ESI-MS-MS will be introduced into most newborn screening programs around the world because of its ability to deal with a large number of samples and to quantify multiple compounds in one blood spot disk in a single process, and because of the substantial benefit most patients with target diseases and their families can be provided through early treatment. However, it is important to recognize the limitation of this screening in view of the false-negative and false-positive rates. In addition, to patients with some target diseases, informed counseling and therapy based on the evidence cannot be offered at present. Furthermore, unexpectedly high incidences of some target diseases, as compared with those before the initiation of this screening, indicate that this screening may be detecting many patients who will not present the symptoms of the disease. Thus ESI-MS-MS screening programs should be further evaluated in terms of quality control in methodology, selection of target diseases, protocols for differential diagnosis, healthcare systems to follow the patients, and psychosocial burdens on the patients and their families.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.