A screening, referral, and follow-up program for high blood pressure at Henry Ford Hospital: Part II. Results of referral and follow-up

This is the second of two articles on the Henry Ford Hospital screening, referral, and follow-up program for high blood pressure. The first reported on the screening results of the program, along with associated epidemiological findings. This article presents the results of referral and follow-up. During the period of March 27 through December 11, 1975, 808 people were screened; 196 (24%) were found to have uncontrolled high blood pressure and were referred to physicians for diagnosis and possible treatment for hypertension. The program is currently following up with these people and their physicians to insure successful referral and maintenance of treatment. This paper outlines the overall procedures used for screening, referral, and long-range follow-up. It also presents an evaluation of these procedures, along with outcome data after an average duration often months of follow-up. As of June, 1976, the success rates recorded by the program Include the following: (a) of all people referred for high blood pressure, 86% were successfully referred (had visited a physician for this condition); (b) of the group successfully referred, 90% had entered (or re-entered) treatment for hypertension; and (c) of those under treatment, 67% were showing successful treatment (blood pressure below 140/90) or progressing toward successful treatment (blood pressure below the screening levels of 160/96)

Worksite Follow-Up and Engagement Strategies for Initiating Health Risk Behavior Changes

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66663/2/10.1177_109019819001700409.pd

A family set method for estimating heredity and stress--I : A pilot survey of blood pressure among Negroes in high and low stress areas, Detroit, 1966-1967

A pilot survey designed to test the feasibility of measuring genetic and stress variables as they relate to blood pressure levels was carried out among Negroes residing in high and low stress census tracts in Detroit, 1966-1967. Fifty-six "family sets" or 280 persons were interviewed and blood pressure recordings were taken by trained nurses. Each family set was composed of an index, a spouse, a sibling and a first cousin of index, and an unrelated person in the census tract matched to index. The method and findings of obtaining such family sets is discussed and found to be encouraging enough to initiate a larger study. It was also found that proportions of persons with hypertensive levels were significantly greater in the high stress tract (32 per cent; N = 102) than in the low stress tract (19 per cent; N = 113).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32720/1/0000088.pd

A family set method for estimating heredity and stress--II : Preliminary results of the genetic methodology in a pilot survey of Negro blood pressure, Detroit, 1966-1967

A prior article described in detail a pilot survey designed to measure the effects of heredity and stress on blood pressures among Negroes residing in high and low stress census tracts in Detroit. This report outlines the construction of a genetic variable to analyze the heritable component in blood pressure variability using a family set composed of an index and spouse, a sibling and a first cousin of index, and an unrelated person in the tract matched to index. Given the theoretical proportions describing the degree to which genes are shared between siblings and first cousins, then it follows that variability of a given trait will increase predictably within each family set. Findings from a limited sample of 56 family sets indicate support for a genetic distance scale when measured against variables such as height and skin color; however, the relationship with blood pressure levels is inconclusive. A study now underway will more critically test the tentative findings from this pilot survey.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32721/1/0000089.pd

Deep Learning for Identification of Acute Illness and Facial Cues of Illness

Background: The inclusion of facial and bodily cues (clinical gestalt) in machine learning (ML) models improves the assessment of patients' health status, as shown in genetic syndromes and acute coronary syndrome. It is unknown if the inclusion of clinical gestalt improves ML-based classification of acutely ill patients. As in previous research in ML analysis of medical images, simulated or augmented data may be used to assess the usability of clinical gestalt. Objective: To assess whether a deep learning algorithm trained on a dataset of simulated and augmented facial photographs reflecting acutely ill patients can distinguish between healthy and LPS-infused, acutely ill individuals. Methods: Photographs from twenty-six volunteers whose facial features were manipulated to resemble a state of acute illness were used to extract features of illness and generate a synthetic dataset of acutely ill photographs, using a neural transfer convolutional neural network (NT-CNN) for data augmentation. Then, four distinct CNNs were trained on different parts of the facial photographs and concatenated into one final, stacked CNN which classified individuals as healthy or acutely ill. Finally, the stacked CNN was validated in an external dataset of volunteers injected with lipopolysaccharide (LPS). Results: In the external validation set, the four individual feature models distinguished acutely ill patients with sensitivities ranging from 10.5% (95% CI, 1.3–33.1% for the skin model) to 89.4% (66.9–98.7%, for the nose model). Specificity ranged from 42.1% (20.3–66.5%) for the nose model and 94.7% (73.9–99.9%) for skin. The stacked model combining all four facial features achieved an area under the receiver characteristic operating curve (AUROC) of 0.67 (0.62–0.71) and distinguished acutely ill patients with a sensitivity of 100% (82.35–100.00%) and specificity of 42.11% (20.25–66.50%). Conclusion: A deep learning algorithm trained on a synthetic, augmented dataset of facial photographs distinguished between healthy and simulated acutely ill individuals, demonstrating that synthetically generated data can be used to develop algorithms for health conditions in which large datasets are difficult to obtain. These results support the potential of facial feature analysis algorithms to support the diagnosis of acute illness

Impact of rough substrates on hydrogen doped indium oxides for the application in CIGS devices

Indium oxide based transparent conductive oxides TCOs are promising contact layers in solar cells due totheir outstanding electrical and optical properties. However, when applied in Cu In,Ga Se2or Si hetero junctionsolar cells the specific roughness of the material beneath can affect the growth and the properties of the TCO.We investigated the electrical properties of hydrogen doped and hydrogen tungsten co doped indium oxidesgrown on rough Cu In,Ga Se2samples as well as on textured and planar glass. At sharp ridges and V shapedvalleys crack shaped voids form inside the indium oxide films, which limit the effective electron mobilityof the In2O3 H and In2O3 H,W thin films. This was found for films deposited by magnetron sputtering andreactive plasma deposition at several deposition parameters, before as well as after annealing and solid phasecrystallization. This suggests universal behavior that will have a wide impact on solar cell device

Active Hydrothermal Features as Tourist Attractions

Tourists are looking increasingly for adventurous experiences by exploring unusual and interesting landscapes. Active volcanic and hydrothermal landscapes and their remarkable manifestations of geysers, fumaroles and boiling mud ponds are some of the surface features that fascinate visitors of National Parks, Geoparks and World Heritage areas worldwide. The uniqueness of hydrothermal activity based on volcanism has provided popular tourist attractions in many countries for several thousand years. The Romans for example have used hydrothermal springs on the Italian island Ischia and visited the Campi Flegrei for recreational purposes. In Iceland the original Geysir already attracted international visitors over 150 years ago, who came to observe this spectacular hydrothermal phenomenon. In Greece and Turkey volcanic hot springs have historically provided attractive destinations, as well as in New Zealand, Japan and the Americas. The fact that locations with hydrothermal activity based on active volcanism have acquired various forms of protected site status, adds a further dimension to their attraction and demonstrates a significant contribution to sustainable and nature based tourism. Countries such as Iceland, New Zealand and Japan have a long tradition of using hydrothermal activity in its various forms to offer tourists a unique natural experience. These environments however are also known for their unpredictable and potentially hostile nature, as the use of hydrothermal features as a natural resource for tourism does harbour certain risks with the potential to affect human health and safety. Hydrothermal systems have erupted in the past, thereby causing the destruction of their immediate environment. Depending on the level of magnitude explosions of super heated water and steam mixed with fractured rocks and hot mud can be violent enough to create craters varying in size from a few metres to several hundred metres in diameter. Apart from unexpected eruptions of hydrothermal vents with the potential to cause thermal burns, further risk factors include seismic activity such as earthquakes, lethal gas emissions of hydrogen sulphide (H2S) as well as ground instability through hydrothermal alteration. While it is essential to prevent injuries to tourists the management of hydrothermal hazards remains problematic. Precursory signs are not well understood by the general public and the communication of imminent danger is frequently unachievable. As a consequence serious thought needs to be given to the risk factors and the potential danger of areas in the proximity of active hydrothermal manifestations such as extreme hot springs and geysers. To improve the safety standards in hydrothermal landscapes that are used as main features in tourism, strategic guidelines for best practice management must cover ALL active volcanic and hydrothermal areas. This chapter looks at management issues at hydrothermal destinations with special consideration of areas where these unique features are integrated as tourist attractions. Examples from destinations traditionally based on active volcanic and hydrothermal phenomena are presented as case studies to highlight the risk management processes in individual countries. Potential hazards in volcanic and hydrothermal areas are assessed with a focus on the prevention of accidents and injuries to tourists