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PubMed1996

[Science needs experimental animals].

Data on the number of animals used in experiments are compared with data on meat consumption. The usefulness of laboratory animals for past achievements in biological sciences is presented. The negative effect of the rather disapproving attitude of the general public and the restrictive Animal Protection Law on Germany as a place of science is demonstrated in the general decrease of the number of registrated scientific projects. Some psychological reasons for the widespread disapproval of animal experiments are listed. The arguments of the opponents and supporters of animal experiments are confronted. Finally, the limits of so-called alternative methods are briefly mentioned and some proposals to ameliorate the keeping conditions of laboratory animals are enumerated.

Animal Testing Alternatives↗
PubMed1995

Social science theory and methods in the study of alternative and complementary medicine.

Anthropology is a holistic science with theory, data, and methods that can be of great service to researchers on alternative medicine. In this paper useful models and methodologic stances were identified that can help researchers to deal creatively with the stresses imposed on science by worldview preferences that differ among both scientists and healthcare systems. I have argued that rather than prefer one paradigm over another, researchers should select techniques based on a rationale featuring deep knowledge of the context of the healthcare issue they want to study. This will not only produce the most accurate and useful data, but should also help free science of its current strictures and allow expansion into a wider conversation about human and medical realities.

Anthropology, Cultural↗
PubMedDate not supplied

The structure of medical informatics journal literature.

OBJECTIVE: Medical informatics is an emergent interdisciplinary field described as drawing upon and contributing to both the health sciences and information sciences. The authors elucidate the disciplinary nature and internal structure of the field. DESIGN: To better understand the field's disciplinary nature, the authors examine the intercitation relationships of its journal literature. To determine its internal structure, they examined its journal cocitation patterns. MEASUREMENTS: The authors used data from the Science Citation Index (SCI) and Social Science Citation Index (SSCI) to perform intercitation studies among productive journal titles, and software routines from SPSS to perform multivariate data analyses on cocitation data for proposed core journals. RESULTS: Intercitation network analysis suggests that a core literature exists, one mark of a separate discipline. Multivariate analyses of cocitation data suggest that major focus areas within the field include biomedical engineering, biomedical computing, decision support, and education. The interpretable dimensions of multidimensional scaling maps differed for the SCI and SSCI data sets. Strong links to information science literature were not found. CONCLUSION: The authors saw indications of a core literature and of several major research fronts. The field appears to be viewed differently by authors writing in journals indexed by SCI from those writing in journals indexed by SSCI, with more emphasis placed on computers and engineering versus decision making by the former and more emphasis on theory versus application (clinical practice) by the latter.

Abstracting and Indexing↗
PubMed1979

Intensive care data--I: Computer controlled analysis.

A flexible, simple computer-controlled system for analysis of administrative and clinical data in intensive care is described. The system uses an interactive data input programme to facilitate data entry, an editor to correct errors, and the Statistical Package for the Social Sciences (SPSS) for data selection, retrieval and analysis. The system has the following features: data input is simple; large amounts of data can be handled rapidly and accurately; old data is readily available for comparison with new data and can be included in the present analysis; available statistical packages remove the need for a programmer; complex analyses are possible. The system has been successfully used for two years to provide administrative and clinical data which is pertinent to patient care.

Australia↗
PubMed1991

Science and social policy problems: resolution of some, creation of others.

The scientist has two jobs: to do good science, and to be a spokesperson for science in the creation of rational social policy. Three categories of interaction between science and policy are described and examples given. The first is where science has provided data that were decisive in causing policy to be enacted. The second is where science is capable of resolving equity issues that have arisen from problems that science itself created. The third is where the issues are ultimately resolved by extra-scientific considerations. Two major issues where it is hoped that science can make a significant contribution include outcomes analysis, a new approach to dealing with health care costs and variations in clinical practice; and the disease concept of alcoholism, with questions it raises of volition, personal responsibility, and punishment. However, science alone is never the dominant force in the shaping of policy, which is determined by the interaction of many social forces, such as morals, values, politics, and economics.

Adult↗
PubMedDate not supplied

Lotka's law and the pattern of scientific productivity in the dental science literature.

Statistical regularities can be observed in many natural and social phenomena. From empirical data on the authorship of scientific papers, Lotka deduced an inverse-square law: the number of authors publishing n papers is 1/n2 of those publishing one paper. The general type for the relation (1/n(c)) has a wide range of applicability to a variety of phenomena. This study examined, by means of bibliometric tools, whether Lotka's law could be applied to the literature of dental science. Data came from 20 leading dental science journals, as reported in Journal Citation Reports. The search was performed with a programme developed using Visual Basic for Applications, which counted the number of authors and analysed their contributions to the literature. Authorship for all contributions, as reported in Medline, was compiled for each of these 20 journals for the last 25 years, 1971 through 1995. The total number of authors was 43,796, responsible for 124,556 authorships. The journals published in countries other than the USA exhibited higher degrees of author concentration. The dental science literature conformed very well to Lotka's model with c = 1.95.

Authorship↗
PubMed1996

Antibiotic-resistant enterococci and the changing face of surgical infections.

BACKGROUND: Enterococci have not been thought to play an important role in intra-abdominal infections because of their relatively low virulence. However, this notion is changing because of the recent emergence of these microbes as significant nosocomial pathogens. OBJECTIVES: To review the mechanisms of antibiotic resistance of enterococci and to discuss the significance of multidrug-resistant enterococci in surgical infections. DATA SOURCES: Medical and basic science literature relating to enterococci. DATA SYNTHESIS: In addition to having intrinsic resistance to a number of antibiotics, enterococci have the ability to acquire resistant genes through the exchange of plasmids or transposons from other bacterial species. Moreover, enterococci have been shown to transmit these genes to other bacterial species in turn. The extensive resistance of these microorganisms has led to their emergence as significant nosocomial pathogens, ranking second only to Escherichia coli in the number of pathogenic isolates recovered from patients in intensive care units. There has also been a marked increase in vancomycin-resistant enterococcal infections in surgical patients in the last 5 years. Some studies associate the prior use of vancomycin or third-generation cephalosporins with the emergence of these strains. Overall, enterococcal infections are associated with increased morbidity and mortality. CONCLUSIONS: In view of the marked resistance of enterococci to antibiotics and their ability to disseminate resistance genes, these microbes have become important pathogens. Enterococci pose a threat to surgical patients, often causing significant therapeutic dilemmas.

Drug Resistance, Microbial↗
PubMed1998

Functions of the prefrontal cortex in the human brain.

The prefrontal cortex of the human brain is affected by various pathological conditions, and for the apparent theoretical gains and clinical benefits, brain scientists and clinicians alike have for decades endeavored to understand the precise role of this region of the brain. Recent findings in electrophysiological and functional neuroimaging studies provide a better insight into the neuronal activities during various cognitive processes performed by the prefrontal cortex. Nevertheless, some of these findings are at odds with others, and the theorized roles of the prefrontal cortex remain largely under dispute. On the clinical side, a longer history of research provides a wealth of symptom descriptions on the multifaceted prefrontal dysfunction. In the midst of this abundance, however, there still exists a need for coherent categorization of these seemingly disparate symptoms. This task could be done based on the nature of affected cognitive processes and their putative neural substrates. With this view in mind, the present article selectively reviews major anatomical evidence and experimental data together with clinical observations on prefrontal patients in an attempt to integrate findings in science with behavioral data and ultimately to propose a model of functional organization within the prefrontal cortex.

Brain Diseases↗
PubMed1999

Life and death in otolaryngology: mechanisms of apoptosis and its role in the pathology and treatment of disease.

OBJECTIVES: To review recent advances in our understanding of programmed cell death, or apoptosis, and discuss implications of these basic science advances in our understanding of causes and potential treatments of a variety of diseases of the head and neck. DATA SOURCES: Basic science literature relevant to the study of apoptosis and its clinical implications. CONCLUSIONS: Apoptosis is now understood to be important in the normal development and survival of all multicellular organisms. Deregulation of this normally tightly controlled process underlies a variety of disease states, including neoplasia, autoimmune disease, and disorders of the central nervous system. A better understanding of this process and its regulation may help otolaryngologists better understand diseases relevant to this specialty and will lead to improved therapeutic interventions.

Apoptosis↗
PubMed1977

The impact of an elective curriculum in pathology.

Under the revised medical curriculum at Duke University, elective courses were offered in the third and fourth years beginning in 1968-1969. Departmental electives in autopsy, surgical, and systemic pathology were offered as major courses, and the subspecialty courses in cardiovascular, renal, pulmonary, pediatric, and neuropathology were taught by specialists in those areas. Special topics in subcellular and molecular pathology, neoplasia, environmental diseases, and experimental pathology were subscribed by medical and graduate students alike. To determine the impact of elective courses in pathology, these electives were compared to those offered by other basic science disciplines. Tabulation of total courses offered, student enrollment, and total academic credit hours were constructed for each basic science area. The data show that over the six year study period the students elected more courses in pathology than in any other basic science. The most heavily subscribed electives in pathology were those that were clinically oriented, such as cardiovascular or renal pathology. One impact of this elective system may be to enhance recruitment. During the period studied, 29 Duke graduates interned in pathology compared to six under a comparable time period in the traditional curriculum.

Curriculum↗
PubMed1990

The application of basic science concepts to clinical problem-solving.

This study looks at the relationship between anatomical concepts held by medical students and their clinical application, and develops a testable model of how students use basic science concepts for clinical problem-solving. According to the model, the essential prerequisites to solve a clinical problem using basic science information include the appropriate basic science knowledge, the ability to collect and interpret clinical information, with the key concept being the link that must then be made between clinical data and basic science. A detailed analysis of the individual components of the model should help to clarify and resolve some of the debate about the nature and balance of basic science and clinical education. A neurological diagnostic problem was used to test the assumptions of the model in a group of medical students who had minimal clinical experiences. There was no demonstrable relationship between anatomical knowledge as assessed by conventional tests and the diagnosis. There was a powerful relationship between measures of organization of knowledge and diagnosis, suggesting that the organization and development of concepts is the key to correct diagnosis. The findings have significant implications for assessment purposes and suggest that standard methods as generally practised may not measure the appropriate conceptual development and are not congruent with curricular objectives. Through the examination of its different learning outcome measures, the model may also be used to provide a profile of individual students or classes, which should help teachers and students deal with difficulties that may be experienced in learning to link clinical and basic science concepts.

Clinical Competence↗
PubMed1993

Mechanisms of ventilator-induced lung injury.

OBJECTIVES: To describe the physiologic mechanisms of ventilator-induced lung injury and to define the major ventilator and host-dependent risk factors that contribute to such injury. DATA SOURCE: Basic science and clinical studies related to ventilator-induced barotrauma and lung pathophysiology. STUDY SELECTION: Emphasis on controlled, experimental studies and clinical studies related to specific mechanisms. DATA EXTRACTION: Preference given to studies with quantitative end-points to assess damage and causal relationships. DATA SYNTHESIS: Related studies are integrated to obtain basic mechanisms of damage where possible. CONCLUSIONS: Ventilation with high tidal volumes can increase vascular filtration pressures; produce stress fractures of capillary endothelium, epithelium, and basement membrane; and cause lung rupture. Mechanical damage leads to leakage of fluid, protein, and blood into tissue and air spaces or leakage of air into tissue spaces. This process is followed by an inflammatory response and possibly a reduced defense against infection. Predisposing factors for lung injury are high peak inspiratory volumes and pressures, a high mean airway pressure, structural immaturity of lung and chest wall, surfactant insufficiency or inactivation, and preexisting lung disease. Damage can be minimized by preventing overdistention of functional lung units during therapeutic ventilation.

Barotrauma↗
PubMed1989

Comparison of performance of students from different high school systems in medical sciences at Kuwait University.

Data, although limited, question the validity of the formula applied for admission to the medical school in which high school grades are the only preselection variable applied. Comparison between two groups of students from two different high school systems in Kuwait was carried out to determine if the admission criteria used currently for entry to the medical school are equally valid for both groups. The results are based on the students' performances in the first three-semester programme of medical sciences. Subjects covered were anatomy, physiology, biochemistry and behavioural sciences. The group derived from the High School National Diploma performed significantly better with a percentage pass rate of 82% while of those who were derived from the Course Credit System only 61% passed the final examination. In addition, only one of the latter group attained total marks of more than 80% compared to 12 students from the National Diploma group. The percentage failure according to subjects was consistently higher among the Course Credit graduates in all the subjects. All differences between the two groups are statistically significant (P less than 0.001).

Achievement↗
PubMed1989

Dental characteristics of a large military population useful for identification.

The number and complexity of dental restorations has decreased for younger Americans. Since the presence and extent of restorations are important data for forensic science identification purposes, the Computer-Assisted Postmortem Identification (CAPMI) system was used to assess the practical effect of the decreased selectivity expected as a result of improved dental health. Dental examination data from 7030 soldiers were recorded on optical mark read forms and entered into a database. The data were reorganized and analyzed to generate summary statistics about the incidence of each type of restoration (divided into 16 categories) for both anterior, posterior, upper, lower, and combined segments. Patients' ages ranged from 17 to 49 with a mean of 24 years 5 months. Sixty percent were from 18 to 25 years old. A characteristic is defined as any situation other than a virgin tooth; for example, extracted, missing, unerupted, or restored. The average subject had 7 dental characteristics with approximately 75% having 4 or more. Within the entire population, 9% had 32 unrestored teeth. 3.6% had only one characteristic. To test the selectivity and uniqueness of various combinations of dental characteristics, 363 simulations using the CAPMI system were made against the entire 7030 subject database. Sample records (33 per group) with 2, 3, 4, 5, 6, 7, 8, 9-11, 12-14, 15-18, and 19+ characteristics were chosen at random from the database and searches were made.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

An additional basic science for clinical medicine: I. The constraining fundamental paradigms.

The four main conceptual paradigms of basic biomedical research are that the explication of mechanisms is a primary goal of science; that scientific data must be "hard"; that formulation of hypotheses and counter-hypotheses is a principal creative challenge; and that experiments are the main mechanism for using scientific methods to conduct investigations. Although suitable for the spectacular accomplishments of biomedical research, these paradigms do not offer a satisfactory foundation for the additional basic science needed in the managerial decisions of patient care. For these decisions, the primary scientific goal is usually prediction rather than explication alone; the crucial data often involve "soft" information about clinical and personal phenomena; and the main creative challenge is to develop an improved methodology for getting adequate data and making unbiased comparisons. Although the experiments conducted as randomized clinical trials have been scientifically helpful, the improved methods will have to include evidence obtained in the often unplanned "experiments" of ordinary clinical practice.

Clinical Trials as Topic↗