Leadership of healthcare commissioning networks in England: a mixed-methods study on clinical commissioning groups.

To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation.

Communication: energy benchmarking with quantum Monte Carlo for water nano-droplets and bulk liquid water.

We show the feasibility of using quantum Monte Carlo (QMC) to compute benchmark energies for configuration samples of thermal-equilibrium water clusters and the bulk liquid containing up to 64 molecules. Evidence that the accuracy of these benchmarks approaches that of basis-set converged coupled-cluster calculations is noted. We illustrate the usefulness of the benchmarks by using them to analyze the errors of the popular BLYP approximation of density functional theory (DFT). The results indicate the possibility of using QMC as a routine tool for analyzing DFT errors for non-covalent bonding in many types of condensed-phase molecular system.

Multi-objective optimization of a fluid structure interaction benchmarking

The integration and application of a new multi-objective tabu search optimization algorithm for Fluid Structure Interaction (FSI) problems are presented. The aim is to enhance the computational design process for real world applications and to achieve higher performance of the whole system for the four considered objectives. The described system combines the optimizer with a well established FSI solver which is based on the fully implicit, monolithic formuFlation of the problem in the Arbitrary Lagrangian-Eulerian FEM approach. The proposed solver resolves the proposed uid-structure interaction benchmark which describes the self-induced elastic deformation of a beam attached to a cylinder in laminar channel ow. The optimized ow characteristics of the aforementioned geometrical arrangement illustrate the performance of the system in two dimensions. Special emphasis is given to the analysis of the simulation package, which is of high accuracy and is the core of application. The design process identifies the best combination of ow features for optimal system behavior and the most important objectives. In addition, the presented methodology has the potential to run in parallel, which will significantly speed-up the elapsed time. Finite Element Method (FEM), Fluid-Structure Interaction (FSI), Multi-Ojective Tabu search (MOTS2). Copyright © 2013 Tech Science Press.

Multiplex detection of mutations in clinical isolates of rifampin-resistant Mycobacterium tuberculosis by short oligonucleotide Ligation assay on DNA chips

A new approach, short-oligonucleotide-ligation assay on DNA chip (SOLAC), is developed to detect mutations in rifampin-resistant Mycobacterium tuberculosis. The method needs only four common probes to detect 15 mutational variants of the rpoB gene within 12 h. Fifty-five rifampin-resistant M. tuberculosis isolates were analyzed, resulting in 87.3% accuracy and 83.6% concordance relative to DNA sequencing.

The development of long - Term ambulatory pH monitoring system and its clinical application

This paper introduced a long-term ambulatory intragastric pH monitoring system, which is designed for prolonged ambulatory studies of Gastroesophageal Reflux Diseases. The whole system is composed of the gastric catheter with two pH sensors, a small data logger (Microdatalog), and a notebook PC. In this paper, the design of monitoring system hardware and software are described in detail. Clinical applications reveal good results.

重离子束治疗皮肤恶性肿瘤的初步临床结果；Clinical trial of carbon ion radiotherapy for malignant neoplasm of skin

目的:评价重离子束对皮肤恶性肿瘤放射治疗的近期疗效和毒副反应。方法:29例皮肤恶性肿瘤患者分6批接受重离子束放射治疗,其中恶性黑色素瘤13例,皮肤鳞癌及Bowen’s病各6例,基底细胞癌2例,其他皮肤恶性肿瘤2例。照射总剂量(50～70)GyE/(6～12)d,单次剂量5.5～11.67GyE,1f/d,连续治疗。采用RTOG标准和WHO近期疗效标准分别评价毒副反应和近期疗效。结果:截止2009-05,中位随访时间为13.5个月(1～25个月),随访率为100%。29例患者中完全缓解(CR)24例(82.8%),部分缓解(PR)5例(17.2%),有效率(RR)为100%,中位生存时间为22.8个月(95%CI:20.6～24.9)。皮肤反应0度11例(37.9%),Ⅰ度9例(31.0%),Ⅱ度6例(20.7%),Ⅲ度2例(6.9%),Ⅳ度1例(3.4%);血液毒副反应治疗前后无明显改变。结论:重离子束(12C6+)放射治疗皮肤恶性肿瘤近期疗效好,并发症轻,远期疗效、晚期副反应等尚需进一步长期全面的观察和更多的研究提供依据。

Application of probabilistic neural network in the clinical diagnosis of cancers based on clinical chemistry data

As a recently developed and powerful classification tool, probabilistic neural network was used to distinguish cancer patients from healthy persons according to the levels of nucleosides in human urine. Two datasets (containing 32 and 50 patterns, respectively) were investigated and the total consistency rate obtained was 100% for dataset 1 and 94% for dataset 2. To evaluate the performance of probabilistic neural network, linear discriminant analysis and learning vector quantization network, were also applied to the classification problem. The results showed that the predictive ability of the probabilistic neural network is stronger than the others in this study. Moreover, the recognition rate for dataset 2 can achieve to 100% if combining, these three methods together, which indicated the promising potential of clinical diagnosis by combining different methods. (C) 2002 Elsevier Science B.V. All rights reserved.

Artificial neural network classification based on high-performance liquid chromatography of urinary and serum nucleosides for the clinical diagnosis of cancer

Nucleosides in human urine and serum have frequently been studied as a possible biomedical marker for cancer, acquired immune deficiency syndrome (AIDS) and the whole-body turnover of RNAs. Fifteen normal and modified nucleosides were determined in 69 urine and 42 serum samples using high-performance liquid chromatography (HPLC). Artificial neural networks have been used as a powerful pattern recognition tool to distinguish cancer patients from healthy persons. The recognition rate for the training set reached 100%. In the validating set, 95.8 and 92.9% of people were correctly classified into cancer patients and healthy persons when urine and serum were used as the sample for measuring the nucleosides. The results show that the artificial neural network technique is better than principal component analysis for the classification of healthy persons and cancer patients based on nucleoside data. (C) 2002 Elsevier Science B.V. All rights reserved.