Biomedical subjects
Publications and source records attributed to J R Beck.
Uric acid levels in the cecal contents of White Leghorn males aged 6, 10, and 24 weeks of age were constant at approximately 2 mg/100 ml. Fecal samples obtained from these birds contained, respectively, 99, 107, and 156 mg/100 ml uric acid. The addition of growth promoting level of antibiotics or other feed additive to the ration of 10-week-old White Leghorn males had no effect upon cecal uric acid levels.
A total of 741 individual colonies or representative colonial types were isolated on basal-hlf-uric acid (UA) agar plates containing various antibiotics and on two types of control media. All of the antibiotics utilized in this study were capable of reducing bacterial numbers and/or bacterial groups in vitro when compared to the control plates. None of the antibiotics were selective for the uric acid bacteria. The majority (96%) of the cecal isolates utilizing uric acid were gram-positive. The basal-half-uric acid agar was a nonselective growth medium and supported the growth of virtually every bacterial group reported to be present in the avian cecum. The cecal flora of the adult White Leghorn hens tested was observed to be composed of 23% G+ (gram-positive) rods, 24% G- (gram-negative) rods, 26% G+ cocci, 9% G- cocci, and 18% G+ coccal-bacilli.
The problem of predictive diagnosis based on laboratory data is approached from a mathematical standpoint. A descriptive system is introduced which examines the current information about a clinical problem and identifies best predictors of the problem. Algorithms are described for the assessment of current diagnostic ability, the evaluation of new laboratory tests, and the identification of patients to study for the development of new procedures. The laboratory approach to the predictive diagnosis of iron deficiency is chosen as an example of the system.
The authors constructed a computer-assisted multivariate data analysis system that finds the subset of a group of laboratory tests (i.e., experimental variables) best able to discriminate between previously identified subpopulations. A Bayesian decision-analysis algorithm was devised for predictive diagnosis by the use of sample means and standard deviations of those identified tests. This approach was used on a set of nine hematologic laboratory tests to find a subset capable of efficiently predicting the presence or absence of bone-marrow iron stores. This identified subset proved to have a diagnostic efficiency of 0.90. The success of this system suggests the feasibility of such an approach in finding a "best" subset of loosely related variables.
The isoenzymes of alkaline phosphatase in turkey serum were separated by disc electrophoresis using polyacrylamide gel as the supporting medium In this laboratory we have been unable to adapt polyacrylamide gel electrophoresis procedures for turkey serum that had been described by previous workers as successful in separating the isoenzymes of avian alkaline phosphatase. A rapid and repeatable procedure that yielded excellent resolution of alkaline phosphatase isoenzymes was devised. This procedure involved a step-by-step determination of the following: a suitable gel system, buffer system, staining procedure and sample preparation.
The isoenzymes of alkaline phosphatase (akp) in turkey serum were separated by disc electrophoresis using polyacrylamide gel as the supporting medium Test subjects consisted of 103 turkeys maintained for the "Vibrator" condition at Michigan State University; and 46 female turkey of the Nicholas Broad Breasted White egg laying strain. Thirteen distinct akp bands were isolated. The 13 bands were observed to occur in 13 different patterns, each pattern being classified as a separate zymogram. Specific types of zymograms were detected for "Vibrator" birds vs. Nicholas strain; females vs, males; high intensity egg production vs. low intensity egg production and molting vs. laying.
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Clinical and laboratory indices of hyperviscosity were studied in three patients presenting with this complication of paraproteinemia. Serum viscosity correctly predicted the presence of clinical hyperviscosity syndrome in patients with stable hemoglobin and albumin concentrations. Serum viscosity also correlated with total protein and paraprotein levels. A simple exponential model proved not only to describe the kinetics of blood viscosity during plasma exchange but also to predict protein concentration at symptomatic recovery. Construction of such a protein-viscosity curve helps manage by plasma exchange patients with paraproteinemia who develop hyperviscosity syndrome.
Careful study of medical informatics research and library-resource projects is necessary to increase the productivity of the research and development enterprise. Medical informatics research projects can present unique problems with respect to evaluation. It is not always possible to adapt directly the evaluation methods that are commonly employed in the natural and social sciences. Problems in evaluating medical informatics projects may be overcome by formulating system development work in terms of a testable hypothesis; subdividing complex projects into modules, each of which can be developed, tested and evaluated rigorously; and utilizing qualitative studies in situations where more definitive quantitative studies are impractical.
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OBJECTIVE: This report updates previous clinical decision analysis for patients with unruptured intracranial aneurysm (UN-AN) based on newly published data and discusses the role of reanalysis in individual decision making. METHODS: The authors employed probabilities for the natural history of UN-AN and results of preventive surgery based on the report by the International Study of Unruptured Intracranial Aneurysms. Probabilistic sensitivity analysis with Monte Carlo simulation and traditional n-way sensitivity analyses were used to assess the uncertainty of clinical decisions. RESULTS: The baseline decision in favor of preventive surgery is reversed by new data from the international study. Probabilistic sensitivity analyses revealed several populations showing heterogeneity in terms of strategy selection. One- and two-way sensitivity analyses detected two important factors for decision making: annual rupture rate and utility for knowingly living with UN-AN. CONCLUSIONS: Annual UN-AN rupture rate and the utility for knowingly living with UN-AN are key factors when deciding on a therapeutic strategy. Also, updating published decision analyses can improve clinical decision making by integrating clinical judgment and newly available clinical data.
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