A telemedicine health care delivery system

The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described

How Good a Clock is Rotation? The Stellar Rotation-Mass-Age Relationship for Old Field Stars

The rotation-mass-age relationship offers a promising avenue for measuring the ages of field stars, assuming the attendant uncertainties to this technique can be well characterized. We model stellar angular momentum evolution starting with a rotation distribution from open cluster M37. Our predicted rotation-mass-age relationship shows significant zero-point offsets compared to an alternative angular momentum loss law and published gyrochronology relations. Systematic errors at the 30 percent level are permitted by current data, highlighting the need for empirical guidance. We identify two fundamental sources of uncertainty that limit the precision of rotation-based ages and quantify their impact. Stars are born with a range of rotation rates, which leads to an age range at fixed rotation period. We find that the inherent ambiguity from the initial conditions is important for all young stars, and remains large for old stars below 0.6 solar masses. Latitudinal surface differential rotation also introduces a minimum uncertainty into rotation period measurements and, by extension, rotation-based ages. Both models and the data from binary star systems 61 Cyg and alpha Cen demonstrate that latitudinal differential rotation is the limiting factor for rotation-based age precision among old field stars, inducing uncertainties at the ~2 Gyr level. We also examine the relationship between variability amplitude, rotation period, and age. Existing ground-based surveys can detect field populations with ages as old as 1-2 Gyr, while space missions can detect stars as old as the Galactic disk. In comparison with other techniques for measuring the ages of lower main sequence stars, including geometric parallax and asteroseismology, rotation-based ages have the potential to be the most precise chronometer for 0.6-1.0 solar mass stars.Comment: For a brief video explaining the key results of this paper, see http://www.youtube.com/user/OSUAstronom

National Telemedicine Initiatives: Essential to Healthcare Reform

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78116/1/tmj.2009.9960.pd

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

The telemedicine intervention in chronic disease management promises to involve patients in their own care, provides continuous monitoring by their healthcare providers, identifies early symptoms, and responds promptly to exacerbations in their illnesses. This review set out to establish the evidence from the available literature on the impact of telemedicine for the management of three chronic diseases: congestive heart failure, stroke, and chronic obstructive pulmonary disease. By design, the review focuses on a limited set of representative chronic diseases because of their current and increasing importance relative to their prevalence, associated morbidity, mortality, and cost. Furthermore, these three diseases are amenable to timely interventions and secondary prevention through telemonitoring. The preponderance of evidence from studies using rigorous research methods points to beneficial results from telemonitoring in its various manifestations, albeit with a few exceptions. Generally, the benefits include reductions in use of service: hospital admissions/re-admissions, length of hospital stay, and emergency department visits typically declined. It is important that there often were reductions in mortality. Few studies reported neutral or mixed findings.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140284/1/tmj.2014.9981.pd

Noninvasive assessment of asthma severity using pulse oximeter plethysmograph estimate of pulsus paradoxus physiology

<p>Abstract</p> <p>Background</p> <p>Pulsus paradoxus estimated by dynamic change in area under the oximeter plethysmograph waveform (PEP) might provide a measure of acute asthma severity. Our primary objective was to determine how well PEP correlates with forced expiratory volume in 1-second (%FEV₁) (criterion validity) and change of %FEV₁(responsiveness) during treatment in pediatric patients with acute asthma exacerbations.</p> <p>Methods</p> <p>We prospectively studied subjects 5 to 17 years of age with asthma exacerbations. PEP, %FEV₁, airway resistance and accessory muscle use were recorded at baseline and at 2 and 4 hours after initiation of corticosteroid and bronchodilator treatments. Statistical associations were tested with Pearson or Spearman rank correlations, logistic regression using generalized estimating equations, or Wilcoxon rank sum tests.</p> <p>Results</p> <p>We studied 219 subjects (median age 9 years; male 62%; African-American 56%). Correlation of PEP with %FEV₁demonstrated criterion validity (r = - 0.44, 95% confidence interval [CI], - 0.56 to - 0.30) and responsiveness at 2 hours (r = - 0.31, 95% CI, - 0.50 to - 0.09) and 4 hours (r = - 0.38, 95% CI, - 0.62 to - 0.07). PEP also correlated with airway resistance at baseline (r = 0.28 for ages 5 to 10; r = 0.45 for ages 10 to 17), but not with change over time. PEP was associated with accessory muscle use (OR 1.16, 95% CI, 1.11 to 1.21, P < 0.0001).</p> <p>Conclusions</p> <p>PEP demonstrates criterion validity and responsiveness in correlations with %FEV₁. PEP correlates with airway resistance at baseline and is associated with accessory muscle use at baseline and at 2 and 4 hours after initiation of treatment. Incorporation of this technology into contemporary pulse oximeters may provide clinicians improved parameters with which to make clinical assessments of asthma severity and response to treatment, particularly in patients who cannot perform spirometry because of young age or severity of illness. It might also allow for earlier recognition and improved management of other disorders leading to elevated pulsus paradoxus.</p

1960: Abilene Christian College Lectures - Full Text

Table of Contents: Theme Speeches: Christian Faith in the Modern World Basis of Faith - Leonard Mullens - 9 Authority in Christianity - John T. Smithson, Jr. - 27 Origin and Preservation of the Bible - Neil R. Lightfoot - 44 Alleged Discrepancies of the Bible - David H. Bobo - 62 The Unity of the Bible - Jack Meyer - 91 Faith and Reason - Joe Sanders - 115 The Reasonableness of Supernaturalism - Virgil Trout - 126 The Present Statue of the Doctrine of Organic Evolution - J.D. Thomas - 146 The Nature of Man - Roy F. Osborne, Jr. - 181 Modern Challenges to Christian Morals - Carl Spain - 199 The Christ, Whose Son is He? - Gordon Teel - 232 Special Speeches Teaching the Word of God in Korea - L. Haskell Chessfire - 255 The Influence of Christian Education - Judge Jack Pope - 276 Mission Opportunities in the Far East - Harry Robert Fox - 288 Mission Work in Austria - Robert Skelton - 303 Report from Switzerland - Heinrich Blum - 313 The Work in Nigeria - Rees Byrant - 320 The Training of Evangelists in Foreign Fields - Reiner Kallus - 331 Christian Scholarships - Everett Ferguson - 340 Evangelizing the World - A.R. Holton - 349 Panel Discussions The Significance of the Dead Sea Scrolls The Scrolls and the Text of the Bible - Paul Rotenberry - 357 The Relation between the Religion of the Essenes and that of Early Christians - Jay Smith - 366 Biblical Interpretation Expediency and Pattern Authority - J.W. Roberts - 381 Examples in Pattern Authority - Thomas B. Warren - 392 Mental Health and Sin The Present State of Mental Health Knowledge - Donald R. Sime - 409 The Relationship of Mental Health Problems to Sin - Paul Easley - 421 The Teenager The Problems of Youth - Mack Wayne Craig - 432 Influences for Good - Wyatt Sawyer - 443 The Benefits of Abilene Christian College To the Church - Hulen Jackson - 451 To The Home - Robert S. Bell - 459 \u27To the Community - Louie Welch - 465 Expenses At Abilene Christian College - James C. Kerr - 469 The Graduate School at Abilene Christian College What I Am Getting Now in the ACC Graduate Program - Harold Vanderpool - 475 How the ACC Graduate Program Has Stood Up - Everett Ferguson - 481 What the ACC Graduate Program Ought To Be - Frank Pack - 486 The Importance to the Church of the ACC Graduate Program A.R. Holton - 490 Beware: Large File Size Uploaded by Jackson Hage

Increasing the Discovery Space in Astrophysics - A Collation of Six Submitted White Papers

We write in response to the call from the 2020 Decadal Survey to submit white papers illustrating the most pressing scientific questions in astrophysics for the coming decade. We propose exploration as the central question for the Decadal Committee's discussions.The history of astronomy shows that paradigm changing discoveries are not driven by well formulated scientific questions, based on the knowledge of the time. They were instead the result of the increase in discovery space fostered by new telescopes and instruments. An additional tool for increasing the discovery space is provided by the analysis and mining of the increasingly larger amount of archival data available to astronomers. Revolutionary observing facilities, and the state of the art astronomy archives needed to support these facilities, will open up the universe to new discovery. Here we focus on exploration for compact objects and multi messenger science. This white paper includes science examples of the power of the discovery approach, encompassing all the areas of astrophysics covered by the 2020 Decadal Survey

Genome-Wide Association Study of Treatment Refractory Schizophrenia in Han Chinese

We report the first genome-wide association study of a joint analysis using 795 Han Chinese individuals with treatment-refractory schizophrenia (TRS) and 806 controls. Three loci showed suggestive significant association with TRS were identified. These loci include: rs10218843 (P = 3.04×10−7) and rs11265461 (P = 1.94×10−7) are adjacent to signaling lymphocytic activation molecule family member 1 (SLAMF1); rs4699030 (P = 1.94×10−6) and rs230529 (P = 1.74×10−7) are located in the gene nuclear factor of kappa light polypeptide gene enhancer in B-cells 1 (NFKB1); and rs13049286 (P = 3.05×10−5) and rs3827219 (P = 1.66×10−5) fall in receptor-interacting serine/threonine-protein kinase 4 (RIPK4). One isolated single nucleotide polymorphism (SNP), rs739617 (P = 3.87×10−5) was also identified to be associated with TRS. The -94delATTG allele (rs28362691) located in the promoter region of NFKB1 was identified by resequencing and was found to associate with TRS (P = 4.85×10−6). The promoter assay demonstrated that the -94delATTG allele had a significant lower promoter activity than the -94insATTG allele in the SH-SY5Y cells. This study suggests that rs28362691 in NFKB1 might be involved in the development of TRS