2.5 cm) were developed through a modification of the titanium-indiffused proton exchanged (TIPE) technique. Such integrated lenses were fabricated by increasing the refractive index of the slab waveguides by the TIPE process while maintaining the refractive index of the lenses at the lower level of Ti:LiNbO _3 waveguide. By means of curvature reversal of the integrated lenses, positive focal length lenses have been fabricated while providing high mode confinement for the slab waveguide. The above elements performed as

  2. An integrated web medicinal materials DNA database: MMDBD (Medicinal Materials DNA Barcode Database)

    PubMed Central

    2010-01-01

    Background Thousands of plants and animals possess pharmacological properties and there is an increased interest in using these materials for therapy and health maintenance. Efficacies of the application is critically dependent on the use of genuine materials. For time to time, life-threatening poisoning is found because toxic adulterant or substitute is administered. DNA barcoding provides a definitive means of authentication and for conducting molecular systematics studies. Owing to the reduced cost in DNA authentication, the volume of the DNA barcodes produced for medicinal materials is on the rise and necessitates the development of an integrated DNA database. Description We have developed an integrated DNA barcode multimedia information platform- Medicinal Materials DNA Barcode Database (MMDBD) for data retrieval and similarity search. MMDBD contains over 1000 species of medicinal materials listed in the Chinese Pharmacopoeia and American Herbal Pharmacopoeia. MMDBD also contains useful information of the medicinal material, including resources, adulterant information, medical parts, photographs, primers used for obtaining the barcodes and key references. MMDBD can be accessed at http://www.cuhk.edu.hk/icm/mmdbd.htm. Conclusions This work provides a centralized medicinal materials DNA barcode database and bioinformatics tools for data storage, analysis and exchange for promoting the identification of medicinal materials. MMDBD has the largest collection of DNA barcodes of medicinal materials and is a useful resource for researchers in conservation, systematic study, forensic and herbal industry. PMID:20576098

  3. The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity.

    PubMed

    Alcaraz, Kassandra I; Sly, Jamilia; Ashing, Kimlin; Fleisher, Linda; Gil-Rivas, Virginia; Ford, Sabrina; Yi, Jean C; Lu, Qian; Meade, Cathy D; Menon, Usha; Gwede, Clement K

    2017-02-01

    Health disparities persist despite ongoing efforts. Given the United States' rapidly changing demography and socio-cultural diversity, a paradigm shift in behavioral medicine is needed to advance research and interventions focused on health equity. This paper introduces the ConNECT Framework as a model to link the sciences of behavioral medicine and health equity with the goal of achieving equitable health and outcomes in the twenty-first century. We first evaluate the state of health equity efforts in behavioral medicine science and identify key opportunities to advance the field. We then discuss and present actionable recommendations related to ConNECT's five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training. The framework holds significant promise for furthering health equity and ushering in a new and refreshing era of behavioral medicine science and practice.

  4. Current advances in systems and integrative biology

    PubMed Central

    Robinson, Scott W.; Fernandes, Marco; Husi, Holger

    2014-01-01

    Systems biology has gained a tremendous amount of interest in the last few years. This is partly due to the realization that traditional approaches focusing only on a few molecules at a time cannot describe the impact of aberrant or modulated molecular environments across a whole system. Furthermore, a hypothesis-driven study aims to prove or disprove its postulations, whereas a hypothesis-free systems approach can yield an unbiased and novel testable hypothesis as an end-result. This latter approach foregoes assumptions which predict how a biological system should react to an altered microenvironment within a cellular context, across a tissue or impacting on distant organs. Additionally, re-use of existing data by systematic data mining and re-stratification, one of the cornerstones of integrative systems biology, is also gaining attention. While tremendous efforts using a systems methodology have already yielded excellent results, it is apparent that a lack of suitable analytic tools and purpose-built databases poses a major bottleneck in applying a systematic workflow. This review addresses the current approaches used in systems analysis and obstacles often encountered in large-scale data analysis and integration which tend to go unnoticed, but have a direct impact on the final outcome of a systems approach. Its wide applicability, ranging from basic research, disease descriptors, pharmacological studies, to personalized medicine, makes this emerging approach well suited to address biological and medical questions where conventional methods are not ideal. PMID:25379142

  5. Current advances in systems and integrative biology.

    PubMed

    Robinson, Scott W; Fernandes, Marco; Husi, Holger

    2014-08-01

    Systems biology has gained a tremendous amount of interest in the last few years. This is partly due to the realization that traditional approaches focusing only on a few molecules at a time cannot describe the impact of aberrant or modulated molecular environments across a whole system. Furthermore, a hypothesis-driven study aims to prove or disprove its postulations, whereas a hypothesis-free systems approach can yield an unbiased and novel testable hypothesis as an end-result. This latter approach foregoes assumptions which predict how a biological system should react to an altered microenvironment within a cellular context, across a tissue or impacting on distant organs. Additionally, re-use of existing data by systematic data mining and re-stratification, one of the cornerstones of integrative systems biology, is also gaining attention. While tremendous efforts using a systems methodology have already yielded excellent results, it is apparent that a lack of suitable analytic tools and purpose-built databases poses a major bottleneck in applying a systematic workflow. This review addresses the current approaches used in systems analysis and obstacles often encountered in large-scale data analysis and integration which tend to go unnoticed, but have a direct impact on the final outcome of a systems approach. Its wide applicability, ranging from basic research, disease descriptors, pharmacological studies, to personalized medicine, makes this emerging approach well suited to address biological and medical questions where conventional methods are not ideal.

  6. Advanced packaging for Integrated Micro-Instruments

    NASA Technical Reports Server (NTRS)

    Lyke, James L.

    1995-01-01

    The relationship between packaging, microelectronics, and micro-electrical-mechanical systems (MEMS) is an important one, particularly when the edges of performance boundaries are pressed, as in the case of miniaturized systems. Packaging is a sort of physical backbone that enables the maximum performance of these systems to be realized, and the penalties imposed by conventional packing approaches is particularly limiting for MEMS devices. As such, advanced packaging approaches, such as multi-chip modules (MCM's) have been touted as a true means of electronic 'enablement' for a variety of application domains. Realizing an optimum system of packaging, however, in not as simple as replacing a set of single chip packages with a substrate of interconnections. Research at Phillips Laboratory has turned up a number of integrating options in the two- and three-dimensional rending of miniature systems with physical interconnection structures with intrinsically high performance. Not only do these structures motivate the redesign of integrated circuits (IC's) for lower power, but they possess interesting features that provide a framework for the direct integration of MEMS devices. Cost remains a barrier to the application of MEMS devices, even in space systems. Several innovations are suggested that will result in lower cost and more rapid cycle time. First, the novelty of a 'constant floor plan' MCM which encapsulates a variety of commonly used components into a stockable, easily customized assembly is discussed. Next, the use of low-cost substrates is examined. The anticipated advent of ultra-high density interconnect (UHDI) is suggested as the limit argument of advanced packaging. Finally, the concept of a heterogeneous 3-D MCM system is outlined that allows for the combination of different compatible packaging approaches into a uniformly dense structure that could also include MEMS-based sensors.

  7. Advances in Integrated Computational Materials Engineering "ICME"

    NASA Astrophysics Data System (ADS)

    Hirsch, Jürgen

    The methods of Integrated Computational Materials Engineering that were developed and successfully applied for Aluminium have been constantly improved. The main aspects and recent advances of integrated material and process modeling are simulations of material properties like strength and forming properties and for the specific microstructure evolution during processing (rolling, extrusion, annealing) under the influence of material constitution and process variations through the production process down to the final application. Examples are discussed for the through-process simulation of microstructures and related properties of Aluminium sheet, including DC ingot casting, pre-heating and homogenization, hot and cold rolling, final annealing. New results are included of simulation solution annealing and age hardening of 6xxx alloys for automotive applications. Physically based quantitative descriptions and computer assisted evaluation methods are new ICME methods of integrating new simulation tools also for customer applications, like heat affected zones in welding of age hardening alloys. The aspects of estimating the effect of specific elements due to growing recycling volumes requested also for high end Aluminium products are also discussed, being of special interest in the Aluminium producing industries.

  8. Integration of Evidence Based Medicine into a Medical Curriculum

    PubMed Central

    Tamim, H M; Ferwana, M; Al Banyan, E; Al Alwan, I; Hajeer, AH

    2009-01-01

    The College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) was established in January 2004. The four-year curriculum was based on the Problem Based Learning (PBL) format and involved the web-based graduate medical program adopted from the University of Sydney, Australia. At KSAU-HS, one additional semester was added to the beginning of this curriculum to prepare the students in English language skills, PBL, Information Technology and Evidence Based Medicine (EBM). EBM is part of the Personal and Professional Development (PPD) theme of the medical curriculum and is integrated into each stage of the medical curriculum. These modifications of the University of Sydney curriculum are presented here as a model of EBM integration into a college of medicine curriculum. PMID:20165529

  9. Environmental Medicine: Integrating a Missing Element into Medical Education.

    ERIC Educational Resources Information Center

    Pope, Andrew M., Ed.; Rall, David P., Ed.

    This volume articulates a general program of implementation strategies and provides practical advice for integrating environmental medicine content into medical education. Chapter 1 is an introduction to the issues and the organization of the volume. Chapter 2 lays the foundation for a curriculum centered on six competency-based learning…

  10. Integrating Complementary and Alternative Medicine into the Health Education Curriculum.

    ERIC Educational Resources Information Center

    Patterson, Sheila M.; Graf, Helen M.

    2000-01-01

    Reviews the popularity of complementary and alternative medicine (CAM) approaches in health education, suggesting a proposed CAM course for health education professional preparation and offering a course outline which can be used as a self- standing course or integrated into existing courses. It includes a proposed course description and goals,…

  11. East meets West: current issues relevant to integrating Chinese medicine

    PubMed Central

    2012-01-01

    This article describes the challenges that integration of Chinese medicine (CM) and biomedicine are likely to bring for improving safety, research, education, and cross-disciplinary communication. Potential strategies to meet these challenges are suggested, including the use of accessible language for the Western biomedical community, and further development of whole-system randomized controlled trials that support individualized treatment approaches. PMID:22943066

  12. Integrating Complementary and Alternative Medicine into the Health Education Curriculum.

    ERIC Educational Resources Information Center

    Patterson, Sheila M.; Graf, Helen M.

    2000-01-01

    Reviews the popularity of complementary and alternative medicine (CAM) approaches in health education, suggesting a proposed CAM course for health education professional preparation and offering a course outline which can be used as a self- standing course or integrated into existing courses. It includes a proposed course description and goals,…

  13. Research advances in traditional Chinese medicine syndromes in cancer patients.

    PubMed

    Ji, Qing; Luo, Yun-quan; Wang, Wen-hai; Liu, Xuan; Li, Qi; Su, Shi-bing

    2016-01-01

    Traditional Chinese medicine (TCM) syndrome, also known as TCM ZHENG or TCM pattern, is an integral and essential part of TCM theory that helps to guide the design of individualized treatments. A TCM syndrome, in essence, is a characteristic profile of all clinical manifestations in one patient that can be readily identified by a TCM practitioner. In this article, the authors reviewed the presentations of TCM syndromes in seven common malignancies (liver, lung, gastric, breast, colorectal, pancreatic and esophageal cancers), the objectivity and the standardization of TCM syndrome differentiation, the evaluation of TCM syndrome modeling in cancer research, and syndrome differentiation-guided TCM treatment of cancers. A better understanding of TCM syndrome theory, as well as its potential biological basis, may contribute greatly to the clinical TCM diagnosis and the treatment of cancer.

  14. [Oral maxillofacial-head and neck tumor and holistic integrative medicine].

    PubMed

    Zhang, C P

    2017-08-09

    The advance of clinical diagnosis and treatment in oral and maxillofacial-head and neck tumors has been through the process of specialization and multidisciplinary cooperation. In most cases, a single discipline cannot meet the requirements of diagnosis and treatment, which needs the cooperation of oral and maxillofacial surgery, otolaryngology and oncology approach and therapeutic method such as surgery, radiotherapy and chemotherapy. Holistic integrative medicine aims at integrating the most effective clinical practice experience and patients' individual situation and prognosis, establishing new medical mode conforming to the modern concept and fulfilling the medical system adapting to the specific characteristics of the diseases.

  15. Integrating Complementary and Alternative Medicine Education Into the Pharmacy Curriculum

    PubMed Central

    Wallis, Marianne

    2008-01-01

    Objectives To evaluate the effectiveness of an integrated approach to the teaching of evidence-based complementary and alternative medicine (CAM) in a pharmacy curriculum. Design Evidence-based CAM education was integrated throughout the third, fourth, and fifth years of the pharmacy curriculum. Specifically, an introductory module focusing on CAM familiarization was added in the third year and integrated, evidence-based teaching related to CAM was incorporated into clinical topics through lectures and clinical case studies in the fourth and fifth years. Assessment Students' self-assessed and actual CAM knowledge increased, as did their use of evidence-based CAM resources. However, only 30% of the fourth-year students felt they had learned enough about CAM. Students preferred having CAM teaching integrated into the curriculum beginning in the first year rather than waiting until later in their education. Conclusion CAM education integrated over several years of study increases students' knowledge and application. PMID:19002274

  16. Challenging integration: clinicians' perspectives of communicating collaboration in a center for integrative medicine.

    PubMed

    Geist-Martin, Patricia; Bollinger, Beth J; Wiechert, Kelsey N; Plump, Brielle; Sharf, Barbara F

    2016-01-01

    A shift has occurred in the provision of health care to include a focus not just on biology and disease but also on the whole person, preventative care, and an array of healing modalities based on systems of beliefs and values not typically included within biomedical practice. This approach to health care, termed integrative medicine (IM), blends biomedicine with a broader understanding of patients and their illnesses, including elements of mind, body, and spirit that may be contributing to an ailment. While the use of integrative medicine has increased and centers for integrative medicine have proliferated within conventional health care organizations, distinct tensions arise from this amalgamation. The tensions between IM and biomedical clinicians often center on their differing training and philosophies, as well as on a larger system of health care that privileges biomedicine. As a result, this research is designed to explore the challenges IM clinicians face in collaborating with conventional practitioners to provide patient care. Analysis of interviews with 14 clinicians at one center for integrative medicine revealed four specific challenges they face in their attempt to co-practice IM with conventional medicine. The four challenges include (a) challenges to collaboration, (b) challenges to legitimacy, (c) challenges to consistency, and (d) challenges to unification. Future research should investigate the ways in which these challenges can be addressed so that collaboration throughout the system is facilitated. The professional training of clinicians, the structuring and institutionalization of integrative medicine, and enhanced systems for communicating patient information all play a significant role in this transformation.

  17. Integrating advanced facades into high performance buildings

    SciTech Connect

    Selkowitz, Stephen E.

    2001-05-01

    Glass is a remarkable material but its functionality is significantly enhanced when it is processed or altered to provide added intrinsic capabilities. The overall performance of glass elements in a building can be further enhanced when they are designed to be part of a complete facade system. Finally the facade system delivers the greatest performance to the building owner and occupants when it becomes an essential element of a fully integrated building design. This presentation examines the growing interest in incorporating advanced glazing elements into more comprehensive facade and building systems in a manner that increases comfort, productivity and amenity for occupants, reduces operating costs for building owners, and contributes to improving the health of the planet by reducing overall energy use and negative environmental impacts. We explore the role of glazing systems in dynamic and responsive facades that provide the following functionality: Enhanced sun protection and cooling load control while improving thermal comfort and providing most of the light needed with daylighting; Enhanced air quality and reduced cooling loads using natural ventilation schemes employing the facade as an active air control element; Reduced operating costs by minimizing lighting, cooling and heating energy use by optimizing the daylighting-thermal tradeoffs; Net positive contributions to the energy balance of the building using integrated photovoltaic systems; Improved indoor environments leading to enhanced occupant health, comfort and performance. In addressing these issues facade system solutions must, of course, respect the constraints of latitude, location, solar orientation, acoustics, earthquake and fire safety, etc. Since climate and occupant needs are dynamic variables, in a high performance building the facade solution have the capacity to respond and adapt to these variable exterior conditions and to changing occupant needs. This responsive performance capability

  18. Integrating advanced mobility into lunar surface exploration

    NASA Astrophysics Data System (ADS)

    Schlutz, Juergen; Messerschmid, Ernst

    2012-06-01

    With growing knowledge of the lunar surface environment from recent robotic missions, further assessment of human lunar infrastructures and operational aspects for surface exploration become possible. This is of particular interest for the integration of advanced mobility assets, where path planning, balanced energy provision and consumption as well as communication coverage grow in importance with the excursion distance. The existing modeling and simulation tools for the lunar surface environment have therefore been revisited and extended to incorporate aspects of mobile exploration. An extended analysis of the lunar topographic models from past and ongoing lunar orbital missions has resulted in the creation of a tool to calculate and visualize slope angles in selected lunar regions. This allows for the identification of traversable terrain with respect to the mobile system capabilities. In a next step, it is combined with the analysis of the solar illumination conditions throughout this terrain to inform system energy budgets in terms of electrical power availability and thermal control requirements. The combination of the traversability analysis together with a time distributed energy budget assessment then allows for a path planning and optimization for long range lunar surface mobility assets, including manned excursions as well as un-crewed relocation activities. The above mentioned tools are used for a conceptual analysis of the international lunar reference architecture, developed in the frame of the International Architecture Working Group (IAWG) of the International Space Exploration Coordination Group (ISECG). Its systems capabilities are evaluated together with the planned surface exploration range and paths in order to analyze feasibility of the architecture and to identify potential areas of optimization with respect to time-based and location-based integration of activities.

  19. Integration of phytochemicals and phytotherapy into cancer precision medicine

    PubMed Central

    Efferth, Thomas; Saeed, Mohamed E.M.; Mirghani, Elhaj; Alim, Awadh; Yassin, Zahir; Saeed, Elfatih; Khalid, Hassan E.; Daak, Salah

    2017-01-01

    Concepts of individualized therapy in the 1970s and 1980s attempted to develop predictive in vitro tests for individual drug responsiveness without reaching clinical routine. Precision medicine attempts to device novel individual cancer therapy strategies. Using bioinformatics, relevant knowledge is extracted from huge data amounts. However, tumor heterogeneity challenges chemotherapy due to genetically and phenotypically different cell subpopulations, which may lead to refractory tumors. Natural products always served as vital resources for cancer therapy (e.g., Vinca alkaloids, camptothecin, paclitaxel, etc.) and are also sources for novel drugs. Targeted drugs developed to specifically address tumor-related proteins represent the basis of precision medicine. Natural products from plants represent excellent resource for targeted therapies. Phytochemicals and herbal mixtures act multi-specifically, i.e. they attack multiple targets at the same time. Network pharmacology facilitates the identification of the complexity of pharmacogenomic networks and new signaling networks that are distorted in tumors. In the present review, we give a conceptual overview, how the problem of drug resistance may be approached by integrating phytochemicals and phytotherapy into academic western medicine. Modern technology platforms (e.g. “-omics” technologies, DNA/RNA sequencing, and network pharmacology) can be applied for diverse treatment modalities such as cytotoxic and targeted chemotherapy as well as phytochemicals and phytotherapy. Thereby, these technologies represent an integrative momentum to merge the best of two worlds: clinical oncology and traditional medicine. In conclusion, the integration of phytochemicals and phytotherapy into cancer precision medicine represents a valuable asset to chemically synthesized chemicals and therapeutic antibodies. PMID:28514737

  20. Using the framework of corporate culture in "mergers" to support the development of a cultural basis for integrative medicine - guidance for building an integrative medicine department or service.

    PubMed

    Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

    2015-01-01

    An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations - usually companies - are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in "mergers," which could be used to build an integrative medicine department or integrative medicine service. Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation.

  1. Integration of Molecular Pathology, Epidemiology, and Social Science for Global Precision Medicine

    PubMed Central

    Nishi, Akihiro; Milner, Danny A; Giovannucci, Edward L.; Nishihara, Reiko; Tan, Andy S.; Kawachi, Ichiro; Ogino, Shuji

    2015-01-01

    Summary The precision medicine concept and the unique disease principle imply that each patient has unique pathogenic processes resulting from heterogeneous cellular genetic and epigenetic alterations, and interactions between cells (including immune cells) and exposures, including dietary, environmental, microbial, and lifestyle factors. As a core method field in population health science and medicine, epidemiology is a growing scientific discipline that can analyze disease risk factors, and develop statistical methodologies to maximize utilization of big data on populations and disease pathology. The evolving transdisciplinary field of molecular pathological epidemiology (MPE) can advance biomedical and health research by linking exposures to molecular pathologic signatures, enhancing causal inference, and identifying potential biomarkers for clinical impact. The MPE approach can be applied to any diseases, although it has been most commonly used in neoplastic diseases (including breast, lung and colorectal cancers) because of availability of various molecular diagnostic tests. However, use of state-of-the-art genomic, epigenomic and other omic technologies and expensive drugs in modern healthcare systems increases racial, ethnic and socioeconomic disparities. To address this, we propose to integrate molecular pathology, epidemiology, and social science. Social epidemiology integrates the latter two fields. The integrative social MPE model can embrace sociology, economics and precision medicine, address global health disparities and inequalities, and elucidate biological effects of social environments, behaviors, and networks. We foresee advancements of molecular medicine, including molecular diagnostics, biomedical imaging, and targeted therapeutics, which should benefit individuals in a global population, by means of an interdisciplinary approach of integrative MPE and social health science. PMID:26636627

  2. Founding integrative medicine centers of excellence: one strategy for chiropractic medicine to build higher cultural authority.

    PubMed

    Lehman, James J; Suozzi, Paul J

    2008-01-01

    Chiropractic physicians are seeking a higher level of cultural authority within their communities and the United States health care system. This commentary suggests an innovative strategy that might expedite the attainment of professional authority while improving the training of chiropractic students and faculty. The authors propose the founding of integrative medicine centers of excellence by colleges of chiropractic that will employ clinical faculties comprised of allopathic, chiropractic, osteopathic, and naturopathic physicians. Initially, the health care facilities should offer primary care through an integrative medicine model. It is anticipated that these centers of excellence will require both government and private funding in order to develop research programs, provide high-quality patient care, and improve the medical training for students with residents programs.

  3. Founding Integrative Medicine Centers of Excellence: One Strategy for Chiropractic Medicine to Build Higher Cultural Authority

    PubMed Central

    Lehman, James J.; Suozzi, Paul J.

    2008-01-01

    Chiropractic physicians are seeking a higher level of cultural authority within their communities and the United States health care system. This commentary suggests an innovative strategy that might expedite the attainment of professional authority while improving the training of chiropractic students and faculty. The authors propose the founding of integrative medicine centers of excellence by colleges of chiropractic that will employ clinical faculties comprised of allopathic, chiropractic, osteopathic, and naturopathic physicians. Initially, the health care facilities should offer primary care through an integrative medicine model. It is anticipated that these centers of excellence will require both government and private funding in order to develop research programs, provide high-quality patient care, and improve the medical training for students with residents programs PMID:18483589

  4. Medicine Delivery Device with Integrated Sterilization and Detection

    NASA Technical Reports Server (NTRS)

    Sheam, Michael J.; Greer, Harold F.; Manohara, Harish

    2013-01-01

    Sterile delivery devices can be created by integrating a medicine delivery instrument with surfaces that are coated with germicidal and anti-fouling material. This requires that a large-surface-area template be developed within a constrained volume to ensure good contact between the delivered medicine and the germicidal material. Both of these can be integrated using JPL-developed silicon nanotip or cryo-etch black silicon technologies with atomic layer deposition (ALD) coating of specific germicidal layers. Nanofabrication techniques that are used to produce a microfluidics device are also capable of synthesizing extremely hig-hsurface-area templates in precise locations, and coating those surfaces with conformal films to manipulate their surface properties. This methodology has been successfully applied at JPL to produce patterned and coated silicon nanotips (also known as black silicon) to manipulate the hydrophilicity of surfaces to direct the spreading of fluids in microdevices. JPL s ALD technique is an ideal method to produce the highly conformal coatings required for this type of application. Certain materials, such as TiO2, have germicidal and anti-fouling properties when they are illuminated with UV light. The proposed delivery device contacts medicine with this high-surface-area black silicon surface coated with a thin-film germicidal deposited conformally with ALD. The coating can also be illuminated with ultraviolet light for the purpose of sterilization or identification of the medicine itself. This constrained volume that is located immediately prior to delivery into a patient, ensures that the medicine delivery device is inherently sterile.

  5. [Intratumoral administration of biological preparations--recommendation for integrative medicine].

    PubMed

    Ebina, T

    2001-10-01

    The antitumor effect of biological preparations was examined in a double grafted tumor system. PSK is a hot water extract of cultured mycelia from Coliolus versicolor. Its protein content is about 38% and the main glycoside portion of PSK is beta-D-glucan. Lentinan is purified from fruit bodies of Lentinus edodes and is a beta-1, 3-glucan. Cepharanthin is an extract from the root of Stephania cepharantha HAYATA, consisting of 4 kinds of biscoclaurine alkaloids. TAHEEBO tea is a hot water extract of Tabebuia avellanedae, the active ingredient of which is naphthoquinones. If protein-bound polysaccharides were to be used in Western medicine, these polysaccharides would be purified, but purified beta-glucan loses its beneficial effects. Similarly, when raw Cepharanthin is purified to isolate its active ingredient (an alkaloid cepharanthine), its anti-tumor effect is weakened. Clear IAP induction was observed in serum of mice treated with extracts of Coliolus versicolor and Stephania cepharantha. However, IAP induction was not observed in the serum of mice treated with purified beta-glucan or purified alkaloid. This suggests that macrophages may recognize extracts but not purified substances. In Western medicine, purified substances with known chemical structures are recognized as drugs, but overdoses of these drugs are toxic to the body, thus adverse reactions are always an issue. In Chinese medicine, mixtures containing several crude drugs are recognized as drugs, whose active ingredients are not identified. In integrative medicine, drugs are extracts that contain active ingredients with known structures and functions. We propose a Japanese version of integrative medicine which is neither Western nor Chinese.

  6. Recent advances in quality control of traditional Chinese medicines.

    PubMed

    Liu, E-Hu; Qi, Lian-Wen; Li, Kai; Chu, Chu; Li, Ping

    2010-12-01

    Traditional Chinese medicines (TCMs) have been used for disease prevention and therapy in China for a long time and are becoming increasingly popular over the world. However, TCMs are complex mixtures and contain usually hundreds of chemically different constituents, which make the quality control of crude drugs and their medical preparations extremely difficult. Therefore, better analytical strategies to assure their efficacy, safety and consistency are in great demand. The present work provides an overview of the development of quality control for TCMs based on microscopic and molecular identification, quantitative and qualitative analysis, fingerprint, combination of fingerprint and multi-component quantification, as well as activity-integrated fingerprint over the last five years. The biological fingerprinting analysis of TCMs with targeting absorption, distribution, metabolism, excretion by chromatographic and chemometric method are also highlighted due to its broad application in the quality control of TCMs. The comprehensive methods analyzed with modern hyphenated techniques are strongly recommended to assess the authenticity, quality consistency and stability of TCMs.

  7. Towards an integrated approach to health and medicine in Africa.

    PubMed

    Batisai, Kezia

    2016-12-01

    This article frames the intersections of medicine and humanities as intrinsic to understanding the practice of health care in Africa. Central to this manuscript, which draws on empirical findings on the interplay between HIV and AIDS and alternative medicine in Zimbabwe is the realisation that very limited research has been undertaken to examine 'HIV/AIDS patient behaviour' with respect to choice of therapy on the continent [Bene, M. & Darkoh, M. B. K. (2014). The Constraints of Antiretroviral Uptake in Rural Areas: The Case of Thamaga and Surrounding Villages, Botswana. Journal of Social Aspects of HIV/AIDS, 11(1), 167-177. doi: 10.1080/17290376.2014.972057 ; Chavunduka, G. (1998). Professionalisation of Traditional Medicine in Zimbabwe, Harare, Jongwe Printers; O'Brien, S. & Broom, A. (2014). HIV in (and out of) the Clinic: Biomedicine, Traditional Medicine and Spiritual Healing in Harare. Journal of Social Aspects of HIV/AIDS, 11(1), 94-104. doi: 10.1080/17290376.2014.938102 ]. As such, a social approach to health-seeking behaviour questions how decisions about alternative therapies including herbal remedies, traditional healing and faith healing are made. The paper unpacks the realities around how people living with HIV and AIDS - who span different age groups and profess various religious backgrounds, faced with an insurmountable health challenge against a background of limited resources and no cure for the virus - often experience shifts in health-seeking behaviour. Grappling with seemingly simple questions about 'when, where and how to seek medical attention', the paper provides pointers to therapy choices and health-seeking behaviour; and it serves as a route into deeper and intense healthcare practice explorations. In conclusion, the paper proposes that medicine and the humanities should engage seriously with those social aspects of HIV and AIDS which call for an integrated approach to healthcare practice in Africa. If combined, medicine and the humanities

  8. Human Microbiome and Learning Healthcare Systems: Integrating Research and Precision Medicine for Inflammatory Bowel Disease.

    PubMed

    Chuong, Kim H; Mack, David R; Stintzi, Alain; O'Doherty, Kieran C

    2017-03-10

    Healthcare institutions face widespread challenges of delivering high-quality and cost-effective care, while keeping up with rapid advances in biomedical knowledge and technologies. Moreover, there is increased emphasis on developing personalized or precision medicine targeted to individuals or groups of patients who share a certain biomarker signature. Learning healthcare systems (LHS) have been proposed for integration of research and clinical practice to fill major knowledge gaps, improve care, reduce healthcare costs, and provide precision care. To date, much discussion in this context has focused on the potential of human genomic data, and not yet on human microbiome data. Rapid advances in human microbiome research suggest that profiling of, and interventions on, the human microbiome can provide substantial opportunity for improved diagnosis, therapeutics, risk management, and risk stratification. In this study, we discuss a potential role for microbiome science in LHSs. We first review the key elements of LHSs, and discuss possibilities of Big Data and patient engagement. We then consider potentials and challenges of integrating human microbiome research into clinical practice as part of an LHS. With rapid growth in human microbiome research, patient-specific microbial data will begin to contribute in important ways to precision medicine. Hence, we discuss how patient-specific microbial data can help guide therapeutic decisions and identify novel effective approaches for precision care of inflammatory bowel disease. To the best of our knowledge, this expert analysis makes an original contribution with new insights poised at the emerging intersection of LHSs, microbiome science, and postgenomics medicine.

  9. Evidence-based pain management: is the concept of integrative medicine applicable?

    PubMed Central

    2012-01-01

    This article is dedicated to the concept of predictive, preventive, and personalized (integrative) medicine beneficial and applicable to advance pain management, overviews recent insights, and discusses novel minimally invasive tools, performed under ultrasound guidance, enhanced by model-guided approach in the field of musculoskeletal pain and neuromuscular diseases. The complexity of pain emergence and regression demands intellectual-, image-guided techniques personally specified to the patient. For personalized approach, the combination of the modalities of ultrasound, EMG, MRI, PET, and SPECT gives new opportunities to experimental and clinical studies. Neuromuscular imaging should be crucial for emergence of studies concerning advanced neuroimaging technologies to predict movement disorders, postural imbalance with integrated application of imaging, and functional modalities for rehabilitation and pain management. Scientific results should initiate evidence-based preventive movement programs in sport medicine rehabilitation. Traditional medicine and mathematical analytical approaches and education challenges are discussed in this review. The physiological management of exactly assessed pathological condition, particularly in movement disorders, requires participative medical approach to gain harmonized and sustainable effect. PMID:23088743

  10. Complementary and integrative medicine in the management of headache.

    PubMed

    Millstine, Denise; Chen, Christina Y; Bauer, Brent

    2017-05-16

    Headaches, including primary headaches such as migraine and tension-type headache, are a common clinical problem. Complementary and integrative medicine (CIM), formerly known as complementary and alternative medicine (CAM), uses evidence informed modalities to assist in the health and healing of patients. CIM commonly includes the use of nutrition, movement practices, manual therapy, traditional Chinese medicine, and mind-body strategies. This review summarizes the literature on the use of CIM for primary headache and is based on five meta-analyses, seven systematic reviews, and 34 randomized controlled trials (RCTs). The overall quality of the evidence for CIM in headache management is generally low and occasionally moderate. Available evidence suggests that traditional Chinese medicine including acupuncture, massage, yoga, biofeedback, and meditation have a positive effect on migraine and tension headaches. Spinal manipulation, chiropractic care, some supplements and botanicals, diet alteration, and hydrotherapy may also be beneficial in migraine headache. CIM has not been studied or it is not effective for cluster headache. Further research is needed to determine the most effective role for CIM in patients with headache. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Increasing resident recruitment into family medicine: effect of a unique curriculum in integrative medicine.

    PubMed

    Lebensohn, Patricia; Dodds, Sally; Brooks, Audrey J; Cook, Paula; Guerrera, Mary; Sierpina, Victor; Teets, Raymond; Woytowicz, John; Maizes, Victoria

    2014-01-01

    Healthcare reform is highlighting the need for more family practice and other primary care physicians. The Integrative Medicine in Residency (IMR) curriculum project helped family medicine residencies pilot a new, online curriculum promoting prevention, patient-centered care competencies, use of complementary and alternative medicine along with conventional medicine for management of chronic illness. A major potential benefit of the IMR program is enhanced recruitment into participating residencies, which is reported here. Using an online questionnaire, accepted applicants to the eight IMR pilot programs (n = 152) and four control programs (n = 50) were asked about their interests in learning integrative medicine (IM) and in the pilot sites how the presence of the IMR curriculum affected their ranking decisions. Of residents at the IMR sites, 46.7% reported that the presence of the IMR was very important or important in their ranking decision. The IMR also ranked fourth overall in importance of ranking after geography, quality of faculty, and academic reputation of the residency. The majority of IMR residents (87.5%) had high to moderate interest in learning IM during their residency; control residents also had a high interest in learning IM (61.2%). The presence of the IMR curriculum was seen as a strong positive by applicants in ranking residencies. Increasing the adoption of innovative IM curricula, such as the IMR, by residency programs may be helpful in increasing applications of competitive medical students into primary care residencies as well as in responding to the expressed interest in learning the IM approach to patient care. Copyright © 2014. Published by Elsevier Inc.

  12. Space Medicine in the Human System Integration Process

    NASA Technical Reports Server (NTRS)

    Scheuring, Richard A.

    2010-01-01

    This slide presentation reviews the importance of integration of space medicine in the human system of lunar exploration. There is a review of historical precedence in reference to lunar surface operations. The integration process is reviewed in a chart which shows the steps from research to requirements development, requirements integration, design, verification, operations and using the lessons learned, giving more information and items for research. These steps are reviewed in view of specific space medical issues. Some of the testing of the operations are undertaken in an environment that is an analog to the exploration environment. Some of these analog environments are reviewed, and there is some discussion of the benefits of use of an analog environment in testing the processes that are derived.

  13. Integrative network modeling approaches to personalized cancer medicine

    PubMed Central

    Kidd, Brian A; Readhead, Ben P; Eden, Caroline; Parekh, Samir; Dudley, Joel T

    2016-01-01

    The ability to collect millions of molecular measurements from patients is a now a reality for clinical medicine. This reality has created the challenge of how to integrate these vast amounts of data into models that accurately predict complex pathophysiology and can translate this complexity into clinically actionable outputs. Integrative informatics and data-driven approaches provide a framework for analyzing large-scale datasets and combining them into multiscale models that can be used to determine the key drivers of disease and identify optimal therapies for treating tumors. In this perspective we discuss how an integrative modeling approach is being used to inform individual treatment decisions, highlighting a recent case report that illustrates the challenges and opportunities for personalized oncology. PMID:27019658

  14. Integrated Flight and Propulsion Controls for Advanced Aircraft Configurations

    NASA Technical Reports Server (NTRS)

    Merrill, Walter; Garg, Sanjay

    1995-01-01

    The research vision of the NASA Lewis Research Center in the area of integrated flight and propulsion controls technologies is described. In particular the Integrated Method for Propulsion and Airframe Controls developed at the Lewis Research Center is described including its application to an advanced aircraft configuration. Additionally, future research directions in integrated controls are described.

  15. Religion, Clinicians, and the Integration of Complementary and Alternative Medicines

    PubMed Central

    Rasinski, Kenneth A.; Kaptchuk, Ted J.; Emanuel, Ezekiel J.; Miller, Franklin G.; Tilburt, Jon C.

    2009-01-01

    Abstract Objective The aim of this study was to compare religious characteristics of general internists, rheumatologists, naturopaths, and acupuncturists, as well as to examine associations between physicians' religious characteristics and their openness to integrating complementary and alternative medicine (CAM). Design The design involved a national mail survey. The subjects were internists, rheumatologists, naturopaths, and acupuncturists. Measures Physician outcome measures were use of and attitudes toward six classes of CAM. Predictors were religious affiliation, intrinsic religiosity, spirituality, and religious traditionalism. Results There was a 65% response. Naturopaths and acupuncturists were three times as likely as internists and rheumatologists to report no religious affiliation (35% versus 12%, p < 0.001), but were more likely to describe themselves as very spiritual (51% versus 20%, p < 0.001) and to agree they try to carry religious beliefs into life's dealings (51% versus 44%, p < 0.01). Among physicians, increased spirituality and religiosity coincided with more personal use of CAM and willingness to integrate CAM into a treatment program. Conclusions Current and future integrative medicine will be shaped in part by religious and spiritual characteristics of providers. PMID:19757976

  16. Metabolomics as a Driver in Advancing Precision Medicine in Sepsis.

    PubMed

    Eckerle, Michelle; Ambroggio, Lilliam; Puskarich, Michael A; Winston, Brent; Jones, Alan E; Standiford, Theodore J; Stringer, Kathleen A

    2017-09-01

    The objective of this review is to explain the science of metabolomics-a science of systems biology that measures and studies endogenous small molecules (metabolites) that are present in a single biological sample-and its application to the diagnosis and treatment of sepsis. In addition, we discuss how discovery through metabolomics can contribute to the development of precision medicine targets for this complex disease state and the potential avenues for those new discoveries to be applied in the clinical environment. A nonsystematic literature review was performed focusing on metabolomics, pharmacometabolomics, and sepsis. Human (adult and pediatric) and animal studies were included. Metabolomics has been investigated in the diagnosis, prognosis, and risk stratification of sepsis, as well as for the identification of drug target opportunities. Metabolomics elucidates a new level of detail when compared with other systems biology sciences, with regard to the metabolites that are most relevant in the pathophysiology of sepsis, as well as highlighting specific biochemical pathways at work in sepsis. Metabolomics also highlights biochemical differences between sepsis survivors and nonsurvivors at a level of detail greater than that demonstrated by genomics, transcriptomics, or proteomics, potentially leading to actionable targets for new therapies. The application of pharmacometabolomics and its integration with other systems pharmacology to sepsis therapeutics could be particularly helpful in differentiating drug responders and nonresponders and furthering knowledge of mechanisms of drug action and response. The accumulated literature on metabolomics suggests it is a viable tool for continued discovery around the pathophysiology, diagnosis and prognosis, and treatment of sepsis in both adults and children, and it provides a greater level of biochemical detail and insight than other systems biology approaches. However, the clinical application of metabolomics in

  17. Integrative medicine to tackle the problem of chronic diseases

    PubMed Central

    Roy, Rustum

    2010-01-01

    This article summarizes important ways that integrative medicine can contribute to resolving the global health crisis with special reference to the US. Research using modern methods of analysis of cellular changes at the epigenetic level has shown that diet and lifestyle interventions greatly improve the state of patients’ health. Estimates have been given that up to 75% of all US health costs can be saved by these methods, particularly if applied preventatively. It is thus vital that active steps are taken to implement such programs, to reduce costs to citizens and society alike, as well as to Government. PMID:21829296

  18. Medicine Delivery Device with Integrated Sterilization and Detection

    NASA Technical Reports Server (NTRS)

    Shearn, Michael J.; Greer, Harold F.; Manohara, Harish

    2013-01-01

    Sterile delivery devices can be created by integrating a medicine delivery instrument with surfaces that are coated with germicidal and anti-fouling material. This requires that a large-surface-area template be developed within a constrained volume to ensure good contact between the delivered medicine and the germicidal material. Both of these can be integrated using JPL-developed silicon nanotip or cryo-etch black silicon technologies with atomic layer deposition (ALD) coating of specific germicidal layers. The application of semiconductor processing techniques and technologies to the problems of fluid manipulation and delivery has enabled the integration of chemical, electrical, and mechanical manipulation of samples all within a single microfluidic device. This approach has been successfully applied at JPL to the automated processing, detection, and analysis of minute quantities (parts per trillion level) of biomaterials to develop instruments for in situ exploration or extraterrestrial bodies. The same nanofabrication techniques that are used to produce a microfluidics device are also capable of synthesizing extremely high-surface-area templates in precise locations, and coating those surfaces with conformal films to manipulate their surface properties. This methodology has been successfully applied at JPL to produce patterned and coated silicon nanotips (also known as black silicon) to manipulate the hydrophilicity of surfaces to direct the spreading of fluids in microdevices. JPL's ALD technique is an ideal method to produce the highly conformal coatings required for this type of application. Certain materials, such as TiO2, have germicidal and anti-fouling properties when they are illuminated with UV light. The proposed delivery device contacts medicine with this high-surface-area black silicon surface coated with a thin-film germicidal deposited conformally with ALD. The coating can also be illuminated with ultraviolet light for the purpose of sterilization

  19. Advanced Neonatal Medicine in China: A National Baseline Database.

    PubMed

    Liao, Xiang-Peng; Chipenda-Dansokho, Selma; Lewin, Antoine; Abdelouahab, Nadia; Wei, Shu-Qin

    2017-01-01

    each unit had more than 20 admissions of ELBW infants in 2010; and the median hospital cost for a single hospital stay in ELBW infants was US$8,613 (IQR 8,153-9,216), which was 3.0 times (IQR 2.0-3.2) the average per-capita disposable income, or 63 times (IQR 40.3-72.1) the average per-capita health expenditure of local urban residents in 2011. Our national database provides baseline data on the status of advanced neonatal medicine in China, gathering valuable information for quality improvement, decision making, longitudinal studies and horizontal comparisons.

  20. Advanced Neonatal Medicine in China: A National Baseline Database

    PubMed Central

    Chipenda-Dansokho, Selma; Lewin, Antoine; Abdelouahab, Nadia; Wei, Shu-Qin

    2017-01-01

    five hospitals where each unit had more than 20 admissions of ELBW infants in 2010; and the median hospital cost for a single hospital stay in ELBW infants was US$8,613 (IQR 8,153–9,216), which was 3.0 times (IQR 2.0–3.2) the average per-capita disposable income, or 63 times (IQR 40.3–72.1) the average per-capita health expenditure of local urban residents in 2011. Our national database provides baseline data on the status of advanced neonatal medicine in China, gathering valuable information for quality improvement, decision making, longitudinal studies and horizontal comparisons. PMID:28099450

  1. Recent advances in herbal medicines treating Parkinson's disease.

    PubMed

    Li, Xu-Zhao; Zhang, Shuai-Nan; Liu, Shu-Min; Lu, Fang

    2013-01-01

    Herbal medicines have attracted considerable attention in recent years, which are used to treat Parkinson's disease (PD) in China based on traditional Chinese medicine or modern pharmacological theories. We summarized and analyzed the anti-Parkinsonian activities of herbal medicines and herbal formulations investigated in PD models and provide future references for basic and clinical investigations. All the herbal medicines and herbal formulations were tested on PD models in vitro and in vivo. The relevant compounds and herbal extracts with anti-Parkinsonian activities were included and analyzed according to their genera or pharmacological activities. A total of 38 herbal medicines and 11 herbal formulations were analyzed. The relevant compounds, herbal extracts and formulations were reported to be effective on PD models by modulating multiple key events or signaling pathways implicated in the pathogenesis of PD. The plant species of these herbal medicines belong to 24 genera and 18 families, such as Acanthopanax, Alpinia and Astragalus, etc. These herbal medicines can be an alternative and valuable source for anti-Parkinsonian drug discovery. The plant species in these genera and families may be the most promising candidates for further investigation and deserve further consideration in clinical trials. Active components in some of the herbal extracts and the compatibility law of herbal formulations remain to be further investigated.

  2. Risk of discontinuation of Advanced Therapy Medicinal Products clinical trials.

    PubMed

    Hanna, Eve; Rémuzat, Cecile; Auquier, Pascal; Toumi, Mondher

    2016-01-01

    Advanced therapy medicinal products (ATMPs) constitute a class of innovative products that encompasses gene therapy, somatic cell therapy, and tissue-engineered products (TEP). There is an increased investment of commercial and non-commercial sponsors in this field and a growing number of ATMPs randomized clinical trials (RCT) and patients enrolled in such trials. RCT generate data to prove the efficacy of a new therapy, but the discontinuation of RCTs wastes scarce resources. Our objective is to identify the number and characteristics of discontinued ATMPs trials in order to evaluate the rate of discontinuation. We searched for ATMPs trials conducted between 1999 to June 2015 using three databases, which are Clinicaltrials.gov, the International Clinical Trials Registry Platform (ICTRP), and the EU Drug Regulating Authorities Clinical Trials (EudraCT). We selected the ATMPs trials after elimination of the duplicates. We identified the disease areas and the sponsors as commercial or non-commercial organizations. We classified ATMPs by type and trial status, that is, ongoing, completed, terminated, discontinued, and prematurely ended. Then, we calculated the rate of discontinuation. Between 1999 and June 2015, 143 withdrawn, terminated, or prematurely ended ATMPs clinical trials were identified. Between 1999 and June 2013, 474 ongoing and completed clinical trials were identified. Therefore, the rate of discontinuation of ATMPs trials is 23.18%, similar to that for non-ATMPs drugs in development. The probability of discontinuation is, respectively, 27.35, 16.28, and 16.34% for cell therapies, gene therapies, and TEP. The highest discontinuation rate is for oncology (43%), followed by cardiology (19.2%). It is almost the same for commercial and non-commercial sponsors; therefore, the discontinuation reason may not be financially driven. No failure risk rate per development phase is available for ATMPs. The discontinuation rate may prove helpful when assessing the

  3. (Video 8 of 8) Omics: Advancing Personalized Medicine from Space to Earth

    NASA Image and Video Library

    NASA’s Human Research Program (HRP) is releasing the video “Omics: Advancing Personalized Medicine from Space to Earth”, to highlight its Twins Study, coinciding with National Twins Days. This is t...

  4. The advanced microgrid. Integration and interoperability

    SciTech Connect

    Bower, Ward Isaac; Ton, Dan T.; Guttromson, Ross; Glover, Steven F; Stamp, Jason Edwin; Bhatnagar, Dhruv; Reilly, Jim

    2014-02-01

    This white paper focuses on "advanced microgrids," but sections do, out of necessity, reference today's commercially available systems and installations in order to clearly distinguish the differences and advances. Advanced microgrids have been identified as being a necessary part of the modern electrical grid through a two DOE microgrid workshops, the National Institute of Standards and Technology, Smart Grid Interoperability Panel and other related sources. With their grid-interconnectivity advantages, advanced microgrids will improve system energy efficiency and reliability and provide enabling technologies for grid-independence to end-user sites. One popular definition that has been evolved and is used in multiple references is that a microgrid is a group of interconnected loads and distributed-energy resources within clearly defined electrical boundaries that acts as a single controllable entity with respect to the grid. A microgrid can connect and disconnect from the grid to enable it to operate in both grid-connected or island-mode. Further, an advanced microgrid can then be loosely defined as a dynamic microgrid.

  5. Comparison of Patient Health History Questionnaires Used in General Internal and Family Medicine, Integrative Medicine, and Complementary and Alternative Medicine Clinics.

    PubMed

    Laube, Justin G R; Shapiro, Martin F

    2017-05-01

    Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM. This study investigated whether integrative medicine and CAM clinics' HHQs include more well-being content and otherwise differ from GIM/FM HHQs. HHQs were obtained from GIM/FM (n = 9), integrative medicine (n = 11), naturopathic medicine (n = 5), chiropractic (n = 4), and TCM (n = 7) clinics in California. HHQs were coded for presence of medical history (chief complaint, past medical history, social history, family history, surgeries, hospitalizations, medications, allergies, review of systems), health maintenance procedures (immunization, screenings), and well-being components (nutrition, exercise, stress, sleep, spirituality). In HHQs of GIM/FM clinics, the average number of well-being components was 1.4 (standard deviation [SD], 1.4) compared with 4.0 (SD, 1.1) for integrative medicine (p < 0.01), 3.2 (SD, 2.1) for naturopathic medicine (p = 0.04), 2.0 (SD, 1.4) for chiropractic (p = 0.54), and 2.0 (SD, 1.5) for TCM (p = 0.47). In HHQs of GIM/FM clinics, the average number of medical history components was 6.4 (SD, 1.9) compared with 8.3 (SD, 1.2) for integrative medicine (p = 0.01), 9.0 (SD, 0) for naturopathic medicine (p = 0.01), 7.1 (SD, 2.8) for chiropractic (p = 0.58), and 7.1 (SD, 1.7) for TCM (p = 0.41). Integrative and naturopathic medicine HHQs included significantly more well-being and medical history components than did GIM/FM HHQs. Further investigation is warranted to determine the optimal HHQ content to

  6. [Advances of the study of sarcosaphagous insects in forensic medicine].

    PubMed

    Wang, Bang-Qin; Cai, Ji-Feng; Ge, Yang; Li, Fa-Zhao; Man, Yi; Chang, Yun-Feng

    2008-06-01

    The study of sarcosaphagous insects is a subspecialty in forensic medicine based on the knowledge of entomology. It could help to determine the time of death, especially the postmortem interval in decomposed cases. This paper explores its history, species and erosion process of sarcosaphagous insects. It reviews the species identifying methods with molecular biology and entomological morphology. Details of its application in estimating postmortem interval in recent years and study of sarcosaphagous insects in the field of forensic medicine are summarized.

  7. Systems medicine and integrated care to combat chronic noncommunicable diseases

    PubMed Central

    2011-01-01

    We propose an innovative, integrated, cost-effective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st century. This proposed holistic strategy involves comprehensive patient-centered integrated care and multi-scale, multi-modal and multi-level systems approaches to tackle NCDs as a common group of diseases. Rather than studying each disease individually, it will take into account their intertwined gene-environment, socio-economic interactions and co-morbidities that lead to individual-specific complex phenotypes. It will implement a road map for predictive, preventive, personalized and participatory (P4) medicine based on a robust and extensive knowledge management infrastructure that contains individual patient information. It will be supported by strategic partnerships involving all stakeholders, including general practitioners associated with patient-centered care. This systems medicine strategy, which will take a holistic approach to disease, is designed to allow the results to be used globally, taking into account the needs and specificities of local economies and health systems. PMID:21745417

  8. A Review of Integrative Medicine in Gynaecological Oncology

    PubMed Central

    Kalder, M.; Müller, T.; Fischer, D.; Müller, A.; Bader, W.; Beckmann, M. W.; Brucker, C.; Hack, C. C.; Hanf, V.; Hasenburg, A.; Hein, A.; Jud, S.; Kiechle, M.; Klein, E.; Paepke, D.; Rotmann, A.; Schütz, F.; Dobos, G.; Voiß, P.; Kümmel, S.

    2016-01-01

    In recent years complementary and alternative medicine (CAM) has increasingly been the focus of international research. Numerous subsidised trials (7903) and systematic reviews (651) have been published, and the evidence is starting to be integrated into treatment guidelines. However, due to insufficient evidence and/or insufficient good quality evidence, this has mostly not translated to practice recommendations in reviews by the Cochrane collaboration gynaecology group. There is nevertheless a not insignificant number of CAM providers and users. The percentage of oncology patients who use CAM varies between 5 and 90 %. Doctors have been identified as the main providers of CAM. Half of gynaecologists offer CAM because of personal conviction or on suggestion from colleagues. This must be viewed in a critical light, since CAM is mostly practiced without appropriate training, often without sufficient evidence for a given method – and where evidence exists, practice guidelines are lacking – and lack of safety or efficacy testing. The combination of patient demand and lucrativeness for doctors/alternative medicine practitioners, both based on supposed effectiveness CAM, often leads to its indiscriminate use with uncertain outcomes and significant cost for patients. On the other hand there is published, positive level I evidence for a number of CAM treatment forms. The aim of this article is therefore to review the available evidence for CAM in gynaecological oncology practice. The continued need for research is highlighted, as is the need to integrate practices supported by good evidence into conventional gynaecological oncology. PMID:26941447

  9. [Perspective on the Development of Integrative Medicine Based on the Paradigm Theory: On the Connotation and Extension of Integrative Medicine].

    PubMed

    Cai, Jing; Liu, Xian-xiang

    2016-05-01

    Integrative medicine (IM) has made great progress after more than half a century practice. However, many issues are yet to be in-depth explored. How to define clinical connotation and extension of IM, how to define feasible methods and means for diagnosis and treatment of IM, how to train more skilled talents of IM, how to elevate clinical efficacy of IM, these are all topics in need of further study. In this paper authors explored the clinical development mode of IM, extracted connotation and extension of IM clinics, hoping to promote the development of IM clinics.

  10. The American Psychosomatic Society - integrating mind, brain, body and social context in medicine since 1942.

    PubMed

    Herrmann-Lingen, Christoph

    2017-01-01

    The American Psychosomatic Society is one of the oldest and probably the most influential scientific society in psychosomatic/biopsychosocial research worldwide. The current article delineates the historical development and current strategic orientation of the society. Review of published literature, archived materials and current documents of the society. The American Psychosomatic Society (APS) was founded in 1942, originally named the "American Society for Research in Psychosomatic Problems ". It originated from the editorial board of the Journal Psychosomatic Medicine, which had already been founded in 1939 and has become one of the major journals in the field. As an organization, APS has developed into a premier international scientific society, providing an interdisciplinary home for researchers from medicine, psychology and related areas, gathering under the mission "to advance and integrate the scientific study of biological, psychological, behavioral and social factors in health and disease" and dedicated to the goals of Scientific Excellence, Clinical Relevance, and Vibrant and Diverse Membership. Besides editing Psychosomatic Medicine, the APS organizes Annual Meetings and specialized events, issues several scientific awards and scholarships and is engaged in collaborative efforts to improve the research and funding landscape for biobehavioral research in the US and translate psychosomatic research findings into medical education and clinical practice. In its 75(th) anniversary year, the American Psychosomatic Society has developed into the scientific landscape of the 21(st) century, and its current updated strategy addresses contemporary demands in advancing science and improving holistic patient care.

  11. Exploring in integrated quality evaluation of Chinese herbal medicines: the integrated quality index (IQI) for aconite.

    PubMed

    Zhang, Ding-kun; Wang, Jia-bo; Yang, Ming; Peng, Cheng; Xiao, Xiao-he

    2015-07-01

    Good medicinal herbs, good drugs. Good evaluation method and indices are the prerequisite of good medicinal herbs. However, there exist numerous indices for quality evaluation and control in Chinese medicinal materials. However, most of these indices are non-interrelated each other, as well as having little relationship with efficiency and safety. The results of different evaluatior methods may not be consistent, even contradictory. Considering the complex material properties of Chinese medicinal materials, single method and index is difficult to objectively and comprehensively reflect the quality. Therefore, it is essential to explore the integrated evaluation methods. In this paper, oriented by the integrated evaluation strategies for traditional Chinese medicine quality, a new method called integrated quality index (IQI) by the integration of empirical evaluation, chemical evaluation, and biological evaluation was proposed. In addition, a study case of hypertoxic herb Aconitum carmichaelii Debx. was provided to explain this method in detail. The results suggested that in the view of specifications, the average weight of Jiangyou aconite was the greatest, followed by Weishan aconite, Butuo aconite, Hanzhong aconite, and Anxian aconite; from the point of chemical components, Jiangyou aconite had the characteristic with strong efficacy and weak toxicity, next was Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite; taking toxicity price as the index, Hanzhong aconite and Jiangyou aconite have the lower toxicity, while Butuo aconite, Weishan aconite, and Anxian aconite have the relatively higher one. After the normalization and integration of evaluation results, we calculated the IQI value of Jiangyou aconite, Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite were 0.842 +/- 0.091, 0.597 +/- 0.047, 0.442 +/- 0.033, 0.454 +/- 0.038, 0.170 +/- 0.021, respectively. The quality of Jiangyou aconite is significantly better than the

  12. Integrating Practice and Theory for Advancement

    ERIC Educational Resources Information Center

    Bakewell, Thomas

    2005-01-01

    This is the first installment of a multipart practitioners' guide focused on strategic planning, organizational development, and legal issues. It features practical advice and powerful insights for implementing advancement programs that are organized, productive, and legal--and that generate top results. The author, an organizational development…

  13. Integrating Language Lab Materials into Advanced Russian.

    ERIC Educational Resources Information Center

    Allar, Gregory

    1986-01-01

    Describes the use of language lab materials supplied by the pedagogical journal "Russkij Jazyk Za Rubezom" in an advanced Russian-language class. Each week students were given a relevant picture and vocabulary list prior to listening to a taped story. The story was used as the basis for conversation. (LMO)

  14. Advanced Wireless Integrated Navy Network (AWINN)

    DTIC Science & Technology

    2006-03-31

    position, policy or decision, unless so designated by other documentation. 14. ABSTRACT Quarterly progress report No. 5 on AWINN hardware and software ...2 1.2 Task 1.2 Advanced Software Radio...122 4.1 TIP #1 Distributed MIMO UJWB sensor networks incorporating software radio ...... 122 4.2 TIP

  15. Integrating an evidence-based medicine rotation into an internal medicine residency program.

    PubMed

    Akl, Elie A; Izuchukwu, Ifeoma S; El-Dika, Samer; Fritsche, Lutz; Kunz, Regina; Schünemann, Holger J

    2004-09-01

    To measure the impact of a resident focused evidence-based medicine (EBM) educational intervention on EBM knowledge of residents and students, to assess its feasibility, and to evaluate residents' attitudes regarding this rotation. In 2002, based on the EBM user and EBM practitioner model, the authors designed the EBM elective rotation and conducted a controlled trial of its implementation in the internal medicine residency program in three teaching hospitals affiliated with the University at Buffalo, New York. The intervention group (one hospital, 17 medical students and residents) received a multifaceted intervention. In the control group (two hospitals, 23 medical students and residents), there was no curriculum change. The effectiveness in a pre- and post-test was assessed using the English version of the Berlin Questionnaire. A survey of all internal medicine residents (n = 119) was conducted to evaluate their attitudes toward the EBM elective rotation. In the intervention group, knowledge improved slightly, but not significantly (.71 on a scale ranging from 0-15 on the Berlin questionnaire, p =.3). The mean score in the control group decreased significantly (1.65, p =.005). The difference in change scores between the two groups was significant even after adjustment for covariates (2.52, p =.006). Residents (response rate 83%) had positive attitudes regarding the rotation. An EBM elective rotation was successfully integrated into a residency program. This multifaceted educational approach with an "on-the-ward" EBM resident, may improve the EBM knowledge and skills of targeted students and residents.

  16. Factors Affecting Definitions of and Approaches to Integrative Medicine: A Mixed Methods Study Examining China's Integrative Medicine Development

    PubMed Central

    Zhang, Weijun; Pritzker, Sonya E.; Hui, Ka-Kit

    2015-01-01

    Aim. This study identifies existing definitions and approaches among China's integrative medicine (IM) experts and examines relationships with key characteristics distinguishing individual experts. Methods. Snowball sampling was used to select 73 IM experts for semistructured interviews. In this mixed methods study, we first identified definitions and approaches through analyzing core statements. Four key factors, including age, education, practice type, and working environment, were then chosen to evaluate the associations with the definitions. Results. Four unique definitions were identified, including IM as a “new medicine” (D1), as a combination of western medicine (WM) and Chinese medicine (CM) (D2), as a modernization of CM (D3), and as a westernization of CM (D4). D4 was mostly supported by those working in WM organizations, while D3 was more prominent from individuals working in CM organizations (P = 0.00004). More than 64% clinicians had D2 while only 1 (5.9%) nonclinician had D2. Only 1 clinician (1.8%) had D4 while almost 30% nonclinicians had D4 (P = 0.0001). Among nonclinicians working in WM organizations, 83.3% of them had D4 (P = 0.001). Conclusion. Findings indicate that institutional structure and practice type are factors affecting IM approaches. These results carry implications for the ways in which western countries move forward with the definition and implementation of IM. PMID:25792999

  17. Implementation of Advanced Access in a Family Medicine Residency Practice.

    PubMed

    Tseng, Ann; Wiser, Eric; Barclay, Emily; Aiello, Karen

    2015-01-01

    Several models of scheduling have been documented in the literature, including the traditional model, the carve-out model, and the advanced access model. We describe the implementation of the advanced access model in our clinic, which has been very successful. Advanced access has decreased third next available appointments to less than seven days for many of our providers and has increased individual primary care physician continuity for 40% of our providers. Interestingly, we had no gains in patient satisfaction, which is consistent with other previously published studies on advanced access.

  18. Advances in Systems Biology, Advances in Experimental Medicine and Biology Volume 547

    SciTech Connect

    Opresko, Lee; Gephart, Julie M.; Mann, Michaela B.

    2002-12-02

    This is the inaugural year for a new series of symposia on systems biology. Particular focus will be on identifying current breakthrough technologies and their application to important model systems. By integrating computational sciences, high-throughput technologies and quantitative biology, we hope to facilitate advancements in this important new area of research.In this first year we are focusing on the four different research areas contained within the new U.S. Department of Energy (DOE) Genomes to Life program. This program is the successor to the Human Genome Project and exceeds it in scope and ambition. Its goal is to understand the basis of life and ?to venture beyond characterizing such individual life components as genes and other DNA sequences toward a more comprehensive, integrated view of biology at a whole-systems level.? These goals will be met by1. identifying the protein machines that carry out critical life functions2. characterizing the gene regulatory networks that control these machines3. exploring the functional repertoire of complex microbial communities in their natural environments to provide a foundation for understanding and using their remarkably diverse capabilities to address DOE missions4. developing the computational capabilities to integrate and understand these data and begin to model complex biological systems.

  19. Integrative medicine in residency education: developing competency through online curriculum training.

    PubMed

    Lebensohn, Patricia; Kligler, Benjamin; Dodds, Sally; Schneider, Craig; Sroka, Selma; Benn, Rita; Cook, Paula; Guerrera, Mary; Low Dog, Tieraona; Sierpina, Victor; Teets, Raymond; Waxman, Dael; Woytowicz, John; Weil, Andrew; Maizes, Victoria

    2012-03-01

    The Integrative Medicine in Residency (IMR) program, a 200-hour Internet-based, collaborative educational initiative was implemented in 8 family medicine residency programs and has shown a potential to serve as a national model for incorporating training in integrative/complementary/alternative medicine in graduate medical education. The curriculum content was designed based on a needs assessment and a set of competencies for graduate medical education developed following the Accreditation Council for Graduate Medical Education outcome project guidelines. The content was delivered through distributed online learning and included onsite activities. A modular format allowed for a flexible implementation in different residency settings. TO ASSESS THE FEASIBILITY OF IMPLEMENTING THE CURRICULUM, A MULTIMODAL EVALUATION WAS UTILIZED, INCLUDING: (1) residents' evaluation of the curriculum; (2) residents' competencies evaluation through medical knowledge testing, self-assessment, direct observations, and reflections; and (3) residents' wellness and well-being through behavioral assessments. The class of 2011 (n  =  61) had a high rate of curriculum completion in the first and second year (98.7% and 84.2%) and course evaluations on meeting objectives, clinical utility, and functioning of the technology were highly rated. There was a statistically significant improvement in medical knowledge test scores for questions aligned with content for both the PGY-1 and PGY-2 courses. The IMR program is an advance in the national effort to make training in integrative medicine available to physicians on a broad scale and is a success in terms of online education. Evaluation suggests that this program is feasible for implementation and acceptable to residents despite the many pressures of residency.

  20. Advances in the theory of box integrals

    SciTech Connect

    Bailey, David H.; Borwein, J.M.; Crandall, R.E.

    2009-06-25

    Box integrals - expectations <|{rvec r}|{sup s}> or <|{rvec r}-{rvec q}|{sup s}> over the unit n-cube (or n-box) - have over three decades been occasionally given closed forms for isolated n,s. By employing experimental mathematics together with a new, global analytic strategy, we prove that for n {le} 4 dimensions the box integrals are for any integer s hypergeometrically closed in a sense we clarify herein. For n = 5 dimensions, we show that a single unresolved integral we call K{sub 5} stands in the way of such hyperclosure proofs. We supply a compendium of exemplary closed forms that naturally arise algorithmically from this theory.

  1. Diagnostic ultrasound in sports medicine: current concepts and advances.

    PubMed

    Nofsinger, Charles; Konin, Jeff G

    2009-03-01

    Diagnostic ultrasound is a valuable imaging tool that is slowly gaining in popularity among sports medicine clinicians. Commonly referred to as "musculoskeletal ultrasound," its valuable role in assisting with sports medicine diagnoses has been to date underused for a variety of reasons. Effective clinical usage for sports medicine diagnoses includes commonly seen conditions such as rotator cuff disease, ulnar collateral ligament of the elbow injury, and internal derangement of the knee, among many others. Limitation of clinical usage has been deterred by the cost of the unit, perception of time associated with assessment procedures, and the lack of formal training associated with diagnostic implementation. However, when properly used, musculoskeletal ultrasound can increase the accuracy of diagnosis and treatment, improve time to treatment intervention, and improve patient satisfaction. The purpose of this paper is to review the fundamentals of musculoskeletal ultrasound and present its specific diagnostic uses.

  2. Integrating Advance Care Planning Into Practice.

    PubMed

    Dingfield, Laura E; Kayser, Joshua B

    2017-06-01

    Advanced respiratory diseases progress over time and often lead to death. As the condition worsens, patients may lose medical decision-making ability. Advance care planning (ACP) is a process in which patients receive information about their diagnosis and prognosis; discuss values, goals, and fears; articulate preferences about life-sustaining treatments and end-of-life care; and appoint a surrogate medical decision maker. This process may result in written documentation of patient preferences or the appointment of a health-care power of attorney (HCPOA). ACP discussions have multiple benefits for patients and their surrogate decision makers, including ensuring that the care provided is aligned with the patient's goals and preferences and decreasing stress, anxiety, and burden in surrogates. Time and provider comfort are often cited barriers to ACP, so it may be necessary for clinicians to gain experience in conversations and identify the patients most likely to benefit from ACP discussions. Two new Current Procedural Terminology (CPT) codes, 99497 and 99498, have been recognized by the Centers for Medicare and Medicaid Services (CMS) as of January 1, 2016 and are intended to incentivize clinicians to engage in ACP discussions with their patients earlier and with more frequency. This manuscript reviews the benefits and barriers to ACP in patients with advanced respiratory disease and provides guidance on the use of the new CPT codes for reimbursement of these conversations. Published by Elsevier Inc.

  3. Consensus on the integrated traditional Chinese and Western medicine criteria of diagnostic classification in polycystic ovary syndrome (draft).

    PubMed

    Yu, Jin; Yu, Chao-Qin; Cao, Qi; Wang, Li; Wang, Wen-Jun; Zhou, Li-Rong; Li, Jing; Qian, Qiao-Hong

    2017-03-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder of women, with complex pathogenesis and heterogeneous manifestations. Professor Jin Yu recently wrote an article entitled "Proposal of Diagnosis and Diagnostic Classification of PCOS in Integrated Traditional Chinese and Western Medicine."From this, the Obstetrics and Gynecology branches of the Chinese Association of Integrative Medicine and the China Association of Chinese Medicine collaborated with the Gynecology branch of the Chinese Association for Research and Advancement of Chinese Medicine to draft a report on the consensus of criteria for the diagnosis and classification of PCOS in integrated traditional Chinese and Western medicine. The diagnosis for PCOS includes all three features: (1) oligo-ovulation or anovulation; (2) clinical and/or laboratory evidence of hyperandrogenism;(3) PCOS is classified into four types: types Ia,Ib, IIa, and IIb. Syndrome differentiation types for PCOS in traditional Chinese medicine are as follows: Kidney deficiency with phlegm blockage syndrome, Kidney Yin deficiency with phlegm blockage and blood stasis syndrome, and Kidney deficiency with Liver Qi stagnation syndrome.

  4. Women in medicine and dermatology: history and advances*

    PubMed Central

    França, Katlein; Ledon, Jennifer; Savas, Jessica; Nouri, Keyvan

    2014-01-01

    The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology. PMID:24626675

  5. Women in medicine and dermatology: history and advances.

    PubMed

    França, Katlein; Ledon, Jennifer; Savas, Jessica; Nouri, Keyvan

    2014-01-01

    The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology.

  6. Advancing Instructional Communication: Integrating a Biosocial Approach

    ERIC Educational Resources Information Center

    Horan, Sean M.; Afifi, Tamara D.

    2014-01-01

    Celebrating 100 years of the National Communication Association necessitates that, as we commemorate our past, we also look toward our future. As part of a larger conversation about the future of instructional communication, this essay reinvestigates the importance of integrating biosocial approaches into instructional communication research. In…

  7. Advancing Instructional Communication: Integrating a Biosocial Approach

    ERIC Educational Resources Information Center

    Horan, Sean M.; Afifi, Tamara D.

    2014-01-01

    Celebrating 100 years of the National Communication Association necessitates that, as we commemorate our past, we also look toward our future. As part of a larger conversation about the future of instructional communication, this essay reinvestigates the importance of integrating biosocial approaches into instructional communication research. In…

  8. Engine/Transmission/Airframe Advanced Integration Techniques

    DTIC Science & Technology

    1975-05-01

    performance penalty. In this case, stringent IR plume and hot -part suppression requirements greatly increased external airflows, adding to the...oil cooling, exhaust plume and hot metal infrared (IR) signature suppression, and engine inlet foreign particle protection. J DD,^ FORI» AN 73...established for the hot - metal IR suppressor. Suppressed signatures for the integrated propulsion system conceots were consistent with the following

  9. Integrative medical education: educational strategies and preliminary evaluation of the Integrated Curriculum for Anthroposophic Medicine (ICURAM).

    PubMed

    Scheffer, Christian; Tauschel, Diethard; Neumann, Melanie; Lutz, Gabriele; Cysarz, Dirk; Heusser, Peter; Edelhäuser, Friedrich

    2012-12-01

    the development and preliminary evaluation of a new medical program aimed at educating students in patient-centered integrative care and developing appropriate educational strategies. The Integrated Curriculum for Anthroposophic Medicine (ICURAM) was developed with modules on anthroposophic medicine integrated into the full 6 years of the regular medical curriculum. The educational strategy is the ESPRI(2)T approach, combining Exploratory learning, Supported participation, Patient-based learning, Reflective practice, Integrated learning, an Integrative approach and Team-based learning. The student participation, assessed based on the number of credit points earned per year (ctp/year) through the ICURAM (1 ctp=30 h workload), served as a preliminary indicator of student interest. Of the 412 55%medical students participated in the program: 16% full participation (≥ 4 ctp/year), 18% partial participation (1-3.99 ctp/year) and 22% occasional participation (0.25-0.99 ctp/year). The amount of additional workload taken on by students was between 7.8h/year for occasional participants, 33 h/year for partial participants and 84 h/year for full participants. More than half of medical students were willing to invest a significant amount of additional time in the optional program. An integrative medical curriculum with a student-centered educational strategy seems to be of interest to most medical students. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. Medical robotics and computer-integrated interventional medicine

    NASA Astrophysics Data System (ADS)

    Taylor, Russell H.

    2012-02-01

    Computer-Integrated Interventional Medicine (CIIM) promises to have a profound impact on health care in the next 20 years, much as and for many of the same reasons that the marriage of computers and information processing methods with other technology have had on manufacturing, transportation, and other sectors of our society. Our basic premise is that the steps of creating patient-specific computational models, using these models for planning, registering the models and plans with the actual patient in the operating room, and using this information with appropriate technology to assist in carrying out and monitoring the intervention are best viewed as part of a complete patient-specific intervention process that occurs over many time scales. Further, the information generated in computer-integrated interventions can be captured and analyzed statistically to improve treatment processes. This paper will explore these themes briefly, using examples drawn from our work at the Engineering Research Center for Computer-Integrated Surgical Systems and Technology (CISST ERC).

  11. Research Advances on Hepatotoxicity of Herbal Medicines in China

    PubMed Central

    Fan, Huirong; Li, Yazhuo; Xiao, Xiaohe

    2016-01-01

    In general, herbal medicines have been considered as safe by the general public, since they are naturally occurring and have been applied in treatment for over thousands of years. As the use of herbal medicine is rapidly increasing globally, the potential toxicity of herbal drugs, in particular drug-induced liver injury (DILI), has now become a serious medical issue. According to the literature, the authors analyzed and discussed the hepatotoxicity problem of Chinese herbal medicines (CHM), including global overview on herbal-induced liver injury (HILI), current research progress on toxic CHM, diagnosis and treatment of HILI, and modern approaches and technologies of study of hepatotoxicity. As to promote the recognition of HILI and tackle the issue, a guideline for the diagnosis and treatment of HILI has recently been drafted by Chinese scientists. As suggested by the guideline, the hepatotoxicity issue of CHM, as a matter of fact, is overestimated. Up to date, the investigation of hepatotoxicity of CHM is now booming with worldwide application of CHM. This review therefore provides useful information for investigating hepatotoxicity of herbal medicine and characterizing DILI caused by CHM. In addition, authors describe in which way further efforts should be made to study the rationale of CHM and liver injury. PMID:28078299

  12. Research Advances on Hepatotoxicity of Herbal Medicines in China.

    PubMed

    Liu, Changxiao; Fan, Huirong; Li, Yazhuo; Xiao, Xiaohe

    2016-01-01

    In general, herbal medicines have been considered as safe by the general public, since they are naturally occurring and have been applied in treatment for over thousands of years. As the use of herbal medicine is rapidly increasing globally, the potential toxicity of herbal drugs, in particular drug-induced liver injury (DILI), has now become a serious medical issue. According to the literature, the authors analyzed and discussed the hepatotoxicity problem of Chinese herbal medicines (CHM), including global overview on herbal-induced liver injury (HILI), current research progress on toxic CHM, diagnosis and treatment of HILI, and modern approaches and technologies of study of hepatotoxicity. As to promote the recognition of HILI and tackle the issue, a guideline for the diagnosis and treatment of HILI has recently been drafted by Chinese scientists. As suggested by the guideline, the hepatotoxicity issue of CHM, as a matter of fact, is overestimated. Up to date, the investigation of hepatotoxicity of CHM is now booming with worldwide application of CHM. This review therefore provides useful information for investigating hepatotoxicity of herbal medicine and characterizing DILI caused by CHM. In addition, authors describe in which way further efforts should be made to study the rationale of CHM and liver injury.

  13. On the night shift: advanced nurse practice in emergency medicine.

    PubMed

    Jenkins, Jennifer

    2016-05-01

    Advanced nurse practitioners in the author's emergency department (ED) work autonomously and as part of a team to assess, diagnose and treat patients with unexplained and undiagnosed illnesses and injuries over a 24-hour cycle of care. The complexity of the role in EDs is often not fully understood, and expectations can vary between trusts and between different clinical areas within trusts. This article describes one night shift in the author's ED to explain the complexity of advanced nurse practitioners' roles in this environment. The article focuses on autonomous decision-making skills and the use of advanced clinical skills in the context of evidence-based practice.

  14. Integrative Skin Care: Dermatology and Traditional and Complementary Medicine.

    PubMed

    Bodeker, Gerard; Ryan, Terence J; Volk, Adva; Harris, Jahnavi; Burford, Gemma

    2017-06-01

    Skin problems and diseases are extremely common globally and, due to their visibility, often result in severe distress and stigma for sufferers. Traditional (i.e., indigenous or local) and complementary health systems are widely used and incorporate many treatment modalities suitable for skin care, and a body of evidence for their efficacy and safety has built up over many decades. These approaches are often used as part of a broader "integrative medicine" (IM) approach that may also include, for example, nutrition and mind-body approaches. This article presents an overview of current knowledge about traditional and complementary medicine (T&CM) and IM principles and practices for skin health; reviews published epidemiologic studies, clinical trials, and wider literature; and discusses the challenges of conducting research into T&CM and IM. It also highlights the need for an innovative research agenda-one which is congruent with the principles of IM, as well as taking policy and public health dimensions into consideration.

  15. Integrated modeling of advanced optical systems

    NASA Technical Reports Server (NTRS)

    Briggs, Hugh C.; Needels, Laura; Levine, B. Martin

    1993-01-01

    This poster session paper describes an integrated modeling and analysis capability being developed at JPL under funding provided by the JPL Director's Discretionary Fund and the JPL Control/Structure Interaction Program (CSI). The posters briefly summarize the program capabilities and illustrate them with an example problem. The computer programs developed under this effort will provide an unprecedented capability for integrated modeling and design of high performance optical spacecraft. The engineering disciplines supported include structural dynamics, controls, optics and thermodynamics. Such tools are needed in order to evaluate the end-to-end system performance of spacecraft such as OSI, POINTS, and SMMM. This paper illustrates the proof-of-concept tools that have been developed to establish the technology requirements and demonstrate the new features of integrated modeling and design. The current program also includes implementation of a prototype tool based upon the CAESY environment being developed under the NASA Guidance and Control Research and Technology Computational Controls Program. This prototype will be available late in FY-92. The development plan proposes a major software production effort to fabricate, deliver, support and maintain a national-class tool from FY-93 through FY-95.

  16. Integration of digital imaging into emergency medicine education.

    PubMed

    Chan, Lisa; Reilly, Kevin M

    2002-01-01

    Medical education has adopted the use of digital photography and other computer technology, which has changed the face of the classroom. Today's presentations couple a computer and digital projection system to create powerful teaching tools. Integration of quality medical images enhances presentations in a way never before possible and at a much lower cost. Changes to presentations can occur rapidly, at a fraction of the cost of slides. However, obtaining quality digital images for presentations is problematic. Services are available on the Internet that offer images for sale, but the cost to obtain images is high. Many institutions of higher learning provide images on the Internet for free, but the quality, number of available images, server capacity, and issues of consent limit the availability of these images. The authors describe their experience in collecting more than 20,000 clinical photographs, and provide examples of their use in emergency medicine education.

  17. Utilization and Perception of Integrative Medicine Among Plastic Surgery Patients.

    PubMed

    Patel, Nirav; Pierson, Justine; Lee, Timothy; Mast, Bruce; Lee, Bernard T; Estores, Irene; Singhal, Dhruv

    2017-05-01

    Integrative medicine (IM) is currently used by 40% of Americans. Our objective is to examine the prevalence and perception of IM utilization in patients being evaluated for elective plastic surgery. In July 2014, 402 consecutive patients presenting to plastic surgery clinics at the University of Florida, Veterans Affairs (VA), and Private Practices in Gainesville, Florida were requested to complete a survey regarding utilization of and attitudes towards IM. The survey completion rate was 75.5% (n = 331). The respondents' mean age was 48.5 years, and they were primarily white (75%), married (48%), and educated with at least a college degree (58%). The respondents were distributed between the university (74%), VA (15%), and private practice (11%). There was an equal mix of reconstructive (52%) and cosmetic (48%) visits. Overall IM utilization was 80.0%. Integrative medicine use correlated with having a college degree (P = 0.0002) and being middle age (40-64 years, P < 0.005). A higher utilization rate of IM in the private sector (87.0%) compared with the university (76.1%) and VA (71.0%) was not statistically significant (P = 0.17). Similarly, higher IM utilization in cosmetic patients compared with reconstructive patients (81% vs 74%) was not statistically significant (P = 0.56). The majority of patients stated a strong belief in self-healing techniques (71%, P < 0.005), and they desired (61%) that their physician should be familiar with these techniques (P < 0.005). The IM utilization is highly prevalent among plastic surgery patients regardless of reason for visit (cosmetic versus reconstruction) or practice setting (private versus academic versus VA). Increasing awareness of IM usage and potential impact on outcomes is especially important for academic and VA plastic surgeons. Moreover, an opportunity exists to study how certain aspects of IM can positively impact plastic surgery care.

  18. Integrative clinical genomics of advanced prostate cancer

    PubMed Central

    Dan, Robinson; Van Allen, Eliezer M.; Wu, Yi-Mi; Schultz, Nikolaus; Lonigro, Robert J.; Mosquera, Juan-Miguel; Montgomery, Bruce; Taplin, Mary-Ellen; Pritchard, Colin C; Attard, Gerhardt; Beltran, Himisha; Abida, Wassim M.; Bradley, Robert K.; Vinson, Jake; Cao, Xuhong; Vats, Pankaj; Kunju, Lakshmi P.; Hussain, Maha; Feng, Felix Y.; Tomlins, Scott A.; Cooney, Kathleen A.; Smith, David C.; Brennan, Christine; Siddiqui, Javed; Mehra, Rohit; Chen, Yu; Rathkopf, Dana E.; Morris, Michael J.; Solomon, Stephen B.; Durack, Jeremy C.; Reuter, Victor E.; Gopalan, Anuradha; Gao, Jianjiong; Loda, Massimo; Lis, Rosina T.; Bowden, Michaela; Balk, Stephen P.; Gaviola, Glenn; Sougnez, Carrie; Gupta, Manaswi; Yu, Evan Y.; Mostaghel, Elahe A.; Cheng, Heather H.; Mulcahy, Hyojeong; True, Lawrence D.; Plymate, Stephen R.; Dvinge, Heidi; Ferraldeschi, Roberta; Flohr, Penny; Miranda, Susana; Zafeiriou, Zafeiris; Tunariu, Nina; Mateo, Joaquin; Lopez, Raquel Perez; Demichelis, Francesca; Robinson, Brian D.; Schiffman, Marc A.; Nanus, David M.; Tagawa, Scott T.; Sigaras, Alexandros; Eng, Kenneth W.; Elemento, Olivier; Sboner, Andrea; Heath, Elisabeth I.; Scher, Howard I.; Pienta, Kenneth J.; Kantoff, Philip; de Bono, Johann S.; Rubin, Mark A.; Nelson, Peter S.; Garraway, Levi A.; Sawyers, Charles L.; Chinnaiyan, Arul M.

    2015-01-01

    SUMMARY Toward development of a precision medicine framework for metastatic, castration resistant prostate cancer (mCRPC), we established a multi-institutional clinical sequencing infrastructure to conduct prospective whole exome and transcriptome sequencing of bone or soft tissue tumor biopsies from a cohort of 150 mCRPC affected individuals. Aberrations of AR, ETS genes, TP53 and PTEN were frequent (40–60% of cases), with TP53 and AR alterations enriched in mCRPC compared to primary prostate cancer. We identified novel genomic alterations in PIK3CA/B, R-spondin, BRAF/RAF1, APC, β-catenin and ZBTB16/PLZF. Aberrations of BRCA2, BRCA1 and ATM were observed at substantially higher frequencies (19.3% overall) than seen in primary prostate cancers. 89% of affected individuals harbored a clinically actionable aberration including 62.7% with aberrations in AR, 65% in other cancer-related genes, and 8% with actionable pathogenic germline alterations. This cohort study provides evidence that clinical sequencing in mCRPC is feasible and could impact treatment decisions in significant numbers of affected individuals. PMID:26000489

  19. Platelet proteomics and its advanced application for research of blood stasis syndrome and activated blood circulation herbs of Chinese medicine.

    PubMed

    Liu, Yue; Yin, Huijun; Chen, Keji

    2013-11-01

    The development of novel and efficient antiplatelet agents that have few adverse effects and methods that improve antiplatelet resistance has long been the focus of international research on the prevention and treatment of cardiovascular and cerebrovascular diseases. Recent advances in platelet proteomics have provided a technology platform for high-quality research of platelet pathophysiology and the development of new antiplatelet drugs. The study of blood stasis syndrome (BSS) and activated blood circulation of traditional Chinese medicine (TCM) is one of the most active fields where the integration of TCM and western medicine in China has been successful. Activated blood circulation herbs (ABC herbs) of Chinese medicine are often used in the treatment of BSS. Most ABC herbs have antiplatelet and anti-atherosclerosis activity, but knowledge about their targets is lacking. Coronary heart disease (CHD), BSS, and platelet activation are closely related. By screening and identifying activated platelet proteins that are differentially expressed in BSS of CHD, platelet proteomics has helped researchers interpret the antiplatelet mechanism of action of ABC herbs and provided many potential biomarkers for BSS that could be used to evaluate the clinical curative effect of new antiplatelet drugs. In this article the progress of platelet proteomics and its advanced application for research of BSS and ABC herbs of Chinese medicine are reviewed.

  20. Current advances in the generation of human iPS cells: implications in cell-based regenerative medicine.

    PubMed

    Revilla, Ana; González, Clara; Iriondo, Amaia; Fernández, Bárbara; Prieto, Cristina; Marín, Carlos; Liste, Isabel

    2016-11-01

    Over the last few years, the generation of induced pluripotent stem cells (iPSCs) from human somatic cells has proved to be one of the most potentially useful discoveries in regenerative medicine. iPSCs are becoming an invaluable tool to study the pathology of different diseases and for drug screening. However, several limitations still affect the possibility of applying iPS cell-based technology in therapeutic prospects. Most strategies for iPSCs generation are based on gene delivery via retroviral or lentiviral vectors, which integrate into the host's cell genome, causing a remarkable risk of insertional mutagenesis and oncogenic transformation. To avoid such risks, significant advances have been made with non-integrative reprogramming strategies. On the other hand, although many different kinds of somatic cells have been employed to generate iPSCs, there is still no consensus about the ideal type of cell to be reprogrammed. In this review we present the recent advances in the generation of human iPSCs, discussing their advantages and limitations in terms of safety and efficiency. We also present a selection of somatic cell sources, considering their capability to be reprogrammed and tissue accessibility. From a translational medicine perspective, these two topics will provide evidence to elucidate the most suitable combination of reprogramming strategy and cell source to be applied in each human iPSC-based therapy. The wide variety of diseases this technology could treat opens a hopeful future for regenerative medicine. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Low Cost, Advanced, Integrated Microcontroller Training Kit

    NASA Astrophysics Data System (ADS)

    Somantri, Y.; Fushshilat, I.

    2017-03-01

    This paper describes the design of an AVR microcontroller training kit with a low cost and the additional feature of an integrated downloader. The main components of this device include: Microcontroller, terminal, I/O keypad, push button, LED, seven segment display, LCD, motor stepper, and sensors. The device configuration results in low cost and ease of use; this device is suitable for laboratories with limited funding. The device can also be used as a training kit for the teaching and learning of microcontrollers.

  2. Advancing Precision Nuclear Medicine and Molecular Imaging for Lymphoma.

    PubMed

    Wright, Chadwick L; Maly, Joseph J; Zhang, Jun; Knopp, Michael V

    2017-01-01

    PET with fluorodeoxyglucose F 18 ((18)F FDG-PET) is a meaningful biomarker for the detection, targeted biopsy, and treatment of lymphoma. This article reviews the evolution of (18)F FDG-PET as a putative biomarker for lymphoma and addresses the current capabilities, challenges, and opportunities to enable precision medicine practices for lymphoma. Precision nuclear medicine is driven by new imaging technologies and methodologies to more accurately detect malignant disease. Although quantitative assessment of response is limited, such technologies will enable a more precise metabolic mapping with much higher definition image detail and thus may make it a robust and valid quantitative response assessment methodology. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. [Advance in herbal medicine applied to intracanal antisepsis].

    PubMed

    Zhongpeng, Yang; Ling, Zou

    2014-12-01

    Intracanal antisepsis acts as one of the fundamental steps in root canal therapy. Intracanal medication is very common among the multitudinous root canal disinfection methods so far. However, as the most frequently-used intracanal medication, calcium hydroxide exists some problems, such as insufficient antimicrobial power and antibiogram. Thus exploring new root canal disinfectant is necessary. Herbal medicine is gaining favor for its wide varieties, broad efficacy and affordable prices. The current researches revealed that many kinds of herbs or compound herbal preparations possess good ability of antimicrobial and other properties that superior to those of traditional root canal disinfectants. However, herbal medicine itself and the studies have shortcomings. This paper will provide a review of various herbal alternatives that are being studied of late years.

  4. Analysis of the Student Experience in an Attending Pharmacist Model General Medicine Advanced Pharmacy Practice Experience

    PubMed Central

    Lau, Carmen; Sy, Erin; Moogk, Hana; Weber, Stanley S.; Danielson, Jennifer

    2017-01-01

    Objective. To characterize and determine the quality of the student experience in an attending pharmacist model (APM). Methods. In-depth interviews were conducted with students completing an advanced pharmacy practice experience (APPE) at two general medicine services using the APM over a 2-year time period. Quantitative information about student learning and interprofessional interactions were extracted from student evaluations of the site. Data from the mixed model were analyzed to identify strengths of the APM and areas needing improvement. Results. Strengths of the APM included positive student interaction with the pharmacy resident and more students reporting full integration in and accountability to the interprofessional team for patient outcomes compared to students in non-teaching models. A few students at one site reported a need for greater delineation of expectations, more initial support from preceptors, and initial responsibility for fewer patients. These factors were modified before the second APM year and subsequent reports from students at this site were uniformly positive. Students at the second site did not note areas needing improvement. The APM increased student capacity at both sites. Conclusion. The attending pharmacist model provided a high quality learning experience for students, particularly with regard to integration into and accountability for patient outcomes to the interprofessional team. Qualitative research methods enabled precise detection of areas needing improvement at one site and confirmed that changes made at that site improved the student experience. PMID:28630507

  5. Emergency medicine systems advancement through community-based development.

    PubMed

    Bloem, Martha M; Bloem, Christina M; Rosentsveyg, Juliana; Arquilla, Bonnie

    2014-02-01

    Humanitarian health programs frequently focus on immediate relief and are supply side oriented or donor driven. More emphasis should be placed on long-term development projects that engage local community leaders to ensure sustainable change in health care systems. With the Emergency Medicine Educational Exchange (EMEDEX) International Rescue, Recover, Rebuild initiative in Northeast Haiti as a model, this paper discusses the opportunities and challenges in using community-based development to establish emergency medical systems in resource-limited settings.

  6. [Advances in research of diagnosis of drowning in forensic medicine].

    PubMed

    Wang, Jia-wen; Yu, Xiao-jun; Wang, Xiao-yan

    2008-08-01

    The current macroscopical and microscopical signs in the fresh drowning victim are non-specific. Moreover, putrefaction will vanish these autopsy findings quite rapidly. The study of additional detecting methods to diagnose drowning has become one of the hottest topics in forensic medicine. This article reviewed several methods commonly used in the determination of drowning in forensic practice. The advantages and disadvantages of various methods were also discussed.

  7. Advances in Treatment Integrity Research: Multidisciplinary Perspectives on the Conceptualization, Measurement, and Enhancement of Treatment Integrity

    ERIC Educational Resources Information Center

    Schulte, Ann C.; Easton, Julia E.; Parker, Justin

    2009-01-01

    Documenting treatment integrity is an important issue in research and practice in any discipline concerned with prevention and intervention. However, consensus concerning the dimensions of treatment integrity and how they should be measured has yet to emerge. Advances from three areas in which significant treatment integrity work has taken…

  8. Advanced integrated WDM system for POF communication

    NASA Astrophysics Data System (ADS)

    Haupt, M.; Fischer, U. H. P.

    2009-01-01

    Polymer Optical Fibres (POFs) show clear advantages compared to copper and glass fibres. In essence, POFs are inexpensive, space-saving and not susceptible to electromagnetic interference. Thus, the usage of POFs have become a reasonable alternative in short distance data communication. Today, POFs are applied in a wide number of applications due to these specific advantages. These applications include automotive communication systems and in-house-networks. State-of-the-art is to transmit data with only one channel over POF, this limits the bandwidth. To solve this problem, an integrated MUX/DEMUX-element for WDM over POF is designed and developed to use multiple channels. This integration leads to low costs, therefore this component is suitable for mass market applications. The fundamental idea is to separate the chromatic parts of the light in its monochromatic components by means of a grating based on an aspheric mirror. Due to the high NA of the POF the setup has to be designed in a 3D-approach. Therefore this setup cannot be compared with the planar solutions available on market, they would result high losses in the 3rd dimension. To achieve a fast and optimized design an optical simulation program is used. Particular attention has to be paid to the design of the POF as a light source in the simulation program and the optimisation of the grating. The following realization of the demultiplexer is planed to be done with injection molding. This technology offers easy and very economical processing. These advantages make this technology first choice for optical components in the low-cost array.

  9. Effects of complementary and integrative medicine on cancer survivorship.

    PubMed

    Frenkel, Moshe; Sierpina, Victor; Sapire, Kenneth

    2015-01-01

    Cancer survivorship has become a topic of great interest in the past few years. Unfortunately, even with successful treatment as well as good follow-up care, many patients continue to experience unmet physical, emotional, and spiritual needs as well as having an unsettling fear, fear of recurrence, a fear which most survivors share, even many years after their treatment ended. As a result, patients are continually looking for additional ways to address these needs and fears. Among the most popular approach is the use of complementary and integrative medicine (CIM). Most studies on CIM use among cancer patients and survivors concentrate on symptom improvement and improvement of quality of life and do not touch a crucial question if these therapies can affect patients' survival in terms of prolongation of life. Interestingly, in recent years, there are a growing number of studies that suggest that approaches such as mind-body interventions, enhanced general nutrition, nutritional supplements, physical activity, and other CIM approaches may have a positive effect on survival of cancer patients. Although additional studies are needed to confirm these findings, given the low cost of these CIM interventions, their minimal risk, and the potential magnitude of their effects, these approaches might be considered as additional important tools to integrate into cancer survivorship care plans.

  10. Novel Advances in Shotgun Lipidomics for Biology and Medicine

    PubMed Central

    Wang, Miao; Wang, Chunyan; Han, Rowland H.; Han, Xianlin

    2015-01-01

    The field of lipidomics, as coined in 2003, has made profound advances and been rapidly expanded. The mass spectrometry-based strategies of this analytical methodology-oriented research discipline for lipid analysis are largely fallen into three categories: direct infusion-based shotgun lipidomics, liquid chromatography-mass spectrometry-based platforms, and matrix-assisted laser desorption/ionization mass spectrometry-based approaches (particularly in imagining lipid distribution in tissues or cells). This review focuses on shotgun lipidomics. After briefly introducing its fundamentals, the major materials of this article cover its recent advances. These include the novel methods of lipid extraction, novel shotgun lipidomics strategies for identification and quantification of previously hardly accessible lipid classes and molecular species including isomers, and novel tools for processing and interpretation of lipidomics data. Representative applications of advanced shotgun lipidomics for biological and biomedical research are also presented in this review. We believe that with these novel advances in shotgun lipidomics, this approach for lipid analysis should become more comprehensive and high throughput, thereby greatly accelerating the lipidomics field to substantiate the aberrant lipid metabolism, signaling, trafficking, and homeostasis under pathological conditions and their underpinning biochemical mechanisms. PMID:26703190

  11. Novel advances in shotgun lipidomics for biology and medicine.

    PubMed

    Wang, Miao; Wang, Chunyan; Han, Rowland H; Han, Xianlin

    2016-01-01

    The field of lipidomics, as coined in 2003, has made profound advances and been rapidly expanded. The mass spectrometry-based strategies of this analytical methodology-oriented research discipline for lipid analysis are largely fallen into three categories: direct infusion-based shotgun lipidomics, liquid chromatography-mass spectrometry-based platforms, and matrix-assisted laser desorption/ionization mass spectrometry-based approaches (particularly in imagining lipid distribution in tissues or cells). This review focuses on shotgun lipidomics. After briefly introducing its fundamentals, the major materials of this article cover its recent advances. These include the novel methods of lipid extraction, novel shotgun lipidomics strategies for identification and quantification of previously hardly accessible lipid classes and molecular species including isomers, and novel tools for processing and interpretation of lipidomics data. Representative applications of advanced shotgun lipidomics for biological and biomedical research are also presented in this review. We believe that with these novel advances in shotgun lipidomics, this approach for lipid analysis should become more comprehensive and high throughput, thereby greatly accelerating the lipidomics field to substantiate the aberrant lipid metabolism, signaling, trafficking, and homeostasis under pathological conditions and their underpinning biochemical mechanisms. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. An Integrated Framework for Gender Equity in Academic Medicine.

    PubMed

    Westring, Alyssa; McDonald, Jennifer M; Carr, Phyllis; Grisso, Jeane Ann

    2016-08-01

    In 2008, the National Institutes of Health funded 14 R01 grants to study causal factors that promote and support women's biomedical careers. The Research Partnership on Women in Biomedical Careers, a multi-institutional collaboration of the investigators, is one product of this initiative.A comprehensive framework is needed to address change at many levels-department, institution, academic community, and beyond-and enable gender equity in the development of successful biomedical careers. The authors suggest four distinct but interrelated aspects of culture conducive to gender equity: equal access to resources and opportunities, minimizing unconscious gender bias, enhancing work-life balance, and leadership engagement. They review the collection of eight articles in this issue, which each address one or more of the four dimensions of culture. The articles suggest that improving mentor-mentee fit, coaching grant reviewers on unconscious bias, and providing equal compensation and adequate resources for career development will contribute positively to gender equity in academic medicine.Academic medicine must adopt an integrated perspective on culture for women and acknowledge the multiple facets essential to gender equity. To effect change, culture must be addressed both within and beyond academic health centers (AHCs). Leaders within AHCs must examine their institutions' processes, resources, and assessment for fairness and transparency; mobilize personnel and financial resources to implement evidence-based initiatives; and assign accountability for providing transparent progress assessments. Beyond AHCs, organizations must examine their operations and implement change to ensure parity of funding, research, and leadership opportunities as well as transparency of assessment and accreditation.

  13. The threat to scientific integrity in environmental and occupational medicine

    PubMed Central

    Tong, S; Olsen, J

    2005-01-01

    Over the last century, environmental and occupational medicine has played a significant role in the protection and improvement of public health. However, scientific integrity in this field has been increasingly threatened by pressure from some industries and governments. For example, it has been reported that the tobacco industry manipulated eminent scientists to legitimise their industrial positions, irresponsibly distorted risk and deliberately subverted scientific processes, and influenced many organisations in receipt of tobacco funding. Many environmental whistleblowers were sued and encountered numerous personal attacks. In some countries, scientific findings have been suppressed and distorted, and scientific advisory committees manipulated for political purposes by government agencies. How to respond to these threats is an important challenge for environmental and occupational medicine professionals and their societies. The authors recommend that professional organisations adopt a code of ethics that requires openness from public health professionals; that they not undertake research or use data where they do not have freedom to publish their results if these data have public health implications; that they disclose all possible conflicts; that the veracity of their research results should not be compromised; and that their research independence be protected through professional and legal support. The authors furthermore recommend that research funding for public health not be directly from the industry to the researcher. An independent, intermediate funding scheme should be established to ensure that there is no pressure to analyse data and publish results in bad faith. Such a funding system should also provide equal competition for funds and selection of the best proposals according to standard scientific criteria. PMID:16299092

  14. Pharmacodynamic-pharmacokinetic integration as a guide to medicinal chemistry.

    PubMed

    Gabrielsson, Johan; Fjellström, Ola; Ulander, Johan; Rowley, Michael; Van Der Graaf, Piet H

    2011-01-01

    A primary objective of pharmacokinetic-pharmacodynamic (PKPD) reasoning is to identify key in vivo drug and system proper¬ties, enabling prediction of the magnitude and time course of drug responses under physiological and pathological conditions in animals and man. Since the pharmacological response generated by a drug is highly dependent on the actual system used to study its action, knowledge about its potency and efficacy at a given concentration or dose is insufficient to obtain a proper understanding of its pharmacodynamic profile. Hence, the output of PKPD activities extends beyond the provision of quantitative measures (models) of results, to the design of future protocols. Furthermore, because PKPD integrates DMPK (e.g. clearance) and pharmacology (e.g. potency),it provides an anchor point for compound selection, and, as such, should be viewed as an important weapon in medicinal chemistry. Here we outline key PK concepts relevant to PD, and then consider real-life experiments to illustrate the importance to the medicinal chemist of data obtained by PKPD. Useful assumptions and potential pitfalls are described, providing a holistic view of the plethora of determinants behind in vitro-in vivo correlations. By condensing complexity to simplicity, there are not only consequences for experimental design, and for the ranking and design of compounds, but it is also possible to make important predictions such as the impact of changes in drug potency and kinetics. In short, by using quantitative methods to tease apart pharmacodynamic complexities such as temporal differences and changes in plasma protein binding, it is possible to target the changes necessary for improving a compound's profile.

  15. Advances in NLTE Modeling for Integrated Simulations

    SciTech Connect

    Scott, H A; Hansen, S B

    2009-07-08

    The last few years have seen significant progress in constructing the atomic models required for non-local thermodynamic equilibrium (NLTE) simulations. Along with this has come an increased understanding of the requirements for accurately modeling the ionization balance, energy content and radiative properties of different elements for a wide range of densities and temperatures. Much of this progress is the result of a series of workshops dedicated to comparing the results from different codes and computational approaches applied to a series of test problems. The results of these workshops emphasized the importance of atomic model completeness, especially in doubly excited states and autoionization transitions, to calculating ionization balance, and the importance of accurate, detailed atomic data to producing reliable spectra. We describe a simple screened-hydrogenic model that calculates NLTE ionization balance with surprising accuracy, at a low enough computational cost for routine use in radiation-hydrodynamics codes. The model incorporates term splitting, {Delta}n = 0 transitions, and approximate UTA widths for spectral calculations, with results comparable to those of much more detailed codes. Simulations done with this model have been increasingly successful at matching experimental data for laser-driven systems and hohlraums. Accurate and efficient atomic models are just one requirement for integrated NLTE simulations. Coupling the atomic kinetics to hydrodynamics and radiation transport constrains both discretizations and algorithms to retain energy conservation, accuracy and stability. In particular, the strong coupling between radiation and populations can require either very short timesteps or significantly modified radiation transport algorithms to account for NLTE material response. Considerations such as these continue to provide challenges for NLTE simulations.

  16. Integrating Advance Research Directives into the European Legal Framework.

    PubMed

    Andorno, Roberto; Gennet, Eloïse; Jongsma, Karin; Elger, Bernice

    2016-04-01

    The possibility of using advance directives to prospectively consent to research participation in the event of dementia remains largely unexplored in Europe. Moreover, the legal status of advance directives for research is unclear in the European regulations governing biomedical research. The article explores the place that advance research directives have in the current European legal framework, and considers the possibility of integrating them more explicitly into the existing regulations. Special focus is placed on issues regarding informed consent, the role of proxies, and the level of acceptable risks and burdens.

  17. Integrative veterinary medical education and consensus guidelines for an integrative veterinary medicine curriculum within veterinary colleges.

    PubMed

    Memon, M A; Shmalberg, J; Adair, H S; Allweiler, S; Bryan, J N; Cantwell, S; Carr, E; Chrisman, C; Egger, C M; Greene, S; Haussler, K K; Hershey, B; Holyoak, G R; Johnson, M; Jeune, S Le; Looney, A; McConnico, R S; Medina, C; Morton, A J; Munsterman, A; Nie, G J; Park, N; Parsons-Doherty, M; Perdrizet, J A; Peyton, J L; Raditic, D; Ramirez, H P; Saik, J; Robertson, S; Sleeper, M; Dyke, J Van; Wakshlag, J

    2016-01-01

    Integrative veterinary medicine (IVM) describes the combination of complementary and alternative therapies with conventional care and is guided by the best available evidence. Veterinarians frequently encounter questions about complementary and alternative veterinary medicine (CAVM) in practice, and the general public has demonstrated increased interest in these areas for both human and animal health. Consequently, veterinary students should receive adequate exposure to the principles, theories, and current knowledge supporting or refuting such techniques. A proposed curriculum guideline would broadly introduce students to the objective evaluation of new veterinary treatments while increasing their preparation for responding to questions about IVM in clinical practice. Such a course should be evidence-based, unbiased, and unaffiliated with any particular CAVM advocacy or training group. All IVM courses require routine updating as new information becomes available. Controversies regarding IVM and CAVM must be addressed within the course and throughout the entire curriculum. Instructional honesty regarding the uncertainties in this emerging field is critical. Increased training of future veterinary professionals in IVM may produce an openness to new ideas that characterizes the scientific method and a willingness to pursue and incorporate evidence-based medicine in clinical practice with all therapies, including those presently regarded as integrative, complementary, or alternative.

  18. Integrative veterinary medical education and consensus guidelines for an integrative veterinary medicine curriculum within veterinary colleges

    PubMed Central

    Memon, M.A.; Shmalberg, J.; Adair, H.S.; Allweiler, S.; Bryan, J.N.; Cantwell, S.; Carr, E.; Chrisman, C.; Egger, C.M.; Greene, S.; Haussler, K.K.; Hershey, B.; Holyoak, G.R.; Johnson, M.; Jeune, S. Le; Looney, A.; McConnico, R.S.; Medina, C.; Morton, A.J.; Munsterman, A.; Nie, G.J.; Park, N.; Parsons-Doherty, M.; Perdrizet, J.A.; Peyton, J.L.; Raditic, D.; Ramirez, H.P.; Saik, J.; Robertson, S.; Sleeper, M.; Dyke, J. Van; Wakshlag, J.

    2016-01-01

    Integrative veterinary medicine (IVM) describes the combination of complementary and alternative therapies with conventional care and is guided by the best available evidence. Veterinarians frequently encounter questions about complementary and alternative veterinary medicine (CAVM) in practice, and the general public has demonstrated increased interest in these areas for both human and animal health. Consequently, veterinary students should receive adequate exposure to the principles, theories, and current knowledge supporting or refuting such techniques. A proposed curriculum guideline would broadly introduce students to the objective evaluation of new veterinary treatments while increasing their preparation for responding to questions about IVM in clinical practice. Such a course should be evidence-based, unbiased, and unaffiliated with any particular CAVM advocacy or training group. All IVM courses require routine updating as new information becomes available. Controversies regarding IVM and CAVM must be addressed within the course and throughout the entire curriculum. Instructional honesty regarding the uncertainties in this emerging field is critical. Increased training of future veterinary professionals in IVM may produce an openness to new ideas that characterizes the scientific method and a willingness to pursue and incorporate evidence-based medicine in clinical practice with all therapies, including those presently regarded as integrative, complementary, or alternative. PMID:27200270

  19. Postoperative diet advancement: surgical dogma vs evidence-based medicine.

    PubMed

    Warren, Jeremy; Bhalla, Varun; Cresci, Gail

    2011-04-01

    Postoperative ileus is a natural part of recovery following abdominal and intestinal surgery. Research in the laboratory and clinical arenas has challenged the long-held belief that enteral nutrition (EN) should not be administered until bowel function has resumed, which is typically judged by a subjective bowel function assessment. Traditional postoperative management begins with clinical monitoring of return of bowel function, followed by a clear liquid diet that is advanced to regular solid food as tolerated. Studies have consistently demonstrated that early EN is safe and well tolerated, showing a reduction in wound morbidity and healing, fewer septic complications, diminished weight loss, and improved protein kinetics in patients administered early EN. Barriers to early enteral feeding include fear of GI morbidity, anastomotic disruption or leak but have not been proven valid in clinical or experimental trials. A clear liquid diet is the most frequently ordered first postoperative meal regardless of early or delayed administration. Although generally well tolerated, this diet fails to provide adequate nutrients to the postsurgical patient. In contrast, advancement to a regular diet as the initial meal has been shown to be well tolerated and provides significantly more nutrients than a clear liquid diet. This article reviews basic GI physiology, including motility, nutrient absorption, and the changes that occur in regulation and function of the GI tract following surgery, as well as clinical data regarding postoperative GI function and diet advancement. This will be applied to the clinical practices of postoperative dietary advancement to discuss the timing and choice of initial feeding in the postoperative patient.

  20. Recent advances in medicines for children and neonates.

    PubMed

    Choonara, Imti

    2011-09-01

    The European Society for Developmental, Perinatal and Paediatric Pharmacology held its 13th Biennial Congress in Oslo, Norway. The congress was attended by over 100 health professionals from all around the world. The focus of the congress was recent advances in drug therapy in neonates and children. Alongside invited speakers, there were a host of presentations by young investigators which consisted of oral and poster presentations.

  1. ADVANCED COMPRESSOR ENGINE CONTROLS TO ENHANCE OPERATION, RELIABILITY AND INTEGRITY

    SciTech Connect

    Gary D. Bourn; Jess W. Gingrich; Jack A. Smith

    2004-03-01

    This document is the final report for the ''Advanced Compressor Engine Controls to Enhance Operation, Reliability, and Integrity'' project. SwRI conducted this project for DOE in conjunction with Cooper Compression, under DOE contract number DE-FC26-03NT41859. This report addresses an investigation of engine controls for integral compressor engines and the development of control strategies that implement closed-loop NOX emissions feedback.

  2. The potential benefit of an advanced integrated utility system

    NASA Technical Reports Server (NTRS)

    Wolfer, B. M.

    1975-01-01

    The applicability of an advanced integrated utility system based on 1980 technology was investigated. An example of such a system, which provides electricity, heating and air conditioning, solid waste disposal, and water treatment in a single integrated plant, is illustrated for a hypothetical apartment complex. The system requires approximately 50 percent of the energy and approximately 55 percent of the water that would be required by a typical current conventional system.

  3. The integration of traditional medicine into the Nigerian health care delivery system: legal implications and complications.

    PubMed

    Ajai, O

    1990-01-01

    At the outset the author stresses the distinction between 'alternative' and traditional medicine, the latter being indigenous to a country. Government recognition of traditional medicine is discussed and its relationship to the law of the land explored. Possible models for the integration of western and traditional medicine are examined, as well as the difficulties likely to arise. The conclusion is that such integration would be unconstitutional.

  4. National Science and Technology Institute for Translational Medicine (INCT-TM): advancing the field of translational medicine and mental health.

    PubMed

    Hallak, Jaime E C; Crippa, José Alexandre S; Quevedo, João; Roesler, Rafael; Schröder, Nadja; Nardi, Antonio Egidio; Kapczinski, Flávio

    2010-03-01

    Translational medicine has been described as the integrated application of innovative pharmacology tools, biomarkers, clinical methods, clinical technologies and study designs to improve the understanding of medical disorders. In medicine, translational research offers an opportunity for applying the findings obtained from basic research to every-day clinical applications. The National Science and Technology Institute for Translational Medicine is comprised of six member institutions (Universidade Federal do Rio Grande do Sul, Universidade de São Paulo-Ribeirão Preto, Universidade Federal do Rio de Janeiro, Pontifícia Universidade Católica do Rio Grande do Sul, Universidade Estadual de Santa Catarina and a core facility that serves all centers). The objectives of the project are divided into four areas: Institutional, Research, Human Resources and Technology for the Community and Productive Sector. In this manuscript, we describe some of the approaches used to attain the main objectives of the National Science and Technology Institute for Translational Medicine, which include the development of 1) animal models for bipolar disorder; 2) strategies to investigate neurobehavioral function and cognitive dysfunction associated with brain disorders; 3) experimental models of brain function and behavior, neuropsychiatric disorders, cell proliferation, and cancer; 4) Simulated Public Speaking and 5) Virtual reality simulation for inducing panic disorder and agoraphobia. The main focus of the National Science and Technology Institute for Translational Medicine is the development of more useful methods that allow for a better application of basic research-based knowledge to the medical field.

  5. Pharmacologic advances in orofacial pain: from molecules to medicine.

    PubMed

    Dionne, R A

    2001-12-01

    The management of chronic orofacial pain often follows a pattern of claims of efficacy based on clinical observations superseded by equivocal findings of effectiveness or belated recognition of toxicity. While therapeutic innovation spurred by genomics and proteomics is likely to result in new drugs for pain, inflammation, and neuropathic pain, the process of drug development and approval takes five to ten years and is often unsuccessful. Therapeutic strategies for improving treatment for chronic orofacial pain are proposed, but recognition of impediments to changing clinical practices suggest the need for interim measures. Greater understanding of the molecular and genetic events that contribute to pain chronicity and interindividual variations in pain responsiveness may eventually result in individualized molecular pain medicine to prevent and treat chronic orofacial pain.

  6. Development and Assessment of an Advanced Pediatric Airway Management Curriculum With Integrated Intubation Videos.

    PubMed

    Nagler, Joshua; Nagler, Alisa; Bachur, Richard G

    2017-04-01

    Opportunities to learn advanced airway management skills on pediatric patients in the emergency department are limited. Current strategies have focused largely on traditional didactics coupled with procedural skills training using simulation. However, these approaches are limited in their exposure to anatomic variation and realism. Here, we describe the development and assessment of an advanced airway curriculum that integrates videolaryngoscopic recordings obtained during actual patient intubations into a series of interactive educational sessions. Trainees and attending physicians were surveyed anonymously to assess the impact of participation in the curriculum. A mixed methods approach to statistical analysis was used. Rating questions were used to evaluate the relative impact of this approach over other traditional strategies and recurrent themes within open-ended questions were identified. Participants reported this to be a highly effective means of learning about pediatric laryngoscopy and endotracheal intubation and regarded it more highly than other traditional educational approaches. Identified benefits included repetitive exposure, approaches to laryngoscopy, the realism of teaching using real and varied anatomy, and the opportunities to identify and troubleshoot difficulty in a learning environment. An advanced pediatric airway curriculum that integrates intubation videos obtained during videolaryngoscopy was highly regarded by pediatric emergency medicine providers. Content emphasis can be shifted to meet the needs of pediatric emergency medicine providers with all levels of skill and experience.

  7. Patients seek integrative medicine for preventive approach to optimize health.

    PubMed

    Wolever, Ruth Q; Abrams, Donald I; Kligler, Benjamin; Dusek, Jeffery A; Roberts, Rhonda; Frye, Joyce; Edman, Joel S; Amoils, Steve; Pradhan, Elizabeth; Spar, Myles; Gaudet, Tracy; Guarneri, Erminia; Homel, Peter; Amoils, Sandra; Lee, Roberta A; Berman, Brian; Monti, Daniel A; Dolor, Rowena

    2012-01-01

    Despite the tremendous growth of integrative medicine (IM) in clinical settings, IM has not been well characterized in the medical literature. To describe characteristics and motivation of patients seeking care at an IM clinic. Patients from a nine-site practice-based research network participated in this cross-sectional survey. Clinicians documented patients' medical conditions. Patients provided information on demographics, lifestyle factors, and reasons for seeking care at an IM center. Clinicians documented the medical condition treated and procedures performed at the visit. A total of 4,182 patients (84.5% white; 72.7% college-educated; and 73.4% female) reported their most important reasons for seeking IM. Top-ranked reasons were (1) "to improve health and wellness now to prevent future problems" (83.9%); (2) "to try new options for health care" (76.7%); and (3) "to maximize my health regardless of whether or not my illness is curable" (74.6%). Interestingly, the same top reasons were reported by subgroups of patients who sought IM for wellness, acute care, or chronic illness. Patient reports of lifestyle also demonstrated healthier behaviors than national samples indicate. Patients seeking clinical care at IM centers desire an expanded paradigm of health care, one that seeks to maximize health. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Integrating family medicine residents into a rural practice.

    PubMed Central

    Kelly, L.

    1997-01-01

    PROBLEM: Integrating residents into community family practices can be challenging for busy doctors, especially when new preceptors have no formal preparation or teaching experience. OBJECTIVE OF PROGRAM: To develop an organized and practical approach to teaching residents in our busy rural group practice. Our seven northern Ontario family doctors have been training elective residents and clerks for 15 years. Recently, we have gone from hosting elective residents and students to teaching core family medicine residents. Our precepting plan allows us to dedicate a reasonable time to teaching while fulfilling our primary care duties. MAIN COMPONENTS: The program involves contracting, teaching, monitoring, feedback, and evaluation. CONCLUSION: We think we have developed a sustainable, workable set of teaching parameters that is applicable by various preceptors in different settings. It has simplified our teaching role and lessened our anxieties. Residents have benefited from the consistent protocol, which can be flexible enough to adapt to individual residents and preceptors, and have valued this teaching approach. Images p278-a p280-a PMID:9040915

  9. Symptom Burden and Integrative Medicine in Cancer Survivorship

    PubMed Central

    Cutshall, Susanne M.; Cha, Stephen S.; Ness, Sheryl M.; Stan, Daniela L.; Christensen, Sarah A.; Bhagra, Anjali; Price, Katharine A.; Thompson, Carrie A.; Hashmi, Shahrukh K.; Chon, Tony Y.; McCray, Tracy J.; Sood, Amit; Bauer, Brent A.; Ruddy, Kathryn J.

    2015-01-01

    Purpose To learn the level of experience with, interest in, and desire for knowledge about integrative medicine (IM) among cancer survivors. Methods Cancer survivors attending the 2014 National Cancer Survivors Day in Rochester, Minnesota, were recruited to participate in a 1-page survey about their ongoing health concerns and symptoms, as well as their experience with, interest in, and desire for knowledge about IM. Two-sided t test was used for univariate analyses of impact of sex, time since diagnosis, and age. Results Among the 260 cancer survivors, 171 persons (female, 74%; male, 26%) completed the survey (mean age, 64.6 years). Symptoms most commonly somewhat or more bothersome were fear of recurrence (52%), stress (43%), fatigue (43%), difficulty sleeping (33%), and weight gain (31%). The most used IM resources were exercise (75%), improved nutrition and diet (66%), stress management (42%), dietary supplementation (33%), meditation (25%), and massage (22%). Older patients (age, ≥65 years) were less experienced with, interested in, and desiring of knowledge about IM techniques. Sex and time since diagnosis were not strongly predictive of most survey response categories. Conclusions Cancer survivors have adverse effects for years into survivorship. They use and express interest in various IM techniques to help manage symptoms. It is critical that oncology providers help survivors address ongoing health concerns. Education about and access to evidence-based IM techniques may have important roles in comprehensive cancer survivorship programs. PMID:25724408

  10. Integrative Medicine Patients Have High Stress, Pain, and Psychological Symptoms.

    PubMed

    Wolever, Ruth Q; Goel, Nikita S; Roberts, Rhonda S; Caldwell, Karen; Kligler, Benjamin; Dusek, Jeffery A; Perlman, Adam; Dolor, Rowena; Abrams, Donald I

    2015-01-01

    Integrative medicine (IM) is a rapidly growing field whose providers report clinical success in treating significant stress, chronic pain, and depressive and anxiety symptoms. While IM therapies have demonstrated efficacy for numerous medical conditions, IM for psychological symptoms has been slower to gain recognition in the medical community. This large, cross-sectional study is the first of its kind to document the psychosocial profiles of 4182 patients at 9 IM clinics that form the BraveNet Practice-Based Research Network (PBRN). IM patients reported higher levels of perceived stress, pain, and depressive symptoms, and lower levels of quality of life compared with national norms. Per provider reports, 60% of patients had at least one of the following: stress (9.3%), fatigue (10.2%), anxiety (7.7%), depression (7.2%), and/or sleep disorders (4.8%). Pain, having both physiological and psychological components, was also included and is the most common condition treated at IM clinics. Those with high stress, psychological conditions, and pain were most frequently treated with acupuncture, IM physician consultation, exercise, chiropractic services, diet/nutrition counseling, and massage. With baseline information on clinical presentation and service utilization, future PBRN studies can examine promising interventions delivered at the clinic to treat stress and psychological conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. [The development of integrated Chinese and western medicine in recent 5 decades].

    PubMed

    Li, Yue-Feng; Zhang, Heng-Hong

    2013-09-01

    Traditional Chinese medicine was excluded from the governmental system in the Republican period since its establishment. The work of integrating Chinese and western medicine in Taiwan only got its real development until 1958. The founding of the China Medical College in the private sector is considered to be a milestone of the development of integrative medicine in Taiwan. It provided students with practical understanding of both Chinese and western medicine, but achieved little in regard to integrating the two medical systems. In the beginning years, students in the Department of the Medicine in China Medical College actually majored in both Chinese and western medicine. A representative physician of this period is Yun Zi-yu, who was educated at China Medical College. It was not until 1980 when the China Medical College Hospital was founded, the integration of the Chinese and Western medicine began to carry out and take shape within a well-organized clinical field in certain scale. For over 3 decades since its establishment, the Hospital was founded, the executing level of the integration of both medical systems has been gradually descended with different tiers of its executive levels, viz., from the "Chinese and Western Medicine Cooperation Hospital" through the "Center for Integrative Chinese and Western Medicine", to the "Department of Integration of Chinese and Western Medicine". In the same period, more departments of Chinese medicine were set up in the teaching hospitals, private and public, in Taiwan, and the interaction and mutual cooperation of the Chinese and western medicine has been mainly practiced through clinical consultation and research projects.

  12. Material Protection, Accounting, and Control Technologies (MPACT) Advanced Integration Roadmap

    SciTech Connect

    Durkee, Joe W.; Cipiti, Ben; Demuth, Scott Francis; Fallgren, Andrew James; Jarman, Ken; Li, Shelly; Meier, Dave; Miller, Mike; Osburn, Laura Ann; Pereira, Candido; Dasari, Venkateswara Rao; Ticknor, Lawrence O.; Yoo, Tae-Sic

    2016-09-30

    The development of sustainable advanced nuclear fuel cycles is a long-term goal of the Office of Nuclear Energy’s (DOE-NE) Fuel Cycle Technologies program. The Material Protection, Accounting, and Control Technologies (MPACT) campaign is supporting research and development (R&D) of advanced instrumentation, analysis tools, and integration methodologies to meet this goal (Miller, 2015). This advanced R&D is intended to facilitate safeguards and security by design of fuel cycle facilities. The lab-scale demonstration of a virtual facility, distributed test bed, that connects the individual tools being developed at National Laboratories and university research establishments, is a key program milestone for 2020. These tools will consist of instrumentation and devices as well as computer software for modeling, simulation and integration.

  13. Advancing oral medicine through informatics and information technology: a proposed framework and strategy.

    PubMed

    Schleyer, T; Mattsson, U; Ní Ríordáin, R; Brailo, V; Glick, M; Zain, R B; Jontell, M

    2011-04-01

    The implementation of information technology in healthcare is a significant focus for many nations around the world. However, information technology support for clinical care, research and education in oral medicine is currently poorly developed. This situation hampers our ability to transform oral medicine into a 'learning healthcare discipline' in which the divide between clinical practice and research is diminished and, ultimately, eliminated. This paper reviews the needs of and requirements for information technology support of oral medicine and proposes an agenda designed to meet those needs. For oral medicine, this agenda includes analyzing and reviewing current clinical and documentation practices, working toward progressively standardizing clinical data, and helping define requirements for oral medicine systems. IT professionals can contribute by conducting baseline studies about the use of electronic systems, helping develop controlled vocabularies and ontologies, and designing, implementing, and evaluating novel systems centered on the needs of clinicians, researchers and educators. Successfully advancing IT support for oral medicine will require close coordination and collaboration among oral medicine professionals, information technology professionals, system vendors, and funding agencies. If current barriers and obstacles are overcome, practice and research in oral medicine stand ready to derive significant benefits from the application of information technology.

  14. Repairing quite swimmingly: advances in regenerative medicine using zebrafish

    PubMed Central

    Goessling, Wolfram; North, Trista E.

    2014-01-01

    Regenerative medicine has the promise to alleviate morbidity and mortality caused by organ dysfunction, longstanding injury and trauma. Although regenerative approaches for a few diseases have been highly successful, some organs either do not regenerate well or have no current treatment approach to harness their intrinsic regenerative potential. In this Review, we describe the modeling of human disease and tissue repair in zebrafish, through the discovery of disease-causing genes using classical forward-genetic screens and by modulating clinically relevant phenotypes through chemical genetic screening approaches. Furthermore, we present an overview of those organ systems that regenerate well in zebrafish in contrast to mammalian tissue, as well as those organs in which the regenerative potential is conserved from fish to mammals, enabling drug discovery in preclinical disease-relevant models. We provide two examples from our own work in which the clinical translation of zebrafish findings is either imminent or has already proven successful. The promising results in multiple organs suggest that further insight into regenerative mechanisms and novel clinically relevant therapeutic approaches will emerge from zebrafish research in the future. PMID:24973747

  15. Integrating biomedical and herbal medicine in Ghana - experiences from the Kumasi South Hospital: a qualitative study.

    PubMed

    Boateng, Millicent Addai; Danso-Appiah, Anthony; Turkson, Bernard Kofi; Tersbøl, Britt Pinkowski

    2016-07-07

    Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants' interviews was employed to collect data. Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations.

  16. AACR precision medicine series: Highlights of the integrating clinical genomics and cancer therapy meeting.

    PubMed

    Maggi, Elaine; Montagna, Cristina

    2015-12-01

    The American Association for Cancer Research (AACR) Precision Medicine Series "Integrating Clinical Genomics and Cancer Therapy" took place June 13-16, 2015 in Salt Lake City, Utah. The conference was co-chaired by Charles L. Sawyers form Memorial Sloan Kettering Cancer Center in New York, Elaine R. Mardis form Washington University School of Medicine in St. Louis, and Arul M. Chinnaiyan from University of Michigan in Ann Arbor. About 500 clinicians, basic science investigators, bioinformaticians, and postdoctoral fellows joined together to discuss the current state of Clinical Genomics and the advances and challenges of integrating Next Generation Sequencing (NGS) technologies into clinical practice. The plenary sessions and panel discussions covered current platforms and sequencing approaches adopted for NGS assays of cancer genome at several national and international institutions, different approaches used to map and classify targetable sequence variants, and how information acquired with the sequencing of the cancer genome is used to guide treatment options. While challenges still exist from a technological perspective, it emerged that there exists considerable need for the development of tools to aid the identification of the therapy most suitable based on the mutational profile of the somatic cancer genome. The process to match patients to ongoing clinical trials is still complex. In addition, the need for centralized data repositories, preferably linked to well annotated clinical records, that aid sharing of sequencing information is central to begin understanding the contribution of variants of unknown significance to tumor etiology and response to therapy. Here we summarize the highlights of this stimulating four-day conference with a major emphasis on the open problems that the clinical genomics community is currently facing and the tools most needed for advancing this field. Copyright © 2015. Published by Elsevier B.V. All rights reserved.

  17. Elements of an advanced integrated operator control station

    SciTech Connect

    Clarke, M.M.; Kreifeldt, J.G.

    1984-01-01

    One of the critical determinants of peformance for any remotely operated maintenance system is the compatibility achieved between elements of the man/machine interface (e.g., master manipulator controller, controls, displays, etc.) and the human operator. In the Remote Control Engineering task of the Consolidated Fuel Reprocessing Program, considerable attention has been devoted to optimizing the man/machine interface of the operator control station. This system must be considered an integral element of the overall maintenance work system which includes transporters, manipulators, remote viewing, and other parts. The control station must reflect the integration of the operator team, control/display panels, manipulator master controllers, and remote viewing monitors. Human factors principles and experimentation have been used in the development of an advanced integrated operator control station designed for the advance servomanipulator. Key features of this next-generation design are summarized in this presentation. 7 references, 4 figures.

  18. Elements of an advanced integrated operator control station

    SciTech Connect

    Clarke, M.M.; Kreifeldt, J.G.

    1984-01-01

    One of the critical determinants of performance for any remotely operated maintenance system is the compatibility achieved between elements of the man/machine interface (e.g., master manipulator controller, controls, displays) and the human operator. In the remote control engineering task of the Consolidated Fuel Reprocessing Program, considerable attention has been devoted to optimizing the man/machine interface of the operator control station. This system must be considered an integral element of the overall maintenance work system which includes transporters, manipulators, remote viewing, and other parts. The control station must reflect the integration of the operator team, control/display panels, manipulator master controllers, and remote viewing monitors. Human factors principles and experimentation have been used in the development of an advanced integrated operator control station designed for the advance servomanipulator. Key features of this next-generation design are summarized in this presentation. 7 references, 4 figures.

  19. An advanced search engine for patent analytics in medicinal chemistry.

    PubMed

    Pasche, Emilie; Gobeill, Julien; Teodoro, Douglas; Gaudinat, Arnaud; Vishnykova, Dina; Lovis, Christian; Ruch, Patrick

    2012-01-01

    Patent collections contain an important amount of medical-related knowledge, but existing tools were reported to lack of useful functionalities. We present here the development of TWINC, an advanced search engine dedicated to patent retrieval in the domain of health and life sciences. Our tool embeds two search modes: an ad hoc search to retrieve relevant patents given a short query and a related patent search to retrieve similar patents given a patent. Both search modes rely on tuning experiments performed during several patent retrieval competitions. Moreover, TWINC is enhanced with interactive modules, such as chemical query expansion, which is of prior importance to cope with various ways of naming biomedical entities. While the related patent search showed promising performances, the ad-hoc search resulted in fairly contrasted results. Nonetheless, TWINC performed well during the Chemathlon task of the PatOlympics competition and experts appreciated its usability.

  20. Bioengineering the Uterus: An Overview of Recent Advances and Future Perspectives in Reproductive Medicine.

    PubMed

    Campo, Hannes; Cervelló, Irene; Simón, Carlos

    2017-07-01

    Since the initial in vitro attempts to more complex models, research on uterine regeneration is moving towards the creation of a functional bioengineered uterus with possible clinical applications. We describe here the most relevant advances in bioengineering of the uterus published in the last decades considering the use of stem cells and biomaterials as well as future developing techniques in Regenerative Medicine.

  1. Innovations in integrative healthcare education: Integrative Medicine DesignShop and National Education Dialogue.

    PubMed

    Sierpina, Victor; Kreitzer, Mary Jo

    2005-11-01

    Content on integrative healthcare and complementary and alternative medicine (CAM) is now being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic, and other programs are finding creative and innovative ways to include these approaches in new models of education and practice. This column spotlights such innovations in integrative healthcare and CAM education and presents readers with specific educational interventions that they can adapt into new or ongoing educational efforts at their institution or program. We invite readers to submit brief descriptions of efforts in their institutions that reflect the creativity, diversity, and interdisciplinary nature of the field. Please submit to Dr. Sierpina at vssierpi@utmb.edu or Dr. Kreitzer at kreit003@umn.edu. Submissions should be brief, no more than 300 to 400 words. Please include any Web site or other resource that is relevant as well as contact information.

  2. Measuring the "whole system" outcomes of an educational innovation: experience from the integrative family medicine program.

    PubMed

    Kligler, Benjamin; Lebensohn, Patricia; Koithan, Mary; Schneider, Craig; Rakel, David; Cook, Paula; Kohatsu, Wendy; Maizes, Victoria

    2009-05-01

    Six family medicine residency programs in the United States collaborated on the development and implementation of an integrative family medicine (IFM) program, which is a postgraduate training model that combines family medicine residency training with an integrative medicine fellowship. This paper reports on effects of IFM on residency programs and clinical systems in which it was implemented. We used the Integrative Medicine Attitudes Questionnaire (IMAQ) to assess participants' attitudes toward integrative medicine before and after the program was implemented. We assessed residency program recruitment success before and after the program was implemented. We conducted interviews with key informants at each program to evaluate the effects of the IFM on the six participating residency programs. IMAQ scores demonstrated a significant increase in the acceptance of integrative medicine after implementation of IFM. Recruiting data showed that participating programs filled at a rate consistently above the national average both before and after implementation. Analysis of interview data showed that programs became more open to an integrative medicine (IM) approach and offered a wider range of clinical services to patients. Our mixed-methods strategy for evaluation of IFM showed that implementing the program increased acceptance of IM, did not affect residency fill rates, and increased use of IM in clinical practice. The combination of quantitative and qualitative methods was an effective strategy for documenting the "systems level" effects of a new educational program.

  3. Advances in personalized medicine - medicinal chemistry and pharmacology of vemurafenib and ivacaftor.

    PubMed

    Pellowska, M; Merk, D; Schubert-Zsilavecz, M

    2013-07-01

    Pharmacogenomics offers an entrance in the field of personalized medicine. This form of adapted therapy is going to be the future concerning the reduction of side effects and efficacy of the treatment of severe diseases. Vemurafenib and Ivacaftor are the first FDA approved drugs specially addressing mutated proteins. Both substances showed promising results in all clinical trials combined with relatively mild side effects by vemurafenib and placebo-like side effects by ivacaftor. The efficacy in addressing the specific mutation of each compound was confirmed in preclinical and clinical development.

  4. System Engineering and Integration of Controls for Advanced Life Support

    NASA Technical Reports Server (NTRS)

    Overland, David; Hoo, Karlene; Ciskowski, Marvin

    2006-01-01

    The Advanced Integration Matrix (AIM) project at the Johnson Space Center (JSC) was chartered to study and solve systems-level integration issues for exploration missions. One of the first issues identified was an inability to conduct trade studies on control system architectures due to the absence of mature evaluation criteria. Such architectures are necessary to enable integration of regenerative life support systems. A team was formed to address issues concerning software and hardware architectures and system controls.. The team has investigated what is required to integrate controls for the types of non-linear dynamic systems encountered in advanced life support. To this end, a water processing bioreactor testbed is being developed which will enable prototyping and testing of integration strategies and technologies. Although systems such as the water bioreactors exhibit the complexities of interactions between control schemes most vividly, it is apparent that this behavior and its attendant risks will manifest itself among any set of interdependent autonomous control systems. A methodology for developing integration requirements for interdependent and autonomous systems is a goal of this team and this testbed. This paper is a high-level summary of the current status of the investigation, the issues encountered, some tentative conclusions, and the direction expected for further research.

  5. Advanced development in analysis of phytochemicals from medicine and food dual purposes plants used in China.

    PubMed

    Zhao, Jing; Lv, Guang-Ping; Chen, Yi-Wen; Li, Shao-Ping

    2011-10-21

    The concept of "Let food be thy medicine and medicine be thy food" was widely accepted for thousand years. It is now well known that some foods and food components have beneficial physiological and psychological effects. In China, the Ministry of Health of the People's Republic of China announced 87 items of materials, including 81 plants, could be used as both medicine and food. Increasing consumer demand for safety and health benefits, it is of critical importance to have high-quality and comprehensive data on bioactive compounds (phytochemicals) in these materials. In this review, we summarized the advanced development (2006-2010) in analysis of phytochemicals from medicine and food dual purposes plants (MFDPP) used in China. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. Biomechanics: an integral part of sport science and sport medicine.

    PubMed

    Elliott, B

    1999-12-01

    Biomechanics is one of the disciplines in the field of Human Movement and Exercise Science and it can be divided into three broad categories from a research perspective. Clinical biomechanics involves research in the areas of gait, neuromuscular control, tissue mechanics, and movement evaluation during rehabilitation from either injury or disease. Occupational biomechanics typically involves research in the areas of ergonomics and human growth or morphology as they influence movement. While these two categories will briefly be discussed, the primary aim of this paper is to show the role of biomechanics in sports science and sports medicine. Research in sports biomechanics may take the form of describing movement from a performance enhancement (such as matching of impulse curves in rowing) or injury reduction perspective (such as diving in swimming or the assessment of knee joint loading during downhill walking). However, the strength of sports biomechanics research is the ability to establish an understanding of causal mechanisms for selected movements (such as the role of internal rotation of the upper arm in hitting or striking, and the influence of elastic energy and muscle pre-stretch in stretch-shorten-cycle actions). The growth of modelling and computer simulation has further enhanced the potential use of sports biomechanics research (such as quantification of knee joint ligament forces from a dynamic model and optimising gymnastics performance through simulation of in-flight movements). Biomechanics research may also play an integral role in reducing the incidence and severity of sporting injuries (such as identification of the causes of back injuries in cricket, and the causes of knee joint injuries in sport). In the following discussion no attempt will be made to reference all papers published in each of these areas because of the enormity of the task. Published and current work from the biomechanics laboratory at the Department of Human Movement and

  7. Evaluating the economics of complementary and integrative medicine.

    PubMed

    Herman, Patricia M

    2013-03-01

    Healthcare in the United States is expensive and becoming more so every year. Policy and decision makers increasingly need information on costs, as well as effectiveness and safety, in order to formulate health-care strategies that are both clinically effective and financially responsible. Many people believe the benefits of complementary and integrative medicine (CIM) exceed its costs. Surveys have shown that a substantial portion of the US population uses CIM and pays directly for that use.(1) (-) (4) The most recent estimates show that total US out-of-pocket expenditures for CIM were $34 billion-11% of all US out-of-pocket healthcare expenditures.(1) However, if CIM is to be considered in broader healthcare strategies, its economic impact must be determined. Theoretically, CIM seems a good candidate for cost-effectiveness, and even cost savings, because it avoids high technology, offers inexpensive and noninvasive remedies, encourages healthy lifestyle change, and focuses on the whole person, all of which may improve health beyond the targeted disease or condition. However, to many in the conventional health-care system, CIM is seen only as an "add on" expense. What must be demonstrated via economic evaluation are the healthcare costs that can be avoided through the use of CIM. CIM offers the potential for several avenues of cost reduction. The first is as a direct replacement for the usual conventional therapy for a condition. The second is in terms of lower future healthcare utilization both in general (through treating the whole person) and for the targeted disease or condition. A third avenue to cost reduction is through reducing productivity loss for employers. A reduction in costs to employers does not directly reduce healthcare costs (unless the employer is itself a health-care facility); however, both are costs to society. Productivity losses can be reduced through improved employee health, and potentially through the improved employee well-being and

  8. Evaluating the Economics of Complementary and Integrative Medicine

    PubMed Central

    2013-01-01

    Healthcare in the United States is expensive and becoming more so every year. Policy and decision makers increasingly need information on costs, as well as effectiveness and safety, in order to formulate health-care strategies that are both clinically effective and financially responsible. Many people believe the benefits of complementary and integrative medicine (CIM) exceed its costs. Surveys have shown that a substantial portion of the US population uses CIM and pays directly for that use.1–4 The most recent estimates show that total US out-of-pocket expenditures for CIM were $34 billion—11% of all US out-of-pocket healthcare expenditures.1 However, if CIM is to be considered in broader healthcare strategies, its economic impact must be determined. Theoretically, CIM seems a good candidate for cost-effectiveness, and even cost savings, because it avoids high technology, offers inexpensive and noninvasive remedies, encourages healthy lifestyle change, and focuses on the whole person, all of which may improve health beyond the targeted disease or condition. However, to many in the conventional health-care system, CIM is seen only as an “add on” expense. What must be demonstrated via economic evaluation are the healthcare costs that can be avoided through the use of CIM. CIM offers the potential for several avenues of cost reduction. The first is as a direct replacement for the usual conventional therapy for a condition. The second is in terms of lower future healthcare utilization both in general (through treating the whole person) and for the targeted disease or condition. A third avenue to cost reduction is through reducing productivity loss for employers. A reduction in costs to employers does not directly reduce healthcare costs (unless the employer is itself a health-care facility); however, both are costs to society. Productivity losses can be reduced through improved employee health, and potentially through the improved employee well-being and

  9. Towards a model for integrative medicine in Swedish primary care

    PubMed Central

    Sundberg, Tobias; Halpin, Jeremy; Warenmark, Anders; Falkenberg, Torkel

    2007-01-01

    Background Collaboration between providers of conventional care and complementary therapies (CTs) has gained in popularity but there is a lack of conceptualised models for delivering such care, i.e. integrative medicine (IM). The aim of this paper is to describe some key findings relevant to the development and implementation of a proposed model for IM adapted to Swedish primary care. Methods Investigative procedures involved research group and key informant meetings with multiple stakeholders including general practitioners, CT providers, medical specialists, primary care administrators and county council representatives. Data collection included meeting notes which were fed back within the research group and used as ongoing working documents. Data analysis was made by immersion/crystallisation and research group consensus. Results were categorised within a public health systems framework of structures, processes and outcomes. Results The outcome was an IM model that aimed for a patient-centered, interdisciplinary, non-hierarchical mix of conventional and complementary medical solutions to individual case management of patients with pain in the lower back and/or neck. The IM model case management adhered to standard clinical practice including active partnership between a gate-keeping general practitioner, collaborating with a team of CT providers in a consensus case conference model of care. CTs with an emerging evidence base included Swedish massage therapy, manual therapy/naprapathy, shiatsu, acupuncture and qigong. Conclusion Despite identified barriers such as no formal recognition of CT professions in Sweden, it was possible to develop a model for IM adapted to Swedish primary care. The IM model calls for testing and refinement in a pragmatic randomised controlled trial to explore its clinical effectiveness. PMID:17623105

  10. Integrative medicine: enhancing quality in primary health care.

    PubMed

    Grace, Sandra; Higgs, Joy

    2010-09-01

    Integrative medicine (IM) is an emerging model of health care in Australia. However, little is known about the contribution that IM makes to the quality of health care. The aim of the research was to understand the contribution IM can make to the quality of primary care practices from the perspectives of consumers and providers of IM. This interpretive research used hermeneutic phenomenology to understand meanings and significance that patients and practitioners attach to their experiences of IM. Various qualitative research techniques were used: case studies; focus groups; and key informant interviews. Data sets were generated from interview transcripts and field notes. Data analysis consisted of repeatedly reading and examining the data sets for what they revealed about experiences of health care and health outcomes, and constantly comparing these to allow themes and patterns to emerge. The setting for this research was Australian IM clinics where general medical practitioners and CAM practitioners were co-located. From the perspective of patients and practitioners, IM: (1) provided authentically patient-centered care; (2) filled gaps in treatment effectiveness, particularly for certain patient populations (those with complex, chronic health conditions, those seeking an alternative to pharmaceutical health care, and those seeking health promotion and illness prevention); and (3) enhanced the safety of primary health care (because IM retained a general medical practitioner as the primary contact practitioner and because IM used strategies to increase disclosure of treatments between practitioners). According to patients and practitioners, IM enhanced the quality of primary health care through its provision of health care that was patient-centered, effective (particularly for chronic health conditions, nonpharmaceutical treatments, and health promotion) and safe.

  11. An advanced Gibbs-Duhem integration method: theory and applications.

    PubMed

    van 't Hof, A; Peters, C J; de Leeuw, S W

    2006-02-07

    The conventional Gibbs-Duhem integration method is very convenient for the prediction of phase equilibria of both pure components and mixtures. However, it turns out to be inefficient. The method requires a number of lengthy simulations to predict the state conditions at which phase coexistence occurs. This number is not known from the outset of the numerical integration process. Furthermore, the molecular configurations generated during the simulations are merely used to predict the coexistence condition and not the liquid- and vapor-phase densities and mole fractions at coexistence. In this publication, an advanced Gibbs-Duhem integration method is presented that overcomes above-mentioned disadvantage and inefficiency. The advanced method is a combination of Gibbs-Duhem integration and multiple-histogram reweighting. Application of multiple-histogram reweighting enables the substitution of the unknown number of simulations by a fixed and predetermined number. The advanced method has a retroactive nature; a current simulation improves the predictions of previously computed coexistence points as well. The advanced Gibbs-Duhem integration method has been applied for the prediction of vapor-liquid equilibria of a number of binary mixtures. The method turned out to be very convenient, much faster than the conventional method, and provided smooth simulation results. As the employed force fields perfectly predict pure-component vapor-liquid equilibria, the binary simulations were very well suitable for testing the performance of different sets of combining rules. Employing Lorentz-Hudson-McCoubrey combining rules for interactions between unlike molecules, as opposed to Lorentz-Berthelot combining rules for all interactions, considerably improved the agreement between experimental and simulated data.

  12. [OMICS AND BIG DATA, MAJOR ADVANCES TOWARDS PERSONALIZED MEDICINE OF THE FUTURE?].

    PubMed

    Scheen, A J

    2015-01-01

    The increasing interest for personalized medicine evolves together with two major technological advances. First, the new-generation, rapid and less expensive, DNA sequencing method, combined with remarkable progresses in molecular biology leading to the post-genomic era (transcriptomics, proteomics, metabolomics). Second, the refinement of computing tools (IT), which allows the immediate analysis of a huge amount of data (especially, those resulting from the omics approaches) and, thus, creates a new universe for medical research, that of analyzed by computerized modelling. This article for scientific communication and popularization briefly describes the main advances in these two fields of interest. These technological progresses are combined with those occurring in communication, which makes possible the development of artificial intelligence. These major advances will most probably represent the grounds of the future personalized medicine.

  13. Integrative Western and Traditional Chinese Medicine service model for low back pain.

    PubMed

    Sit, Regina W S; Wong, Wendy; Law, Sheung Wai; Wu, Justin C Y

    2016-07-01

    Low back pain (LBP) is a common, costly, and debilitating condition that creates a heavy socioeconomic burden on the global health care systems. In Western Medicine (WM), the treatment goals are to relieve pain, reduce disability, and enhance rehabilitation. In Traditional Chinese Medicine (TCM), acupuncture is frequently used to rebalance the vital energy "Qi". Whilst numerous literatures are available from WM and TCM in the management of LBP, the value of an integrative WMTCM therapy remains unknown. This article aims to introduce an integrative WM-TCM service model for LBP, which is now available at the Hong Kong Institute of Integrative Medicine, the Chinese University of Hong Kong.

  14. Integrated intelligent systems in advanced reactor control rooms

    SciTech Connect

    Beckmeyer, R.R.

    1989-01-01

    An intelligent, reactor control room, information system is designed to be an integral part of an advanced control room and will assist the reactor operator's decision making process by continuously monitoring the current plant state and providing recommended operator actions to improve that state. This intelligent system is an integral part of, as well as an extension to, the plant protection and control systems. This paper describes the interaction of several functional components (intelligent information data display, technical specifications monitoring, and dynamic procedures) of the overall system and the artificial intelligence laboratory environment assembled for testing the prototype. 10 refs., 5 figs.

  15. Which medicine? Whose standard? Critical reflections on medical integration in China

    PubMed Central

    Fan, Ruiping; Holliday, Ian

    2007-01-01

    There is a prevailing conviction that if traditional medicine (TRM) or complementary and alternative medicine (CAM) are integrated into healthcare systems, modern scientific medicine (MSM) should retain its principal status. This paper contends that this position is misguided in medical contexts where TRM is established and remains vibrant. By reflecting on the Chinese policy on three entrenched forms of TRM (Tibetan, Mongolian and Uighur medicines) in western regions of China, the paper challenges the ideology of science that lies behind the demand that all traditional forms of medicine be evaluated and reformed according to MSM standards. Tibetan medicine is used as a case study to indicate the falsity of a major premise of the scientific ideology. The conclusion is that the proper integrative system for TRM and MSM is a dual standard based system in which both TRM and MSM are free to operate according to their own medical standards. PMID:17664302

  16. A feasibility study for advanced technology integration for general aviation

    NASA Technical Reports Server (NTRS)

    Kohlman, D. L.; Matsuyama, G. T.; Hawley, K. E.; Meredith, P. T.

    1980-01-01

    An investigation was conducted to identify candidate technologies and specific developments which offer greatest promise for improving safety, fuel efficiency, performance, and utility of general aviation airplanes. Interviews were conducted with general aviation airframe and systems manufacturers and NASA research centers. The following technologies were evaluated for use in airplane design tradeoff studies conducted during the study: avionics, aerodynamics, configurations, structures, flight controls, and propulsion. Based on industry interviews and design tradeoff studies, several recommendations were made for further high payoff research. The most attractive technologies for use by the general aviation industry appear to be advanced engines, composite materials, natural laminar flow airfoils, and advanced integrated avionics systems. The integration of these technologies in airplane design can yield significant increases in speeds, ranges, and payloads over present aircraft with 40 percent to 50 percent reductions in fuel used.

  17. Making Whole: Applying the Principles of Integrative Medicine to Medical Education.

    PubMed

    Chow, Grace; Liou, Kevin T; Heffron, Robert C

    2016-03-01

    In the past few decades, the public's use of complementary and alternative medicine (CAM) has steadily increased. The term "integrative medicine" is often used to refer to the combination of CAM with conventional medicine. Many medical schools have incorporated didactic content on CAM and/or integrative medicine into their curricula. A frequently cited rationale for these course offerings is that medical students ought to be taught the basics of CAM in order to counsel patients on safe, effective therapeutic options. Schools have also offered these courses to meet the needs of students who are interested in incorporating CAM into future practices. In this article, the authors suggest that the core principles of integrative medicine--holistic worldview, centrality of the doctor-patient relationship, emphasis on wellness, and inclusiveness--are aligned with the goals of contemporary medical education and serve a critical function in the development of effective, humanistic physicians.

  18. Investigation of an advanced fault tolerant integrated avionics system

    NASA Technical Reports Server (NTRS)

    Dunn, W. R.; Cottrell, D.; Flanders, J.; Javornik, A.; Rusovick, M.

    1986-01-01

    Presented is an advanced, fault-tolerant multiprocessor avionics architecture as could be employed in an advanced rotorcraft such as LHX. The processor structure is designed to interface with existing digital avionics systems and concepts including the Army Digital Avionics System (ADAS) cockpit/display system, navaid and communications suites, integrated sensing suite, and the Advanced Digital Optical Control System (ADOCS). The report defines mission, maintenance and safety-of-flight reliability goals as might be expected for an operational LHX aircraft. Based on use of a modular, compact (16-bit) microprocessor card family, results of a preliminary study examining simplex, dual and standby-sparing architectures is presented. Given the stated constraints, it is shown that the dual architecture is best suited to meet reliability goals with minimum hardware and software overhead. The report presents hardware and software design considerations for realizing the architecture including redundancy management requirements and techniques as well as verification and validation needs and methods.

  19. Advanced Integrated Power and Attitude Control System (IPACS) study

    NASA Technical Reports Server (NTRS)

    Oglevie, R. E.; Eisenhaure, D. B.

    1985-01-01

    Integrated Power and Attitude Control System (IPACS) studies performed over a decade ago established the feasibility of simultaneously satisfying the demands of energy storage and attitude control through the use of rotating flywheels. It was demonstrated that, for a wide spectrum of applications, such a system possessed many advantages over contemporary energy storage and attitude control approaches. More recent technology advances in composite material rotors, magnetic suspension systems, and power control electronics have triggered new optimism regarding the applicability and merits of this concept. This study is undertaken to define an advanced IPACS and to evaluate its merits for a space station application. System and component designs are developed to establish the performance of this concept and system trade studies conducted to examine the viability of this approach relative to conventional candidate systems. It is clearly demonstrated that an advanced IPACS concept is not only feasible, but also offers substantial savings in mass and life-cycle cost for the space station mission.

  20. Monolithic microwave integrated circuit technology for advanced space communication

    NASA Technical Reports Server (NTRS)

    Ponchak, George E.; Romanofsky, Robert R.

    1988-01-01

    Future Space Communications subsystems will utilize GaAs Monolithic Microwave Integrated Circuits (MMIC's) to reduce volume, weight, and cost and to enhance system reliability. Recent advances in GaAs MMIC technology have led to high-performance devices which show promise for insertion into these next generation systems. The status and development of a number of these devices operating from Ku through Ka band will be discussed along with anticipated potential applications.

  1. Advanced Laser Chemical Processing For Microelectronics and Integrated Optics

    DTIC Science & Technology

    1992-08-15

    Barbara, CA (June 25-27, 1990). 15. R.M. Osgood, Jr., " Laser - Fabrication for Integrated Electronics and Optics," OITDA Conference, Tokyo, Japan, (July 5...Society Meeting, Boston, MA, November 26 - December 3, 1990. 20. R.M. Osgood, Jr., "Advances in Laser Fabrication for Solid-State Electronics and...Thin, Excimer Laser-Deposited Cd Interlayers," J. Elec. Mat. 12, 1239 (July, 1990). 14. R.M. Osgood, Jr., " Laser - Fabrication for Solid State

  2. Foundational development of an advanced nuclear reactor integrated safety code.

    SciTech Connect

    Clarno, Kevin; Lorber, Alfred Abraham; Pryor, Richard J.; Spotz, William F.; Schmidt, Rodney Cannon; Belcourt, Kenneth; Hooper, Russell Warren; Humphries, Larry LaRon

    2010-02-01

    This report describes the activities and results of a Sandia LDRD project whose objective was to develop and demonstrate foundational aspects of a next-generation nuclear reactor safety code that leverages advanced computational technology. The project scope was directed towards the systems-level modeling and simulation of an advanced, sodium cooled fast reactor, but the approach developed has a more general applicability. The major accomplishments of the LDRD are centered around the following two activities. (1) The development and testing of LIME, a Lightweight Integrating Multi-physics Environment for coupling codes that is designed to enable both 'legacy' and 'new' physics codes to be combined and strongly coupled using advanced nonlinear solution methods. (2) The development and initial demonstration of BRISC, a prototype next-generation nuclear reactor integrated safety code. BRISC leverages LIME to tightly couple the physics models in several different codes (written in a variety of languages) into one integrated package for simulating accident scenarios in a liquid sodium cooled 'burner' nuclear reactor. Other activities and accomplishments of the LDRD include (a) further development, application and demonstration of the 'non-linear elimination' strategy to enable physics codes that do not provide residuals to be incorporated into LIME, (b) significant extensions of the RIO CFD code capabilities, (c) complex 3D solid modeling and meshing of major fast reactor components and regions, and (d) an approach for multi-physics coupling across non-conformal mesh interfaces.

  3. Role of Kampo Medicine in Integrative Cancer Therapy

    PubMed Central

    Yamakawa, Jun-ichi; Motoo, Yoshiharu; Moriya, Junji; Ogawa, Masao; Uenishi, Hiroaki; Akazawa, Sumiyo; Sasagawa, Toshiyuki; Nishio, Matomo; Kobayashi, Junji

    2013-01-01

    Clinical trials to date demonstrate that standard cancer treatments are currently the most efficient treatments for large numbers of cancer patients. Cancer treatments will increasingly require approaches that allow patients to live with cancer, by increasing their natural healing power and tumor immunity, as well as attenuating the progression of their cancers, instead of only attacking the cancer cells directly. Complementary and alternative medicine, including Kampo medicine, compensates for the drawbacks of western medicine by increasing patients' self-defense mechanisms. In Japan, clinicians who have studied both western medicine and Kampo treat cancer patients by fusing the two medical systems into a unitary one. The goal of the system is to assist the functional maintenance and recovery of the living body complex with the physical, mental, social, and spiritual balance, rather than addressing direct antitumor effects. In this review, we describe the usefulness of Kampo medicine, especially juzentaihoto, and outline the reports on evidence, in addition to the report on an attitudinal survey about the use of Kampo medicine in cancer treatment in Japan. PMID:23997796

  4. A General Pediatrics and Integrative Medicine Approach to Pervasive Refusal Syndrome: A Case Report

    PubMed Central

    von Schoen-Angerer, Tido; Helmschmidt, Elisabeth; Madeleyn, René; Kindt, Reinhard; Möller, Christoph; Kienle, Gunver Sophia; Vagedes, Jan

    2016-01-01

    Introduction Pervasive refusal syndrome (PRS) describes children with social withdrawal who become unable to walk, eat, or care for themselves. This case report examines whether an integrative medicine approach is useful for treating PRS. Case Presentation A seven-year-old girl with symptoms most consistent with PRS and depression was admitted to a pediatric ward in Germany that integrates conventional pediatric and psychosomatic care with anthroposophic medicine. She was integrated into the structured activities of the ward and received massages, movement therapy, and color light therapy. Her parents were fully integrated into her care. After four weeks, she talked again, showed increased appetite, and supported herself when moved passively. She made a full recovery within four weeks after hospital discharge. Discussion Integration of parents and an integrative medicine approach providing a variety of comforting sensory experiences was helpful for this patient with PRS. PMID:27644046

  5. A General Pediatrics and Integrative Medicine Approach to Pervasive Refusal Syndrome: A Case Report.

    PubMed

    Von Schoen-Angerer, Tido; Helmschmidt, Elisabeth; Madeleyn, René; Kindt, Reinhard; Möller, Christoph; Kienle, Gunver Sophia; Vagedes, Jan

    2016-01-01

    Pervasive refusal syndrome (PRS) describes children with social withdrawal who become unable to walk, eat, or care for themselves. This case report examines whether an integrative medicine approach is useful for treating PRS. A seven-year-old girl with symptoms most consistent with PRS and depression was admitted to a pediatric ward in Germany that integrates conventional pediatric and psychosomatic care with anthroposophic medicine. She was integrated into the structured activities of the ward and received massages, movement therapy, and color light therapy. Her parents were fully integrated into her care. After four weeks, she talked again, showed increased appetite, and supported herself when moved passively. She made a full recovery within four weeks after hospital discharge. Integration of parents and an integrative medicine approach providing a variety of comforting sensory experiences was helpful for this patient with PRS.

  6. Recent Advances in Developing Insect Natural Products as Potential Modern Day Medicines

    PubMed Central

    Ratcliffe, Norman; Azambuja, Patricia; Mello, Cicero Brasileiro

    2014-01-01

    Except for honey as food, and silk for clothing and pollination of plants, people give little thought to the benefits of insects in their lives. This overview briefly describes significant recent advances in developing insect natural products as potential new medicinal drugs. This is an exciting and rapidly expanding new field since insects are hugely variable and have utilised an enormous range of natural products to survive environmental perturbations for 100s of millions of years. There is thus a treasure chest of untapped resources waiting to be discovered. Insects products, such as silk and honey, have already been utilised for thousands of years, and extracts of insects have been produced for use in Folk Medicine around the world, but only with the development of modern molecular and biochemical techniques has it become feasible to manipulate and bioengineer insect natural products into modern medicines. Utilising knowledge gleaned from Insect Folk Medicines, this review describes modern research into bioengineering honey and venom from bees, silk, cantharidin, antimicrobial peptides, and maggot secretions and anticoagulants from blood-sucking insects into medicines. Problems and solutions encountered in these endeavours are described and indicate that the future is bright for new insect derived pharmaceuticals treatments and medicines. PMID:24883072

  7. Pain Gains for Complementary and Integrative Medicine | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Pain Management Pain Gains for Complementary and Integrative Medicine Past ... magazine about research and complementary approaches to pain management. What can you tell us about NCCIH's work ...

  8. The vital force "reincarnated": modeling entelechy as a quantized spinning gyroscopic metaphor for integrated medicine.

    PubMed

    Milgrom, Lionel R

    2015-01-01

    The ancient concept of the Vital Force receives a modern incarnation as a metaphorical multidimensional spinning gyroscope. The consequences for a different understanding of health and disease are examined in the context of integrated medicine.

  9. Research on application information system integration platform in medicine manufacturing enterprise.

    PubMed

    Deng, Wu; Zhao, Huimin; Zou, Li; Li, Yuanyuan; Li, Zhengguang

    2012-08-01

    Computer and information technology popularizes in the medicine manufacturing enterprise for its potentials in working efficiency and service quality. In allusion to the explosive data and information of application system in current medicine manufacturing enterprise, we desire to propose a novel application information system integration platform in medicine manufacturing enterprise, which based on a combination of RFID technology and SOA, to implement information sharing and alternation. This method exploits the application integration platform across service interface layer to invoke the RFID middleware. The loose coupling in integration solution is realized by Web services. The key techniques in RFID event components and expanded role-based security access mechanism are studied in detail. Finally, a case study is implemented and tested to evidence our understanding on application system integration platform in medicine manufacturing enterprise.

  10. Gynecologic oncologists' attitudes and practices relating to integrative medicine: results of a nationwide AGO survey.

    PubMed

    Klein, Evelyn; Beckmann, Matthias W; Bader, Werner; Brucker, Cosima; Dobos, Gustav; Fischer, Dorothea; Hanf, Volker; Hasenburg, Annette; Jud, Sebastian M; Kalder, Matthias; Kiechle, Marion; Kümmel, Sherko; Müller, Andreas; Müller, Myrjam-Alice T; Paepke, Daniela; Rotmann, Andre-Robert; Schütz, Florian; Scharl, Anton; Voiss, Petra; Wallwiener, Markus; Witt, Claudia; Hack, Carolin C

    2017-08-01

    The growing popularity and acceptance of integrative medicine is evident both among patients and among the oncologists treating them. As little data are available regarding health-care professionals' knowledge, attitudes, and practices relating to the topic, a nationwide online survey was designed. Over a period of 11 weeks (from July 15 to September 30, 2014) a self-administered, 17-item online survey was sent to all 676 members of the Research Group on Gynecological Oncology (Arbeitsgemeinschaft Gynäkologische Onkologie) in the German Cancer Society. The questionnaire items addressed the use of integrative therapy methods, fields of indications for them, advice services provided, level of specific qualifications, and other topics. Of the 104 respondents (15.4%) using integrative medicine, 93% reported that integrative therapy was offered to breast cancer patients. The second most frequent type of tumor in connection with which integrative therapy methods were recommended was ovarian cancer, at 80% of the participants using integrative medicine. Exercise, nutritional therapy, dietary supplements, herbal medicines, and acupuncture were the methods the patients were most commonly advised to use. There is considerable interest in integrative medicine among gynecological oncologists, but integrative therapy approaches are at present poorly implemented in routine clinical work. Furthermore there is a lack of specific training. Whether future efforts should focus on extending counseling services on integrative medicine approaches in gynecologic oncology or not, have to be discussed. Evidence-based training on integrative medicine should be implemented in order to safely guide patients in their wish to do something by themselves.

  11. Advance care planning and palliative medicine in advanced dementia: a literature review.

    PubMed

    Jethwa, Ketan Dipak; Onalaja, Oluwademilade

    2015-04-01

    Aims and method To assess the factors that affect the clinical use of advanced care planning and palliative care interventions in patients with dementia. A literature search of Medline, Embase and PsycINFO was performed to identify themes in advanced care planning and palliative care in dementia. Results In total, 64 articles were found, including 12 reviews, and three key areas emerged: barriers to advanced care planning, raising awareness and fostering communication between professionals and patients, and disease-specific interventions. Clinical implications Most of the studies analysed were carried out in the USA or Continental Europe. This narrative review aims to help guide future primary research, systematic reviews and service development in the UK.

  12. Integrating information systems in medicine: a reference model for middleware.

    PubMed

    Toussaint, P J; Bakker, A R; Groenewegen, L P

    1997-01-01

    This paper addresses the problem of integrating healthcare information systems, from a technological viewpoint. We propose to take the concept of an ¿integration service' as an elementary concept in discussing the problem of integration. We then propose a taxonomy for grouping integration services according to their functionality and their domain specificity. The use of this taxonomy for decomposing an integration problem into (less complex) sub-problems is demonstrated. Finally, a sequence of steps to be taken in solving an integration problem is discussed.

  13. Limitations of Western Medicine and Models of Integration Between Medical Systems.

    PubMed

    Attena, Francesco

    2016-05-01

    This article analyzes two major limitations of Western medicine: maturity and incompleteness. From this viewpoint, Western medicine is considered an incomplete system for the explanation of living matter. Therefore, through appropriate integration with other medical systems, in particular nonconventional approaches, its knowledge base and interpretations may be widened. This article presents possible models of integration of Western medicine with homeopathy, the latter being viewed as representative of all complementary and alternative medicine. To compare the two, a medical system was classified into three levels through which it is possible to distinguish between different medical systems: epistemological (first level), theoretical (second level), and operational (third level). These levels are based on the characterization of any medical system according to, respectively, a reference paradigm, a theory on the functioning of living matter, and clinical practice. The three levels are consistent and closely consequential in the sense that from epistemology derives theory, and from theory derives clinical practice. Within operational integration, four models were identified: contemporary, alternative, sequential, and opportunistic. Theoretical integration involves an explanation of living systems covering simultaneously the molecular and physical mechanisms of functioning living matter. Epistemological integration provides a more thorough and comprehensive explanation of the epistemic concepts of indeterminism, holism, and vitalism to complement the reductionist approach of Western medicine; concepts much discussed by Western medicine while lacking the epistemologic basis for their emplacement. Epistemologic integration could be reached with or without a true paradigm shift and, in the latter, through a model of fusion or subsumption.

  14. General medicine advanced training: lessons from the John Hunter training programme.

    PubMed

    Jackel, D; Attia, J; Pickles, R

    2014-03-01

    Recent years have seen a rapid growth in the number of advanced trainees pursuing general medicine as a specialty. This reflects an awareness of the need for broader training experiences to equip future consultant physicians with the skills to manage the healthcare challenges arising from the demographic trends of ageing and increasing comorbidity. The John Hunter Hospital training programme in general medicine has several characteristics that have led to the success in producing general physicians prepared for these challenges. These include support from a core group of committed general physicians, an appropriate and sustainable funding model, flexibility with a focus on genuine training and developing awareness of a systems approach, and strong links with rural practice. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  15. Advanced Big Data Analytics for -Omic Data and Electronic Health Records: Toward Precision Medicine.

    PubMed

    Wu, Po-Yen; Cheng, Chih-Wen; Kaddi, Chanchala; Venugopalan, Janani; Hoffman, Ryan; Wang, May D

    2016-10-10

    Rapid advances of high-throughput technologies and wide adoption of electronic health records (EHRs) have led to fast accumulation of -omic and EHR data. These voluminous complex data contain abundant information for precision medicine, and big data analytics can extract such knowledge to improve the quality of health care. In this article, we present -omic and EHR data characteristics, associated challenges, and data analytics including data pre-processing, mining, and modeling. To demonstrate how big data analytics enables precision medicine, we provide two case studies, including identifying disease biomarkers from multi-omic data and incorporating -omic information into EHR. Big data analytics is able to address -omic and EHR data challenges for paradigm shift towards precision medicine. Big data analytics makes sense of -omic and EHR data to improve healthcare outcome. It has long lasting societal impact.

  16. Hospital Exemption for Advanced Therapy Medicinal Products: Issue in Application in the European Union Member States.

    PubMed

    Ivaskiene, Tatjana; Mauricas, Mykolas; Ivaska, Justinas

    2017-01-01

    Regulation (EC) 1394/2007 of the European Parliament and the Council on advanced therapy medicinal products and amending Directive 2001/83/EC and Regulation (EC) No 726/2004 allowed the use of non - authorized advanced therapy medicinal products under the certain circumstances. This socalled hospital exemption rule needs to be applied in the each Member State of the European Union individually and for this purpose Member States should provide national procedures and control measures. The aim of this article is to clear up the criteria for hospital exemption listed in Regulation (EC) 1394/2007 and to contrast the difference in implementing hospital exemption rule into national legal regimes on examples of the United Kingdom, Lithuania and Poland.

  17. A bright future for precision medicine: advances in fluorescent chemical probe design and their clinical application

    PubMed Central

    Garland, Megan; Yim, Joshua J.; Bogyo, Matthew

    2016-01-01

    The Precision Medicine Initiative aims to use advances in basic and clinical research to develop therapeutics that selectively target and kill cancer cells. Under the same doctrine of precision medicine, there is an equally important need to visualize these diseased cells to enable diagnosis, facilitate surgical resection and monitor therapeutic response. Therefore, there is a great opportunity for chemists to develop chemically tractable probes that can image cancer in vivo. This review focuses on recent advances in the development of optical probes as well as their current and future applications in the clinical management of cancer. The progress in probe development described here suggests that optical imaging is an important and rapidly developing field of study that encourages continued collaboration between chemists, biologists and clinicians to further refine these tools for interventional surgical imaging, as well as for diagnostic and therapeutic applications. PMID:26933740

  18. Advancing complementary and alternative medicine through social network analysis and agent-based modeling.

    PubMed

    Frantz, Terrill L

    2012-01-01

    This paper introduces the contemporary perspectives and techniques of social network analysis (SNA) and agent-based modeling (ABM) and advocates applying them to advance various aspects of complementary and alternative medicine (CAM). SNA and ABM are invaluable methods for representing, analyzing and projecting complex, relational, social phenomena; they provide both an insightful vantage point and a set of analytic tools that can be useful in a wide range of contexts. Applying these methods in the CAM context can aid the ongoing advances in the CAM field, in both its scientific aspects and in developing broader acceptance in associated stakeholder communities.

  19. [Integration of psychosomatics to internal medicine (author's transl)].

    PubMed

    Dagnelie, J

    1979-01-01

    After a long experience of about fourty years, an internist with an anatomopathological background explains how he has been brought to improve his knowledge in psychology, psychopathology and psychiatry. He did it not only by reading classical publications, starting with Freud, but also through teaching of highly qualified masters in psychotherapy and psychosomatic medicine. He describes about twelve personal cases particularly interesting where only modern psychotherapy has brought spectacular improvement, even long term care, while drug treatment ever failed. The author concludes that for young specialists in internal medicine who would have the motivation and courage to learn the bases of psychosomatics and psychotherapy, there is in practice of future medicine a place of choice waiting for them.

  20. Integrating medicines management into mental health nursing in UK.

    PubMed

    Snowden, Austyn

    2010-06-01

    There is increasing concern that mental health nurses in UK are inadequately trained in medicines management. Recommended solutions entail proposals for further training to improve safety for service users. Although fundamentally important, these organizational approaches lack a conceptual framework to explain how individual practitioners develop competence in medicines management. This is important because applying knowledge of how individuals learn makes strategic interventions more effective. This article presents empirical evidence of how individual mental health nurse prescribers develop competence in prescribing within the context of the therapeutic relationship. It is proposed that these findings can then be extended to inform medicines management training relevant to all mental health nurses, whether prescribers or not. Copyright 2010 Elsevier Inc. All rights reserved.

  1. Integrating abortion training into family medicine residency programs.

    PubMed

    Dehlendorf, Christine; Brahmi, Dalia; Engel, David; Grumbach, Kevin; Joffe, Carole; Gold, Marji

    2007-05-01

    Family physicians provide many office-based procedures in primary care settings. While first-trimester abortion is a procedure appropriate for and performed by family physicians, few residency programs offer routine training in this skill. This study explored the experience of residency programs that have initiated or are in the process of initiating required abortion training. Faculty members responsible for abortion training curricula in identified programs completed questionnaires and semi-structured interviews. Faculty members from nine programs with required training and seven programs interested in initiating this training were included in the study. Factors that assisted in curriculum development included the support of family medicine and obstetrician-gynecologist faculty. Commonly encountered challenges included the need for dedicated resources, inter-specialty conflict, and limited access to training sites. Family medicine programs can be successful at developing required abortion training. Collaboration with colleagues inside and outside the family medicine department and with receptive training sites will benefit programs interested in such.

  2. Advancing Pharmacogenomics as a Component of Precision Medicine: How, Where, and Who?

    PubMed

    Johnson, J A; Weitzel, K W

    2016-02-01

    Pharmacogenomics is an important element of precision medicine. Advances in pharmacogenomics implementation have been made but significant barriers remain, including evidence, reimbursement, and clinician knowledge, among others. Widespread adoption of pharmacogenomics requires overcoming these barriers, a clinician champion group, which we propose will be pharmacists, and an easily accessible setting, which may be the community pharmacy. Whatever the path, it must be evidence-driven and pharmacogenomics must improve drug-related outcomes to become a standard of care.

  3. [Evolution of the significance of advance directives in the ethos of medicine].

    PubMed

    Delfosse, Marie-Luce

    2008-01-01

    Patient's right to formulate advanced directives is a result of the joint evolution of laws and the medical ethos. How is this bringing together at the same time the recognization of patient autonomy and objectifs of the art of medicine? Due to the impossibility of answering the question in a general way, the issue will be studied by referring to the positions of the Belgium order of doctors.

  4. Advances in Medicinal Plants with Effects on Anxiety Behavior Associated to Mental and Health Conditions.

    PubMed

    Barreto, George E; Avila-Rodriguez, Marco; Foitzick, Madeline; Aliev, Gjumrakch; Echeverria, Valentina

    2017-01-01

    Many mental health conditions including psychiatric disorders and neurodegenerative conditions are poorly responsive for actual medications or have low patient adherence to treatment due to the side effects or costs associated with these treatments. The main goal of this review is to provide clinical providers and patients with actualized information about the efficacy of selected herbal medicines for anxiety disorders derived from mental and/or health conditions, and their associated side effects. In this review, actual scientific advances about the use of medicinal plants for anxiety disorders are presented. In recent years, the herbal therapies have reemerged as a source of efficacious natural treatments, at a lower cost and most of the time reduced side effects than currently prescribed pharmaceutical drugs. The herbs described mainly correspond to plants of traditional medicine from the American continent and near islands and Asia. Current evidence confirms the therapeutic effects of traditional medicine. Further clinical investigation is required to confirm these findings. The current understanding of the molecular mechanisms involved in psychiatric disorders, as well as the new advances in brain imaging permit a rapid and serious evaluation of anxiolytic compounds. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. [Systems biology is a bridge of integrated traditional Chinese and Western medicine].

    PubMed

    Chen, Hai-Bin; Cheng, Hai-Bo; Lu, Wei; Zhou, Hong-Guang; Wu, Mian-Hua

    2013-01-01

    The integration of Chinese medicine (CM) and Western medicine (WM) is the only way for the development of medicine, and it is the best form for unifying systems theory and reductionism. In this paper, systems biology and its application in medical research were discussed. The authors put forward that systems biology may possibly interpret the scientific connotation of the complex theoretic systems of CM, which will make WM to well know the human body and disease. We hold that systems biology is a bridge of integrated CM and WM.

  6. Curriculum Development of a Research Laboratory Methodology Course for Complementary and Integrative Medicine Students

    PubMed Central

    Vasilevsky, Nicole; Schafer, Morgan; Tibbitts, Deanne; Wright, Kirsten; Zwickey, Heather

    2015-01-01

    Training in fundamental laboratory methodologies is valuable to medical students because it enables them to understand the published literature, critically evaluate clinical studies, and make informed decisions regarding patient care. It also prepares them for research opportunities that may complement their medical practice. The National College of Natural Medicine's (NCNM) Master of Science in Integrative Medicine Research (MSiMR) program has developed an Introduction to Laboratory Methods course. The objective of the course it to train clinical students how to perform basic laboratory skills, analyze and manage data, and judiciously assess biomedical studies. Here we describe the course development and implementation as it applies to complementary and integrative medicine students. PMID:26500806

  7. Enhanced performance in graphene RF transistors via advanced process integration

    NASA Astrophysics Data System (ADS)

    Hong, Seul Ki; Oh, Joong Gun; Hwang, Wan Sik; Cho, Byung Jin

    2017-04-01

    The state-of-the-art performance of a graphene radio-frequency (RF) field-effect transistor (FET) made of chemical vapor deposition (CVD) graphene is presented. The record high cut-off frequency as high as 380 GHz using CVD graphene was attributed to the implementation of advanced process integration. On the one hand, interface engineering has become critical in two-dimensional (2D) electronics since the charge transport of a 2D electron system like graphene is highly affected by the interface. The interface engineering was made for both the top and bottom of the graphene surface by implementing a non-polar material (1, 3, 5-trimethyl-1, 3, 5-trivinyl cyclotrisiloxane). In contrast to conventional polar materials, such as SiO2, the non-polar materials significantly reduce the surface optical phonon scattering in the graphene channel, leading to the enhanced RF performance of graphene FET. On the other hand, micro-scaled holes over the multilayer graphene and self-aligned structure also become a critical factor in minimizing the parasitic resistance that is inversely proportional to RF performance. As the growth technique of CVD graphene greatly advances, the advanced process integration scheme could bring graphene electronics one step further towards practical application.

  8. Circular causality in integrative multi-scale systems biology and its interaction with traditional medicine.

    PubMed

    Tasaki, Kazuyo Maria

    2013-04-01

    This paper discusses the concept of circular causality in "biological relativity" (Noble, Interface Focus. 2, 56-64, 2012) in the context of integrative and multi-scale systems approaches to biology. It also discusses the relationship between systems biology and traditional medicine (sometimes called scholarly medical traditions) mainly from East Asia and India. Systems biology helps illuminate circular processes identified in traditional medicine, while the systems concept of attractors in complex systems will also be important in analysing dynamic balance in the body processes that traditional medicine is concerned with. Ways of nudging disordered processes towards good attractors through the use of traditional medicines can lead to the development of new ways not only of curing disease but also of its prevention. Examples are given of cost-effective multi-component remedies that use integrative ideas derived from traditional medicine.

  9. Human Exploration Spacecraft Testbed for Integration and Advancement (HESTIA)

    NASA Technical Reports Server (NTRS)

    Banker, Brian F.; Robinson, Travis

    2016-01-01

    The proposed paper will cover ongoing effort named HESTIA (Human Exploration Spacecraft Testbed for Integration and Advancement), led at the National Aeronautics and Space Administration (NASA) Johnson Space Center (JSC) to promote a cross-subsystem approach to developing Mars-enabling technologies with the ultimate goal of integrated system optimization. HESTIA also aims to develop the infrastructure required to rapidly test these highly integrated systems at a low cost. The initial focus is on the common fluids architecture required to enable human exploration of mars, specifically between life support and in-situ resource utilization (ISRU) subsystems. An overview of the advancements in both integrated technologies, in infrastructure, in simulation, and in modeling capabilities will be presented, as well as the results and findings of integrated testing,. Due to the enormous mass gear-ratio required for human exploration beyond low-earth orbit, (for every 1 kg of payload landed on Mars, 226 kg will be required on Earth), minimization of surface hardware and commodities is paramount. Hardware requirements can be minimized by reduction of equipment performing similar functions though for different subsystems. If hardware could be developed which meets the requirements of both life support and ISRU it could result in the reduction of primary hardware and/or reduction in spares. Minimization of commodities to the surface of mars can be achieved through the creation of higher efficiency systems producing little to no undesired waste, such as a closed-loop life support subsystem. Where complete efficiency is impossible or impractical, makeup commodities could be manufactured via ISRU. Although, utilization of ISRU products (oxygen and water) for crew consumption holds great promise of reducing demands on life support hardware, there exist concerns as to the purity and transportation of commodities. To date, ISRU has been focused on production rates and purities for

  10. Curricular integration of social medicine: a prospective for medical educators.

    PubMed

    Vanderbilt, Allison A; Baugh, Reginald F; Hogue, Patricia A; Brennan, Julie A; Ali, Imran I

    2016-01-01

    In the United States, the health of a community falls on a continuum ranging from healthy to unhealthy and fluctuates based on several variables. Research policy and public health practice literature report substantial disparities in life expectancy, morbidity, risk factors, and quality of life, as well as persistence of these disparities among segments of the population. One such way to close this gap is to streamline medical education to better prepare our future physicians for our patients in underserved communities. Medical schools have the potential to close the gap when training future physicians by providing them with the principles of social medicine that can contribute to the reduction of health disparities. Curriculum reform and systematic formative assessment and evaluative measures can be developed to match social medicine and health disparities curricula for individual medical schools, thus assuring that future physicians are being properly prepared for residency and the workforce to decrease health inequities in the United States. We propose that curriculum reform includes an ongoing social medicine component for medical students. Continued exposure, practice, and education related to social medicine across medical school will enhance the awareness and knowledge for our students. This will result in better preparation for the zero mile stone residency set forth by the Accreditation Council of Graduate Medical Education and will eventually lead to the outcome of higher quality physicians in the United States to treat diverse populations.

  11. A New Integrated Course in Preventive and Community Medicine

    ERIC Educational Resources Information Center

    Schwartz, K.

    1977-01-01

    Details of the fourth, fifth, and sixth clinical years' course in preventive and community medicine, introduced at New Zealand's Christchurch Clinical School in 1974, are presented. Topic studies, rotating attachments, preventive medical examinations and ward rounds, simulated disabilities, and conferences are discussed. (LBH)

  12. How far has The Korean Journal of Internal Medicine advanced in terms of journal metrics?

    PubMed

    Huh, Sun

    2013-11-01

    The Korean Journal of Internal Medicine has already been valued as an international journal, according to a citation analysis in 2011. Now, 2 years later, I would like to confirm how much the Journal has advanced from the point of view of journal metrics by looking at the impact factor, cites per document (2 years), SCImago Journal Rank (SJR), and the Hirsch index. These were obtained from a variety of databases, such as the Korean Medical Citation Index, KoreaMed Synapse, Web of Science, JCR Web, and SCImago Journal & Country Rank. The manually calculated 2012 impact factor was 1.252 in the Web of Science, with a ranking of 70/151 (46.4%) in the category of general and internal medicine. Cites per documents (2 years) for 2012 was 1.619, with a ranking of 267/1,588 (16.8%) in the category of medicine (miscellaneous). The 2012 SJR was 0.464, with a ranking of 348/1,588 (21.9%) in the category of medicine (miscellaneous). The Hirsch index from KoreaMed Synapse, Web of Science, and SCImago Journal & Country Rank were 12, 15, and 19, respectively. In comparison with data from 2010, the values of all the journal metrics increased consistently. These results reflect favorably on the increased competency of editors and authors of The Korean Journal of Internal Medicine.

  13. [Scientific advice by the national and European approval authorities concerning advanced therapy medicinal products].

    PubMed

    Jost, Nils; Schüssler-Lenz, Martina; Ziegele, Bettina; Reinhardt, Jens

    2015-11-01

    The aim of scientific advice is to support pharmaceutical developers in regulatory and scientific questions, thus facilitating the development of safe and efficacious new medicinal products. Recent years have shown that the development of advanced therapy medicinal products (ATMPs) in particular needs a high degree of regulatory support. On one hand, this is related to the complexity and heterogeneity of this group of medicinal products and on the other hand due to the fact that mainly academic research institutions and small- and medium-sized enterprises (SMEs) are developing ATMPs. These often have limited regulatory experience and resources. In 2009 the Paul-Ehrlich-Institut (PEI) initiated the Innovation Office as a contact point for applicants developing ATMPs. The mandate of the Innovation Office is to provide support on regulatory questions and to coordinate national scientific advice meetings concerning ATMPs for every phase in drug development and especially with view to the preparation of clinical trial applications. On the European level, the Scientific Advice Working Party (SAWP) of the Committee for Medicinal Products for Human Use (CHMP) of the European Medicinal Agency (EMA) offers scientific advice. This article describes the concepts of national and EMA scientific advice concerning ATMPs and summarizes the experience of the last six years.

  14. How far has The Korean Journal of Internal Medicine advanced in terms of journal metrics?

    PubMed Central

    2013-01-01

    The Korean Journal of Internal Medicine has already been valued as an international journal, according to a citation analysis in 2011. Now, 2 years later, I would like to confirm how much the Journal has advanced from the point of view of journal metrics by looking at the impact factor, cites per document (2 years), SCImago Journal Rank (SJR), and the Hirsch index. These were obtained from a variety of databases, such as the Korean Medical Citation Index, KoreaMed Synapse, Web of Science, JCR Web, and SCImago Journal & Country Rank. The manually calculated 2012 impact factor was 1.252 in the Web of Science, with a ranking of 70/151 (46.4%) in the category of general and internal medicine. Cites per documents (2 years) for 2012 was 1.619, with a ranking of 267/1,588 (16.8%) in the category of medicine (miscellaneous). The 2012 SJR was 0.464, with a ranking of 348/1,588 (21.9%) in the category of medicine (miscellaneous). The Hirsch index from KoreaMed Synapse, Web of Science, and SCImago Journal & Country Rank were 12, 15, and 19, respectively. In comparison with data from 2010, the values of all the journal metrics increased consistently. These results reflect favorably on the increased competency of editors and authors of The Korean Journal of Internal Medicine. PMID:24307835

  15. All Health Is Global Health, All Medicine Is Social Medicine: Integrating the Social Sciences Into the Preclinical Curriculum.

    PubMed

    Kasper, Jennifer; Greene, Jeremy A; Farmer, Paul E; Jones, David S

    2016-05-01

    As physicians work to achieve optimal health outcomes for their patients, they often struggle to address the issues that arise outside the clinic. Social, economic, and political factors influence patients' burden of disease, access to treatment, and health outcomes. This challenge has motivated recent calls for increased attention to the social determinants of health. At the same time, advocates have called for increased attention to global health. Each year, more U.S. medical students participate in global health experiences. Yet, the global health training that is available varies widely. The discipline of social medicine, which attends to the social determinants of disease, social meanings of disease, and social responses to disease, offers a solution to both challenges. The analyses and techniques of social medicine provide an invaluable toolkit for providing health care in the United States and abroad.In 2007, Harvard Medical School implemented a new course, required for all first-year students, that teaches social medicine in a way that integrates global health. In this article, the authors argue for the importance of including social medicine and global health in the preclinical curriculum; describe Harvard Medical School's innovative, integrated approach to teaching these disciplines, which can be used at other medical schools; and explore the barriers that educators may face in implementing such a curriculum, including resistance from students. Such a course can equip medical students with the knowledge and tools that they will need to address complex health problems in the United States and abroad.

  16. Advanced lift-off planarization process for Josephson integrated circuits

    SciTech Connect

    Ishida, I.; Tahara, S.; Wada, Y.

    1988-07-25

    An advanced lift-off planarization process utilizing an undercut technique of a photoresist etching mask has been developed to achieve planarization of thin-sputtered and fine-patterned films that are necessary for high-performance Josephson integrated circuits (IC's). A stack of the same kind of photoresist layers, including the modified layer between them, has been utilized as an etching mask providing fine-patterned film profiles with minimized resist degradation by the top photoresist protection layer. This advanced planarization process brings about smooth surfaces having no residues and no grooves along pattern edges. 30 nm deviation from planarity has been demonstrated on a 200-nm-thick planarized Nb superconducting layer. A four-level interconnection of Josephson IC's was successfully fabricated by this process.

  17. The expanding role of the clinical haematologist in the new world of advanced therapy medicinal products.

    PubMed

    Lowdell, Mark W; Thomas, Amy

    2017-01-01

    Advanced therapy medicinal products (ATMPs) represent the current pinnacle of 'patient-specific medicines' and will change the nature of medicine in the near future. They fall into three categories; somatic cell-therapy products, gene therapy products and cells or tissues for regenerative medicine, which are termed 'tissue engineered' products. The term also incorporates 'combination products' where a human cell or tissue is combined with a medical device. Plainly, many of these new medicines share similarities with conventional haematological stem cell transplant products and donor lymphocyte infusions as well as solid organ grafts and yet ATMPs are regulated as medicines and their development has remained predominantly in academic settings and within specialist centres. However, with the advent of commercialisation of dendritic cell vaccines, chimeric antigen receptor (CAR)-T cells and genetically modified autologous haematopoietic stem cells to cure single gene-defects in β-thalassaemia and haemophilia, the widespread availability of these therapies needs to be accommodated. Uniquely to ATMPs, the patient or an allogeneic donor is regularly part of the manufacturing process. All of the examples given above require procurement of blood, bone marrow or an apheresate from a patient as a starting material for manufacture. This can only occur in a clinical facility licensed for the procurement of human cells for therapeutic use and this is likely to fall to haematology departments, either as stem cell transplant programmes or as blood transfusion departments, to provide under a contract with the company that will manufacture and supply the final medicine. The resource implications associated with this can impact on all haematology departments, not just stem cell transplant units, and should not be under-estimated.

  18. Stepping from traditional to integrative medicine: perspectives of Israeli-Arab patients on complementary medicine's role in cancer care.

    PubMed

    Ben-Arye, E; Massalha, E; Bar-Sela, G; Silbermann, M; Agbarya, A; Saad, B; Lev, E; Schiff, E

    2014-02-01

    Limited research is available on the perspectives of patients with cancer regarding integration of complementary medicine (CM) in conventional supportive cancer care. The purpose of this study was to explore patients' perspectives concerning CM integration within conventional oncology settings. A 27-item questionnaire was constructed and administered to a convenient sample of Arab patients receiving cancer care in three oncology centers in northern Israel. Of the 324 respondents (94.7% response rate), 124 of 313 (39.6%) reported the use of CM for cancer-related outcomes. A logistic regression model indicated that CM was used with active chemo- or radiotherapy treatment [EXP [B], 2.926, 95% confidence interval (CI) 1.276-6.708; P=0.011] and a higher degree of spiritual quest (EXP [B], 3.425, 95% CI 1.042-11.253; P=0.043). Herbal medicine was the leading CM modality (87.9% of CM users), which included the use of 28 plants and traditional remedies, of which 17 were used to improve QOL, with 5 of the herbs having potential interactions with chemotherapy. 83.1% of respondents stated that they would consult with a CM provider if CM were to be integrated into the oncology department. Patients' expectation of CM consultation was clearly associated with expectations of QOL improvement, coping with cancer, and alleviating chemotherapy's side-effects when compared with expectations of cancer cure (P<0.0001). The three leading concerns which patients expected to be improved by integrative CM treatment were gastrointestinal symptoms (63.2%), fatigue (51.9%), and pain (40.5%). Integrative CM consultations should focus on the improvement of QOL concomitant with safety concerns regarding potential drug-herb interactions. The need to integrate a nonjudgmental yet evidence-based CM consultation service may also be applicable to oncology institutions challenged with culturally diverse populations with a high prevalence of traditional medicine use.

  19. Advanced integrated solvent extraction and ion exchange systems

    SciTech Connect

    Horwitz, P.

    1996-10-01

    Advanced integrated solvent extraction (SX) and ion exchange (IX) systems are a series of novel SX and IX processes that extract and recover uranium and transuranics (TRUs) (neptunium, plutonium, americium) and fission products {sup 90}Sr, {sup 99}Tc, and {sup 137}Cs from acidic high-level liquid waste and that sorb and recover {sup 90}Sr, {sup 99}Tc, and {sup 137}Cs from alkaline supernatant high-level waste. Each system is based on the use of new selective liquid extractants or chromatographic materials. The purpose of the integrated SX and IX processes is to minimize the quantity of waste that must be vitrified and buried in a deep geologic repository by producing raffinates (from SX) and effluent streams (from IX) that will meet the specifications of Class A low-level waste.

  20. Integration of Advanced Simulation and Visualization for Manufacturing Process Optimization

    NASA Astrophysics Data System (ADS)

    Zhou, Chenn; Wang, Jichao; Tang, Guangwu; Moreland, John; Fu, Dong; Wu, Bin

    2016-05-01

    The integration of simulation and visualization can provide a cost-effective tool for process optimization, design, scale-up and troubleshooting. The Center for Innovation through Visualization and Simulation (CIVS) at Purdue University Northwest has developed methodologies for such integration with applications in various manufacturing processes. The methodologies have proven to be useful for virtual design and virtual training to provide solutions addressing issues on energy, environment, productivity, safety, and quality in steel and other industries. In collaboration with its industrial partnerships, CIVS has provided solutions to companies, saving over US38 million. CIVS is currently working with the steel industry to establish an industry-led Steel Manufacturing Simulation and Visualization Consortium through the support of National Institute of Standards and Technology AMTech Planning Grant. The consortium focuses on supporting development and implementation of simulation and visualization technologies to advance steel manufacturing across the value chain.

  1. Advanced general aviation comparative engine/airframe integration study

    NASA Technical Reports Server (NTRS)

    Huggins, G. L.; Ellis, D. R.

    1981-01-01

    The NASA Advanced Aviation Comparative Engine/Airframe Integration Study was initiated to help determine which of four promising concepts for new general aviation engines for the 1990's should be considered for further research funding. The engine concepts included rotary, diesel, spark ignition, and turboprop powerplants; a conventional state-of-the-art piston engine was used as a baseline for the comparison. Computer simulations of the performance of single and twin engine pressurized aircraft designs were used to determine how the various characteristics of each engine interacted in the design process. Comparisons were made of how each engine performed relative to the others when integrated into an airframe and required to fly a transportation mission.

  2. Seeking the Optimal Time for Integrated Curriculum in Jinan University School of Medicine

    ERIC Educational Resources Information Center

    Pan, Sanqiang; Cheng, Xin; Zhou, Yanghai; Li, Ke; Yang, Xuesong

    2017-01-01

    The curricular integration of the basic sciences and clinical medicine has been conducted for over 40 years and proved to increase medical students' study interests and clinical reasoning. However, there is still no solid data suggesting what time, freshmen or year 3, is optimal to begin with the integrated curriculum. In this study, the…

  3. An integrated psychological strategy for advanced colorectal cancer patients

    PubMed Central

    Pugliese, Patrizia; Perrone, Maria; Nisi, Enrica; Garufi, Carlo; Giannarelli, Diana; Bottomley, Andrew; Terzoli, Edmondo

    2006-01-01

    Background There is evidence regarding the usefulness of psychosocial intervention to improve health related quality of life (HRQOL) in adult cancer patients. The aim of this report is to describe an integrated approach and to evaluate its feasibility in routine clinical practice in 98 advanced colorectal cancer (ACC) patients during chronomodulated chemotherapy. Methods A prospective non-randomised design was developed and applied in a cancer out-patient setting. The intervention consisted of an integrated approach, whereby the psycho-oncologist had an active role in the health care team with the physician and routinely included psychological understanding in the medical treatment program. The psychological evaluation assessed: a) adaptation, awareness, psychopathological disorders through a psychodynamic interview; b) anxiety and depression using the HAD scale; c) subjective perception of care quality through a structured interview and d) HRQOL evaluation assessment with the EORTC QLQ C30. Outcomes data were collected before and after 18 weeks of chemotherapy. Results After 18 weeks of chemotherapy a significant improvement of adaptation and awareness was observed. The HADs results showed a significant decrease in anxiety when compared to pre-treatment. The structured interview showed a significant increase of patients who positively experienced the impact of medical treatment on HRQOL, anxiety, depression, interpersonal relationships, free-time and who positively experienced the care quality. Indeed, a majority of patients positively experienced the team relationship modality during the whole treatment. All scales on the EORTC questionnaire remained unchanged during the entire treatment. Conclusion Our results suggest that it is feasible to carry out an integrated approach during chemotherapy. These results seem to support the integrated approach as a tool in aiding advanced colorectal cancer patients' ability to cope with their diagnosis and treatment although

  4. Integrative medicine for chronic pain: A cohort study using a process-outcome design in the context of a department for internal and integrative medicine.

    PubMed

    Saha, Felix J; Brüning, Alexander; Barcelona, Cyrus; Büssing, Arndt; Langhorst, Jost; Dobos, Gustav; Lauche, Romy; Cramer, Holger

    2016-07-01

    Integrative medicine inpatient treatment has been shown to improve physical and mental health in patients with internal medicine conditions. The aim of this study was to investigate the effectiveness of a 2-week integrative medicine inpatient treatment in patients with chronic pain syndromes and the association of treatment success with patient-related process variables. Inpatients with chronic pain syndromes participating in a 2-week integrative medicine inpatient program were included. Patients' pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were measured on admission, discharge, and 6 months after discharge. Likewise process variables including ability and will to change, emotional/rational disease acceptance, mindfulness, life and health satisfaction, and easiness of life were assessed. A total of 310 inpatients (91% female, mean age 50.7 ± 12.4 year, 26.5% low back pain, and 22.9% fibromyalgia) were included. Using mixed linear models, significant improvements in pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were found (all P < 0.05). Ability to change and implementation, disease acceptance, mindfulness, life and health satisfaction, and light heartedness/easiness likewise improved (all P < 0.05). Improved outcomes were associated with increases in process variables, mainly ability to change and implementation, disease acceptance, life and health satisfaction, and light heartedness/easiness (R = 0.03-0.40). Results of this study suggest that a 2-week integrative medicine inpatient treatment can benefit patients with chronic pain conditions. Functional improvements are associated with improved ability to change and implementation, disease acceptance, and satisfaction.

  5. Integration of palliative medicine into comprehensive cancer care.

    PubMed

    Lagman, Ruth; Walsh, Declan

    2005-04-01

    Because of the advent of disease-modifying agents for patients with malignancies, cancer is now a chronic illness. However, most cancer patients will experience significant symptoms and complications during the course of their illness or its treatment. In addition to their physical symptoms, patient and families are burdened with psychological, social, and spiritual difficulties. Palliative medicine addresses all these issues and complements attempts to cure the disease; it is an essential part of modern comprehensive cancer care.

  6. Integrating carbon-halogen bond formation into medicinal plant metabolism.

    PubMed

    Runguphan, Weerawat; Qu, Xudong; O'Connor, Sarah E

    2010-11-18

    Halogenation, which was once considered a rare occurrence in nature, has now been observed in many natural product biosynthetic pathways. However, only a small fraction of halogenated compounds have been isolated from terrestrial plants. Given the impact that halogenation can have on the biological activity of natural products, we reasoned that the introduction of halides into medicinal plant metabolism would provide the opportunity to rationally bioengineer a broad variety of novel plant products with altered, and perhaps improved, pharmacological properties. Here we report that chlorination biosynthetic machinery from soil bacteria can be successfully introduced into the medicinal plant Catharanthus roseus (Madagascar periwinkle). These prokaryotic halogenases function within the context of the plant cell to generate chlorinated tryptophan, which is then shuttled into monoterpene indole alkaloid metabolism to yield chlorinated alkaloids. A new functional group-a halide-is thereby introduced into the complex metabolism of C. roseus, and is incorporated in a predictable and regioselective manner onto the plant alkaloid products. Medicinal plants, despite their genetic and developmental complexity, therefore seem to be a viable platform for synthetic biology efforts.

  7. Challenges and opportunities for medical directors in pathology and laboratory medicine: standardization, integration, and innovation.

    PubMed

    Hernandez, James S; Dale, Jane C; Bennet, Kevin E; Varkey, Prathibha

    2010-01-01

    Because the practice of pathology and laboratory medicine evolves rapidly, laboratory medical directors must constantly introduce new tests and services and continue to provide consistent, reliable results for existing tests. Innovations in laboratory medicine are frequently introduced, and the number of commercial vendors of test kits and reagents increases yearly. These innovations, however, may pose barriers to standardization and integration of laboratories and to interpretation of results generated by different laboratories. We propose a practical framework for medical directors to address the seemingly contradictory challenges of standardizing and integrating while simultaneously providing the flexibility to introduce innovations. We recommend initiating standardization first, then integration, while maintaining flexibility for innovation. As organizations strive to create effective processes to enhance value, the role of the laboratory medical director will become critical in resolving the natural tension between standardization/integration and innovation in laboratory medicine and pathology.

  8. Clinical consultation, a personal perspective: components of a successful integrative medicine clinical consultation.

    PubMed

    Frenkel, Moshe

    2008-01-01

    Integrative medicine is becoming an increasingly popular and visible component in oncology care. Thus, the question arises: How can clinicians facilitate, encourage, and integrate the use of complementary and integrative medicines (CIMs) in patients with cancer? The integrative medicine consultation is not easy and involves much more than simply providing reliable information about the proper use of CIM therapies to alleviate symptoms. Some key factors are necessary to allow for a successful consultation for patients and their families and caregivers: physicians must have extensive knowledge of CIM and of cancer care; they must use a sensitive approach in communication with the patient that relies on effective communication skills and experience in listening; and they must have the ability to convey empathy and compassion.

  9. Integrated internist - addiction medicine - hepatology model for hepatitis C management for individuals on methadone maintenance.

    PubMed

    Martinez, A D; Dimova, R; Marks, K M; Beeder, A B; Zeremski, M; Kreek, M J; Talal, A H

    2012-01-01

    Despite a high prevalence of hepatitis C virus (HCV) among drug users, HCV evaluation and treatment acceptance are extremely low among these patients when referred from drug treatment facilities for HCV management. We sought to increase HCV treatment effectiveness among patients from a methadone maintenance treatment program (MMTP) by maintaining continuity of care. We developed, instituted and retrospectively assessed the effectiveness of an integrated, co-localized care model in which an internist-addiction medicine specialist from MMTP was embedded in the hepatitis clinic. Methadone maintenance treatment program patients were referred, evaluated by the internist and hepatologist in hepatitis clinic and provided HCV treatment with integration between both sites. Of 401 evaluated patients, anti-HCV antibody was detected in 257, 86% of whom were older than 40 years. Hepatitis C virus RNA levels were measured in 222 patients, 65 of whom were aviremic. Of 157 patients with detectable HCV RNA, 125 were eligible for referral to the hepatitis clinic, 76 (61%) of whom accepted and adhered with the referral. Men engaged in MMTP <36 months were significantly less likely to be seen in hepatitis clinic than men in MMTP more than 36 months (odds ratio = 7.7; 95% confidence interval 2.6-22.9) or women. We evaluated liver histology in 63 patients, and 83% had moderate to advanced liver disease. Twenty-four patients initiated treatment with 19 completing and 13 (54%) achieving sustained response. In conclusion, integrated care between the MMTP and the hepatitis clinic improves adherence with HCV evaluation and treatment compared to standard referral practices.

  10. Integration of herbal medicine into modern medical practices: issues and prospects.

    PubMed

    Fong, Harry H S

    2002-09-01

    The integration of herbal medicine into modern medical practices including cancer treatments must take into account the interrelated issues of quality, safety, and efficacy. Quality is the paramount issue because it can affect the efficacy and/or safety of the herbal products being used. Current product quality ranges from very high to very low due to intrinsic, extrinsic, and regulatory factors. Intrinsically, species differences, organ specificity, diurnal and seasonal variations can affect the qualitative and quantitative accumulation of active chemical constituents in the source medicinal plants. Extrinsically, environmental factors; field collection methods such as cultivation, harvest, post-harvest transport and storage; manufacturing practices; inadvertent contamination and substitution; and intentional adulteration are contributing factors to the quality of herbal medicinal products. Source plant materials that are contaminated with microbes, microbial toxins, environmental pollutants, or heavy metals; or finished products that are adulterated with foreign toxic plants or synthetic pharmaceutical agents can lead to adverse events. Substandard source materials or finished products will yield therapeutically less effective agents. Herbal medicine quality can also be attributed to regulatory practices. In a number of countries, herbal medicines are unregulated, which has led to product quality differences. Product quality improvement may be achieved by implementing control measures from the point of medicinal plant procurement under good agricultural practices (GAPs) and the manufacture of the finished botanical products under good manufacturing practices (GMPs), plus post-marketing quality assurance surveillance. The lack of pharmacological and clinical data on the majority of herbal medicinal products is a major impediment to the integration of herbal medicines into conventional medical practices. For valid integration, pharmacological and especially

  11. Dawn of Advanced Molecular Medicine: Nanotechnological Advancements in Cancer Imaging and Therapy

    PubMed Central

    Kaittanis, Charalambos; Shaffer, Travis M.; Thorek, Daniel L. J.; Grimm, Jan

    2014-01-01

    Nanotechnology plays an increasingly important role not only in our everyday life (with all its benefits and dangers) but also in medicine. Nanoparticles are to date the most intriguing option to deliver high concentrations of agents specifically and directly to cancer cells; therefore, a wide variety of these nanomaterials has been developed and explored. These span the range from simple nanoagents to sophisticated smart devices for drug delivery or imaging. Nanomaterials usually provide a large surface area, allowing for decoration with a large amount of moieties on the surface for either additional functionalities or targeting. Besides using particles solely for imaging purposes, they can also carry as a payload a therapeutic agent. If both are combined within the same particle, a theranostic agent is created. The sophistication of highly developed nanotechnology targeting approaches provides a promising means for many clinical implementations and can provide improved applications for otherwise suboptimal formulations. In this review we will explore nanotechnology both for imaging and therapy to provide a general overview of the field and its impact on cancer imaging and therapy. PMID:25271430

  12. A controlled trial of an advanced access appointment system in a residency family medicine center.

    PubMed

    Belardi, Francis G; Weir, Sam; Craig, Francis W

    2004-05-01

    The implementation of advanced access appointment systems has improved continuity of care, patient and physician satisfaction, physician productivity, and average physician panel size in private practice and group-model HMO settings. This study's purpose was to document the patient care benefits, practice management benefits, and educational outcomes from the controlled implementation of an advanced access appointment system in a residency family medicine center. Two faculty-resident teams were created. One team adopted the advanced access system while the other team continued using a traditional access system. Outcome measures included length of time needed to obtain an appointment (days to third available appointment), continuity (percentage of visits with the patient's designated provider), no-show rates, productivity, visits lost to outside providers, panel sizes, and patient satisfaction. Outcomes were measured at baseline and quarterly for 1 year after initial implementation. After implementation, the "days to third available appointment" for the advanced access group was 5 days, compared to 21 days for the traditional access group. A significant improvement in continuity (ie, a match between the primary care physician and patient) for the advanced access team was found. Comparison of no-show rates between the advanced access and traditional access teams revealed significant between-subjects effect, but controlling for within-subject variation using repeated measures ANOVA eliminated this effect. Advanced access residents increased their continuity above 50% while increasing provider satisfaction with office practice and scope of practice. Faculty and residents can successfully use advanced access. Advanced access can enhance residency education by reducing appointment delays and significantly increasing the patient-primary care physician match.

  13. Assessing integration of clinical and public health skills in preventive medicine residencies: using competency mapping.

    PubMed

    Wells, Eden V; Sarigiannis, Amy N; Boulton, Matthew L

    2012-06-01

    To evaluate the utility of a competency mapping process for assessing the integration of clinical and public health skills in a newly developed Community Health Center (CHC) rotation at the University of Michigan School of Public Health Preventive Medicine residency. Learning objectives for the CHC rotation were derived from the Accreditation Council for Graduate Medical Education core clinical preventive medicine competencies. CHC learning objectives were mapped to clinical preventive medicine competencies specific to the specialty of public health and general preventive medicine. Objectives were also mapped to The Council on Linkages Between Academia and Public Health Practice's Tier-2 Core Competencies for Public Health Professionals. CHC learning objectives mapped to all four (100%) of the public health and general preventive medicine clinical preventive medicine competencies. CHC population-level learning objectives mapped to 32 (94%) of 34 competencies for public health professionals. Utilizing competency mapping to assess clinical-public health integration in a new CHC rotation proved to be feasible and useful. Clinical preventive medicine learning objectives for a CHC rotation can also address public health competencies. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. [Usefulness of nuclear medicine extension code keeping the integrity with JJ1017].

    PubMed

    Shibutani, Takayuki; Tsushima, Hiroyuki; Shimizu, Keiji; Hanaoka, Kohei; Matsuda, Shigeo; Jinguji, Koji; Sakurai, Minoru; Katou, Seiji; Takeda, Satoru; Kuwano, Tadao; Fujisawa, Ichiro; Takehana, Kazuya; Oku, Shinya

    2013-02-01

    Working group on JJ1017 nuclear medicine domain extension code in the Japanese Society of Nuclear Medicine has created nuclear medicine extension codes keeping the integrity with JJ1017. The objective of this study was to investigate the usefulness of nuclear medicine extension codes in real clinical settings. Nuclear medicine examinations of each institution were extracted from the examination master table and then the target subset of examinations to be coded with JJ1017 were identified. For this subset, working process was conducted, during which the followings compared conformity rate, application rate of representative frequently code set and compliance rate of nuclear medicine extension codes. Without using representative frequently code set, it was difficult to invent the same code for the same examination. By using the representative frequently code set, the same code expression could be invented for the same examination. Furthermore, using nuclear medicine extension codes additionally, these which could not be appropriately coded with representative frequently code set alone. Nuclear medicine extension codes keeping the integrity with JJ1017, was proved to be useful to improve the accuracy of coding.

  15. Development and Validation of a Standardized Questionnaire and Standardized Diary for Use in Integrative Medicine Consultations in Gynecologic Oncology

    PubMed Central

    Hack, C. C.; Hüttner, N. B. M.; Fasching, P. A.; Beckmann, M. W.

    2015-01-01

    Introduction: Use of complementary and alternative medicine (CAM) in diagnoses is not standardized and is very heterogeneous. There are few published standards on integrative medicine consultations or CAM-specific validated follow-up questionnaires. The aim of this study was to develop a standard for integrative medicine consultations, a patient questionnaire which could be used as a basis for medical decisions, and a diary to evaluate the course of the integrative therapy. Patients and Methods: Between June 2013 and September 2014 a standardized integrative medicine consultation in gynecologic oncology was developed and implemented at the Department of Gynecology and Obstetrics of Erlangen University Hospital. A standard operating procedure for consultations was developed; the necessary instruments were developed and validated. Results: Overall patient assessment of the integrative medicine questionnaire and the integrative medicine diary with regard to the time required for completion, comprehensibility, complexity and functionality was positive. Patients evaluated the standardized overall concept of the integrative medicine consultation and its instruments as suitable. Conclusion: Our team is one of the first study groups to develop, validate and publish a standard procedure for integrative medicine consultations. In future, the standard operating procedure for integrative medicine procedures of the Department of Gynecology and Obstetrics of Erlangen University Hospital could be introduced in other hospitals and certified breast cancer centers and gynecologic cancer centers. This would offer patients maximum security and a standardized quality of care in integrative medicine. PMID:26028695

  16. Intelligent Systems and Technology for Integrative and Predictive Medicine: An ACP Approach.

    PubMed

    Wang, Fei-Yue; Wong, Pak Kin

    2013-03-01

    One of the principal goals in medicine is to determine and implement the best treatment for patients through fastidious estimation of the effects and benefits of therapeutic procedures. The inherent complexities of physiological and pathological networks that span across orders of magnitude in time and length scales, however, represent fundamental hurdles in determining effective treatments for patients. Here we argue for a new approach, called ACP-based approach that combines artificial (societies), computational (experiments) and parallel (execution)methods in intelligent systems and technology for integrative and predictive medicine, or more general, precision medicine and smart health management. The advent of artificial societies that collect the clinically relevant information in prognostics and therapeutics provides a promising platform for organizing and experimenting complex physiological systems toward integrative medicine. The ability of computational experiments to analyze distinct, interactive systems such as the host mechanisms, pathological pathways, therapeutic strategies as well as other factors using the artificial systems will enable control and management through parallel execution of real and arficial systems concurrently within the integrative medicine context. The development of this framework in integrative medicine fueled by close collaborations between physicians, engineers, and scientists will result in preventive and predictive practices of personal, proactive, and precision nature, including rational combinatorial treatments, adaptive therapeutics, and patient-oriented disease management.

  17. Intelligent Systems and Technology for Integrative and Predictive Medicine: An ACP Approach

    PubMed Central

    Wang, Fei-Yue; Wong, Pak Kin

    2014-01-01

    One of the principal goals in medicine is to determine and implement the best treatment for patients through fastidious estimation of the effects and benefits of therapeutic procedures. The inherent complexities of physiological and pathological networks that span across orders of magnitude in time and length scales, however, represent fundamental hurdles in determining effective treatments for patients. Here we argue for a new approach, called ACP-based approach that combines artificial (societies), computational (experiments) and parallel (execution)methods in intelligent systems and technology for integrative and predictive medicine, or more general, precision medicine and smart health management. The advent of artificial societies that collect the clinically relevant information in prognostics and therapeutics provides a promising platform for organizing and experimenting complex physiological systems toward integrative medicine. The ability of computational experiments to analyze distinct, interactive systems such as the host mechanisms, pathological pathways, therapeutic strategies as well as other factors using the artificial systems will enable control and management through parallel execution of real and arficial systems concurrently within the integrative medicine context. The development of this framework in integrative medicine fueled by close collaborations between physicians, engineers, and scientists will result in preventive and predictive practices of personal, proactive, and precision nature, including rational combinatorial treatments, adaptive therapeutics, and patient-oriented disease management. PMID:24883228

  18. Integrative medicine for subacute stroke rehabilitation: a study protocol for a multicentre, randomised, controlled trial.

    PubMed

    Fang, Jianqiao; Chen, Lifang; Chen, Luni; Wang, Chao; Keeler, Crystal Lynn; Ma, Ruijie; Xu, Shouyu; Shen, Laihua; Bao, Yehua; Ji, Conghua

    2014-12-04

    Many patients with stroke receive integrative medicine in China, which includes the basic treatment of Western medicine and routine rehabilitation, in conjunction with acupuncture and Chinese medicine. The question of whether integrative medicine is efficacious for stroke rehabilitation is still controversial and very little research currently exists on the integrated approach for this condition. Consequently, we will conduct a multicentre, randomised, controlled, assessor-blinded clinical trial to assess the effectiveness of integrative medicine on stroke rehabilitation. 360 participants recruited from three large Chinese medical hospitals in Zhejiang Province will be randomly divided into the integrative medicine rehabilitation (IMR) group and the conventional rehabilitation (CR) group in a 1:1 ratio. Participants in the IMR group will receive acupuncture and Chinese herbs in addition to basic Western medicine and rehabilitation treatment. The CR group will not receive acupuncture and Chinese herbal medicine. The assessment data will be collected at baseline, 4 and 8 weeks postrandomisation, and then at 12 weeks' follow-up. The primary outcome is measured by the Modified Barthel Index. The secondary outcomes are the National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment, the mini-mental state examination and Montreal Cognitive, Hamilton's Depression Scale and Self-Rating Depression Scale, and the incidence of adverse events. Ethical approval was obtained from ethics committees of three hospitals. The results will be disseminated in a peer-reviewed journal and presented at international congresses. The results will also be disseminated to patients by telephone, during follow-up calls inquiring on patient's post-study health status. Chinese Clinical Trial Register: ChiCTR-TRC-12001972, http://www.chictr.org/en/proj/show.aspx?proj=2561. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  19. Integrative medicine for subacute stroke rehabilitation: a study protocol for a multicentre, randomised, controlled trial

    PubMed Central

    Fang, Jianqiao; Chen, Lifang; Chen, Luni; Wang, Chao; Keeler, Crystal Lynn; Ma, Ruijie; Xu, Shouyu; Shen, Laihua; Bao, Yehua; Ji, Conghua

    2014-01-01

    Introduction Many patients with stroke receive integrative medicine in China, which includes the basic treatment of Western medicine and routine rehabilitation, in conjunction with acupuncture and Chinese medicine. The question of whether integrative medicine is efficacious for stroke rehabilitation is still controversial and very little research currently exists on the integrated approach for this condition. Consequently, we will conduct a multicentre, randomised, controlled, assessor-blinded clinical trial to assess the effectiveness of integrative medicine on stroke rehabilitation. Methods and analysis 360 participants recruited from three large Chinese medical hospitals in Zhejiang Province will be randomly divided into the integrative medicine rehabilitation (IMR) group and the conventional rehabilitation (CR) group in a 1:1 ratio. Participants in the IMR group will receive acupuncture and Chinese herbs in addition to basic Western medicine and rehabilitation treatment. The CR group will not receive acupuncture and Chinese herbal medicine. The assessment data will be collected at baseline, 4 and 8 weeks postrandomisation, and then at 12 weeks’ follow-up. The primary outcome is measured by the Modified Barthel Index. The secondary outcomes are the National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment, the mini-mental state examination and Montreal Cognitive, Hamilton's Depression Scale and Self-Rating Depression Scale, and the incidence of adverse events. Ethics and dissemination Ethical approval was obtained from ethics committees of three hospitals. The results will be disseminated in a peer-reviewed journal and presented at international congresses. The results will also be disseminated to patients by telephone, during follow-up calls inquiring on patient's post-study health status. Trial registration number Chinese Clinical Trial Register: ChiCTR-TRC-12001972, http://www.chictr.org/en/proj/show.aspx?proj=2561 PMID:25475247

  20. [Report from the Committee for Advanced Therapies (CAT). Pitfalls on the way from concept to medical treatment with advanced therapy medicinal products].

    PubMed

    Reiss, M; Büttel, I C; Schneider, C K

    2011-07-01

    Advanced therapy medicinal products (ATMP) are highly innovative and complex medicines. They comprise gene therapy medicinal products, somatic cell therapy medicinal products, and tissue-engineered products (TEP). With the European Regulation on ATMP that came into force in 2008, a consolidated regulatory framework was created, where the Committee for Advanced Therapies (CAT) at the European Medicines Agency (EMA) plays a central role. This article discusses pitfalls and challenges that the CAT has experienced in its discussions of various procedures. Often ATMPs are developed by small and medium-sized enterprises (SME) which also face nonscientific challenges. The CAT wishes to meet these challenges on a scientific and regulatory level during its 2010-2015 work program.

  1. Advances in the Molecular Analysis of Breast Cancer: Pathway Toward Personalized Medicine.

    PubMed

    Rosa, Marilin

    2015-04-01

    Breast cancer is a heterogeneous disease that encompasses a wide range of clinical behaviors and histological and molecular variants. It is the most common type of cancer affecting women worldwide and is the second leading cause of cancer death. A comprehensive literature search was performed to explore the advances in molecular medicine related to the diagnosis and treatment of breast cancer. During the last few decades, advances in molecular medicine have changed the landscape of cancer treatment as new molecular tests complement and, in many instances, exceed traditional methods for determining patient prognosis and response to treatment options. Personalized medicine is becoming the standard of care around the world. Developments in molecular profiling, genomic analysis, and the discovery of targeted drug therapies have significantly improved patient survival rates and quality of life. This review highlights what pathologists need to know about current molecular tests for classification and prognostic/ predictive assessment of breast carcinoma as well as their role as part of the medical team.

  2. [Traditional or popular medicine and official or modern medicine: considerations on their eventual integration].

    PubMed

    Medina, E

    1988-09-01

    The goal of health for all by the year 2000 and the development of primary health care systems have led to increased interaction in recent years between modern or official medical systems and traditional or popular systems. To dismiss traditional medical systems as ineffective or weak is to overlook their relevance and benefits in the context of their sociocultural systems. It is also to overlook the shortcomings of modern medical systems: their technological sophistication, escalating costs, curative rather than preventive focus, iatrogenic risks, and limited accessibility for large population sectors. Latin American traditional medical systems were a result of blending of prehispanic systems with medieval European religious, empirical, and scientific elements brought by the Conquerors. The official system slowly became consolidated in the more powerful social sectors, while the great masses continued to utilize the traditional system. Both systems are structurally similar, with coherent bodies of knowledge and belief about definitions and etiology of illness, the sick role, and treatment. Traditional systems have different methods of recruiting specialists, tend to direct their therapies to the family and social group as well as the individual patient, and consider a wide range of factors in etiology, such as perturbations of the cosmos or natural forces. Forms of health intervention not derived from modern official medicine vary greatly throughout the world, but are relatively homogeneous in Latin America. A large number of publications concerning traditional medical systems has become available, but most suffer from 4 basic limitations: the tendency to lump together all forms of medical care not directly derived from modern medicine, the tendency to ignore or neglect historic and sociocultural dynamics inherent in health institutions, the tendency to consider practically any form of health action as a manifestation of traditional medicine, and the tendency to

  3. Using the framework of corporate culture in “mergers” to support the development of a cultural basis for integrative medicine – guidance for building an integrative medicine department or service

    PubMed Central

    Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

    2015-01-01

    Background An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations − usually companies − are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. Purpose The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. Methods A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in “mergers,” which could be used to build an integrative medicine department or integrative medicine service. Results Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). Conclusion The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation. PMID:25632226

  4. The Next Generation of Dietitians: Implementing Dietetics Education and Practice in Integrative Medicine.

    PubMed

    Wagner, Leigh E; Evans, Randall G; Noland, Diana; Barkley, Rachel; Sullivan, Debra K; Drisko, Jeanne

    2015-01-01

    Integrative medicine is a quickly expanding field of health care that emphasizes nutrition as a key component. Dietitians and nutritionists have an opportunity to meet workforce demands by practicing dietetics and integrative medicine (DIM). The purpose of this article is to describe a DIM education program and practicum. We report the results of an interprofessional nutrition education and practicum program between the University of Kansas Medical Center (KUMC) Department of Dietetics and Nutrition and KU Integrative Medicine. This partnered program provides training that builds on the strong foundation of the Nutrition Care Process and adds graduate-level educational and practicum experiences in foundational integrative medicine knowledge, including nutritional approaches from a systems biology perspective, nutrigenomics, and biochemistry as the core knowledge to understand the root cause of a chronic disorder and to choose appropriate nutritional tools for interventions. This interprofessional KUMC program provides a dietetic internship, master's degree, and graduate certificate in DIM and fulfills a need for dietitians and nutritionists who seek careers practicing in an integrative medicine setting. The program fulfills expanding workforce needs to provide quality health care for patients with chronic illnesses.

  5. Local and Systemic Therapies for Breast Cancer Patients: Reducing Short-term Symptoms with the Methods of Integrative Medicine

    PubMed Central

    Hack, C. C.; Voiß, P.; Lange, S.; Paul, A. E.; Conrad, S.; Dobos, G. J.; Beckmann, M. W.; Kümmel, S.

    2015-01-01

    With improved prognosis due to advances in the diagnosis and therapy of breast cancer, physicians and therapists now focus on aspects such as quality of life and the management of side effects from breast cancer treatment. Therapy- and disease-related side effects often reduce the patientʼs quality of life and can place a further burden on patients, with non-compliance or discontinuation of therapy a potential consequence. Study data have shown that therapy- and disease-related side effects can be reduced using the methods of integrative medicine. Reported benefits include improving patientsʼ wellbeing and quality of life, reducing stress, and improving patientsʼ mood, sleeping patterns and capacity to cope with disease. Examining the impact of integrative medicine on the side effects of cancer treatment would be beyond the scope of this review. This article therefore looks at short-term side effects of cancer treatment which are usually temporary and occur during or after local and systemic therapy. The focus is on mind-body medicine, acupuncture and classic naturopathic treatments developed by Sebastian Kneipp as complementary therapies. The latter includes hydrotherapy, phytotherapy, nutritional therapy, exercise therapy and a balanced lifestyle. PMID:26257404

  6. p-Medicine: From data sharing and integration via VPH models to personalized medicine

    PubMed Central

    Rossi, S; Christ-Neumann, ML; Rüping, S; Buffa, FM; Wegener, D; McVie, G; Coveney, PV; Graf, N; Delorenzi, M

    2011-01-01

    The Worldwide innovative Networking in personalized cancer medicine (WIN) initiated by the Institute Gustave Roussy (France) and The University of Texas MD Anderson Cancer Center (USA) has dedicated its 3rd symposium (Paris, 6–8 July 2011) to discussion on gateways to increase the efficacy of cancer diagnostics and therapeutics (http://www.winconsortium.org/symposium.html). Speakers ranged from clinical oncologist to researchers, industrial partners, and tools developers; a famous patient was present: Janelle Hail, a 30-year breast cancer survivor, founder and CEO of the National Breast Cancer Foundation, Inc. (NBCF). The p-medicine consortium found this venue a perfect occasion to present a poster about its activities that are in accordance with the take home message of the symposium. In this communication, we summarize what we presented with particular attention to the interaction between the symposium’s topic and content and our project. PMID:22276060

  7. p-Medicine: From data sharing and integration via VPH models to personalized medicine.

    PubMed

    Rossi, S; Christ-Neumann, Ml; Rüping, S; Buffa, Fm; Wegener, D; McVie, G; Coveney, Pv; Graf, N; Delorenzi, M

    2011-01-01

    The Worldwide innovative Networking in personalized cancer medicine (WIN) initiated by the Institute Gustave Roussy (France) and The University of Texas MD Anderson Cancer Center (USA) has dedicated its 3rd symposium (Paris, 6-8 July 2011) to discussion on gateways to increase the efficacy of cancer diagnostics and therapeutics (http://www.winconsortium.org/symposium.html).Speakers ranged from clinical oncologist to researchers, industrial partners, and tools developers; a famous patient was present: Janelle Hail, a 30-year breast cancer survivor, founder and CEO of the National Breast Cancer Foundation, Inc. (NBCF).The p-medicine consortium found this venue a perfect occasion to present a poster about its activities that are in accordance with the take home message of the symposium.In this communication, we summarize what we presented with particular attention to the interaction between the symposium's topic and content and our project.

  8. Integrated phase shift measurements for advanced mask etch process control

    NASA Astrophysics Data System (ADS)

    Sahin, Turgut; Collard, Corey; Anderson, Scott A.; Mak, Alfred W.; Brooks, Cynthia B.; Buie, Melisa J.; Walsh, Philip; Li, George

    2003-12-01

    The phase shift effect in Alternating Phase Shift Masks (AAPSMs) and chrome-less phase shift masks is created by etching trenches directly into the quartz substrate. Since the phase shift is critically dependent on the etch depth, the quartz etch process must be tightly controlled. In the absence of an etch stop for the process, an integrated metrology solution is desirable on the mask tech tool. Traditional methods for measuring etch depth or phase shift, such as interferometry, profilometry, AFM, and SEM, are expensive, slow, and/or destructive. In addition, traditional methods cannot measure quartz etch depth without removing the resist and in some cases the chrome mask, making them unsuitable for integration into the etch process. This paper will present measurements of trench depth and phase shift on quartz phase shift mask using the n&k Analyzer 1512-RT. The n&k Analyzer measures reflectance (R) and transmittance (T) from 190-1000nm, which is analyzed according to the Forouhi-Bloomer dispersion relations to simultaneously determine n, k, film thicknesses, trench depth, and phase shift. The measurement is non-destructive and fast, typically taking 2-3 seconds per measurement point. No special test structures are required for the measurement. In addition, the n&k Analyzer can measure quartz etch depth with the chrome mask, ARC layers, and resist still intact. The n&k Analyzer measurements show good correlation with 193nm interferometer measurements, and good repeatability. The small footprint, ease of use, measurement speed, and the ability to measure quartz depth in the presence of chrome and resist make the n&k Analyzer an ideal candidate for integrated metrology applications on mask etch tools for advanced proces control (APC). The Applied Materials' Tetra II phootmask etch system has the unique capability to accommodate integrated metrology modules through the factory interface. Applications of APC with integrated phase shift measurements will be discussed.

  9. An attempt to integrate Western and Chinese medicine: rationale for applying Chinese medicine as chronotherapy against cancer

    PubMed Central

    Seki, K.; Chisaka, M.; Eriguchi, M.; Yanagie, H.; Hisa, T.; Osada, I.; Sairenji, T.; Otsuka, K.; Halberg, F.

    2008-01-01

    Current Western medical treatment lays its main emphasis on evidence-based medicine (EBM) and cure is assessed by quantifying the effects of treatment statistically. In contrast, in Chinese medicine, cure is generally assessed by evaluating the patient's “pattern” (Zheng) [cf. Glossary] and medicines are prescribed according to this. We believe that traditional Chinese medicine (TCM) cannot be evaluated precisely according to Western principles, in which a constant amount of the same medicine is given to a group of patients to be evaluated. When assessing cure using TCM, Zheng is more important than the determination of medical effects. This means that quantitative evaluation of TCM treatment can be very difficult. In this paper, we focused on the Yin-Yang [cf. Glossary] balance to determine Zheng, and at the same time attempted to determine the treatment effects by applying the concept of regulation of Yin-Yang according to chronotherapeutic principles. According to Zheng, advanced cancer patients generally lack both Yin and Yang. Chinese medical treatment therefore seeks to supplement both Yin and Yang. However, we divided patients into two groups and compared them with respect to survival. One group was administered a predominantly Yang (Qi) [cf. Glossary] tonic herbal treatment during the daytime, while the other group was administered Yin (Blood) [cf. Glossary] tonics during night time. A comparison of the results of treatment showed that the patients in the group receiving Yang (Qi) replenishment during the daytime lived longer than patients receiving Yin (Blood) nourishment during the night. Moreover, the patients in the daytime Yang (Qi) replenishment group also fared significantly better than patients treated solely by Western methods. PMID:16275482

  10. Recent Advance in Applications of Proteomics Technologies on Traditional Chinese Medicine Research

    PubMed Central

    Zhu, Fangshi; Liu, Xuan; Li, Qi; Su, Shi-bing

    2015-01-01

    Proteomics technology, a major component of system biology, has gained comprehensive attention in the area of medical diagnosis, drug development, and mechanism research. On the holistic and systemic theory, proteomics has a convergence with traditional Chinese medicine (TCM). In this review, we discussed the applications of proteomic technologies in diseases-TCM syndrome combination researches. We also introduced the proteomic studies on the in vivo and in vitro effects and underlying mechanisms of TCM treatments using Chinese herbal medicine (CHM), Chinese herbal formula (CHF), and acupuncture. Furthermore, the combined studies of proteomics with other “-omics” technologies in TCM were also discussed. In summary, this report presents an overview of the recent advances in the application of proteomic technologies in TCM studies and sheds a light on the future global and further research on TCM. PMID:26557869

  11. Advanced rural skills training - the value of an addiction medicine rotation.

    PubMed

    Allan, Julaine

    2011-11-01

    General practitioners are ideally placed to address drug and alcohol problems in the Australian population. Lack of adequate undergraduate and postgraduate training has been suggested as a key barrier limiting their involvement in addiction medicine. This article describes the establishment and operations of an advanced rural skills training program at the Lyndon Community - a rural drug and alcohol treatment organisation in New South Wales. An addiction medicine rotation offers general practice registrars the opportunity to develop skills and experience in psychosocial interventions as well as physical and mental health issues common in the treatment population. Registrars participating in the Lyndon Community program perceived that the training period had influenced and enhanced their future practice.

  12. Applying Precision Medicine and Immunotherapy Advances from Oncology to Host-Directed Therapies for Infectious Diseases

    PubMed Central

    Mahon, Robert N.; Hafner, Richard

    2017-01-01

    To meet the challenges of increasing antimicrobial resistance, the infectious disease community needs innovative therapeutics. Precision medicine and immunotherapies are transforming cancer therapeutics by targeting the regulatory signaling pathways that are involved not only in malignancies but also in the metabolic and immunologic function of the tumor microenvironment. Infectious diseases target many of the same regulatory pathways as they modulate host metabolic functions for their own nutritional requirements and to impede host immunity. These similarities and the advances made in precision medicine and immuno-oncology that are relevant for the current development of host-directed therapies (HDTs) to treat infectious diseases are discussed. To harness this potential, improvements in drug screening methods and development of assays that utilize the research tools including high throughput multiplexes already developed by oncology are essential. A multidisciplinary approach that brings together immunologists, infectious disease specialists, and oncologists will be necessary to fully develop the potential of HDTs. PMID:28706516

  13. Integration of Cardiac Proteome Biology and Medicine by a Specialized Knowledgebase

    PubMed Central

    Zong, Nobel C.; Li, Haomin; Li, Hua; Lam, Maggie P.Y.; Jimenez, Rafael C.; Kim, Christina S.; Deng, Ning; Kim, Allen K.; Choi, Jeong Ho; Zelaya, Ivette; Liem, David; Meyer, David; Odeberg, Jacob; Fang, Caiyun; Lu, Hao-jie; Xu, Tao; Weiss, James; Duan, Huilong; Uhlen, Mathias; Yates, John R.; Apweiler, Rolf; Ge, Junbo; Hermjakob, Henning; Ping, Peipei

    2014-01-01

    Rationale Omics sciences enable a systems-level perspective in characterizing cardiovascular biology. Integration of diverse proteomics data via a computational strategy will catalyze the assembly of contextualized knowledge, foster discoveries through multidisciplinary investigations, and minimize unnecessary redundancy in research efforts. Objective The goal of this project is to develop a consolidated cardiac proteome knowledgebase with novel bioinformatics pipeline and web portals, thereby serving as a new resource to advance cardiovascular biology and medicine. Methods and Results We created Cardiac Organellar Protein Atlas Knowledgebase (COPaKB), a centralized platform of high quality cardiac proteomic data, bioinformatics tools and relevant cardiovascular phenotypes. Currently, COPaKB features eight organellar modules, comprising 4,203 LC-MS/MS experiments from human, mouse, drosophila and C. elegans as well as expression images of 10,924 proteins in human myocardium. In addition, the Java-coded bioinformatics tools provided by COPaKB enable cardiovascular investigators in all disciplines to retrieve and analyze pertinent organellar protein properties of interest. Conclusions COPaKB (www.HeartProteome.org) provides an innovative and interactive resource, which connects research interests with the new biological discoveries in protein sciences. With an array of intuitive tools in this unified web server, non-proteomics investigators can conveniently collaborate with proteomics specialists to dissect the molecular signatures of cardiovascular phenotypes. PMID:23965338

  14. Integration of isothermal amplification methods in microfluidic devices: Recent advances.

    PubMed

    Giuffrida, Maria Chiara; Spoto, Giuseppe

    2017-04-15

    The integration of nucleic acids detection assays in microfluidic devices represents a highly promising approach for the development of convenient, cheap and efficient diagnostic tools for clinical, food safety and environmental monitoring applications. Such tools are expected to operate at the point-of-care and in resource-limited settings. The amplification of the target nucleic acid sequence represents a key step for the development of sensitive detection protocols. The integration in microfluidic devices of the most popular technology for nucleic acids amplifications, polymerase chain reaction (PCR), is significantly limited by the thermal cycling needed to obtain the target sequence amplification. This review provides an overview of recent advances in integration of isothermal amplification methods in microfluidic devices. Isothermal methods, that operate at constant temperature, have emerged as promising alternative to PCR and greatly simplify the implementation of amplification methods in point-of-care diagnostic devices and devices to be used in resource-limited settings. Possibilities offered by isothermal methods for digital droplet amplification are discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Marketing Regulatory Oversight of Advanced Therapy Medicinal Products (ATMPs) in Europe: The EMA/CAT Perspective.

    PubMed

    Salmikangas, Paula; Schuessler-Lenz, Martina; Ruiz, Sol; Celis, Patrick; Reischl, Ilona; Menezes-Ferreira, Margarida; Flory, Egbert; Renner, Matthias; Ferry, Nicolas

    2015-01-01

    With the release of Regulation 1394/2007, a new framework for gene and cell therapy medicinal products and tissue-engineered products was established in the European Union. For all three product classes, called advanced therapy medicinal products, a centralised marketing authorisation became mandatory. The European Medicines Agency (EMA) together with its Committee for Advanced Therapies, Committee for Human Medicinal Products and the network of national agencies is responsible for scientific evaluation of the marketing authorisation applications. For a new application, data and information relating to manufacturing processes and quality control of the active substance and the final product have to be submitted for evaluation together with data from non-clinical and clinical safety and efficacy studies. Technical requirements for ATMPs are defined in the legislation, and guidance for different products is available through several EMA/CAT guidelines. Due to the diversity of ATMPs, a tailored approach for regulating these products is considered necessary. Thus, a risk-based approach has been introduced for ATMPs allowing flexibility for the regulatory requirements. Since the regulatory framework for ATMPs was established, five products have been licenced in the European Union. However, the pipeline of new ATMPs is much bigger, as seen from the significant numbers of different products discussed by the CAT in scientific advice and classification procedures. In 2013, a public consultation on the ATMP Regulation was conducted by the European Commission, and the results were published in 2014. The report proposes several improvements for the current framework and established procedures for the regulation of ATMPs.

  16. Opening plenary speaker: Human genomics, precision medicine, and advancing human health.

    PubMed

    Green, Eric D

    2016-08-01

    Starting with the launch of the Human Genome Project in 1990, the past quarter-century has brought spectacular achievements in genomics that dramatically empower the study of human biology and disease. The human genomics enterprise is now in the midst of an important transition, as the growing foundation of genomic knowledge is being used by researchers and clinicians to tackle increasingly complex problems in biomedicine. Of particular prominence is the use of revolutionary new DNA sequencing technologies for generating prodigious amounts of DNA sequence data to elucidate the complexities of genome structure, function, and evolution, as well as to unravel the genomic bases of rare and common diseases. Together, these developments are ushering in the era of genomic medicine. Augmenting the advances in human genomics have been innovations in technologies for measuring environmental and lifestyle information, electronic health records, and data science; together, these provide opportunities of unprecedented scale and scope for investigating the underpinnings of health and disease. To capitalize on these opportunities, U.S. President Barack Obama recently announced a major new research endeavor - the U.S. Precision Medicine Initiative. This bold effort will be framed around several key aims, which include accelerating the use of genomically informed approaches to cancer care, making important policy and regulatory changes, and establishing a large research cohort of >1 million volunteers to facilitate precision medicine research. The latter will include making the partnership with all participants a centerpiece feature in the cohort's design and development. The Precision Medicine Initiative represents a broad-based research program that will allow new approaches for individualized medical care to be rigorously tested, so as to establish a new evidence base for advancing clinical practice and, eventually, human health.

  17. Advancing regenerative surgery in orthopaedic sports medicine: the critical role of the surgeon.

    PubMed

    Moran, Cathal J; Barry, Frank P; Maher, Suzanne A; Shannon, Fintan J; Rodeo, Scott A

    2012-04-01

    The constant desire to improve outcomes in orthopaedic sports medicine requires us to continuously consider the challenges faced in the surgical repair or reconstruction of soft tissue and cartilaginous injury. In many cases, surgical efforts targeted at restoring normal anatomy and functional status are ultimately impaired by the biological aspect of the natural history of these injuries, which acts as an obstacle to a satisfactory repair process after surgery. The clinical management of sports injuries and the delivery of appropriate surgical intervention are continuously evolving, and it is likely that the principles of regenerative medicine will have an increasing effect in this specialized field of orthopaedic practice going forward. Ongoing advances in arthroscopy and related surgical techniques should facilitate this process. In contrast to the concept of engineered replacement of entire tissues, it is probable that the earliest effect of regenerative strategies seen in clinical practice will involve biological augmentation of current operative techniques via a synergistic process that might be best considered "regenerative surgery." This article provides an overview of the principles of regenerative surgery in cartilage repair and related areas of orthopaedic surgery sports medicine. The possibilities and challenges of a gradual yet potential paradigm shift in treatment through the increased use of biological augmentation are considered. The translational process and critical role to be played by the specialist surgeon are also addressed. We conclude that increased understanding of the potential and challenges of regenerative surgery should allow those specializing in orthopaedic surgery sports medicine to lead the way in advancing the frontiers of biological strategies to enhance modern clinical care in an evidence-based manner.

  18. Assessing integration of clinical and public health skills in preventive medicine residencies: using competency mapping.

    PubMed

    Wells, Eden V; Sarigiannis, Amy N; Boulton, Matthew L

    2012-06-01

    We evaluated the utility of a competency mapping process for assessing the integration of clinical and public health skills in a newly developed Community Health Center (CHC) rotation at the University of Michigan School of Public Health Preventive Medicine residency. Learning objectives for the CHC rotation were derived from the Accreditation Council for Graduate Medical Education core clinical preventive medicine competencies. CHC learning objectives were mapped to clinical preventive medicine competencies specific to the specialty of public health and general preventive medicine. Objectives were also mapped to The Council on Linkages Between Academia and Public Health Practice's tier 2 Core Competencies for Public Health Professionals. CHC learning objectives mapped to all 4 (100%) of the public health and general preventive medicine clinical preventive medicine competencies. CHC population-level learning objectives mapped to 32 (94%) of 34 competencies for public health professionals. Utilizing competency mapping to assess clinical-public health integration in a new CHC rotation proved to be feasible and useful. Clinical preventive medicine learning objectives for a CHC rotation can also address public health competencies.

  19. Assessing Integration of Clinical and Public Health Skills in Preventive Medicine Residencies: Using Competency Mapping

    PubMed Central

    Sarigiannis, Amy N.; Boulton, Matthew L.

    2012-01-01

    Objectives. We evaluated the utility of a competency mapping process for assessing the integration of clinical and public health skills in a newly developed Community Health Center (CHC) rotation at the University of Michigan School of Public Health Preventive Medicine residency. Methods. Learning objectives for the CHC rotation were derived from the Accreditation Council for Graduate Medical Education core clinical preventive medicine competencies. CHC learning objectives were mapped to clinical preventive medicine competencies specific to the specialty of public health and general preventive medicine. Objectives were also mapped to The Council on Linkages Between Academia and Public Health Practice’s tier 2 Core Competencies for Public Health Professionals. Results. CHC learning objectives mapped to all 4 (100%) of the public health and general preventive medicine clinical preventive medicine competencies. CHC population-level learning objectives mapped to 32 (94%) of 34 competencies for public health professionals. Conclusions. Utilizing competency mapping to assess clinical–public health integration in a new CHC rotation proved to be feasible and useful. Clinical preventive medicine learning objectives for a CHC rotation can also address public health competencies. PMID:22690972

  20. What does «integrative medicine» provide to daily scientific clinical care?

    PubMed

    Bataller-Sifre, R; Bataller-Alberola, A

    2015-11-01

    Integrative medicine is an ambitious and noble-minded attempt to address the shortcomings of the current public health systems in our Western societies, which is restricted by the limited time available, especially in outpatient clinics. Integrative medicine also does not limit the possibilities of useful therapies that have been tested over the centuries (from China, India, etc.) or of certain resources that do not achieve the level of desired scientific credibility but that present certain therapeutic support in specific cases (homeopathy, acupuncture, etc.) but still require a scientific approach. Finally, the resource of botanical products (phytotherapy) constitutes a wide range of possibilities that universities can (and do) make progress on by providing drug brands for these products through the use of the scientific method and evidence-based medical criteria. This approach will help avoid the irrationality of the daily struggle between conventional scientific medicine (which we apply to the immense majority of patients) and the other diagnostic-therapeutic «guidelines» (natural medicine, alternative medicine, complementary medicine, patient-focused medicine and others). Copyright © 2015. Published by Elsevier España, S.L.U.

  1. Geographic mobility advances careers: study of the Executive Leadership in Academic Medicine (ELAM) program for women.

    PubMed

    McLean, Marsha R; Morahan, Page S; Dannels, Sharon A; McDade, Sharon A

    2013-11-01

    To explore whether geographic mobility is associated with career advancement of women in U.S. medical schools who are entering mid- to executive-level positions. Using an existing dataset of 351 participants in academic medicine who attended the Executive Leadership in Academic Medicine (ELAM) Program for Women (1996-2005) (adjusted to 345 participants in some analyses because data on initial faculty rank were missing), the authors conducted a quantitative study in 2009 to determine whether geographic mobility was associated with administrative promotion for those who relocated geographically (from employer while attending ELAM to employer at last job of record). Twenty-four percent of women (83/345) relocated geographically (movers) after attending ELAM. Moving had a positive association with career advancement (P = .001); odds for promotion were 168% higher for movers than for stayers [odds ratio Exp(β) = 2.684]. Movers attained higher administrative positions (P = .003), and more movers (60%) were promoted at the most recent job compared with stayers (40%) (P = .0001). Few movers changed city size; 70% already resided in large or urban cities where most medical schools are located. Age was not a barrier to mobility. Career advancement was not related to research reputation (National Institutes of Health grant award ranking) of participants' schools (either at time of attending ELAM or post-ELAM). Similar to findings outside academic medicine, 24% of women classified as geographic "movers" among midcareer faculty in medical schools attained career advantages. Psychosocial and socioeconomic factors underlying women's relocation decisions require additional study.

  2. Role of O.G. Gazenko in formation and advancement of space biology and medicine

    NASA Astrophysics Data System (ADS)

    Grigoriev, Anatoly I.

    2011-05-01

    Oleg G. Gazenko belongs to the noble cohort of pupils of well-known Russian physiologist L.A. Orbeli. He was one of the fathers of space biology and medicine, discipline in which he displayed his brilliant talents of experimenter and thinker. He was acknowledged for the investigations of spaceflight effects on living systems, the concept of medical operations system to support long-term piloted missions and implementation of biological researches that fostered the advance of space and gravitational biology. The analytical works of Oleg G. Gazenko are of imperishable significance for future researches to the benefit of space biomedicine.

  3. Personalized Medicine applied to Forensic Sciences: new advances and perspectives for a tailored forensic approach.

    PubMed

    Santurro, Alessandro; Vullo, Anna Maria; Borro, Marina; Gentile, Giovanna; Russa, Raffaele La; Simmaco, Maurizio; Frati, Paola; Fineschi, Vittorio

    2017-02-07

    Personalized medicine (PM), included in P5 medicine (Personalized, Predictive, Preventive, Participative and Precision medicine) is an innovative approach to the patient, emerging from the need to tailor and to fit the profile of each individual. PM promises to dramatically impact also on forensic sciences and justice system in ways we are only beginning to understand. The application of omics (genomic, transcriptomics, epigenetics/imprintomics, proteomic and metabolomics) is ever more fundamental in the so called "molecular autopsy". Emerging fields of interest in forensic pathology are represented by diagnosis and detection of predisposing conditions to fatal thromboembolic and hypertensive events, determination of genetic variants related to sudden death, such as congenital long QT syndromes, demonstration of lesions vitality, identification of biological matrices and species diagnosis of a forensic trace on crime scenes without destruction of the DNA. The aim of this paper is to describe the state-of-art in the application of personalized medicine in forensic sciences, to understand the possibilities of integration in routine investigation of these procedures with classical post-mortem studies and to underline the importance of these new updates in medical examiners' armamentarium in determining cause of death or contributing factors to death.

  4. Advancing One Health Policy and Implementation Through the Concept of One Medicine One Science.

    PubMed

    Cardona, Carol; Travis, Dominic A; Berger, Kavita; Coat, Gwenaële; Kennedy, Shaun; Steer, Clifford J; Murtaugh, Michael P; Sriramarao, P

    2015-09-01

    Numerous interspecies disease transmission events, Ebola virus being a recent and cogent example, highlight the complex interactions between human, animal, and environmental health and the importance of addressing medicine and health in a comprehensive scientific manner. The diversity of information gained from the natural, social, behavioral, and systems sciences is critical to developing and sustainably promoting integrated health approaches that can be implemented at the local, national, and international levels to meet grand challenges. The Concept of One Medicine One Science (COMOS) as outlined herein describes the interplay between scientific knowledge that underpins health and medicine and efforts toward stabilizing local systems using 2 linked case studies: the food system and emerging infectious disease. Forums such as the International Conference of One Medicine One Science (iCOMOS), where science and policy can be debated together, missing pieces identified, and science-based collaborations formed among industry, governmental, and nongovernmental policy makers and funders, is an essential step in addressing global health. The expertise of multiple disciplines and research foci to support policy development is critical to the implementation of one health and the successful achievement of global health security goals.

  5. Advancing One Health Policy and Implementation Through the Concept of One Medicine One Science

    PubMed Central

    Cardona, Carol; Travis, Dominic A.; Berger, Kavita; Coat, Gwenaële; Kennedy, Shaun; Steer, Clifford J.; Murtaugh, Michael P.

    2015-01-01

    Numerous interspecies disease transmission events, Ebola virus being a recent and cogent example, highlight the complex interactions between human, animal, and environmental health and the importance of addressing medicine and health in a comprehensive scientific manner. The diversity of information gained from the natural, social, behavioral, and systems sciences is critical to developing and sustainably promoting integrated health approaches that can be implemented at the local, national, and international levels to meet grand challenges. The Concept of One Medicine One Science (COMOS) as outlined herein describes the interplay between scientific knowledge that underpins health and medicine and efforts toward stabilizing local systems using 2 linked case studies: the food system and emerging infectious disease. Forums such as the International Conference of One Medicine One Science (iCOMOS), where science and policy can be debated together, missing pieces identified, and science-based collaborations formed among industry, governmental, and nongovernmental policy makers and funders, is an essential step in addressing global health. The expertise of multiple disciplines and research foci to support policy development is critical to the implementation of one health and the successful achievement of global health security goals. PMID:26421234

  6. Lithography for enabling advances in integrated circuits and devices.

    PubMed

    Garner, C Michael

    2012-08-28

    Because the transistor was fabricated in volume, lithography has enabled the increase in density of devices and integrated circuits. With the invention of the integrated circuit, lithography enabled the integration of higher densities of field-effect transistors through evolutionary applications of optical lithography. In 1994, the semiconductor industry determined that continuing the increase in density transistors was increasingly difficult and required coordinated development of lithography and process capabilities. It established the US National Technology Roadmap for Semiconductors and this was expanded in 1999 to the International Technology Roadmap for Semiconductors to align multiple industries to provide the complex capabilities to continue increasing the density of integrated circuits to nanometre scales. Since the 1960s, lithography has become increasingly complex with the evolution from contact printers, to steppers, pattern reduction technology at i-line, 248 nm and 193 nm wavelengths, which required dramatic improvements of mask-making technology, photolithography printing and alignment capabilities and photoresist capabilities. At the same time, pattern transfer has evolved from wet etching of features, to plasma etch and more complex etching capabilities to fabricate features that are currently 32 nm in high-volume production. To continue increasing the density of devices and interconnects, new pattern transfer technologies will be needed with options for the future including extreme ultraviolet lithography, imprint technology and directed self-assembly. While complementary metal oxide semiconductors will continue to be extended for many years, these advanced pattern transfer technologies may enable development of novel memory and logic technologies based on different physical phenomena in the future to enhance and extend information processing.

  7. An integrated computer system for preliminary design of advanced aircraft.

    NASA Technical Reports Server (NTRS)

    Fulton, R. E.; Sobieszczanski, J.; Landrum, E. J.

    1972-01-01

    A progress report is given on the first phase of a research project to develop a system of Integrated Programs for Aerospace-Vehicle Design (IPAD) which is intended to automate to the largest extent possible the preliminary and detailed design of advanced aircraft. The approach used is to build a pilot system and simultaneously to carry out two major contractual studies to define a practical IPAD system preparatory to programing. The paper summarizes the specifications and goals of the IPAD system, the progress to date, and any conclusion reached regarding its feasibility and scope. Sample calculations obtained with the pilot system are given for aircraft preliminary designs optimized with respect to discipline parameters, such as weight or L/D, and these results are compared with designs optimized with respect to overall performance parameters, such as range or payload.

  8. Advanced Packaging and Integration Technologies for Microsensors. Phase 1

    DTIC Science & Technology

    1994-08-12

    CV VU CW %so - U Advanced Packaging & Integration Technologies for " icrosensors Final Report A.AUTN0I) i A. A. Ned and A. D. Kurtz 7. P.i-• N - 0-1O... N •AnMN NAME(SI AND .----- •S$() 6L P•,•E•_-_G •---•wWaOu Kulite Semiconductor Products, Inc. NPOW u•NeUMBE One Willow Tree Rd. Leonia, NJ 07605 I1...T I YaAU W 16UJNU S 17. S ý " cu. . t lmV IC .M N . I& . SO ,-,- C L, •.A T 1% ý, . . C L . ... ... L O • .A .. _ w un Unclassified Unclassified

  9. A brief report: Yale Research Symposium on Complementary and Integrative Medicine.

    PubMed

    Ali, Ather; Vitulano, Lawrence A

    2010-09-01

    The 2010 Yale Research Symposium on Complementary and Integrative Medicine highlighted original research in related areas by Yale faculty and provided a forum to discuss and debate issues of evidence and plausibility. In this brief report, we describe selected presentations on such diverse foci as nutritional influences on cancer, acupuncture for low back pain, protein intake's effects on bone consumption, Chinese herb-derived adjuvant chemotherapy, and the relationship between anger and cardiac arrhythmia. This symposium demonstrated that rigorous research methods are being used to study unconventional therapies and that an integrative medicine approach requires a solid scientific foundation.

  10. Phantom limbs: pain, embodiment, and scientific advances in integrative therapies.

    PubMed

    Lenggenhager, Bigna; Arnold, Carolyn A; Giummarra, Melita J

    2014-03-01

    Research over the past two decades has begun to identify some of the key mechanisms underlying phantom limb pain and sensations; however, this continues to be a clinically challenging condition to manage. Treatment of phantom pain, like all chronic pain conditions, demands a holistic approach that takes into consideration peripheral, spinal, and central neuroplastic mechanisms. In this review, we focus on nonpharmacological treatments tailored to reverse the maladaptive neuroplasticity associated with phantom pain. Recent scientific advances emerging from interdisciplinary research between neuroscience, virtual reality, robotics, and prosthetics show the greatest promise for alternative embodiment and maintaining the integrity of the multifaceted representation of the body in the brain. Importantly, these advances have been found to prevent and reduce phantom limb pain. In particular, therapies that involve sensory and/or motor retraining, most naturally through the use of integrative prosthetic devices, as well as peripheral (e.g., transcutaneous electrical nerve stimulation) or central (e.g., transcranial magnetic stimulation or deep brain stimulation) stimulation techniques, have been found to both restore the neural representation of the missing limb and to reduce the intensity of phantom pain. While the evidence for the efficacy of these therapies is mounting, but well-controlled and large-scale studies are still needed. WIREs Cogn Sci 2014, 5:221-231. doi: 10.1002/wcs.1277 CONFLICT OF INTEREST: The authors have no financial or other relationship that might lead to a conflict of interest. For further resources related to this article, please visit the WIREs website. © 2014 John Wiley & Sons, Ltd.

  11. Lime enhanced chromium removal in advanced integrated wastewater pond system.

    PubMed

    Tadesse, I; Isoaho, S A; Green, F B; Puhakka, J A

    2006-03-01

    The removal of trivalent chromium from a combined tannery effluent in horizontal settling tanks and subsequent Advanced Integrated Wastewater Pond System (AIWPS) reactors was investigated. The raw combined effluent from Modjo tannery had pH in the range of 11.2-12. At this pH, a trivalent chromium removal of 46-72% was obtained in the horizontal settling tanks after a one-day detention time. Trivalent chromium precipitated as chromium hydroxide, Cr(OH)3. 58-95% Cr(III) was removed in the advanced facultative pond (AFP) where the water column pH of 7.2-8.4 was close to pH 8, which is the optimum precipitation pH for trivalent chromium. Chromium removals in the secondary facultative pond (SFP) and maturation pond (MP) were 30-50% and 6-16%, respectively. With Cr(III) concentration of 0.2-0.8 mg/l in the final treated effluent, the AIWPS preceded by horizontal settling tanks produced effluent that could easily meet most of the current Cr(III) discharge limits to receive water bodies.

  12. Getting personal: can systems medicine integrate scientific and humanistic conceptions of the patient?

    PubMed

    Vogt, Henrik; Ulvestad, Elling; Eriksen, Thor Eirik; Getz, Linn

    2014-12-01

    The practicing doctor, and most obviously the primary care clinician who encounters the full complexity of patients, faces several fundamental but intrinsically related theoretical and practical challenges - strongly actualized by so-called medically unexplained symptoms (MUS) and multi-morbidity. Systems medicine, which is the emerging application of systems biology to medicine and a merger of molecular biomedicine, systems theory and mathematical modelling, has recently been proposed as a primary care-centered strategy for medicine that promises to meet these challenges. Significantly, it has been proposed to do so in a way that at first glance may seem compatible with humanistic medicine. More specifically, it is promoted as an integrative, holistic, personalized and patient-centered approach. In this article, we ask whether and to what extent systems medicine can provide a comprehensive conceptual account of and approach to the patient and the root causes of health problems that can be reconciled with the concept of the patient as a person, which is an essential theoretical element in humanistic medicine. We answer this question through a comparative analysis of the theories of primary care doctor Eric Cassell and systems biologist Denis Noble. We argue that, although systems biological concepts, notably Noble's theory of biological relativity and downward causation, are highly relevant for understanding human beings and health problems, they are nevertheless insufficient in fully bridging the gap to humanistic medicine. Systems biologists are currently unable to conceptualize living wholes, and seem unable to account for meaning, value and symbolic interaction, which are central concepts in humanistic medicine, as constraints on human health. Accordingly, systems medicine as currently envisioned cannot be said to be integrative, holistic, personalized or patient-centered in a humanistic medical sense. © 2014 The Authors. Journal of Evaluation in Clinical

  13. A web-based knowledge management system integrating Western and Traditional Chinese Medicine for relational medical diagnosis.

    PubMed

    Herrera-Hernandez, Maria C; Lai-Yuen, Susana K; Piegl, Les A; Zhang, Xiao

    2016-10-26

    This article presents the design of a web-based knowledge management system as a training and research tool for the exploration of key relationships between Western and Traditional Chinese Medicine, in order to facilitate relational medical diagnosis integrating these mainstream healing modalities. The main goal of this system is to facilitate decision-making processes, while developing skills and creating new medical knowledge. Traditional Chinese Medicine can be considered as an ancient relational knowledge-based approach, focusing on balancing interrelated human functions to reach a healthy state. Western Medicine focuses on specialties and body systems and has achieved advanced methods to evaluate the impact of a health disorder on the body functions. Identifying key relationships between Traditional Chinese and Western Medicine opens new approaches for health care practices and can increase the understanding of human medical conditions. Our knowledge management system was designed from initial datasets of symptoms, known diagnosis and treatments, collected from both medicines. The datasets were subjected to process-oriented analysis, hierarchical knowledge representation and relational database interconnection. Web technology was implemented to develop a user-friendly interface, for easy navigation, training and research. Our system was prototyped with a case study on chronic prostatitis. This trial presented the system's capability for users to learn the correlation approach, connecting knowledge in Western and Traditional Chinese Medicine by querying the database, mapping validated medical information, accessing complementary information from official sites, and creating new knowledge as part of the learning process. By addressing the challenging tasks of data acquisition and modeling, organization, storage and transfer, the proposed web-based knowledge management system is presented as a tool for users in medical training and research to explore, learn and

  14. Advanced hemodynamic monitoring in intensive care medicine : A German web-based survey study.

    PubMed

    Saugel, B; Reese, P C; Wagner, J Y; Buerke, M; Huber, W; Kluge, S; Prondzinsky, R

    2017-05-04

    Advanced hemodynamic monitoring is recommended in patients with complex circulatory shock. To evaluate the current attitudes and beliefs among German intensivists, regarding advanced hemodynamic monitoring, the actual hemodynamic management in clinical practice, and the barriers to using it. Web-based survey among members of the German Society of Medical Intensive Care and Emergency Medicine. Of 284 respondents, 249 (87%) agreed that further hemodynamic assessment is needed to determine the type of circulatory shock if no clear clinical diagnosis can be made. In all, 281 (99%) agreed that echocardiography is helpful for this purpose (transpulmonary thermodilution: 225 [79%]; pulmonary artery catheterization: 126 [45%]). More than 70% of respondents agreed that blood flow variables (cardiac output, stroke volume) should be measured in patients with hemodynamic instability. The parameters most respondents agreed should be assessed in a patient with hemodynamic instability were mean arterial pressure, cardiac output, and serum lactate. Echocardiography is available in 99% of ICUs (transpulmonary thermodilution: 91%; pulmonary artery catheter: 63%). The respondents stated that, in clinical practice, invasive arterial pressure measurements and serum lactate measurements are performed in more than 90% of patients with hemodynamic instability (cardiac output monitoring in about 50%; transpulmonary thermodilution in about 40%). The respondents did not feel strong barriers to the use of advanced hemodynamic monitoring in clinical practice. This survey study shows that German intensivists deem advanced hemodynamic assessment necessary for the differential diagnosis of circulatory shock and to guide therapy with fluids, vasopressors, and inotropes in ICU patients.

  15. Orientation of Dental Professionals in India towards Integrative Medicine: A Cross-Sectional Survey

    PubMed Central

    Gayathri, Haritheertham; Garhnayak, Mirna; Naik, Eslavath Seena

    2016-01-01

    Introduction There is a growing demand on our health care system, including Dentistry, to shift from a bio-medical approach to Integrative model of care. The attitudes of health professionals towards Integrative Medicine (IM) are an important factor that influences this transition. Aim The aim of this study was to evaluate and compare the orientation of the dental professionals in India towards the principles and practice of Integrative Medicine. Materials and Methods A cross-sectional survey was conducted on 286 dental faculty and postgraduate students from three dental schools in India. The participants voluntarily and anonymously completed the “Integrative Medicine-30’ questionnaire, a 30 item self-report instrument that measures the health care provider’s orientation towards Integrative Medicine in five subscales. Data analysis included summary statistics and intergroup comparisons by gender and professional status with independent samples Mann-Whitney U test. Results The overall orientation of the dental professionals towards IM was almost neutral. While the use of learning resources on Complementary and Alternative Medicine was lower, they showed a more positive orientation towards patient-centred care. Compared to postgraduate students of Dentistry, the dental faculty were more oriented towards IM (median score of 82 vs. 79.5, p<0.01), especially in terms of learning from alternate paradigms (14 vs. 12, p<0.01) and safety of Complementary and Alternative Medicine (13 vs. 12, p<0.01). Females scored better than males both in terms of overall orientation (82 vs. 78, p<0.01) and towards patient-centred care (12 vs. 11, p<0.001). Conclusion The results highlight the impending need to improve the orientation of dental professionals in India towards the principles and practice of IM. PMID:27042588

  16. Normalising advance care planning in a general medicine service of a tertiary hospital: an exploratory study.

    PubMed

    Scott, Ian A; Rajakaruna, Nalaka; Shah, Darshan; Miller, Leyton; Reymond, Elizabeth; Daly, Michael

    2015-11-05

    Objective The aim of the present study was to develop, implement and explore the effects of a program in advance care planning (ACP) within a tertiary hospital general medicine service.Methods Before-after exploratory mixed-methods analysis was conducted of an ACP program comprising seven components designed to overcome well-documented barriers to ACP in clinical practice. The results of pre-ACP program audits performed in June 2014 were compared with those of post-ACP audits performed over 5 months from July to November 2014. The main outcome measure was the number of advance care plans completed in patients considered eligible for ACP based on a life expectancy of 12 months or less as assessed by two prognostication instruments. Questionnaire surveys ascertained staff perceptions of ACP and the usefulness of training and resources in ACP.Results Pre-ACP program analysis of 166 consecutive patients deemed eligible for ACP revealed that only 1% had a documented advance care plan. Following ACP implementation, 115 of 215 (53%) potentially eligible patients were considered able to participate in ACP discussions and were approached to do so before discharge, of whom 89 (77.4%) completed an advance care plan, whereas 26 (23.6%) declined. This equated to an overall completion rate for all potentially eligible patients of 41% compared to 1% pre-ACP (P < 0.001). Major barriers to ACP perceived by at least 30% of questionnaire respondents included the reluctance of patients and family to discuss ACP, insufficient time to initiate or complete ACP, patient and/or family factors that rendered ACP impractical, inadequate communication skills around end-of-life issues, confusion about who was primarily responsible for conducting ACP and difficulty using ACP documentation forms. Enabling factors included dedicated ACP workshops, facilitator and resource packages for staff, and ACP brochures for patients and family.Conclusion A multifaceted ACP program in a general medicine

  17. Advanced research technology for discovery of new effective compounds from Chinese herbal medicine and their molecular targets.

    PubMed

    Wong, Vincent Kam-Wai; Law, Betty Yuen-Kwan; Yao, Xiao-Jun; Chen, Xi; Xu, Su Wei; Liu, Liang; Leung, Elaine Lai-Han

    2016-09-01

    Traditional biotechnology has been utilized by human civilization for long in wide aspects of our daily life, such as wine and vinegar production, which can generate new phytochemicals from natural products using micro-organism. Today, with advanced biotechnology, diverse applications and advantages have been exhibited not only in bringing benefits to increase the diversity and composition of herbal phytochemicals, but also helping to elucidate the treatment mechanism and accelerate new drug discovery from Chinese herbal medicine (CHM). Applications on phytochemical biotechnologies and microbial biotechnologies have been promoted to enhance phytochemical diversity. Cell labeling and imaging technology and -omics technology have been utilized to elucidate CHM treatment mechanism. Application of computational methods, such as chemoinformatics and bioinformatics provide new insights on direct target of CHM. Overall, these technologies provide efficient ways to overcome the bottleneck of CHM, such as helping to increase the phytochemical diversity, match their molecular targets and elucidate the treatment mechanism. Potentially, new oriented herbal phytochemicals and their corresponding drug targets can be identified. In perspective, tighter integration of multi-disciplinary biotechnology and computational technology will be the cornerstone to accelerate new arena formation, advancement and revolution in the fields of CHM and world pharmaceutical industry. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Advances in Neuroprotective Ingredients of Medicinal Herbs by Using Cellular and Animal Models of Parkinson's Disease

    PubMed Central

    More, Sandeep Vasant; Kumar, Hemant; Kang, Seong Mook; Song, Soo-Yeol; Lee, Kippeum; Choi, Dong-Kug

    2013-01-01

    Parkinson's disease (PD) is a multifactorial disorder, which is neuropathologically identified by age-dependent neurodegeneration of dopaminergic neurons in the substantia nigra. Development of symptomatic treatments has been partly successful for PD research, but there remain a number of inadequacies in therapeutic strategies for the disease. The pathogenesis of PD remains intricate, and the present anti-PD treatments appears to be clinically insufficient. Comprehensive research on discovery of novel drug candidates has demonstrated that natural products, such as medicinal herbs, plant extracts, and their secondary metabolites, have great potential as therapeutics with neuroprotective activity in PD. Recent preclinical studies suggest that a number of herbal medicines and their bioactive ingredients can be developed into optimum pharmaceuticals for treating PD. In many countries, traditional herbal medicines are used to prevent or treat neurodegenerative disorders, and some have been developed as nutraceuticals or functional foods. Here we focus on recent advances of the evidence-linked neuroprotective activity of bioactive ingredients of herbal origin in cellular and animal models of PD research. PMID:24073012

  19. Advanced Tissue Sciences Inc.: learning from the past, a case study for regenerative medicine.

    PubMed

    Pangarkar, Nitin; Pharoah, Marc; Nigam, Avinav; Hutmacher, Dietmar W; Champ, Simon

    2010-09-01

    On 31st March 2003 Advanced Tissue Sciences (ATS) was liquidated, with the effect that in excess of US$300 million of stakeholder financing was destroyed. Although successful in the development of breakthrough technologies in the regenerative medicine arena and the building of a substantial portfolio of patents, the company never made a profit. In this case study, ATS’ business strategy, market and competitive environment will be discussed in the context of the company’s historical development. A number of important lessons from this case are discussed. From a management perspective the most critical lesson is the importance of effective financial planning and management of costs, and in particular R&D costs, including the significant costs associated with clinical trials. In addition, a clear strategic focus is extremely important due to the significant resources required in the development of a new therapy. From an investor’s perspective the lessons to be gathered from the ATS case are related to the risk involved in investing in the field of regenerative medicine. This case indicates that both professional and private investors did not fully question the validity of ATS’ business strategy and financial forecasts. A clear and focused strategy based on long-term investor commitment is essential for the successful commercialization of regenerative medicine.

  20. Canadians' support for radical life extension resulting from advances in regenerative medicine.

    PubMed

    Dragojlovic, Nick

    2013-04-01

    This paper explores Canadian public perceptions of a hypothetical scenario in which a radical increase in life expectancy results from advances in regenerative medicine. A national sample of 1231 adults completed an online questionnaire on stem cell research and regenerative medicine, including three items relating to the possibility of Canadians' average life expectancy increasing to 120 years by 2050. Overall, Canadians are strongly supportive of the prospect of extended lifespans, with 59% of the sample indicating a desire to live to 120 if scientific advances made it possible, and 47% of respondents agreeing that such increases in life expectancy are possible by 2050. The strongest predictors of support for radical life extension are individuals' general orientation towards science and technology and their evaluation of its plausibility. These results contrast with previous research, which has suggested public ambivalence for biomedical life extension, and point to the need for more research in this area. They suggest, moreover, that efforts to increase public awareness about anti-aging research are likely to increase support for the life-extending consequences of that research program.

  1. TCMID: Traditional Chinese Medicine integrative database for herb molecular mechanism analysis.

    PubMed

    Xue, Ruichao; Fang, Zhao; Zhang, Meixia; Yi, Zhenghui; Wen, Chengping; Shi, Tieliu

    2013-01-01

    As an alternative to modern western medicine, Traditional Chinese Medicine (TCM) is receiving increasingly attention worldwide. Great efforts have been paid to TCM's modernization, which tries to bridge the gap between TCM and modern western medicine. As TCM and modern western medicine share a common aspect at molecular level that the compound(s) perturb human's dysfunction network and restore human normal physiological condition, the relationship between compounds (in herb, refer to ingredients) and their targets (proteins) should be the key factor to connect TCM and modern medicine. Accordingly, we construct this Traditional Chinese Medicine Integrated Database (TCMID, http://www.megabionet.org/tcmid/), which records TCM-related information collected from different resources and through text-mining method. To enlarge the scope of the TCMID, the data have been linked to common drug and disease databases, including Drugbank, OMIM and PubChem. Currently, our TCMID contains ∼47 000 prescriptions, 8159 herbs, 25 210 compounds, 6828 drugs, 3791 diseases and 17 521 related targets, which is the largest data set for related field. Our web-based software displays a network for integrative relationships between herbs and their treated diseases, the active ingredients and their targets, which will facilitate the study of combination therapy and understanding of the underlying mechanisms for TCM at molecular level.

  2. ATOS: Integration of advanced technology software within distributed Spacecraft Mission Operations Systems

    NASA Technical Reports Server (NTRS)

    Jones, M.; Wheadon, J.; Omullane, W.; Whitgift, D.; Poulter, K.; Niezette, M.; Timmermans, R.; Rodriguez, Ivan; Romero, R.

    1994-01-01

    The Advanced Technology Operations System (ATOS) is a program of studies into the integration of advanced applications (including knowledge based systems (KBS)) with ground systems for the support of spacecraft mission operations.

  3. Career advancement for women faculty in a U.S. school of medicine: perceived needs.

    PubMed

    McGuire, Lindsay K; Bergen, Merlynn R; Polan, Mary Lake

    2004-04-01

    The percentage of women faculty at the professor level has remained at approximately 11%. The medical community could benefit from knowing what is required to attract, retain, and advance women in the academy. The Committee on Women in Medicine and Science at Stanford University School of Medicine was charged with improving career success and well-being of women faculty. In 2001-02, a survey instrument including both needs and perceived school climate was sent to 309 women faculty. Responses were analyzed using one-way analyses of variance with Tukey follow-up tests. A total of 163 (53%) faculty responded. The highest ranked needs were a flexible work environment without negative consequences for women with young children (mean = 4.37 on a five-point scale); a three-month sabbatical from clinical and administrative duties (mean = 4.15); departmental mentoring for academic career development (mean = 4.13); and school/departmental administrative secretarial support for grant and manuscript preparation (mean = 4.11). Climate data obtained in 2002, compared to data from similar surveys in 1994 and 1995, showed a nonsignificant decrease in mean ratings for sexual harassment, gender discrimination, and gender insensitivity in the intervening years. Mean ratings for positive climate and cohesion increased between 1994 and 1995 but remained stable from 1995 to 2002. Results of the survey were presented to the dean, faculty, and staff of the medical school. Women faculty members were able to clearly indicate specific interventions that would improve their career success and sense of well-being. Since administrators are committed to serious consideration of these recommendations, this was a key step in advancing women's careers in academic medicine at Stanford.

  4. [Changes in knowledge and carrying out the advance directives of patients admitted to internal medicine].

    PubMed

    Pérez, M; Herreros, B; Martín, M D; Molina, J; Guijarro, C; Velasco, M

    2013-01-01

    Advance directives (ADs), are documents in which patients express in advance that their wishes are fulfilled when they are unable to communicate them. It is unknown whether patients admitted to internal medicine are more aware of and make ADs. To study the changes in the level of knowledge and implementation of AD among patients admitted to an internal medicine department of a hospital in Madrid since a specific regulation to implement them was introduced. A survey was conducted among patients admitted to internal medicine in two periods: 2008 and 2010. A total of 206 surveys were analysed (84 in 2008 and 122 in 2010). The mean age of the patients was 76.8 years, and 51.5% were women. More than two-thirds (69.4%) had a co-morbidity. and 4.4% had a terminal illness, with no statistical differences between the periods. Only 5.3% knew what ADs are, 1 had implemented ADs, and 46.1%, once informed, would like to implement them. There were no differences between 2008 and 2010 as regards knowledge and implementation of AD. In 2010 there was a greater interest to implement them (would like to implement them: 52.5 vs 36.9%), although in 2010 less respondents believe that AD would change the attitude of the doctor (not change the attitude: 92.6 vs. 69%, P<.001). Knowledge and implementation of AD did not change significantly in the years following the regulation (from 2008-2010). In both periods, their knowledge and implementation are scarce. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

  5. Assessing the integration of genomic medicine in genetic counseling training programs.

    PubMed

    Profato, Jessica; Gordon, Erynn S; Dixon, Shannan; Kwan, Andrea

    2014-08-01

    Medical genetics has entered a period of transition from genetics to genomics. Genetic counselors (GCs) may take on roles in the clinical implementation of genomics. This study explores the perspectives of program directors (PDs) on including genomic medicine in GC training programs, as well as the status of this integration. Study methods included an online survey, an optional one-on-one telephone interview, and an optional curricula content analysis. The majority of respondents (15/16) reported that it is important to include genomic medicine in program curricula. Most topics of genomic medicine are either "currently taught" or "under development" in all participating programs. Interview data from five PDs and one faculty member supported the survey data. Integrating genomics in training programs is challenging, and it is essential to develop genomics resources for curricula.

  6. Integrating motivational interviewing and narrative therapy to teach behavior change to family medicine resident physicians.

    PubMed

    Oshman, Lauren D; Combs, Gene N

    2016-05-01

    Motivational interviewing is a useful skill to address the common problem of patient ambivalence regarding behavior change by uncovering and strengthening a person's own motivation and commitment to change. The Family Medicine Milestones underline the need for clear teaching and monitoring of skills in communication and behavior change in Family Medicine postgraduate training settings. This article reports the integration of a motivational interviewing curriculum into an existing longitudinal narrative therapy-based curriculum on patient-centered communication. Observed structured clinical examination for six participants indicate that intern physicians are able to demonstrate moderate motivational interviewing skill after a brief 2-h workshop. Participant self-evaluations for 16 participants suggest a brief 2-h curriculum was helpful at increasing importance of learning motivational interviewing by participants, and that participants desire further training opportunities. A brief motivational interviewing curriculum can be integrated into existing communication training in a Family Medicine residency training program. © The Author(s) 2016.

  7. Successful Integrative Medicine Assessment and Treatment of Chronic Pain Associated With Breast Surgery

    PubMed Central

    Chung, Myung Kyu

    2017-01-01

    Presented is the first reported case series of chronic neck and back pain associated with breast scars from breast surgery and successfully treated with an integrative medicine assessment and treatment approach, which included the assessment technique of autonomic response testing and the scar therapy technique of neural therapy. Implications for nursing practice are discussed. PMID:27782920

  8. A Precision Medicine Initiative for Alzheimer's disease: the road ahead to biomarker-guided integrative disease modeling.

    PubMed

    Hampel, H; O'Bryant, S E; Durrleman, S; Younesi, E; Rojkova, K; Escott-Price, V; Corvol, J-C; Broich, K; Dubois, B; Lista, S

    2017-04-01

    After intense scientific exploration and more than a decade of failed trials, Alzheimer's disease (AD) remains a fatal global epidemic. A traditional research and drug development paradigm continues to target heterogeneous late-stage clinically phenotyped patients with single 'magic bullet' drugs. Here, we propose that it is time for a paradigm shift towards the implementation of precision medicine (PM) for enhanced risk screening, detection, treatment, and prevention of AD. The overarching structure of how PM for AD can be achieved will be provided through the convergence of breakthrough technological advances, including big data science, systems biology, genomic sequencing, blood-based biomarkers, integrated disease modeling and P4 medicine. It is hypothesized that deconstructing AD into multiple genetic and biological subsets existing within this heterogeneous target population will provide an effective PM strategy for treating individual patients with the specific agent(s) that are likely to work best based on the specific individual biological make-up. The Alzheimer's Precision Medicine Initiative (APMI) is an international collaboration of leading interdisciplinary clinicians and scientists devoted towards the implementation of PM in Neurology, Psychiatry and Neuroscience. It is hypothesized that successful realization of PM in AD and other neurodegenerative diseases will result in breakthrough therapies, such as in oncology, with optimized safety profiles, better responder rates and treatment responses, particularly through biomarker-guided early preclinical disease-stage clinical trials.

  9. Spiritual care of cancer patients by integrated medicine in urban green space: a pilot study.

    PubMed

    Nakau, Maiko; Imanishi, Jiro; Imanishi, Junichi; Watanabe, Satoko; Imanishi, Ayumi; Baba, Takeshi; Hirai, Kei; Ito, Toshinori; Chiba, Wataru; Morimoto, Yukihiro

    2013-01-01

    Psycho-oncological care, including spiritual care, is essential for cancer patients. Integrated medicine, a therapy combining modern western medicine with various kinds of complementary and alternative medicine, can be appropriate for the spiritual care of cancer because of the multidimensional characteristics of the spirituality. In particular, therapies that enable patients to establish a deeper contact with nature, inspire feelings of life and growth of plants, and involve meditation may be useful for spiritual care as well as related aspects such as emotion. The purpose of the present study was to examine the effect of spiritual care of cancer patients by integrated medicine in a green environment. The present study involved 22 cancer patients. Integrated medicine consisted of forest therapy, horticultural therapy, yoga meditation, and support group therapy, and sessions were conducted once a week for 12 weeks. The spirituality (the Functional Assessment of Chronic Illness Therapy-Spiritual well-being), quality of life (Short Form-36 Health Survey Questionnaire), fatigue (Cancer Fatigue Scale), psychological state (Profile of Mood States, short form, and State-Trait Anxiety Inventory) and natural killer cell activity were assessed before and after intervention. In Functional Assessment of Chronic Illness Therapy-Spiritual well-being, there were significant differences in functional well-being and spiritual well-being pre- and postintervention. This program improved quality of life and reduced cancer-associated fatigue. Furthermore, some aspects of psychological state were improved and natural killer cell activity was increased. It is indicated that integrated medicine performed in a green environment is potentially useful for the emotional and spiritual well-being of cancer patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. CMKb: a web-based prototype for integrating Australian Aboriginal customary medicinal plant knowledge

    PubMed Central

    Gaikwad, Jitendra; Khanna, Varun; Vemulpad, Subramanyam; Jamie, Joanne; Kohen, Jim; Ranganathan, Shoba

    2008-01-01

    Background The customary medicinal plant knowledge possessed by the Australian Aboriginal people is a significant resource. Published information on it is scattered throughout the literature, in heterogeneous data formats, and is scattered among various Aboriginal communities across Australia, due to a multiplicity of languages. This ancient knowledge is at risk due to loss of biodiversity, cultural impact and the demise of many of its custodians. We have developed the Customary Medicinal Knowledgebase (CMKb), an integrated multidisciplinary resource, to document, conserve and disseminate this knowledge. Description CMKb is an online relational database for collating, disseminating, visualising and analysing initially public domain data on customary medicinal plants. The database stores information related to taxonomy, phytochemistry, biogeography, biological activities of customary medicinal plant species as well as images of individual species. The database can be accessed at . Known bioactive molecules are characterized within the chemoinformatics module of CMKb, with functions available for molecular editing and visualization. Conclusion CMKb has been developed as a prototype data resource for documenting, integrating, disseminating, analysing multidisciplinary customary medicinal plant data from Australia and to facilitate user-defined complex querying. Each species in CMKb is linked to online resources such as the Integrated Taxonomic Information System (ITIS), NCBI Taxonomy, Australia's SpeciesLinks-Integrated Botanical Information System (IBIS) and Google images. The bioactive compounds are linked to the PubChem database. Overall, CMKb serves as a single knowledgebase for holistic plant-derived therapeutics and can be used as an information resource for biodiversity conservation, to lead discovery and conservation of customary medicinal knowledge. PMID:19091025

  11. Cancer Pharmacogenomics: Integrating Discoveries in Basic, Clinical and Population Sciences to Advance Predictive Cancer Care

    Cancer.gov

    Cancer Pharmacogenomics: Integrating Discoveries in Basic, Clinical and Population Sciences to Advance Predictive Cancer Care, a 2010 workshop sponsored by the Epidemiology and Genomics Research Program.

  12. Integration of advanced practice providers into the Israeli healthcare system.

    PubMed

    Aaron, Eliana Marcus; Andrews, Caryn Scheinberg

    2016-01-01

    Many countries around the world have integrated various types of Advanced Practice Providers (APPs) into their healthcare systems. The main motivating factors for recognizing and developing APPs worldwide include physician shortages and the need for improved access or delivery (US, France, Belgium, Scotland, Switzerland), reduced residency hours (US, UK), shortages in underserved regions (US, Canada, Finland, Australia), and cost containment (Germany, Netherlands, UK, US). Israel is experiencing a shortage of physicians in peripheral geographic regions and in critical medical specialties. Recent by-laws approved by the Knesset (Parliament), combined with Israel Ministry of Health (MOH) policies, have thus far been unable to fully address the shortages. To understand the potential contribution of APPs in Israel, we evaluated the international historical foundations and development of APP roles. We assessed how APPs have impacted healthcare in other countries by analyzing public data and published international research about APP education, safety, quality of care, motivators, barriers, and impact. We found that APPs are recognized in dozens of countries, and have similar scopes of practice, graduate level education requirements (in developed countries), and clinical training. At the same time, there is wide variability among countries in the actual function and independence of the advanced practice nurse (APN), particularly the nurse practitioner (NP). APPs have been established as cost effective, safe healthcare providers who improve healthcare access. Israel has begun to introduce APPs, specifically NPs, in a variety of fields, including geriatrics, palliative care and diabetic care. We recommend a rapid expansion of existing and new APP roles into the Israeli healthcare system based on evidence and the recommendations of international evaluations by non-government organizations. By shifting the education to a university setting, mirroring successful, evidence

  13. Integrated Colony Imaging, Analysis, and Selection Device for Regenerative Medicine.

    PubMed

    Kwee, Edward; Herderick, Edward E; Adams, Thomas; Dunn, James; Germanowski, Robert; Krakosh, Frank; Boehm, Cynthia; Monnich, James; Powell, Kimerly; Muschler, George

    2017-04-01

    Stem and progenitor cells derived from human tissues are being developed as cell sources for cell-based assays and therapies. However, tissue-derived stem and progenitor cells are heterogeneous. Differences in observed clones of stem cells likely reflect important aspects of the underlying state of the source cells, as well as future potency for cell therapies. This paper describes a colony analysis and picking device that provides quantitative analysis of heterogeneous cell populations and precise tools for cell picking for research or biomanufacturing applications. We describe an integrated robotic system that enables image acquisition and automated image analysis to be coupled with rapid automated selection of individual colonies in adherent cell cultures. Other automated systems have demonstrated feasibility with picking from semisolid media or off feeder layers. We demonstrate the capability to pick adherent bone-derived stem cells from tissue culture plastic. Cells are efficiently picked from a target site and transferred to a recipient well plate. Cells demonstrate viability and adherence and maintain biologic potential for surface markers CD73 and CD90 based on phase contrast and fluorescence imaging 6 days after transfer. Methods developed here can be applied to the study of other stem cell types and automated culture of cells.

  14. Cooperative Research and Development for Advanced Microturbines Program on Advanced Integrated Microturbine System

    SciTech Connect

    Michael J. Bowman

    2007-05-30

    The Advanced Integrated Microturbine Systems (AIMS) project was kicked off in October of 2000 to develop the next generation microturbine system. The overall objective of the project was to develop a design for a 40% electrical efficiency microturbine system and demonstrate many of the enabling technologies. The project was initiated as a collaborative effort between several units of GE, Elliott Energy Systems, Turbo Genset, Oak Ridge National Lab and Kyocera. Since the inception of the project the partners have changed but the overall direction of the project has stayed consistent. The project began as a systems study to identify design options to achieve the ultimate goal of 40% electrical efficiency. Once the optimized analytical design was identified for the 40% system, it was determined that a 35% efficient machine would be capable of demonstrating many of the advanced technologies within the given budget and timeframe. The items that would not be experimentally demonstrated were fully produced ceramic parts. However, to understand the requirements of these ceramics, an effort was included in the project to experimentally evaluate candidate materials in representative conditions. The results from this effort would clearly identify the challenges and improvement required of these materials for the full design. Following the analytical effort, the project was dedicated to component development and testing. Each component and subsystem was designed with the overall system requirements in mind and each tested to the fullest extent possible prior to being integrated together. This method of component development and evaluation helps to minimize the technical risk of the project. Once all of the components were completed, they were assembled into the full system and experimentally evaluated.

  15. An exploratory typology of provider responses that encourage and discourage conversation about complementary and integrative medicine during routine oncology visits

    PubMed Central

    Koenig, Christopher J.; Ho, Evelyn Y.; Trupin, Laura; Dohan, Daniel

    2015-01-01

    OBJECTIVE To characterize how providers respond to patient mentions of complementary and integrative medicine (CIM) during routine oncology visits. METHODS Ethnographic methods were used over a two and a half year period with 82 advanced cancer patients and their providers across four oncology clinics. Participant observation fieldnotes were analyzed using Discourse Analysis. RESULTS CIM was mentioned in 78/229 (34%) of the total observed visits. Patients initiated talk about CIM (76%) more than providers (24%). Patients mentioning CIM may indicate a preference for or interest in non-pharmacological adjunctive treatment options. Providers’ responses inhibited further talk in 44% of observations and promoted talk in 56% of observations. CONCLUSION How providers respond may indicate their willingness to discuss a range of treatment options and to collaboratively engage in treatment decision-making. Provider responses that inhibited CIM conversation passed on the opportunity to discuss patient interests, and responses that promoted further conversation helped counsel patients about appropriate CIM use. Promoting discussion did not require additional time or extensive knowledge about CIM. PRACTICE IMPLICATIONS Providers can facilitate high quality communication without endorsing CIM to help patients make treatment decisions and to evaluate CIM appropriateness and safety in ways that are responsive to patient preferences and values. An exploratory typology of provider responses that encourage and discourage conversation about complementary and integrative medicine during routine oncology visits PMID:25865412

  16. Trends and challenges toward integration of traditional medicine in formal health-care system: Historical perspectives and appraisal of education curricula in Sub-Sahara Africa

    PubMed Central

    Innocent, Ester

    2016-01-01

    The population residing Sub-Sahara Africa (SSA) continues to suffer from communicable health problems such as HIV/AIDS, malaria, tuberculosis, and various neglected tropical as well as non-communicable diseases. The disease burden is aggravated by shortage of medical personnel and medical supplies such as medical devices and minimal access to essential medicine. For long time, human beings through observation and practical experiences learned to use different plant species that led to the emergence of traditional medicine (TM) systems. The ancient Pharaonic Egyptian TM system is one of the oldest documented forms of TM practice in Africa and the pioneer of world’s medical science. However, the medical practices diffused very fast to other continents being accelerated by advancement of technologies while leaving Africa lagging behind in the integration of the practice in formal health-care system. Challenging issues that drag back integration is the development of education curricula for training TM experts as the way of disseminating the traditional medical knowledge and practices imbedded in African culture. The few African countries such as Ghana managed to integrate TM products in the National Essential Medicine List while South Africa, Sierra Leone, and Tanzania have TM products being sold over the counters due to the availability of education training programs facilitated by research. This paper analyses the contribution of TM practice and products in modern medicine and gives recommendations that Africa should take in the integration process to safeguard the SSA population from disease burdens. PMID:27366358

  17. NEED FOR AN INTEGRATED SYSTEM OF MEDICINE-A PROPOSAL FOR ITS ATTAINMENT

    PubMed Central

    Parikh, M.D.; Mistry, R.R.; Bhatt, N.S.

    1984-01-01

    Integration of various systems of medicine is in the best interest of all concerned. It enables the physician to provide the best available therapeutic care to the patient without undue delay, making way for a better prognosis. It also makes available to him a greater variety of treatment measures hitherto restricted to one or the other system. Integration must be achieved at the theoretical level first by pooling together the facts available in the existing systems. From this pooled data must be formulated newer integrated concepts of human being, illness, etiology and treatment. It is not difficult to achieve such integrations for their already exist certain similarities among the prevalent systems of medicine. This will help to translate ancient wisdom into practice and find proper orientation to modern discoveries. Therefore the adherents of various systems must sink their differences and strive to develop an integrated system of medicine The entire world is the teacher to the intelligent and the foe to the unintelligent. Caraka Vimana 8/14. PMID:22557454

  18. Need for an integrated system of medicine-a proposal for its attainment.

    PubMed

    Parikh, M D; Mistry, R R; Bhatt, N S

    1984-10-01

    Integration of various systems of medicine is in the best interest of all concerned. It enables the physician to provide the best available therapeutic care to the patient without undue delay, making way for a better prognosis. It also makes available to him a greater variety of treatment measures hitherto restricted to one or the other system. Integration must be achieved at the theoretical level first by pooling together the facts available in the existing systems. From this pooled data must be formulated newer integrated concepts of human being, illness, etiology and treatment. It is not difficult to achieve such integrations for their already exist certain similarities among the prevalent systems of medicine. This will help to translate ancient wisdom into practice and find proper orientation to modern discoveries. Therefore the adherents of various systems must sink their differences and strive to develop an integrated system of medicineThe entire world is the teacher to the intelligent and the foe to the unintelligent. Caraka Vimana 8/14.

  19. Integration of advanced teleoperation technologies for control of space robots

    NASA Technical Reports Server (NTRS)

    Stagnaro, Michael J.

    1993-01-01

    Teleoperated robots require one or more humans to control actuators, mechanisms, and other robot equipment given feedback from onboard sensors. To accomplish this task, the human or humans require some form of control station. Desirable features of such a control station include operation by a single human, comfort, and natural human interfaces (visual, audio, motion, tactile, etc.). These interfaces should work to maximize performance of the human/robot system by streamlining the link between human brain and robot equipment. This paper describes development of a control station testbed with the characteristics described above. Initially, this testbed will be used to control two teleoperated robots. Features of the robots include anthropomorphic mechanisms, slaving to the testbed, and delivery of sensory feedback to the testbed. The testbed will make use of technologies such as helmet mounted displays, voice recognition, and exoskeleton masters. It will allow tor integration and testing of emerging telepresence technologies along with techniques for coping with control link time delays. Systems developed from this testbed could be applied to ground control of space based robots. During man-tended operations, the Space Station Freedom may benefit from ground control of IVA or EVA robots with science or maintenance tasks. Planetary exploration may also find advanced teleoperation systems to be very useful.

  20. Integrated Refrigeration and Storage for Advanced Liquid Hydrogen Operations

    NASA Technical Reports Server (NTRS)

    Swanger, A. M.; Notardonato, W. U.; Johnson, W. L.; Tomsik, T. M.

    2016-01-01

    NASA has used liquefied hydrogen (LH2) on a large scale since the beginning of the space program as fuel for the Centaur and Apollo upper stages, and more recently to feed the three space shuttle main engines. The LH2 systems currently in place at the Kennedy Space Center (KSC) launch pads are aging and inefficient compared to the state-of-the-art. Therefore, the need exists to explore advanced technologies and operations that can drive commodity costs down, and provide increased capabilities. The Ground Operations Demonstration Unit for Liquid Hydrogen (GODU-LH2) was developed at KSC to pursue these goals by demonstrating active thermal control of the propellant state by direct removal of heat using a cryocooler. The project has multiple objectives including zero loss storage and transfer, liquefaction of gaseous hydrogen, and densification of liquid hydrogen. The key technology challenge was efficiently integrating the cryogenic refrigerator into the LH2 storage tank. A Linde LR1620 Brayton cycle refrigerator is used to produce up to 900W cooling at 20K, circulating approximately 22 g/s gaseous helium through the hydrogen via approximately 300 m of heat exchanger tubing. The GODU-LH2 system is fully operational, and is currently under test. This paper will discuss the design features of the refrigerator and storage system, as well as the current test results.

  1. Advanced polymer systems for optoelectronic integrated circuit applications

    NASA Astrophysics Data System (ADS)

    Eldada, Louay A.; Stengel, Kelly M. T.; Shacklette, Lawrence W.; Norwood, Robert A.; Xu, Chengzeng; Wu, Chengjiu; Yardley, James T.

    1997-01-01

    An advanced versatile low-cost polymeric waveguide technology is proposed for optoelectronic integrated circuit applications. We have developed high-performance organic polymeric materials that can be readily made into both multimode and single-mode optical waveguide structures of controlled numerical aperture (NA) and geometry. These materials are formed from highly crosslinked acrylate monomers with specific linkages that determine properties such as flexibility, toughness, loss, and stability against yellowing and humidity. These monomers are intermiscible, providing for precise adjustment of the refractive index from 1.30 to 1.60. Waveguides are formed photolithographically, with the liquid monomer mixture polymerizing upon illumination in the UV via either mask exposure or laser direct-writing. A wide range of rigid and flexible substrates can be used, including glass, quartz, oxidized silicon, glass-filled epoxy printed circuit board substrate, and flexible polyimide film. We discuss the use of these materials on chips and on multi-chip modules (MCMs), specifically in transceivers where we adaptively produced waveguides on vertical-cavity surface-emitting lasers (VCSELs) embedded in transmitter MCMs and on high- speed photodetector chips in receiver MCMs. Light coupling from and to chips is achieved by cutting 45 degree mirrors using excimer laser ablation. The fabrication of our polymeric structures directly on the modules provides for stability, ruggedness, and hermeticity in packaging.

  2. Dual embedded agency: physicians implement integrative medicine in health-care organizations.

    PubMed

    Keshet, Yael

    2013-11-01

    The paradox of embedded agency addresses the question of how embedded agents are able to conceive of new ideas and practices and then implement them in institutionalized organizations if social structures exert so powerful an influence on behavior, and agents operate within a framework of institutional constraints. This article proposes that dual embedded agency may provide an explanation of the paradox. The article draws from an ethnographic study that examined the ways in which dual-trained physicians, namely medical doctors trained also in some modality of complementary and alternative medicine, integrate complementary and alternative medicine into the biomedical fortress of mainstream health-care organizations. Participant observations were conducted during the years 2006-2011. The observed physicians were found to be embedded in two diverse medical cultures and to have a hybrid professional identity that comprised two sets of health-care values. Seeking to introduce new ideas and practices associated with complementary and alternative medicine to medical institutions, they maneuvered among the constraints of institutional structures while using these very structures, in an isomorphic mode of action, as a platform for launching complementary and alternative medicine practices and values. They drew on the complementary and alternative medicine philosophical principle of interconnectedness and interdependency of seemingly polar opposites or contrary forces and acted to achieve change by means of nonadversarial strategies. By addressing the structure-agency dichotomy, this study contributes to the literature on change in institutionalized health-care organizations. It likewise contributes both theoretically and empirically to the study of integrative medicine and to the further development of this relatively new area of inquiry within the sociology of medicine.

  3. Comparative cost analysis of inpatient integrative medicine-Results of a pilot study.

    PubMed

    Ostermann, Thomas; Lauche, Romy; Cramer, Holger; Dobos, Gustav

    2017-06-01

    Costs of integrative treatment alone and in comparison with other treatment approaches have scarcely been reported in the past. This study presents results of a comparative cost analysis of an inpatient integrative medicine treatment costs. Data from 2006 for inpatients referred to a Department of Integrative Medicine in Germany were used. Case-related treatment costs were calculated, and transformed into Casemix-Indices and revenues per DRG. Costs were compared between departments at the same hospital and between different hospitals using univariate statistics and Chi-Square tests. In total 1253 inpatients (81.4% female, 61.1±14.4years) were included in the current analysis. Most patients were treated for diseases of the musculoskeletal system (57.2%), followed by diseases of the digestive system (11.4%), and diseases of the nervous system (10.4%). The department received an additional payment for most of the patients (88.0%), which led to an effective appreciation of 10.8% per case compared to the standardized Casemix-Index. In-house comparisons with other departments found the department in close vicinity to the departments of Internal medicine with regards to CMI and mean revenue, however the Patient Clinical Complexity Level was significantly lower in the Integrative medicine department. The interhospital comparison revealed comparable Casemix-Index and DRG-revenue, however the additional payment increased the mean revenue significantly. Modern integrative in-patient treatment is mostly cost-equivalent to conventional treatment. Cost effectiveness studies should be considered to further investigate the potential of integrative in patient treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Vertical integration of biochemistry and clinical medicine using a near-peer learning model.

    PubMed

    Gallan, Alexander J; Offner, Gwynneth D; Symes, Karen

    2016-11-12

    Vertical integration has been extensively implemented across medical school curricula but has not been widely attempted in the field of biochemistry. We describe a novel curricular innovation in which a near-peer learning model was used to implement vertical integration in our medical school biochemistry course. Senior medical students developed and facilitated a case-based small group session for first year biochemistry students. Students were surveyed before and after the session on their attitudes about biochemistry, as well as the effectiveness of the session. Prior to the session, the students believed biochemistry was more important to understanding the basic science of medicine than it was to understanding clinical medicine or becoming a good physician. The session improved students' attitudes about the importance of biochemistry in clinical medicine, and after the session they now believe that understanding biochemistry is equally important to the basic sciences as clinical medicine. Students would like more sessions and believe the senior student facilitators were knowledgeable and effective teachers. The facilitators believe they improved their teaching skills. This novel combination of near-peer learning and vertical integration in biochemistry provided great benefit to both first year and senior medical students, and can serve as a model for other institutions. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(6):507-516, 2016.

  5. Pediatric Integrative Medicine in Residency (PIMR): Description of a New Online Educational Curriculum.

    PubMed

    McClafferty, Hilary; Dodds, Sally; Brooks, Audrey J; Brenner, Michelle G; Brown, Melanie L; Frazer, Paige; Mark, John D; Weydert, Joy A; Wilcox, Graciela M G; Lebensohn, Patricia; Maizes, Victoria

    2015-03-17

    Use of integrative medicine (IM) is prevalent in children, yet availability of training opportunities is limited. The Pediatric Integrative Medicine in Residency (PIMR) program was designed to address this training gap. The PIMR program is a 100-hour online educational curriculum, modeled on the successful Integrative Medicine in Residency program in family medicine. Preliminary data on site characteristics, resident experience with and interest in IM, and residents' self-assessments of perceived knowledge and skills in IM are presented. The embedded multimodal evaluation is described. Less than one-third of residents had IM coursework in medical school or personal experience with IM. Yet most (66%) were interested in learning IM, and 71% were interested in applying IM after graduation. Less than half of the residents endorsed pre-existing IM knowledge/skills. Average score on IM medical knowledge exam was 51%. Sites endorsed 1-8 of 11 site characteristics, with most (80%) indicating they had an IM practitioner onsite and IM trained faculty. Preliminary results indicate that the PIMR online curriculum targets identified knowledge gaps. Residents had minimal prior IM exposure, yet expressed strong interest in IM education. PIMR training site surveys identified both strengths and areas needing further development to support successful PIMR program implementation.

  6. Integration of evidence based medicine into the clinical years of a medical curriculum

    PubMed Central

    Ferwana, Mazen; Al Alwan, Ibrahim; Moamary, Mohamed A.; Magzoub, Mohi E.; Tamim, Hani M.

    2012-01-01

    Teaching Evidence Based Medicine (EBM) helps medical students to develop their decision making skills based on current best evidence, especially when it is taught in a clinical context. Few medical schools integrate Evidence Based Medicine into undergraduate curriculum, and those who do so, do it at the academic years only as a standalone (classroom) teaching but not at the clinical years. The College of Medicine at King Saud bin Abdulaziz University for Health Sciences was established in January 2004. The college adopted a four-year Problem Based Learning web-based curriculum. The objective of this paper is to present our experience in the integration of the EBM in the clinical phase of the medical curriculum. We teach EBM in 3 steps: first step is teaching EBM concepts and principles, second is teaching the appraisal and search skills, and the last step is teaching it in clinical rotations. Teaching EBM at clinical years consists of 4 student-centered tutorials. In conclusion, EBM may be taught in a systematic, patient centered approach at clinical rounds. This paper could serve as a model of Evidence Based Medicine integration into the clinical phase of a medical curriculum. PMID:22870419

  7. Energy Systems Integration: NREL + Advanced Energy (Fact Sheet)

    SciTech Connect

    Not Available

    2015-02-01

    This fact sheet describes the collaboration between NREL and Advanced Energy Industries at the ESIF to test its advanced photovoltaic inverter technology with the ESIF's power hardware-in-the-loop system and megawatt-scale grid simulators.

  8. Interest in Integrative Medicine Among Postmenopausal Hormone Receptor-Positive Breast Cancer Patients in the EvAluate-TM Study.

    PubMed

    Hack, Carolin C; Fasching, Peter A; Fehm, Tanja; de Waal, Johann; Rezai, Mahdi; Baier, Bernd; Baake, Gerold; Kolberg, Hans-Christian; Guggenberger, Martin; Warm, Mathias; Harbeck, Nadia; Wuerstlein, Rachel; Deuker, Jörg-Uwe; Dall, Peter; Richter, Barbara; Wachsmann, Grischa; Brucker, Cosima; Siebers, Jan W; Fersis, Nikos; Kuhn, Thomas; Wolf, Christopher; Vollert, Hans-Walter; Breitbach, Georg-Peter; Janni, Wolfgang; Landthaler, Robert; Kohls, Andreas; Rezek, Daniela; Noesslet, Thomas; Fischer, Gunnar; Henschen, Stefan; Praetz, Thomas; Heyl, Volker; Kühn, Thorsten; Krauss, Thomas; Thomssen, Christoph; Hohn, Andre; Tesch, Hans; Mundhenke, Christoph; Hein, Alexander; Rauh, Claudia; Bayer, Christian M; Jacob, Adib; Schmidt, Katja; Belleville, Erik; Hadji, Peyman; Brucker, Sara Y; Wallwiener, Diethelm; Kümmel, Sherko; Beckmann, Matthias W; Paepke, Daniela

    2016-09-14

    Background Breast cancer patients often use complementary and alternative medicine, but few prospectively collected data on the topic are available specifically for postmenopausal breast cancer patients. A large prospective study was therefore conducted within a noninterventional study in order to identify the characteristics of patients interested in integrative medicine. Methods The EvAluate-TM study is a prospective, multicenter noninterventional study in which treatment with the aromatase inhibitor letrozole was evaluated in postmenopausal women with hormone receptor-positive primary breast cancer. Between 2008 and 2009, 5045 postmenopausal patients were enrolled at 339 certified breast centers in Germany. As part of the data collection process, patients were asked at the baseline about their interest in and information needs relating to integrative medicine. Results Of the 5045 patients recruited, 3411 responded to the questionnaire on integrative medicine and took part in the analysis, 1583 patients expressed an interest in integrative medicine, and 1828 patients declared no interest. Relevant predictors of interest in integrative medicine were age, body mass index, tumor size, previous chemotherapy, and use of concomitant medications for other medical conditions. Interest in integrative medicine declined highly significantly (P < .001) with age (<50 years, 74.1%; 50-60 years, 54.1%; >65 years, 38.0%). Patients in favor of integrative medicine were significantly less satisfied with the information received about individual treatments and antihormonal therapy. Patients with interest in integrative medicine were more often interested in rehabilitation and fitness, nutritional counseling, and additional support from self-help organizations. These women were mostly interested in receiving information about their disease and integrative medicine from a physician, rather than from other sources. Conclusions This study shows that a considerable proportion of

  9. Integrated residency training leading to radiology and nuclear medicine board certification: the Arkansas experience.

    PubMed

    McDonald, James E; Deloney, Linda A; Jambhekar, Kedar

    2014-08-01

    The pool of qualified nuclear medicine (NM) physicians is declining as fewer choose to enter the specialty. In June 2012, we began developing an integrated categorical residency training position satisfying the requirements of both the American Board of Radiology (ABR) and the American Board of Nuclear Medicine (ABNM). Termed "NuRad," this was listed and filled in the 2013 NRMP match. We found it to be more attractive to qualified applicants than our traditional, three year NM residency. This approach may play a significant role in the future in ensuring the training of physicians expert in NM and molecular imaging.

  10. Framework negotiations: diagnostic insights among alternative medical practitioners participating in integrative medicine case conferences.

    PubMed

    Salkeld, Ellen J

    2014-03-01

    Medical anthropology concerns itself with cultural interpretations of health and illness in complex pluralistic societies whose members incorporate multiple strategies to address health issues. This research explored the variety of complementary and alternative medicine (CAM) topics introduced into biomedically structured clinical evaluation. A field study of routine case conferences held within a clinical fellowship program in integrative medicine (IM) provided the ideal setting to explore contrasting conceptualizations of disease. Study results yielded five core sources of information sought by CAM practitioners, typically not addressed in biomedicine: social relations history within family of origin, emotional health, energetic health, spiritual health, and in-depth nutritional evaluation. © 2014 by the American Anthropological Association.

  11. Recent advances in the development of dopamine D3 receptor antagonists: a medicinal chemistry perspective.

    PubMed

    Micheli, Fabrizio

    2011-07-04

    Dopamine (DA) D(3) receptor antagonism might play a significant role in different therapeutic areas. A high number of preclinical studies on DA D(3) receptor antagonists have shown efficacy in animal models of Parkinson's disease, schizophrenia and drug dependence. This Review covers the activities of medicinal chemists in this field over the last ten years towards the identification of truly selective compounds. Both primary and patent literature is reviewed here. Since the original discoveries, a clear trend towards the optimization of the developability properties of the new scaffold has clearly emerged with time, from both academic and industrial researchers. Examples of advanced leads from academia and industry are described. The latest potential therapeutic applications are reported too.

  12. From discovery to approval of an advanced therapy medicinal product-containing stem cells, in the EU.

    PubMed

    Pellegrini, Graziella; Lambiase, Alessandro; Macaluso, Claudio; Pocobelli, Augusto; Deng, Sophie; Cavallini, Gian Maria; Esteki, Roza; Rama, Paolo

    2016-06-01

    In 1997, the human corneal epithelium was reconstructed in vitro and transplanted on patients. Later, it became a routine treatment, before regulations considered advanced therapy medicinal products and drugs on the same lines. Manufacturing, before and after good manufacturing practice setting, was established in different facilities and the clinical application in several hospitals. Advanced therapy medicinal products, including stem cells, are unique products with different challenges than other drugs: some uncertainties, in addition to benefit, cannot be avoided. This review will focus on all recent developments in the stem cell-based corneal therapy.

  13. Maintaining a Twitter Feed to Advance an Internal Medicine Residency Program's Educational Mission.

    PubMed

    Bergl, Paul A; Narang, Akhil; Arora, Vineet M

    2015-07-10

    Residency programs face many challenges in educating learners. The millennial generation's learning preferences also force us to reconsider how to reach physicians in training. Social media is emerging as a viable tool for advancing curricula in graduate medical education. The authors sought to understand how social media enhances a residency program's educational mission. While chief residents in the 2013-2014 academic year, two of the authors (PB, AN) maintained a Twitter feed for their academic internal medicine residency program. Participants included the chief residents and categorical internal medicine house staff. At the year's end, the authors surveyed residents about uses and attitudes toward this initiative. Residents generally found the chief residents' tweets informative, and most residents (42/61, 69%) agreed that Twitter enhanced their overall education in residency. Data from this single-site intervention corroborate that Twitter can strengthen a residency program's educational mission. The program's robust following on Twitter outside of the home program also suggests a need for wider adoption of social media in graduate medical education. Improved use of data analytics and dissemination of these practices to other programs would lend additional insight into social media's role in improving residents' educational experiences.

  14. Maintaining a Twitter Feed to Advance an Internal Medicine Residency Program’s Educational Mission

    PubMed Central

    Narang, Akhil; Arora, Vineet M

    2015-01-01

    Background Residency programs face many challenges in educating learners. The millennial generation’s learning preferences also force us to reconsider how to reach physicians in training. Social media is emerging as a viable tool for advancing curricula in graduate medical education. Objective The authors sought to understand how social media enhances a residency program’s educational mission. Methods While chief residents in the 2013-2014 academic year, two of the authors (PB, AN) maintained a Twitter feed for their academic internal medicine residency program. Participants included the chief residents and categorical internal medicine house staff. Results At the year’s end, the authors surveyed residents about uses and attitudes toward this initiative. Residents generally found the chief residents’ tweets informative, and most residents (42/61, 69%) agreed that Twitter enhanced their overall education in residency. Conclusions Data from this single-site intervention corroborate that Twitter can strengthen a residency program’s educational mission. The program’s robust following on Twitter outside of the home program also suggests a need for wider adoption of social media in graduate medical education. Improved use of data analytics and dissemination of these practices to other programs would lend additional insight into social media’s role in improving residents’ educational experiences. PMID:27731845

  15. An advanced course in long term care for geriatric medicine fellows.

    PubMed

    White, Heidi K; Buhr, Gwendolen; McConnell, Eleanor; Sullivan, Robert J; Twersky, Jack; Colon-Emeric, Cathleen; Heflin, Mitchell; Cutson, Toni M; Logan, William; Lyles, Kenneth; Pinheiro, Sandro O

    2013-07-01

    Long term care deserves focused attention within a geriatric medicine fellowship curriculum to ensure that graduates are prepared not only for clinical care but also for the leadership, administrative, educational, quality improvement, and health policy aspects of their future roles. This report describes the curriculum development and program evaluation of an advanced course in long term care for geriatric medicine fellows and other graduate/post-graduate health professionals at Duke University. Course evaluation had 4 goals: (1) to determine how well the learning objectives were met; (2) to evaluate individual components of the course to improve subsequent offerings; (3) to determine whether additional topics needed to be added; and (4) to evaluate the effectiveness of the discussion forum component of the course. Learner self-efficacy improved within all competency areas but especially those of practice-based learning and system-based practice. Evaluation results led to curriculum revision that has maintained course relevance and sustained it within the larger geriatrics fellowship curriculum. Components of this course can be easily adapted to other curricular settings for fellows and residents.

  16. Advancing our understanding of religion and spirituality in the context of behavioral medicine.

    PubMed

    Park, Crystal L; Masters, Kevin S; Salsman, John M; Wachholtz, Amy; Clements, Andrea D; Salmoirago-Blotcher, Elena; Trevino, Kelly; Wischenka, Danielle M

    2017-02-01

    Recognizing and understanding the potentially powerful roles that religiousness and spirituality (RS) may serve in the prevention and amelioration of disease, as well as symptom management and health related quality of life, significantly enhances research and clinical efforts across many areas of behavioral medicine. This article examines the knowledge established to date and suggests advances that remain to be made. We begin with a brief summary of the current knowledge regarding RS as related to three exemplary health conditions: (a) cardiovascular disease; (b) cancer; and, (c) substance abuse. We then focus on particular concerns for future investigations, emphasizing conceptual issues, possible mediators and moderators of relationships or effects, and methodology. Our discussion is framed by a conceptual model that may serve to guide and organize future investigations. This model highlights a number of important issues regarding the study of links between RS and health: (a) RS comprise many diverse constructs, (b) the mechanisms through which RS may influence health outcomes are quite diverse, and (c) a range of different types of health and health relevant outcomes may be influenced by RS. The multidimensional nature of RS and the complexity of related associations with different types of health relevant outcomes present formidable challenges to empirical study in behavioral medicine. These issues are referred to throughout our review and we suggest several solutions to the presented challenges in our summary. We end with a presentation of barriers to be overcome, along with strategies for doing so, and concluding thoughts.

  17. Medicines

    MedlinePlus

    ... better. In the United States, the Food and Drug Administration is in charge of assuring the safety ... prescription and over-the-counter medicines. Even safe drugs can cause unwanted side effects or interactions with ...

  18. Concepts of Scientific Integrative Medicine Applied to the Physiology and Pathophysiology of Catecholamine Systems

    PubMed Central

    Goldstein, David S.

    2016-01-01

    This review presents concepts of scientific integrative medicine and relates them to the physiology of catecholamine systems and to the pathophysiology of catecholamine-related disorders. The applications to catecholamine systems exemplify how scientific integrative medicine links systems biology with integrative physiology. Concepts of scientific integrative medicine include (i) negative feedback regulation, maintaining stability of the body’s monitored variables; (ii) homeostats, which compare information about monitored variables with algorithms for responding; (iii) multiple effectors, enabling compensatory activation of alternative effectors and primitive specificity of stress response patterns; (iv) effector sharing, accounting for interactions among homeostats and phenomena such as hyperglycemia attending gastrointestinal bleeding and hyponatremia attending congestive heart failure; (v) stress, applying a definition as a state rather than as an environmental stimulus or stereotyped response; (vi) distress, using a noncircular definition that does not presume pathology; (vii) allostasis, corresponding to adaptive plasticity of feedback-regulated systems; and (viii) allostatic load, explaining chronic degenerative diseases in terms of effects of cumulative wear and tear. From computer models one can predict mathematically the effects of stress and allostatic load on the transition from wellness to symptomatic disease. The review describes acute and chronic clinical disorders involving catecholamine systems—especially Parkinson disease—and how these concepts relate to pathophysiology, early detection, and treatment and prevention strategies in the post-genome era. PMID:24265239

  19. Concepts of scientific integrative medicine applied to the physiology and pathophysiology of catecholamine systems.

    PubMed

    Goldstein, David S

    2013-10-01

    This review presents concepts of scientific integrative medicine and relates them to the physiology of catecholamine systems and to the pathophysiology of catecholamine-related disorders. The applications to catecholamine systems exemplify how scientific integrative medicine links systems biology with integrative physiology. Concepts of scientific integrative medicine include (i) negative feedback regulation, maintaining stability of the body's monitored variables; (ii) homeostats, which compare information about monitored variables with algorithms for responding; (iii) multiple effectors, enabling compensatory activation of alternative effectors and primitive specificity of stress response patterns; (iv) effector sharing, accounting for interactions among homeostats and phenomena such as hyperglycemia attending gastrointestinal bleeding and hyponatremia attending congestive heart failure; (v) stress, applying a definition as a state rather than as an environmental stimulus or stereotyped response; (vi) distress, using a noncircular definition that does not presume pathology; (vii) allostasis, corresponding to adaptive plasticity of feedback-regulated systems; and (viii) allostatic load, explaining chronic degenerative diseases in terms of effects of cumulative wear and tear. From computer models one can predict mathematically the effects of stress and allostatic load on the transition from wellness to symptomatic disease. The review describes acute and chronic clinical disorders involving catecholamine systems-especially Parkinson disease-and how these concepts relate to pathophysiology, early detection, and treatment and prevention strategies in the post-genome era.

  20. Family medicine education in rural communities as a health service intervention supporting recruitment and retention of physicians: Advancing Rural Family Medicine: The Canadian Collaborative Taskforce.

    PubMed

    Soles, Trina Larsen; Ruth Wilson, C; Oandasan, Ivy F

    2017-01-01

    To develop a pan-Canadian rural education road map to advance the recruitment and retention of family physicians in rural, remote, and isolated regions of Canada in order to improve access and health care outcomes for these populations. Members of the task force were chosen from key stakeholder groups including educators, practitioners, the College of Family Physicians of Canada education committee chairs, deans, chairs of family medicine, experts in rural education, and key decision makers. The task force members were purposefully selected to represent a mix of key perspectives needed to ensure the work produced was rigorous and of high quality. Observers from the Canadian Medical Association and Health Canada's Council on Health Workforce, and representatives from the Royal College of Physicians and Surgeons of Canada, were also invited to provide their perspectives and to encourage and coordinate multiorganization action. The task force commissioned a focused literature review of the peer-reviewed and gray literature to examine the status of rural medical education, training, and practice in relation to the health needs of rural and remote communities in Canada, and also completed an environmental scan. The environmental scan included interviews with more than 100 policy makers, government representatives, providers, educators, learners, and community leaders; 17 interviews with practising rural physicians; and 2 surveys administered to all 17 faculties of medicine. The gaps identified from the focused literature review and the results of the environmental scan will be used to develop the task force's recommendations for action, highlighting the role of key partners in implementation and needed action. The work of the task force provides an opportunity to bring the various partners together in a coordinated way. By understanding who is responsible and the actions each stakeholder needs to take to make the recommendations a reality, the task force can lay the

  1. United by Goals: There Is No Integrated Advancement without Communications and Marketing

    ERIC Educational Resources Information Center

    DiConsiglio, John

    2011-01-01

    The idea behind integrated advancement is simple and dates back to the 1990s: A strong relationship between advancement offices conserves resources. It leads to a more efficient workforce. It portrays a highly unified message to stakeholders, including donors, alumni, local officials, and opinion leaders. In short, the entire advancement team…

  2. United by Goals: There Is No Integrated Advancement without Communications and Marketing

    ERIC Educational Resources Information Center

    DiConsiglio, John

    2011-01-01

    The idea behind integrated advancement is simple and dates back to the 1990s: A strong relationship between advancement offices conserves resources. It leads to a more efficient workforce. It portrays a highly unified message to stakeholders, including donors, alumni, local officials, and opinion leaders. In short, the entire advancement team…

  3. Integrated residency training pathways of the future: diagnostic radiology, nuclear radiology, nuclear medicine, and molecular imaging.

    PubMed

    Oates, M Elizabeth

    2012-04-01

    Following up on the recommendations of the ACR/SNM Task Force on Nuclear Medicine Training, the respective leaderships convened Task Force II. Its charge is to develop realistic residency training pathways integrating diagnostic radiology, nuclear radiology, nuclear medicine, and molecular imaging. The diagnostic radiology participants offer these "pathways of the future" that are built on a foundation of training in diagnostic radiology. It is hoped that these pathways will ensure that the traditional and emerging clinical, educational, and research domains of nuclear radiology, nuclear medicine, and molecular imaging will be sustained and will indeed flourish in the decades to come. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. Integrative genomics--a basic and essential tool for the development of molecular medicine.

    PubMed

    Ostrowski, Jerzy

    2008-01-01

    Understanding the molecular mechanisms of disease requires the introduction of molecular diagnostics into medical practice. Current medicine employs only elements of molecular diagnostics, and usually on the scale of single genes. Medicine in the post-genomic era will utilize thousands of molecular markers associated with disease that are provided by high-throughput sequencing and functional genomic, proteomic and metabolomic studies. Such a spectrum of techniques will link clinical medicine based on molecularly oriented diagnostics with the prediction and prevention of disease. To achieve this task, large-scale and genome-wide biological and medical data must be combined with biostatistical analyses and bioinformatic modeling of biological systems. The collecting, cataloging and comparison of data from molecular studies and the subsequent development of conclusions create the fundamentals of systems biology. This highly complex analytical process reflects a new scientific paradigm called integrative genomics.

  5. Integrating genomics, proteomics and bioinformatics in translational studies of molecular medicine.

    PubMed

    Ostrowski, Jerzy; Wyrwicz, Lucjan S

    2009-09-01

    Understanding the molecular mechanisms of disease requires the introduction of molecular diagnostics into medical practice. Current medicine employs only elements of molecular diagnostics, which are usually applied on the scale of single genes. Medicine in the postgenomic era will utilize thousands of disease-associated molecular markers provided by high-throughput sequencing and functional genomic, proteomic and metabolomic studies. Such a spectrum of techniques will link clinical medicine based on molecularly oriented diagnostics with the prediction and prevention of disease. To achieve this task, large-scale and genome-wide biological and medical data must be combined with biostatistical and bioinformatic analyses to model biological systems. Collecting, cataloging and comparing data from molecular studies, and the subsequent development of conclusions, creates the fundamentals of systems biology. This highly complex analytical process reflects a new scientific paradigm known as integrative genomics.

  6. [Treatment of intrahepatic cholestasis with integrated traditional Chinese and Western medicine].

    PubMed

    Zhu, De-Zeng

    2004-11-01

    Intrahepatic cholestasis results from the disturbance of the structure and function of bile secretory apparatus in hepatic cells. At present, the mechanism of the disease is still not clearly understood. The currently used Western medicine for liver-protective, cholagogic and immuno-suppressive treatment are not effective enough. According to the theory of traditional Chinese medicine, moisture, heat, stasis and toxin are the main factors of the etiology and pathogenesis of the jaundice in patients with intrahepatic cholestasis. Therefore, clearing away heat to drain dampness, cooling blood to remove toxin, activating blood to resolve stasis, soothing liver and invigorating spleen should be adopted in the treatment. In order to increase the therapeutic effects, rational application of traditional Chinese herbs combined with Western medicine should be emphasized in treating the disease under the doctrine of integration of syndrome differentiation and disease differentiation.

  7. Progress of integrative Chinese and Western medicine in treating polycystic ovarian syndrome caused infertility.

    PubMed

    Song, Juan-juan; Yan, Miao-e; Wu, Xiao-ke; Hou, Li-hui

    2006-12-01

    Polycystic ovarian syndrome (PCOS) is one of the most popular diseases that cause menstrual dysfunction and infertility in women. The present paper is a brief retrospection on the progress in treatment of PCOS caused infertility with integrative Chinese and Western medicine (ICWM). It can be seen from these materials that using traditional Chinese medicine (TCM) recipes formulated by Shen-replenishing herbs or acupuncture to reinforce Gan-Shen, regulate Chong-Ren Channels in treating PCOS, stable clinical efficacy could be obtained, with less adverse reaction, though the effect initiated somewhat late. Whereas, when Shen-replenishing recipe and acupuncture are combined with hormone or ovulation promoting drugs of Western medicine, the above-mentioned shortcomings would be overcome. So, this combined therapy is frequently used in clinical practice.

  8. Community medicine in action: an integrated, fourth-year urban continuity preceptorship.

    PubMed

    Brill, John R; Jackson, Thomas C; Stearns, Marjorie A

    2002-07-01

    To provide an opportunity for fourth-year students at the University of Wisconsin Medical School in Madison to immerse in urban community medicine during a 34-week program. This experience enhances the integrity of the fourth year as well as merges medicine and public health perspectives in medical education as called for by the Medicine and Public Health Initiative. A limited number of fourth-year Wisconsin medical students have the opportunity to select a one-year, continuity-based preceptorship at the Milwaukee clinical campus with a focus in one of three domains: family medicine, internal medicine, or women's health. Students participate in the following clinical activities: a one-year, integrated preceptorship (one to three half days per week in a primary preceptor's office), medicine subinternship, senior surgery clerkship, selectives (16-20 weeks of clerkships relevant to preceptorship focus area), and one month of out-of-city electives. Complementing this community-based clinical experience is the opportunity to develop an increased appreciation for urban community health issues and resources by participating in a required urban community medicine clerkship and a mentored student scholarly project focusing on an aspect of urban community medicine and population health. All students begin the year in July with a four-week urban community medicine clerkship, which is based on the St. Luke's family practice residency's community medicine rotation and arranged by residency faculty. They conduct a "windshield survey" of a Milwaukee neighborhood, observing health hazards and identifying assets, and then present these observations to others in the clerkship. During this first month, students are introduced to the work of a variety of social service agencies, the Milwaukee City Health Department, and the Aurora Health Care/UW community clinics, which serve the state's most diverse zip codes. They meet with providers and researchers who share their expertise in

  9. On recent advances in human engineering Provocative trends in embryology, genetics, and regenerative medicine.

    PubMed

    Anton, Roman

    2016-01-01

    Advances in embryology, genetics, and regenerative medicine regularly attract attention from scientists, scholars, journalists, and policymakers, yet implications of these advances may be broader than commonly supposed. Laboratories culturing human embryos, editing human genes, and creating human-animal chimeras have been working along lines that are now becoming intertwined. Embryogenic methods are weaving traditional in vivo and in vitro distinctions into a new "in vivitro" (in life in glass) fabric. These and other methods known to be in use or thought to be in development promise soon to bring society to startling choices and discomfiting predicaments, all in a global effort to supply reliably rejuvenating stem cells, to grow immunologically non-provocative replacement organs, and to prevent, treat, cure, or even someday eradicate diseases having genetic or epigenetic mechanisms. With humanity's human-engineering era now begun, procedural prohibitions, funding restrictions, institutional controls, and transparency rules are proving ineffective, and business incentives are migrating into the most basic life-sciences inquiries, wherein lie huge biomedical potentials and bioethical risks. Rights, health, and heritage are coming into play with bioethical presumptions and formal protections urgently needing reassessment.

  10. Advanced Functional Tumor Imaging and Precision Nuclear Medicine Enabled by Digital PET Technologies

    PubMed Central

    2017-01-01

    The purpose of this article is to provide a brief overview of the background, basic principles, technological evolution, clinical capabilities, and future directions for functional tumor imaging as PET evolves from the conventional photomultiplier tube-based platform into a fully digital detector acquisition platform. The recent introduction of solid-state digital photon counting PET detector is the latest evolution of clinical PET which enables faster time-of-flight timing resolution that leads to more precise localization of the annihilation events and further contributes to reduction in partial volume and thus makes high definition and ultrahigh definition PET imaging feasible with current standard acquisition procedures. The technological advances of digital PET can be further leveraged by optimizing many of the acquisition and reconstruction methodologies to achieve faster image acquisition to improve cancer patient throughput, lower patient dose in accordance with ALARA, and improved quantitative accuracy to enable biomarker capability. Digital PET technology will advance molecular imaging capabilities beyond oncology and enable Precision Nuclear Medicine.

  11. Experiences in the realisation of a research project on anthroposophical medicine in patients with advanced cancer.

    PubMed

    von Rohr, E; Pampallona, S; van Wegberg, B; Hürny, C; Bernhard, J; Heusser, P; Cerny, T

    2000-08-26

    To date most of the published studies on the effectiveness of complementary therapies in cancer patients have yielded controversial results because of questionable methodology. Research strategies and methodologies acceptable to both conventional and unconventional medicine are difficult to find due to different belief systems. In this publication we describe the development and implementation of a project conducted as part of National Research Programme 34 (NFP 34). Detailed analysis of our experiences might provide some information on how to deal with practical difficulties in the planning and conduct of further research projects in this field. The project involved the anthroposophical Lukas Clinic in Arlesheim and the Institute of Medical Oncology of the University Hospital, Berne. This interdisciplinary research project was devised to study the relative merits of these two schools of medicine in the care of advanced cancer patients. The project was made up of three components: (1) a registration study aimed at comparing the case mix at the two institutions; (2) a three armed randomised study on the effectiveness of supportive therapy, comparing anthroposophy to psychosocial group therapy, and (3) a longitudinal study to monitor the evaluation of quality of life of patients at the anthroposophical clinic. After a brief review of the study protocol, which presents the theoretical framework of the project, problems of its implementation are described. Aspects of accrual, acceptance of randomisation and data availability are presented using simple descriptive statistics and logistic regression. The registration study was duly completed with a total of 567 patients. For several reasons (not meeting inclusion requirements, high refusal rate) the accrual into the randomised study was slower than expected and required modification of the original design specifications with regard to inclusion criteria and data collection schedule. Additionally, a high dropout rate

  12. [Development of an advanced education program for community medicine by Nagasaki pharmacy and nursing science union consortium].

    PubMed

    Teshima, Mugen; Nakashima, Mikiro; Hatakeyama, Susumi

    2012-01-01

    The Nagasaki University School of Pharmaceutical Sciences has conducted a project concerning "development of an advanced education program for community medicine" for its students in collaboration with the University's School of Nursing Sciences, the University of Nagasaki School of Nursing Sciences, and the Nagasaki International University School of Pharmaceutical Sciences. The project was named "formation of a strategic base for the integrated education of pharmacy and nursing science specially focused on home-healthcare and welfare", that has been adopted at "Strategic University Cooperative Support Program for Improving Graduate" by the Ministry of Education, Culture, Sports, Science and Technology, Japan from the 2009 academic year to the 2011 academic year. Our project is a novel education program about team medical care in collaboration with pharmacist and nurse. In order to perform this program smoothly, we established "Nagasaki pharmacy and nursing science union consortium (Nagasaki University, The University of Nagasaki, Nagasaki International University, Nagasaki Pharmaceutical Association, Nagasaki Society of Hospital Pharmacists, Nagasaki Nursing Association, Nagasaki Medical Association, Nagasaki Prefectural Government)". In this symposium, we introduce contents about university education program and life learning program of the project.

  13. Advanced general aviation engine/airframe integration study

    NASA Technical Reports Server (NTRS)

    Zmroczek, L. A.

    1982-01-01

    A comparison of the in-airframe performance and efficiency of the advanced engine concepts is presented. The results indicate that the proposed advanced engines can significantly improve the performance and economy of general aviation airplanes. The engine found to be most promising is the highly advanced version of a rotary combustion (Wankel) engine. The low weight and fuel consumption of this engine, as well as its small size, make it suited for aircraft use.

  14. Processes and Outcomes from a Medical Student Research Training Program in Integrative, Complementary, and Alternative Medicine.

    PubMed

    Dicianno, Brad E; Glick, Ronald M; Sowa, Gwendolyn A; Boninger, Michael L

    2016-10-01

    In response to the growing need to train a new generation of clinician scientists, a research program was developed to train medical students in integrative, complementary, and alternative medicine (ICAM) research early in their careers. A total of 25 students (100%) successfully completed a 10-week program. Students reported significantly increased levels of knowledge in all 7 integrative, complementary, and alternative medicine topics at the conclusion of the program. All students presented their work at one or more local research symposia. In addition, the average number of quality research outputs, which included manuscripts, awards, and abstracts presented at national and international meetings, was 1.5 per student, which exceeded benchmarks based on prior program outcomes. Results from this program may be useful when planning larger or longer-term projects aimed at attracting physicians who will become our next generation of academicians, researchers, and healers.

  15. An Integrated Biochemical, Proteomics, and Metabolomics Approach for Supporting Medicinal Value of Panax ginseng Fruits

    PubMed Central

    Kim, So W.; Gupta, Ravi; Lee, Seo H.; Min, Cheol W.; Agrawal, Ganesh K.; Rakwal, Randeep; Kim, Jong B.; Jo, Ick H.; Park, Soo-Yun; Kim, Jae K.; Kim, Young-Chang; Bang, Kyong H.; Kim, Sun T.

    2016-01-01

    Panax ginseng roots are well known for their medicinal properties and have been used in Korean and Chinese traditional medicines for 1000s of years. However, the medicinal value of P. ginseng fruits remain poorly characterized. In this study, we used an integrated biochemical, proteomics, and metabolomics approach to look into the medicinal properties of ginseng fruits. DPPH (1,1-diphenyl-2-picrylhydrazyl) and ABTS [2,2′-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid)] assays showed higher antioxidant activities in ginseng fruits than leaves or roots. Two-dimensional gel electrophoresis (2-DE) profiling of ginseng fruit proteins (cv. Cheongsun) showed more than 400 spots wherein a total of 81 protein spots were identified by mass spectrometry using NCBInr, UniRef, and an in-house developed RNAseq (59,251 protein sequences)-based databases. Gene ontology analysis showed that most of the identified proteins were related to the hydrolase (18%), oxidoreductase (16%), and ATP binding (15%) activities. Further, a comparative proteome analysis of four cultivars of ginseng fruits (cvs. Yunpoong, Gumpoong, Chunpoong, and Cheongsun) led to the identification of 22 differentially modulated protein spots. Using gas chromatography-time of flight mass spectrometry (GC-TOF MS), 66 metabolites including amino acids, sugars, organic acids, phenolic acids, phytosterols, tocopherols, and policosanols were identified and quantified. Some of these are well known medicinal compounds and were not previously identified in ginseng. Interestingly, the concentration of almost all metabolites was higher in the Chunpoong and Gumpoong cultivars. Parallel comparison of the four cultivars also revealed higher amounts of the medicinal metabolites in Chunpoong and Gumpoong cultivars. Taken together, our results demonstrate that ginseng fruits are a rich source of medicinal compounds with potential beneficial health effects. PMID:27458475

  16. An Integrated Biochemical, Proteomics, and Metabolomics Approach for Supporting Medicinal Value of Panax ginseng Fruits.

    PubMed

    Kim, So W; Gupta, Ravi; Lee, Seo H; Min, Cheol W; Agrawal, Ganesh K; Rakwal, Randeep; Kim, Jong B; Jo, Ick H; Park, Soo-Yun; Kim, Jae K; Kim, Young-Chang; Bang, Kyong H; Kim, Sun T

    2016-01-01

    Panax ginseng roots are well known for their medicinal properties and have been used in Korean and Chinese traditional medicines for 1000s of years. However, the medicinal value of P. ginseng fruits remain poorly characterized. In this study, we used an integrated biochemical, proteomics, and metabolomics approach to look into the medicinal properties of ginseng fruits. DPPH (1,1-diphenyl-2-picrylhydrazyl) and ABTS [2,2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid)] assays showed higher antioxidant activities in ginseng fruits than leaves or roots. Two-dimensional gel electrophoresis (2-DE) profiling of ginseng fruit proteins (cv. Cheongsun) showed more than 400 spots wherein a total of 81 protein spots were identified by mass spectrometry using NCBInr, UniRef, and an in-house developed RNAseq (59,251 protein sequences)-based databases. Gene ontology analysis showed that most of the identified proteins were related to the hydrolase (18%), oxidoreductase (16%), and ATP binding (15%) activities. Further, a comparative proteome analysis of four cultivars of ginseng fruits (cvs. Yunpoong, Gumpoong, Chunpoong, and Cheongsun) led to the identification of 22 differentially modulated protein spots. Using gas chromatography-time of flight mass spectrometry (GC-TOF MS), 66 metabolites including amino acids, sugars, organic acids, phenolic acids, phytosterols, tocopherols, and policosanols were identified and quantified. Some of these are well known medicinal compounds and were not previously identified in ginseng. Interestingly, the concentration of almost all metabolites was higher in the Chunpoong and Gumpoong cultivars. Parallel comparison of the four cultivars also revealed higher amounts of the medicinal metabolites in Chunpoong and Gumpoong cultivars. Taken together, our results demonstrate that ginseng fruits are a rich source of medicinal compounds with potential beneficial health effects.

  17. Integrative oncology research in the Middle East: weaving traditional and complementary medicine in supportive care.

    PubMed

    Ben-Arye, Eran; Ali-Shtayeh, Mohammed Saleem; Nejmi, Mati; Schiff, Elad; Hassan, Esmat; Mutafoglu, Kamer; Afifi, Fatma U; Jamous, Rana Majed; Lev, Efraim; Silbermman, Michael

    2012-03-01

    Complementary and alternative medicine (CAM) has an important role in supportive cancer care in the Middle East and is often used in association with traditional medicine. This article provides a comprehensive review of published data on CAM research in supportive cancer care in the Middle East. A multi-disciplinary Middle-Eastern Research Group in Integrative Oncology (MERGIO) was established in six countries. Authors independently searched Medline database for articles in Arabic, Hebrew, French, and Turkish using oncology and CAM-related keywords. Articles were recorded according to the first author's affiliation with an academic or clinical institution in the Middle East. We identified 143 articles on CAM and cancer care that had been published in 12 Middle-Eastern countries. Eighty-five articles were directly related to cancer supportive care. The latter included studies on the prevalence of CAM use by patients with cancer, aspects related to of doctor-patient communication, ethics and regulation, psychosocial aspects of CAM, CAM safety and quality assurance, studies of CAM education for health care providers, and ethno-botanical studies and reviews. Twenty-eight articles referred to clinical research on supportive care, and the use of specific CAM modalities that included acupuncture, anthroposophic medicine, dietary and nutritional therapies herbal medicine, homeopathy, mind-body medicine, shiatsu, therapeutic touch, and yoga. CAM-related supportive care research is prevalent in the Middle East, a fact that may serve as a basis for future multinational-multidisciplinary research work in supportive care in oncology.

  18. [Establishment of diagnosis and treatment patterns of holistic integrated medicine for neuro-ophthalmology].

    PubMed

    Wang, Yanling

    2014-12-01

    Neuro-ophthalmology, as an interdisciplinary, covers at least three disciplines- ophthalmology, neurology and neurosurgery. With limited knowledge in each discipline, doctors often make misdiagnoses for neuro-ophthalmology diseases. Therefore, it is imperative to abandon the distinction between disciplines and combine all the knowledge to diagnose and treat patients in patterns of holistic integrated medicine in order to effectively improve the diagnosis and treatment of neuro-ophthalmology.

  19. Twenty Years in Maine: Integrating Insights from Developmental Biology into Translational Medicine in a Small State.

    PubMed

    Gridley, Thomas

    2016-01-01

    In this chapter, I give my personal reflections on more than 30 years of studying developmental biology in the mouse model, spending 20 of those years doing research in Maine, a small rural state. I also give my thoughts on my recent experience transitioning to a large medical center in Maine, and the issues involved with integrating insights from developmental biology and regenerative medicine into the fabric of translational and clinical patient care in such an environment.

  20. Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety: A Case Report

    PubMed Central

    Couture, Danielle Chung; Chung, Myung Kyu; Shinnick, Phillip; Curzon, Jonathan; McClure, Mark J.

    2016-01-01

    Pediatric obsessive-compulsive disorder (OCD) is prevalent in 1% to 2% of the population. Emerging studies have correlated non-celiac gluten sensitivity with psychiatric conditions such as schizophrenia, depression, mania, and anxiety. This case study is the first reported case of OCD associated with non-celiac gluten sensitivity. The objectives of this case report are to (1) identify gluten sensitivity as a possible contributing factor to OCD in some patients; and (2) point out the possible benefit of an integrative medicine approach to the management of OCD in a patient with suboptimal benefit from a standard treatment regime. A 7-year-old male treated at a multi-physician integrative medicine practice in the United States had marked reduction of OCD symptoms and anxiety along with marked improvement of social behavior and school work after treatment consisting of gluten avoidance and other integrative medicine modalities. The patient's rapid response without side effects behooves the medical research community to further investigate the association of non-celiac gluten sensitivity and pediatric OCD. PMID:26937323

  1. Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety: A Case Report.

    PubMed

    Couture, Danielle Chung; Chung, Myung Kyu; Shinnick, Phillip; Curzon, Jonathan; McClure, Mark J; LaRiccia, Patrick J

    2016-01-01

    Pediatric obsessive-compulsive disorder (OCD) is prevalent in 1% to 2% of the population. Emerging studies have correlated non-celiac gluten sensitivity with psychiatric conditions such as schizophrenia, depression, mania, and anxiety. This case study is the first reported case of OCD associated with non-celiac gluten sensitivity. The objectives of this case report are to (1) identify gluten sensitivity as a possible contributing factor to OCD in some patients; and (2) point out the possible benefit of an integrative medicine approach to the management of OCD in a patient with suboptimal benefit from a standard treatment regime. A 7-year-old male treated at a multi-physician integrative medicine practice in the United States had marked reduction of OCD symptoms and anxiety along with marked improvement of social behavior and school work after treatment consisting of gluten avoidance and other integrative medicine modalities. The patient's rapid response without side effects behooves the medical research community to further investigate the association of non-celiac gluten sensitivity and pediatric OCD.

  2. A Retrospective Analysis of Precision Medicine Outcomes in Patients With Advanced Cancer Reveals Improved Progression-Free Survival Without Increased Health Care Costs.

    PubMed

    Haslem, Derrick S; Van Norman, S Burke; Fulde, Gail; Knighton, Andrew J; Belnap, Tom; Butler, Allison M; Rhagunath, Sharanya; Newman, David; Gilbert, Heather; Tudor, Brian P; Lin, Karen; Stone, Gary R; Loughmiller, David L; Mishra, Pravin J; Srivastava, Rajendu; Ford, James M; Nadauld, Lincoln D

    2016-09-06

    The advent of genomic diagnostic technologies such as next-generation sequencing has recently enabled the use of genomic information to guide targeted treatment in patients with cancer, an approach known as precision medicine. However, clinical outcomes, including survival and the cost of health care associated with precision cancer medicine, have been challenging to measure and remain largely unreported. We conducted a matched cohort study of 72 patients with metastatic cancer of diverse subtypes in the setting of a large, integrated health care delivery system. We analyzed the outcomes of 36 patients who received genomic testing and targeted therapy (precision cancer medicine) between July 1, 2013, and January 31, 2015, compared with 36 historical control patients who received standard chemotherapy (n = 29) or best supportive care (n = 7). The average progression-free survival was 22.9 weeks for the precision medicine group and 12.0 weeks for the control group (P = .002) with a hazard ratio of 0.47 (95% CI, 0.29 to 0.75) when matching on age, sex, histologic diagnosis, and previous lines of treatment. In a subset analysis of patients who received all care within the Intermountain Healthcare system (n = 44), per patient charges per week were $4,665 in the precision treatment group and $5,000 in the control group (P = .126). These findings suggest that precision cancer medicine may improve survival for patients with refractory cancer without increasing health care costs. Although the results of this study warrant further validation, this precision medicine approach may be a viable option for patients with advanced cancer. Copyright © 2016 by American Society of Clinical Oncology.

  3. Grid Integration Studies: Advancing Clean Energy Planning and Deployment

    SciTech Connect

    Katz, Jessica; Chernyakhovskiy, Ilya

    2016-07-01

    Integrating significant variable renewable energy (VRE) into the grid requires an evolution in power system planning and operation. To plan for this evolution, power system stakeholders can undertake grid integration studies. This Greening the Grid document reviews grid integration studies, common elements, questions, and guidance for system planners.

  4. Advancing a comprehensive cancer care agenda for children and their families: Institute of Medicine Workshop highlights and next steps.

    PubMed

    Kirch, Rebecca; Reaman, Gregory; Feudtner, Chris; Wiener, Lori; Schwartz, Lisa A; Sung, Lillian; Wolfe, Joanne

    2016-09-01

    This article highlights key findings from the "Comprehensive Cancer Care for Children and Their Families" March 2015 joint workshop by the Institute of Medicine (IOM) and the American Cancer Society. This initiative convened more than 100 family members, clinician investigators, advocates, and members of the public to discuss emerging evidence and care models and to determine the next steps for optimizing quality-of-life outcomes and well-being for children and families during pediatric cancer treatment, after treatment completion, and across the life spectrum. Participants affirmed the triple aim of pediatric oncology that strives for every child with cancer to be cured; provides high-quality palliative and psychosocial supportive, restorative, and rehabilitative care to children and families throughout the illness course and survivorship; and assures receipt of high-quality end-of-life care for patients with advancing disease. Workshop outcomes emphasized the need for new pediatric cancer drug development and identified critical opportunities to prioritize palliative care and psychosocial support as an integral part of pediatric cancer research and treatment, including the necessity for adequately resourcing these supportive services to minimize suffering and distress, effectively address quality-of-life needs for children and families at all stages of illness, and mitigate the long-term health risks associated with childhood cancer and its treatment. Next steps include dismantling existing silos and enhancing collaboration between clinical investigators, disease-directed specialists, and supportive care services; expanding the use of patient-reported and parent-reported outcomes; effectively integrating palliative and psychosocial care; and clinical communication skills development. CA Cancer J Clin 2016;66:398-407. © 2016 American Cancer Society. © 2016 American Cancer Society.

  5. A One Health overview, facilitating advances in comparative medicine and translational research.

    PubMed

    Stroud, Cheryl; Dmitriev, Igor; Kashentseva, Elena; Bryan, Jeffrey N; Curiel, David T; Rindt, Hans; Reinero, Carol; Henry, Carolyn J; Bergman, Philip J; Mason, Nicola J; Gnanandarajah, Josephine S; Engiles, Julie B; Gray, Falon; Laughlin, Danielle; Gaurnier-Hausser, Anita; Wallecha, Anu; Huebner, Margie; Paterson, Yvonne; O'Connor, Daniel; Treml, Laura S; Stannard, James P; Cook, James L; Jacobs, Marc; Wyckoff, Gerald J; Likins, Lee; Sabbagh, Ubadah; Skaff, Andrew; Guloy, Amado S; Hays, Harlen D; LeBlanc, Amy K; Coates, Joan R; Katz, Martin L; Lyons, Leslie A; Johnson, Gayle C; Johnson, Gary S; O'Brien, Dennis P; Duan, Dongsheng; Calvet, James P; Gandolfi, Barbara; Baron, David A; Weiss, Mark L; Webster, Debra A; Karanu, Francis N; Robb, Edward J; Harman, Robert J

    2016-08-01

    A1 One health advances and successes in comparative medicine and translational researchCheryl StroudA2 Dendritic cell-targeted gorilla adenoviral vector for cancer vaccination for canine melanomaIgor Dmitriev, Elena Kashentseva, Jeffrey N. Bryan, David T. CurielA3 Viroimmunotherapy for malignant melanoma in the companion dog modelJeffrey N. Bryan, David Curiel, Igor Dmitriev, Elena Kashentseva, Hans Rindt, Carol Reinero, Carolyn J. HenryA4 Of mice and men (and dogs!): development of a commercially licensed xenogeneic DNA vaccine for companion animals with malignant melanomaPhilip J. BergmanA5 Successful immunotherapy with a recombinant HER2-expressing Listeria monocytogenes in dogs with spontaneous osteosarcoma paves the way for advances in pediatric osteosarcomaNicola J. Mason, Josephine S. Gnanandarajah, Julie B. Engiles, Falon Gray, Danielle Laughlin, Anita Gaurnier-Hausser, Anu Wallecha, Margie Huebner, Yvonne PatersonA6 Human clinical development of ADXS-HER2Daniel O'ConnorA7 Leveraging use of data for both human and veterinary benefitLaura S. TremlA8 Biologic replacement of the knee: innovations and early clinical resultsJames P. StannardA9 Mizzou BioJoint Center: a translational success storyJames L. CookA10 University and industry translational partnership: from the lab to commercializationMarc JacobsA11 Beyond docking: an evolutionarily guided OneHealth approach to drug discoveryGerald J. Wyckoff, Lee Likins, Ubadah Sabbagh, Andrew SkaffA12 Challenges and opportunities for data applications in animal health: from precision medicine to precision husbandryAmado S. GuloyA13 A cloud-based programmable platform for healthHarlen D. HaysA14 Comparative oncology: One Health in actionAmy K. LeBlancA15 Companion animal diseases bridge the translational gap for human neurodegenerative diseaseJoan R. Coates, Martin L. Katz, Leslie A. Lyons, Gayle C. Johnson, Gary S. Johnson, Dennis P. O'BrienA16 Duchenne muscular dystrophy gene therapyDongsheng DuanA17 Polycystic

  6. Systematic review of recent advances in pharmacokinetics of four classical Chinese medicines used for the treatment of cerebrovascular disease.

    PubMed

    Zeng, Mingfei; Pan, Linmei; Qi, Shunmei; Cao, Yuntai; Zhu, Huaxu; Guo, Liwei; Zhou, Jing

    2013-07-01

    Recent studies have focused more on Chinese medicine used for the treatment of cerebrovascular disease. The current review covers researches on the pharmacokinetics of Chinese medicine, providing a convenient reference for researchers to increase efficiency of drug discovery, by compiling and discussing the pharmacokinetics of four classical Chinese medicines for therapy of cerebrovascular disease containing: Panax notoginseng, Salvia miltiorrhiza, Ligusticum Chuanxiong and Gardenia. It also helps to eliminate side effect as far as possible from inappropriate Chinese medicine usage. Current integrative and comprehensive review of Chinese medicine for cerebrovascular disease including 1) the absorption of some constituents is limited such as ginsenosides Rg1 and Rb1. It may be affected by gastric juice, first-pass effect, etc. 2) The interactions between Chinese medicine and prescription can occur. Borneol and carbomer would enhance the absorption of R1 and Rg1 in vivo by increasing adjacent cell transport ability. 3) The distribution of active constituents in brain is important for cerebrovascular disease. BBB protects brain from xenobiotic. Intranasal, intra-tympanic administration is a promising alternative to conventional administration to reach brain for ligustrazine. 4) Renal excretion is the uppermost route of these Chinese medicines. But biliary, fecal and urinary excretion are the other major routes. Theoretical and practical aspects are described with pharmacokinetic examples. In the end, this paper also discusses recent development of bio-analysis of Chinese medicine.

  7. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    PubMed

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too.

  8. Three-Dimensional Integration Technology for Advanced Focal Planes and Integrated Circuits

    SciTech Connect

    Keast, Craig

    2007-02-28

    Over the last five years MIT Lincoln Laboratory (MIT-LL) has developed a three-dimensional (3D) circuit integration technology that exploits the advantages of silicon-on-insulator (SOI) technology to enable wafer-level stacking and micrometer-scale electrical interconnection of fully fabricated circuit wafers. Advanced focal plane arrays have been the first applications to exploit the benefits of this 3D integration technology because the massively parallel information flow present in 2D imaging arrays maps very nicely into a 3D computational structure as information flows from circuit-tier to circuit-tier in the z-direction. To date, the MIT-LL 3D integration technology has been used to fabricate four different focal planes including: a 2-tier 64 x 64 imager with fully parallel per-pixel A/D conversion; a 3-tier 640 x 480 imager consisting of an imaging tier, an A/D conversion tier, and a digital signal processing tier; a 2-tier 1024 x 1024 pixel, 4-side-abutable imaging modules for tiling large mosaic focal planes, and a 3-tier Geiger-mode avalanche photodiode (APD) 3-D LIDAR array, using a 30 volt APD tier, a 3.3 volt CMOS tier, and a 1.5 volt CMOS tier. Recently, the 3D integration technology has been made available to the circuit design research community through DARPA-sponsored Multiproject fabrication runs. The first Multiproject Run (3DL1) completed fabrication in early 2006 and included over 30 different circuit designs from 21 different research groups. 3D circuit concepts explored in this run included stacked memories, field programmable gate arrays (FPGAs), and mixed-signal circuits. The second Multiproject Run (3DM2) is currently in fabrication and includes particle detector readouts designed by Fermilab. This talk will provide a brief overview of MIT-LL's 3D-integration process, discuss some of the focal plane applications where the technology is being applied, and provide a summary of some of the Multiproject Run circuit results.

  9. Integration and Visualization of Translational Medicine Data for Better Understanding of Human Diseases

    PubMed Central

    Satagopam, Venkata; Gu, Wei; Eifes, Serge; Gawron, Piotr; Ostaszewski, Marek; Gebel, Stephan; Barbosa-Silva, Adriano; Balling, Rudi; Schneider, Reinhard

    2016-01-01

    Abstract Translational medicine is a domain turning results of basic life science research into new tools and methods in a clinical environment, for example, as new diagnostics or therapies. Nowadays, the process of translation is supported by large amounts of heterogeneous data ranging from medical data to a whole range of -omics data. It is not only a great opportunity but also a great challenge, as translational medicine big data is difficult to integrate and analyze, and requires the involvement of biomedical experts for the data processing. We show here that visualization and interoperable workflows, combining multiple complex steps, can address at least parts of the challenge. In this article, we present an integrated workflow for exploring, analysis, and interpretation of translational medicine data in the context of human health. Three Web services—tranSMART, a Galaxy Server, and a MINERVA platform—are combined into one big data pipeline. Native visualization capabilities enable the biomedical experts to get a comprehensive overview and control over separate steps of the workflow. The capabilities of tranSMART enable a flexible filtering of multidimensional integrated data sets to create subsets suitable for downstream processing. A Galaxy Server offers visually aided construction of analytical pipelines, with the use of existing or custom components. A MINERVA platform supports the exploration of health and disease-related mechanisms in a contextualized analytical visualization system. We demonstrate the utility of our workflow by illustrating its subsequent steps using an existing data set, for which we propose a filtering scheme, an analytical pipeline, and a corresponding visualization of analytical results. The workflow is available as a sandbox environment, where readers can work with the described setup themselves. Overall, our work shows how visualization and interfacing of big data processing services facilitate exploration, analysis, and

  10. Integration and Visualization of Translational Medicine Data for Better Understanding of Human Diseases.

    PubMed

    Satagopam, Venkata; Gu, Wei; Eifes, Serge; Gawron, Piotr; Ostaszewski, Marek; Gebel, Stephan; Barbosa-Silva, Adriano; Balling, Rudi; Schneider, Reinhard

    2016-06-01

    Translational medicine is a domain turning results of basic life science research into new tools and methods in a clinical environment, for example, as new diagnostics or therapies. Nowadays, the process of translation is supported by large amounts of heterogeneous data ranging from medical data to a whole range of -omics data. It is not only a great opportunity but also a great challenge, as translational medicine big data is difficult to integrate and analyze, and requires the involvement of biomedical experts for the data processing. We show here that visualization and interoperable workflows, combining multiple complex steps, can address at least parts of the challenge. In this article, we present an integrated workflow for exploring, analysis, and interpretation of translational medicine data in the context of human health. Three Web services-tranSMART, a Galaxy Server, and a MINERVA platform-are combined into one big data pipeline. Native visualization capabilities enable the biomedical experts to get a comprehensive overview and control over separate steps of the workflow. The capabilities of tranSMART enable a flexible filtering of multidimensional integrated data sets to create subsets suitable for downstream processing. A Galaxy Server offers visually aided construction of analytical pipelines, with the use of existing or custom components. A MINERVA platform supports the exploration of health and disease-related mechanisms in a contextualized analytical visualization system. We demonstrate the utility of our workflow by illustrating its subsequent steps using an existing data set, for which we propose a filtering scheme, an analytical pipeline, and a corresponding visualization of analytical results. The workflow is available as a sandbox environment, where readers can work with the described setup themselves. Overall, our work shows how visualization and interfacing of big data processing services facilitate exploration, analysis, and interpretation of

  11. Integrating complementary and alternative medicine into conventional health care system in developing countries: an example of Amchi.

    PubMed

    Mishra, Shiva Raj; Neupane, Dinesh; Kallestrup, Per

    2015-01-01

    Complementary and alternative medicine has been a part of human life and practices since the beginning of time. The role of complementary and alternative medicine for the health of humans is undisputed particularly in light of its role in health promotion and well-being. This article discusses ways through which complementary and alternative medicine can be promoted and sustained as an integrated element of health care in developing countries. We specifically present the exemplary of Amchi traditional doctors of Northern Himalayas.

  12. A new low drift integrator system for the Experiment Advanced Superconductor Tokamak.

    PubMed

    Liu, D M; Wan, B N; Wang, Y; Wu, Y C; Shen, B; Ji, Z S; Luo, J R

    2009-05-01

    A new type of the integrator system with the low drift characteristic has been developed to accommodate the long pulse plasma discharges on Experiment Advanced Superconductor Tokamak (EAST). The integrator system is composed of the Ethernet control module and the integral module which includes one integrator circuit, followed by two isolation circuits and two program-controlled amplifier circuits. It compensates automatically integration drift and is applied in real-time control. The performance test and the experimental results in plasma discharges show that the developed integrator system can meet the requirements of plasma control on the accuracy and noise level of the integrator in long pulse discharges.

  13. Integrated Advanced Information Management Systems: a twenty-year history at the University of Cincinnati*

    PubMed Central

    Guard, J. Roger; Brueggemann, Ralph F.; Fant, William K.; Hutton, John J.; Kues, John R.; Marine, Stephen A.; Rouan, Gregory W.; Schick, Leslie C.

    2004-01-01

    The University of Cincinnati (UC) has been active in the National Library of Medicine's Integrated Advanced Information Management Systems (IAIMS) program since IAIMS' inception in 1984. UC received IAIMS planning and modeling grants in the 1980s, spent the 1990s practicing its own form of “iaims” and refining its vision, and, in May 2003, received an IAIMS operations grant in the first round of awards under “the next generation” program. This paper discusses the history of IAIMS at UC and describes the goals, methods, and strategies of the current IAIMS program. The goals of UC's IAIMS program are to: improve teaching effectiveness by improving the assessment of health professional students and residents in laboratory and clinical teaching and learning environments; improve the ability of researchers, educators, and students to acquire and apply the knowledge required to be more productive in genomic research and education; and increase the productivity of researchers and administrators in the pre-award, post-award, and compliance phases of the research lifecycle. PMID:15098045

  14. Indianapolis I3: the third generation Integrated Advanced Information Management Systems.

    PubMed

    McGowan, Julie J; Overhage, J Marc; Barnes, Mike; McDonald, Clement J

    2004-04-01

    In 2001, the Regenstrief Institute for Health Care and the Indiana University School of Medicine (IUSM) began an IAIMS planning effort to create a vision and a tactical plan for the first Integrated Advanced Information Management Systems (IAIMS) implementation to cross a large area and include unaffiliated institutions. A number of elements made this planning effort unique. Among these elements were the existence of a network infrastructure that supported the Indianapolis Network for Patient Care, the existence of a mature medical informatics program at the Regenstrief Institute, and the existence of a wide-area knowledge network fostered by the IUSM libraries. However, the leadership for a strong information technology role in the IUSM that could promote collaboration in support of education and research across the diverse Indianapolis hospital systems had been lacking. By bringing together various groups, each with a commitment to improve health care quality and public health across the Indianapolis metropolitan area, regardless of individual institutional affiliation, the strategic directions for I3-Indianapolis IAIMS Initiative have been defined and the foundations for a third generation IAIMS construct have been laid in Indianapolis, Indiana.

  15. Ethnopharmacological Survey of Plants Used in the Traditional Treatment of Gastrointestinal Pain, Inflammation and Diarrhea in Africa: Future Perspectives for Integration into Modern Medicine

    PubMed Central

    Stark, Timo D.; Mtui, Dorah J.; Balemba, Onesmo B.

    2013-01-01

    Simple Summary This review provides an inventory of numerous plant species used as traditional remedies for pain and diarrhea in Africa. Africa can emulate advances in traditional Chinese medicine through research, commercialization, teaching traditional medicine in medical schools, and incorporating botanical products in treating veterinary and human patients. Prioritized research of plant species with proven folklore in treating pain and diarrhea using high throughput screening to identify and test bioactive compounds to verify their effectiveness, mechanisms of action and safety and translational research are needed to facilitate these advances and the integration of traditional African botanical preparations for treating pain and gastrointestinal disorders into western medicine. Abstract There is a growing need to find the most appropriate and effective treatment options for a variety of painful syndromes, including conditions affecting the gastrointestinal tract, for treating both veterinary and human patients. The most successful regimen may come through integrated therapies including combining current and novel western drugs with acupuncture and botanical therapies or their derivatives. There is an extensive history and use of plants in African traditional medicine. In this review, we have highlighted botanical remedies used for treatment of pain, diarrheas and inflammation in traditional veterinary and human health care in Africa. These preparations are promising sources of new compounds comprised of flavonoids, bioflavanones, xanthones, terpenoids, sterols and glycosides as well as compound formulas and supplements for future use in multimodal treatment approaches to chronic pain, gastrointestinal disorders and inflammation. The advancement of plant therapies and their derivative compounds will require the identification and validation of compounds having specific anti-nociceptive neuromodulatory and/or anti-inflammatory effects. In particular, there is

  16. Tracking patient radiation exposure: challenges to integrating nuclear medicine with other modalities

    PubMed Central

    Mercuri, Mathew; Rehani, Madan M.; Einstein, Andrew J.

    2013-01-01

    The cumulative radiation exposure to the patient from multiple radiological procedures can place some individuals at significantly increased risk for stochastic effects and tissue reactions. Approaches, such as those in the International Atomic Energy Agency’s Smart Card program, have been developed to track cumulative radiation exposures to individuals. These strategies often rely on the availability of structured dose reports, typically found in the DICOM header. Dosimetry information is currently readily available for many individual x-ray based procedures. Nuclear medicine, of which nuclear cardiology constitutes the majority of the radiation burden in the U.S., currently lags behind x-ray based procedures with respect to reporting of radiation dosimetric information. This paper discusses qualitative differences between nuclear medicine and x-ray based procedures, including differences in the radiation source and measurement of its strength, the impact of biokinetics on dosimetry, and the capability of current scanners to record dosimetry information. These differences create challenges in applying monitoring and reporting strategies used in x-ray based procedures to nuclear medicine, and integrating dosimetry information across modalities. A concerted effort by the medical imaging community, dosimetry specialists and manufacturers of imaging equipment is required to develop strategies to improve the reporting of radiation dosimetry data in nuclear medicine. Some ideas on how to address this issue are suggested. PMID:22695788

  17. Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process.

    PubMed

    Farrell, Kathleen; Payne, Camille; Heye, Mary

    2015-01-01

    The emergence of interprofessional collaboration and practice as a means to provide patient-centered care and to decrease the current fragmentation of health care services in the 21st century provides a clear and unique opportunity for the advanced practice registered nurse (APRN) to assume a key role. For APRNs and other health care providers, to participate effectively as team members requires an interprofessional mindset. Development of interprofessional skills and knowledge for the APRN has been hindered by a silo approach to APRN role socialization. The Institute of Medicine Report (IOM; 2010) states that current health care systems should focus on team collaboration to deliver accessible, high-quality, patient-centered health care that addresses wellness and prevention of illness and adverse events, management of chronic illness, and increased capacity of all providers on the team. The purpose of this article is to demonstrate the need to incorporate interprofessional education (IPE) into the socialization models used in advanced practice nursing programs. IPE requires moving beyond profession-specific educational efforts to engage students of different health care professions in interactive learning. Being able to work effectively as member of a clinical team while a student is a fundamental part of that learning (Interprofessional Education Collaborative Expert Panel, 2011). The objective of IPE curriculum models in graduate nursing programs is to educate APRNs in the development of an interprofessional mindset. Interprofessional collaboration and coordination are needed to achieve seamless transitions for patients between providers, specialties, and health care settings (IOM, 2010). Achieving the vision requires the continuous development of interprofessional competencies by APRNs as part of the learning process, so that upon entering the workforce, APRNs are ready to practice effective teamwork and team-based care. Socialization of the professional APRN

  18. Integrating Clinical Medicine into Biomedical Graduate Education to Promote Translational Research: Strategies from Two New PhD Programs

    PubMed Central

    Smith, Carolyn L.; Jarrett, Marcia; Bierer, S. Beth

    2012-01-01

    For several decades, a barrier has existed between research and clinical medicine, making it difficult for aspiring scientists to gain exposure to human pathophysiology and access to clinical/translational research mentors during their graduate training. In 2005, the Howard Hughes Medical Institute announced the Med Into Grad initiative to support graduate programs that integrate clinical knowledge into PhD biomedical training, with the goal of preparing a new cadre of translational researchers to work at the interface of the basic sciences and clinical medicine. Two institutions, Baylor College of Medicine and the Cleveland Clinic/Case Western Reserve University, developed new PhD programs in translational biology and/or molecular medicine. These programs teach the topics and skills that today’s translational researchers must learn as well as expose students to clinical medicine. In this article, the authors compare and contrast the history, implementation, and evaluation of the Translational Biology and Molecular Medicine program at Baylor College of Medicine and the Molecular Medicine program at the Cleveland Clinic/Case Western Reserve University. The authors also demonstrate the feasibility of creating a multidisciplinary graduate program in molecular medicine that integrates pathophysiology and clinical medicine without extending training time. They conclude with a discussion of the similarities in training approaches that exist despite the fact that each program was independently developed and offer observations that emerged during their collaboration that may benefit others who are considering developing similar programs. PMID:23165264

  19. Integrating clinical medicine into biomedical graduate education to promote translational research: strategies from two new PhD programs.

    PubMed

    Smith, Carolyn L; Jarrett, Marcia; Bierer, S Beth

    2013-01-01

    For several decades, a barrier has existed between research and clinical medicine, making it difficult for aspiring scientists to gain exposure to human pathophysiology and access to clinical/translational research mentors during their graduate training. In 2005, the Howard Hughes Medical Institute announced the Med Into Grad initiative to support graduate programs that integrate clinical knowledge into PhD biomedical training, with the goal of preparing a new cadre of translational researchers to work at the interface of the basic sciences and clinical medicine. Two institutions, Baylor College of Medicine and the Cleveland Clinic/Case Western Reserve University, developed new PhD programs in translational biology and/or molecular medicine. These programs teach the topics and skills that today's translational researchers must learn and expose students to clinical medicine. In this article, the authors compare and contrast the history, implementation, and evaluation of the Translational Biology and Molecular Medicine program at Baylor College of Medicine and the Molecular Medicine program at the Cleveland Clinic/Case Western Reserve University. The authors also demonstrate the feasibility of creating a multidisciplinary graduate program in molecular medicine that integrates pathophysiology and clinical medicine without extending training time. They conclude with a discussion of the similarities in training approaches that exist despite the fact that each program was independently developed and offer observations that emerged during their collaboration that may benefit others who are considering developing similar programs.

  20. Add-On Complementary Medicine in Cancer Care: Evidence in Literature and Experiences of Integration

    PubMed Central

    Rossi, Elio; Di Stefano, Mariella; Firenzuoli, Fabio; Monechi, Maria Valeria; Baccetti, Sonia

    2017-01-01

    Background: According to the literature an increasing number of cancer patients demand for complementary therapies during their disease. Research has demonstrated that some of these therapies are effective and safe as adjunctive treatments in specific symptoms of these patients. Methods: The aims of the paper are to review the main and recent papers of international literature on the effectiveness of complementary medicine (CM) therapies on side effects of anti-cancer protocols and improvement in the quality of life of oncological patients, and to describe the integration of evidence-based acupuncture, herbal medicine and homeopathy treatments in Public Cancer Network of the region of Tuscany. Results: After the review of literature and the approval of a Regional Resolution, some CM will be introduced in Cancer Departments in Tuscany to additionally treat cancer-related symptoms and side effects of conventional cancer therapy: acupuncture for nausea and post-chemotherapy and post-surgery vomiting, pain, hot flashes of iatrogenic menopause, xerostomia; homeopathy for hot flashes of iatrogenic menopause and the side effects of radiotherapy; herbal medicine for cancer-related fatigue, nausea and vomiting, pain, mucositis, anxiety, and depression. Conclusions: The integration of evidence-based complementary treatments allows for an effective response to the demand coming from cancer patients and combines safety and equity of access in public health systems. PMID:28930222

  1. Comprehensive rehabilitation with integrative medicine for subacute stroke: A multicenter randomized controlled trial.

    PubMed

    Fang, Jianqiao; Chen, Lifang; Ma, Ruijie; Keeler, Crystal Lynn; Shen, Laihua; Bao, Yehua; Xu, Shouyu

    2016-05-13

    To determine whether integrative medicine rehabilitation (IMR) that combines conventional rehabilitation (CR) with acupuncture and Chinese herbal medicine has better effects for subacute stroke than CR alone, we conducted a multicenter randomized controlled trial that involved three hospitals in China. Three hundred sixty patients with subacute stroke were randomized into IMR and CR groups. The primary outcome was the Modified Barthel Index (MBI). The secondary outcomes were the National Institutes of Health Stroke Scale (NIHSS), the Fugl-Meyer Assessment (FMA), the mini-mental state examination (MMSE), the Montreal Cognitive Assessment (MoCA), Hamilton's Depression Scale (HAMD), and the Self-Rating Depression Scale (SDS). All variables were evaluated at week 0 (baseline), week 4 (half-way of intervention), week 8 (after treatment) and week 20 (follow-up). In comparison with the CR group, the IMR group had significantly better improvements (P < 0.01 or P < 0.05) in all the primary and secondary outcomes. There were also significantly better changes from baseline in theses outcomes in the IMR group than in the CR group (P < 0.01). A low incidence of adverse events with mild symptoms was observed in the IMR group. We conclude that conventional rehabilitation combined with integrative medicine is safe and more effective for subacute stroke rehabilitation.

  2. Comprehensive rehabilitation with integrative medicine for subacute stroke: A multicenter randomized controlled trial

    PubMed Central

    Fang, Jianqiao; Chen, Lifang; Ma, Ruijie; Keeler, Crystal Lynn; Shen, Laihua; Bao, Yehua; Xu, Shouyu

    2016-01-01

    To determine whether integrative medicine rehabilitation (IMR) that combines conventional rehabilitation (CR) with acupuncture and Chinese herbal medicine has better effects for subacute stroke than CR alone, we conducted a multicenter randomized controlled trial that involved three hospitals in China. Three hundred sixty patients with subacute stroke were randomized into IMR and CR groups. The primary outcome was the Modified Barthel Index (MBI). The secondary outcomes were the National Institutes of Health Stroke Scale (NIHSS), the Fugl-Meyer Assessment (FMA), the mini-mental state examination (MMSE), the Montreal Cognitive Assessment (MoCA), Hamilton’s Depression Scale (HAMD), and the Self-Rating Depression Scale (SDS). All variables were evaluated at week 0 (baseline), week 4 (half-way of intervention), week 8 (after treatment) and week 20 (follow-up). In comparison with the CR group, the IMR group had significantly better improvements (P < 0.01 or P < 0.05) in all the primary and secondary outcomes. There were also significantly better changes from baseline in theses outcomes in the IMR group than in the CR group (P < 0.01). A low incidence of adverse events with mild symptoms was observed in the IMR group. We conclude that conventional rehabilitation combined with integrative medicine is safe and more effective for subacute stroke rehabilitation. PMID:27174221

  3. PharmDB-K: Integrated Bio-Pharmacological Network Database for Traditional Korean Medicine

    PubMed Central

    Lee, Ji-Hyun; Park, Kyoung Mii; Han, Dong-Jin; Bang, Nam Young; Kim, Do-Hee; Na, Hyeongjin; Lim, Semi; Kim, Tae Bum; Kim, Dae Gyu; Kim, Hyun-Jung; Chung, Yeonseok; Sung, Sang Hyun; Surh, Young-Joon; Kim, Sunghoon; Han, Byung Woo

    2015-01-01

    Despite the growing attention given to Traditional Medicine (TM) worldwide, there is no well-known, publicly available, integrated bio-pharmacological Traditional Korean Medicine (TKM) database for researchers in drug discovery. In this study, we have constructed PharmDB-K, which offers comprehensive information relating to TKM-associated drugs (compound), disease indication, and protein relationships. To explore the underlying molecular interaction of TKM, we integrated fourteen different databases, six Pharmacopoeias, and literature, and established a massive bio-pharmacological network for TKM and experimentally validated some cases predicted from the PharmDB-K analyses. Currently, PharmDB-K contains information about 262 TKMs, 7,815 drugs, 3,721 diseases, 32,373 proteins, and 1,887 side effects. One of the unique sets of information in PharmDB-K includes 400 indicator compounds used for standardization of herbal medicine. Furthermore, we are operating PharmDB-K via phExplorer (a network visualization software) and BioMart (a data federation framework) for convenient search and analysis of the TKM network. Database URL: http://pharmdb-k.org, http://biomart.i-pharm.org. PMID:26555441

  4. PharmDB-K: Integrated Bio-Pharmacological Network Database for Traditional Korean Medicine.

    PubMed

    Lee, Ji-Hyun; Park, Kyoung Mii; Han, Dong-Jin; Bang, Nam Young; Kim, Do-Hee; Na, Hyeongjin; Lim, Semi; Kim, Tae Bum; Kim, Dae Gyu; Kim, Hyun-Jung; Chung, Yeonseok; Sung, Sang Hyun; Surh, Young-Joon; Kim, Sunghoon; Han, Byung Woo

    2015-01-01

    Despite the growing attention given to Traditional Medicine (TM) worldwide, there is no well-known, publicly available, integrated bio-pharmacological Traditional Korean Medicine (TKM) database for researchers in drug discovery. In this study, we have constructed PharmDB-K, which offers comprehensive information relating to TKM-associated drugs (compound), disease indication, and protein relationships. To explore the underlying molecular interaction of TKM, we integrated fourteen different databases, six Pharmacopoeias, and literature, and established a massive bio-pharmacological network for TKM and experimentally validated some cases predicted from the PharmDB-K analyses. Currently, PharmDB-K contains information about 262 TKMs, 7,815 drugs, 3,721 diseases, 32,373 proteins, and 1,887 side effects. One of the unique sets of information in PharmDB-K includes 400 indicator compounds used for standardization of herbal medicine. Furthermore, we are operating PharmDB-K via phExplorer (a network visualization software) and BioMart (a data federation framework) for convenient search and analysis of the TKM network. Database URL: http://pharmdb-k.org, http://biomart.i-pharm.org.

  5. Hurdles in clinical implementation of academic advanced therapy medicinal products: A national evaluation.

    PubMed

    de Wilde, Sofieke; Veltrop-Duits, Louise; Hoozemans-Strik, Merel; Ras, Thirza; Blom-Veenman, Janine; Guchelaar, Henk-Jan; Zandvliet, Maarten; Meij, Pauline

    2016-06-01

    Since the implementation of the European Union (EU) regulation for advanced therapy medicinal products (ATMPs) in 2009, only six ATMPs achieved marketing authorization approval in the EU. Recognizing the major developments in the ATMP field, starting mostly in academic institutions, we investigated which hurdles were experienced in the whole pathway of ATMP development towards clinical care. Quality interviews were executed with different stakeholders in The Netherlands involved in the ATMP development field, e.g. academic research groups, national authorities and patient organizations. Based on the hurdles mentioned in the interviews, questionnaires were subsequently sent to the academic principal investigators (PIs) and ATMP good manufacturing practice (GMP) facility managers to quantify these hurdles. Besides the familiar regulatory routes of marketing authorization (MA) and hospital exemption (HE), a part of the academic PIs perceived that ATMPs should become available by the Tissues and Cells Directive or did not anticipate on the next development steps towards implementation of their ATMP towards regular clinical care. The main hurdles identified were: inadequate financial support, rapidly evolving field, study-related problems, lacking regulatory knowledge, lack of collaborations and responsibility issues. Creating an academic environment stimulating and planning ATMP development and licensing as well as investing in expanding the relevant regulatory knowledge in academic institutions seems a prerequisite to develop ATMPs from bench to patient. Copyright © 2016 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  6. [Problems in microbial safety of advanced therapy medicinal products. Squaring the circle].

    PubMed

    Montag-Lessing, T; Störmer, M; Schurig, U; Brachert, J; Bubenzer, M; Sicker, U; Beshir, R; Spreitzer, I; Löschner, B; Bache, C; Becker, B; Schneider, C K

    2010-01-01

    Today, sterility of parenteral drugs is practically guaranteed. Well-defined procedures in the pharmaceutical industry enable effective protection against contamination by bacteria and fungi. In contrast, problems regarding microbial safety of advanced therapy medicinal products (ATMPs), especially of cell therapeutics, are at best only partially solved. The latter should be understood as a challenge for manufacturers, regulators, and physicians. Many of the manufacturing principles mentioned above are not applicable in production of cell therapeutics. Sterility of source materials cannot be guaranteed and the hitherto known procedures for sterilization are, as a rule, not feasible. Thus, the sterility of the final product cannot be guaranteed. Considering the extremely short shelf life of many cell therapeutics, sometimes only a few hours, the results from established methods for sterility testing are often available too late. Furthermore, the sterility of a test sample does not indicate sterility of the whole product. In most cases, conventional methods for pyrogen testing are not applicable for ATMPs. This paper demonstrates relevant limitations regarding microbial safety and pyrogenicity. Possibilities to overcome these problems are discussed and some novel solutions are proposed.

  7. Cell based advanced therapeutic medicinal products for bone repair: Keep it simple?

    PubMed

    Leijten, J; Chai, Y C; Papantoniou, I; Geris, L; Schrooten, J; Luyten, F P

    2015-04-01

    The development of cell based advanced therapeutic medicinal products (ATMPs) for bone repair has been expected to revolutionize the health care system for the clinical treatment of bone defects. Despite this great promise, the clinical outcomes of the few cell based ATMPs that have been translated into clinical treatments have been far from impressive. In part, the clinical outcomes have been hampered because of the simplicity of the first wave of products. In response the field has set-out and amassed a plethora of complexities to alleviate the simplicity induced limitations. Many of these potential second wave products have remained "stuck" in the development pipeline. This is due to a number of reasons including the lack of a regulatory framework that has been evolving in the last years and the shortage of enabling technologies for industrial manufacturing to deal with these novel complexities. In this review, we reflect on the current ATMPs and give special attention to novel approaches that are able to provide complexity to ATMPs in a straightforward manner. Moreover, we discuss the potential tools able to produce or predict 'goldilocks' ATMPs, which are neither too simple nor too complex.

  8. Development of an alternating integrator for magnetic measurements for experimental advanced superconducting tokamak.

    PubMed

    Liu, D M; Wan, B N; Zhao, W Z; Shen, B; He, Y G; Chen, B; Huang, J; Liu, H Q

    2014-11-01

    A high-performance integrator is one of the key electronic devices for reliably controlling plasma in the experimental advanced superconducting tokamak for long pulse operation. We once designed an integrator system of real-time drift compensation, which has a low integration drift. However, it is not feasible for really continuous operations due to capacitive leakage error and nonlinearity error. To solve the above-mentioned problems, this paper presents a new alternating integrator. In the new integrator, the integrator system of real-time drift compensation is adopted as one integral cell while two such integral cells work alternately. To achieve the alternate function, a Field Programmable Gate Array built in the digitizer is utilized. The performance test shows that the developed integrator with the integration time constant of 20 ms has a low integration drift (<15 mV) for 1000 s.

  9. Development of an alternating integrator for magnetic measurements for experimental advanced superconducting tokamak

    SciTech Connect

    Liu, D. M. Zhao, W. Z.; He, Y. G.; Chen, B.; Wan, B. N.; Shen, B.; Huang, J.; Liu, H. Q.

    2014-11-15

    A high-performance integrator is one of the key electronic devices for reliably controlling plasma in the experimental advanced superconducting tokamak for long pulse operation. We once designed an integrator system of real-time drift compensation, which has a low integration drift. However, it is not feasible for really continuous operations due to capacitive leakage error and nonlinearity error. To solve the above-mentioned problems, this paper presents a new alternating integrator. In the new integrator, the integrator system of real-time drift compensation is adopted as one integral cell while two such integral cells work alternately. To achieve the alternate function, a F