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PubMed2006

Quality of life of family caregivers of patients with cancer: a literature review.

PURPOSE/OBJECTIVES: To systematically review literature regarding the quality of life (QOL) of family caregivers of patients with cancer and evaluate the instruments measuring family caregivers' QOL. DATA SOURCES: PubMed, CINAHL, PsycINFO, ISI Web of Science, and EBSCO electronic databases; published literature. DATA SYNTHESIS: Overall, the QOL of family caregivers of patients with cancer varied. Influences related to family caregivers' QOL were identified. Global and generic measures have been used because of the lack of specific instruments. Comparisons are complicated because several measures were used at different times along the illness trajectory with caregivers caring for people with various types and stages of cancer. CONCLUSIONS: A more explicit definition of QOL for family caregivers of patients with cancer and specific instruments suitable for different cultures are needed to enhance knowledge. IMPLICATIONS FOR NURSING: Maintaining the QOL of caregivers is important in their ability to provide the care required to keep family members with cancer in the community. Nurses must provide care to maintain caregivers' QOL.

Caregivers↗
PubMed2026

Challenges and future directions in AI-driven biomaterials for microbiome-associated oral infectious diseases: A systematic review.

Oral biofilm-induced antimicrobial resistance is the core pathogenic mechanism of microbiome-associated oral infectious diseases (dental caries, periodontitis, peri-implantitis, and endodontic infection). Traditional therapies and biomaterials are limited by poor biofilm penetration, drug resistance induction, single functionality, and inadequate adaptation to dynamic oral microenvironmental changes (e.g., pH fluctuations, salivary rinsing, masticatory stimulation). Artificial intelligence (AI) has transformed the field by integrating materials science, microbiology, and stomatology data. Via machine learning, deep learning, and multi-physics simulation, AI optimizes biomaterial physicochemical properties, decodes microenvironmental signals, constructs precise sensing-response loops, and supports the full chain of material design, performance prediction, and action simulation, advancing treatment from empirical intervention to precision regulation. This systematic review retrieved literature from PubMed, Embase, and Web of Science (January 2016-January 2026) using keywords across three dimensions: AI, biomaterials, and oral microbiome. Following inclusion/exclusion criteria, 99 articles were included. It elaborates on five core mechanisms of AI-driven oral biomaterials (precise oral microbiome analysis, targeted material design/optimization, performance prediction/simulation, targeted delivery/intervention, effect evaluation/dynamic regulation), analyzes their applications in microbiome-targeted biomaterial research and development (R&D) and clinical practice for the four major oral infectious diseases, addresses technical bottlenecks (insufficient targeting specificity and precision of biomaterials, poor stability and durability in complex oral microenvironments, inadequate biofilm disruption capacity, and clinical translation obstacles), and proposes future directions (multimodal design to enhance targeting specificity, structural and component optimization to improve stability/durability, development of multi-mechanism synergistic biofilm disruption strategies, strengthening translational research for clinical application, and deep integration of AI in the full chain of biomaterial R&D). This work provides comprehensive theoretical and practical support for the R&D, optimization, and clinical translation of AI-driven microbiome-targeted oral biomaterials.

Humans↗
PubMed1994

Two methods for allocating pharmacy cost per patient case.

The consequences of two different methods of allocating pharmacy costs per patient case were studied. The study was conducted using cost data from Sunnybrook Health Science Centre (SHSC), a 1205-bed teaching hospital in Toronto, Canada. A sample of the 1991-1992 cases for the three case mix groups (CMGs) with the highest total pharmacy cost and the three CMGs with the highest pharmacy cost per case were examined. Information was obtained from patient records and used to produce two sets of data: pharmacy prescription unit costs and pharmacy costs per case using the relative value unit (RVU) method, and pharmacy prescription unit costs and pharmacy costs per case using the workload measurement system (WMS) method. For each case, the difference between the RVU and WMS pharmacy costs was determined. The RVU method consistently produced higher pharmacy costs per case for the CMGs with the highest pharmacy cost per case. If these CMGs are typical of other CMGs with high pharmacy costs per case, then case reimbursement based on the WMS method of cost allocation would result in underfunding of hospitals whose case mix has a high proportion of CMGs with high pharmacy costs per case and overfunding of hospitals whose case mix has a high proportion of CMGs with low pharmacy costs per case. However, the RVU method of cost allocation, although it appears to be more accurate, places a greater data collection burden on pharmacy managers. The RVU and WMS methods of pharmacy cost allocation gave significantly different pharmacy costs per case for the six CMGs studied.

Cost Allocation↗
PubMed1998

Understanding the context of healthcare utilization: assessing environmental and provider-related variables in the behavioral model of utilization.

OBJECTIVE: The behavioral model of utilization, developed by Andersen, Aday, and others, is one of the most frequently used frameworks for analyzing the factors that are associated with patient utilization of healthcare services. However, the use of the model for examining the context within which utilization occurs-the role of the environment and provider-related factors-has been largely neglected. OBJECTIVE: To conduct a systematic review and analysis to determine if studies of medical care utilization that have used the behavioral model during the last 20 years have included environmental and provider-related variables and the methods used to analyze these variables. We discuss barriers to the use of these contextual variables and potential solutions. DATA SOURCES: The Social Science Citation Index and Science Citation Index. We included all articles from 1975-1995 that cited any of three key articles on the behavioral model, that included all articles that were empirical analyses and studies of formal medical care utilization, and articles that specifically stated their use of the behavioral model (n = 139). STUDY DESIGN: Design was a systematic literature review. DATA ANALYSIS: We used a structured review process to code articles on whether they included contextual variables: (1) environmental variables (characteristics of the healthcare delivery system, external environment, and community-level enabling factors); and (2) provider-related variables (patient factors that may be influenced by providers and provider characteristics that interact with patient characteristics to influence utilization). We also examined the methods used in studies that included contextual variables. PRINCIPAL FINDINGS: Forty-five percent of the studies included environmental variables and 51 percent included provider-related variables. Few studies examined specific measures of the healthcare system or provider characteristics or used methods other than simple regression analysis with hierarchical entry of variables. Only 14 percent of studies analyzed the context of healthcare by including both environmental and provider-related variables as well as using relevant methods. CONCLUSIONS: By assessing whether and how contextual variables are used, we are able to highlight the contributions made by studies using these approaches, to identify variables and methods that have been relatively underused, and to suggest solutions to barriers in using contextual variables.

Environment↗
PubMed1986

A microcomputer-based system for detailed analysis of rat behavior.

A microcomputer-based system that can measure rotational behavior and moving velocity is described. Infrared photobeams detect the animal behavior. One advantage of this system is that data can be stored on floppy disks and analyzed in arbitrary time intervals. This system may be useful for detailed analysis of rat behavior in physiological or psychopharmacological experiments.

Animals↗
PubMed2007

CYCLONET--an integrated database on cell cycle regulation and carcinogenesis.

Computational modelling of mammalian cell cycle regulation is a challenging task, which requires comprehensive knowledge on many interrelated processes in the cell. We have developed a web-based integrated database on cell cycle regulation in mammals in normal and pathological states (Cyclonet database). It integrates data obtained by 'omics' sciences and chemoinformatics on the basis of systems biology approach. Cyclonet is a specialized resource, which enables researchers working in the field of anticancer drug discovery to analyze the wealth of currently available information in a systematic way. Cyclonet contains information on relevant genes and molecules; diagrams and models of cell cycle regulation and results of their simulation; microarray data on cell cycle and on various types of cancer, information on drug targets and their ligands, as well as extensive bibliography on modelling of cell cycle and cancer-related gene expression data. The Cyclonet database is also accessible through the BioUML workbench, which allows flexible querying, analyzing and editing the data by means of visual modelling. Cyclonet aims to predict promising anticancer targets and their agents by application of Prediction of Activity Spectra for Substances. The Cyclonet database is available at http://cyclonet.biouml.org.

Animals↗
PubMed2006

Modelling geographically referenced survival data with a cure fraction.

The emergence of geographical information systems and related softwares nowadays enables medical databases to incorporate the geographical information on patients, allowing studies in spatial associations. Public health administrators and researchers are often interested in detecting variation in survival patterns by region or county in order to understand the possible factors that contribute towards such spatial discrepancies. These issues have led statisticians to develop survival models that account for spatial clustering and variation. Additionally, with rapid developments in medical and health sciences, researchers increasingly encounter data sets where a substantial portion of patients are cured. Models accounting for cure in the population assist in the prognosis of potentially terminal diseases. This article proposes a Bayesian modelling framework that models spatial associations for areally referenced survival data using a general class of cure models proposed by Cooner et al. The special models we outline are alternatives to the traditional proportional hazards models and can be fitted using standard Bayesian software such as WinBUGS.

Bayes Theorem↗
PubMed2004

Being a parent or grandparent with back pain, ankylosing spondylitis or rheumatoid arthritis: a descriptive postal survey.

Research that explores being a parent or grandparent with musculoskeletal problems has been fairly limited to date. The aim of this study was to describe the experience of parenting in the context of back pain (BP), ankylosing spondylitis (AS) and rheumatoid arthritis (RA), with a particular focus on the extent and nature of childcare experiences and to compare these experiences across the three groups. In addition, the possible reasons for these reported experiences, the availability of advice and support and the development of strategies for coping were explored using a cross-sectional descriptive survey. A total of 448 participants was recruited from relevant charitable organizations and the National Health Service (280 with BP, 106 with AS and 62 with RA). A combination of opportunistic and random sampling was used. Quantitative data were analysed with appropriate descriptive and inferential statistics using Statistical Package for the Social Sciences (SPSS version 10). Qualitative data were analysed using content analysis. Results indicate that a high proportion of all groups experienced a wide range of difficulties with parenting (81% BP, 77% AS, 97% RA). The most prevalent problems were similar for all three groups: lifting baby/child from the floor or cot, encouraging children/grandchildren to help with domestic chores and keeping up (in terms of energy) with children/grandchildren. However, the RA group reported having greater difficulties than the other two groups. Very little advice was offered to participants with parenting difficulties which may indicate a gap in service provision. However, a wide range of strategies for coping were described by respondents. The study highlighted a need for healthcare professionals to develop a greater awareness of parenting issues and to provide opportunities for these issues to be addressed.

Journal Article↗
PubMed2026

Clade-dependent antifungal resistance and susceptibility in Candidozyma auris: A global scoping review.

BACKGROUND: Candidozyma auris (formerly Candida auris) is an emerging multidrug-resistant fungal pathogen that has spread globally since its first identification in 2009 and is now classified as a critical-priority pathogen by the World Health Organization. Distinct genetic clades are associated with variations in geographic distribution, antifungal susceptibility, and resistance mechanisms; however, clade-specific evidence remains fragmented. AIMS: To systematically map global evidence on clade diversity, antifungal susceptibility patterns, resistance mechanisms, and clinical implications of C. auris. METHODS: A scoping review was conducted following PRISMA-ScR guidelines. Peer-reviewed primary studies published between 2009 and September 2025 were included if they reported clade attribution and antifungal susceptibility or resistance data. PubMed/MEDLINE, Scopus, and Web of Science were searched. Two reviewers independently screened studies and extracted data using a standardized form. RESULTS: Of 2050 records identified, 105 studies met inclusion criteria, representing 29 countries and diverse study designs. Whole-genome sequencing was the most common typing method. Antifungal susceptibility varied substantially across clades. High fluconazole resistance was consistently reported (MIC 4 to >256μg/mL). Echinocandins generally retained activity, although reduced susceptibility associated with FKS1 mutations was observed. Resistance mechanisms primarily involved mutations in ERG11, FKS1, and efflux-related genes. Studies also reported challenges in healthcare-associated transmission, environmental persistence, and diagnostic misidentification. CONCLUSIONS: C. auris exhibits marked clade-dependent variability in antifungal susceptibility and resistance mechanisms. These findings support the need for clade-informed interpretation of susceptibility data, standardized surveillance, improved diagnostics, and development of novel antifungal therapies.

Antifungal Agents↗
PubMed2001

Selectin receptor-ligand bonds: Formation limited by shear rate and dissociation governed by the Bell model.

We have studied the principles that govern the formation and dissociation of an adhesive bond between a cell moving in shear flow and a substrate and tested different theories of how force affects bond dissociation. Viscosity relates the kinematics of fluid movement (shear rate, units of time(-1)) to shear stress (units of force/area, the product of shear rate and viscosity). At different medium viscosities, the formation of receptor-ligand bonds between a cell in the flowstream and P-selectin on the vessel wall showed a similar efficiency as a function of shear rate but not of shear stress. Therefore, bond formation was a function of shear rate and hence of the kinematics of receptor and ligand movement. By contrast, the kinetics of bond dissociation was a function of shear stress and hence of force on the bond. The different requirements for bond formation and dissociation allowed dissociation kinetics to be measured at higher forces on the bond by increasing medium viscosity. Data over an extended range of forces on the bond therefore could be collected that enabled five different proposed equations, relating force to bond dissociation, to be compared for fit to experimental data. The relationship proposed by Bell [Bell, G. I. (1978) Science 200, 618-627] fit the data significantly the best and also predicted an off-rate in the absence of force that best matched an independent measurement [Mehta, P., Cummings, R. D. & McEver, R. P. (1998) J. Biol. Chem. 273, 32506-32513].

Binding Sites↗
PubMed2006

Cardiac arrhythmia and geomagnetic activity.

BACKGROUND: The purpose of this paper is a review of a number of studies considering links between life threatening cardiac arrhythmias, sudden cardiac death (SCD) and the level of environmental physical activity factors like geomagnetic activity (GMA) and opposite them cosmic ray and high energy proton flux. This is a part of studies in the field named Clinical Cosmobiology. METHODS: Temporal distribution of cardiac arrhythmias and SCD daily and monthly were compared to the level of GMA, space proton flux, cosmic ray activity according to neutron activity (impulse/min) on the earth's surface. The cosmophysical data was obtained from the cosmic science institutions in the USA, Russia and Finland (cosmic ray data, partially). RESULTS: As it follows from the results of the quoted studies there is an inverse relationship between the frequency of cardiac arrhythmic events and SCD and the level of daily GMA. CONCLUSION: Now studies are in progress considering the role of neutron (cosmic ray) activity in the natural history of the mentioned events. According to the various studies, we can presume that the GMA has some protective effect on cardiac arrhythmias and SCD.

Journal Article↗
PubMed2005

Sturdy cycles in the chaotic Tribolium castaneum data series.

Because of the inherent discreteness of individuals, population dynamical models must be discrete variable systems. In case of strong nonlinearity, such systems interacting with noise can generate a great variety of patterns from nearly periodic behavior through complex combination of nearly periodic and chaotic patterns to noisy chaotic time series. The interaction of a population consisting of discrete individuals and demographic noise has been analyzed in laboratory population data Henson et al. (Science 294 (2001) 602; Proc. Roy. Soc. Ser. B 270 (2003) 1549). In this paper we point out that some of the cycles are fragile, i.e. they are sensitive to the discretization algorithm and to small variation of the model parameters, while others remain "sturdy" against the perturbations. We introduce a statistical algorithm to detect disjoint, nearly-periodic patterns in data series. We show that only the sturdy cycles of the discrete variable models appear in the data series significantly. Our analysis identified the quasiperiodic 11-cycle (emerging in the continuous model) to be present significantly only in one of the three experimental data series. Numerical simulations confirm that cycles can be detected only if noise is smaller than a certain critical level and population dynamics display the largest variety of nearly-periodic patterns if they are on the border of "grey" and "noisy" regions, defined in Domokos and Scheuring (J. Theor. Biol. 227 (2004) 535).

Algorithms↗
PubMed2004

The membrane proteases adams and hepsin are differentially expressed in renal cell carcinoma. Are they potential tumor markers?

PURPOSE: ADAMs (a disintegrin and metalloproteinases) as cell surface proteins with adhesion and protease activity, and hepsin as a transmembrane protease have important roles in many biological processes. We assessed the expression of various ADAMs and of hepsin in human renal cell carcinoma (RCC), and correlated expression with clinicopathological data. MATERIALS AND METHODS: mRNA expression of ADAM-8, 17, 19, 28, TS1 and TS2, and of hepsin was investigated in paired tissue samples from cancerous and noncancerous parts of the kidneys of 27 patients with RCC who underwent tumor nephrectomy. Measurements were performed by quantitative real-time reverse transcriptase-polymerase chain reaction on a LightCycler instrument (Roche Applied Science, Mannheim, Germany). The data were related to housekeeping gene porphobilinogen deaminase mRNA. RESULTS: All ADAMs except ADAM-TS1 were significantly higher but hepsin was less expressed (at least p <0.05) in cancerous vs matched noncancerous tissue. Expression was differentially related to tumor stage. ADAM-8 and ADAM-TS2 over expression as well as decreased hepsin expression were associated with shorter patient survival. The Cox proportional hazards regression model revealed that ADAM-TS2 was an independent prognostic factor for cancer related death. ADAM-8 was the best predictor of distant metastases. CONCLUSIONS: The differential expression of hepsin and ADAMs suggests early and late involvement of membrane proteases in the development of RCC. Their association with the clinical outcome illustrates their potential usefulness as biomarkers for RCC.

ADAM Proteins↗
PubMed2006

The art of surgery in the 21st century: based on natural sciences and new ethical dimensions.

BACKGROUND AND AIMS: In the future, new surgical techniques will only be introduced in clinical practice if evidence-based results--frequently the results of controlled clinical trials--are presented. Unlike any other medical discipline, surgeons provide their diagnostic and operative skills through the surgeons' hand and the use of technical equipment, which ranges from instruments and devices employed during operation to the use of surgical robots. RESULTS: Analysing the fundaments of surgery on the turn of the century, there is only a little doubt about the increasing impact of data deriving from natural sciences on knowledge in medicine and management of diseases. The natural scientific method of detecting, measuring, and verifying facts is the methodological basis of surgery as well. The autonomy of the surgeon's clinical decision making is significantly restricted by the definition of guidelines. They shift the decision from a single patient to a collective panel. Patient safety and the efficiency of new treatment modalities compared with previous standards are the criteria for the judgement of innovative surgery today. The communication and interaction between surgeon-scientist and patients is guaranteed legally by written consensus. But beside of the high probability of benefit from therapy and written consensus, the surgeon-patient relation is determined by these factors: limitation of time for care of an individual patient, increase of time for administration and documentation, increase of bureaucratic barriers for medical research, and health cost constraints. CONCLUSION: The medical mandate to cure a sick patient is an individual mandate to take action. Measures, numbers, and images are only preconditions for a surgeon's action in daily clinical work; they can never replace it. The call for an ethical imperative in scientific surgery that is dependent on technology is justified when the state of science and uncritical use of surgical skills and financial constraints have major impact on providing medical care.

Decision Making↗
PubMed2006

Bone-patellar tendon-bone autografts versus hamstring autografts for reconstruction of anterior cruciate ligament: meta-analysis.

OBJECTIVES: To compare bone-patellar tendon-bone autografts with hamstring autografts for reconstruction of the anterior cruciate ligament. DATA SOURCES: Medline, WebSPIRS, Science Citation Index, Current Contents databases, and Cochrane Central Register of Controlled Trials. Review methods All randomised controlled trials reporting one or more outcome related to stability (instrumented measurement of knee laxity, Lachman test, or pivot shift test) and morbidity (anterior knee pain, kneeling test, loss of extension, or graft failure). Study quality was assessed by using a 5 point scale. Random effect models were used to pool the data. Heterogeneity in the effect of treatment was tested on the basis of study quality, randomisation status, and number of tendon strands used. RESULTS: 24 trials of 18 cohorts (1512 patients) met the inclusion criteria. Study quality was poor for nine studies and fair for nine studies. The weighted mean difference of the instrumented measurement of knee laxity was 0.36 (95% confidence interval 0.01 to 0.71; P = 0.04). Relative risk of a positive Lachman test was 1.22 (1.01 to 1.47; P = 0.04), of anterior knee pain 0.57 (0.44 to 0.74; P < 0.0001), of a positive kneeling test 0.26 (0.14 to 0.48; P < 0.0001), and of loss of extension 0.52 (0.34 to 0.80; P = 0.003). Other results were not significant. CONCLUSION: Morbidity was lower for hamstring autografts than for patellar tendon autografts. Evidence that patellar tendon autografts offer better stability was weak. The poor quality of the studies calls into question the robustness of the analyses.

Adult↗
PubMed2006

Normal Misbehavior: Scientists Talk about the Ethics of Research.

Those concerned with protecting the Integrity of science generally focus on the serious but rare infractions of falsification, fabrication, and plagiarism (FFP). While the violations of FFP are clear threats to the quality of scientific work and public trust in science, are they the behaviors that researchers themselves find most troubling? Noticing that scientists seldom are asked to report their perceptions of the behaviors that pose problems for the enterprise of science, we conducted six focus groups with researchers from major research universities. A total of 51 scientists participated in our focus-group discussions, which lasted from 1.5 to 2 hours each. We found that while researchers were aware of the problems of FFP, in their eyes misconduct generally is associated with more mundane, everyday problems in the work environment. These more common problems fall into four categories: the meaning of data, the rules of science, life with colleagues, and the pressures of production in science. Focus on the "normal misbehaviors" that are part of the ordinary life of researchers allows us to see the way the organization of science generates both compliance and deviance from ethical norms.

Journal Article↗
PubMed2005

Family background and genius II: Nobel laureates in science.

OBJECTIVE: In a previous study of literary creative achievement, we presented evidence refuting the still-influential statistical studies of Frances Galton on the inheritance of genius and also described a family background constellation of creativity. This study aims to assess empirically the hereditary transmission hypothesis with respect to creative achievement in the natural sciences. METHODS: Family background data were collected on 435 of all 488 Nobel laureates in chemistry, physics, and medicine and physiology, from 1901 through 2003. These were compared with a matching group of 548 eminent nonscientists for incidence of occupational inheritance (that is, same parent-offspring occupations) and with 560 high-IQ nonprizewinners for predominant type of occupation. RESULTS: The incidence of one or both parents having the same occupation was only 2% for science Nobel laureates but 20% for eminent nonscientists (P < 0.001). The predominant family background constellation (63%) for science Nobel laureates consisted of the same-sex parent either having a performance-equivalent occupation involving applied science, technology, or a natural-world focus and skills (P < 0.001, compared with the matching group) or having an unrelated occupation with unfulfilled scientific interests and wishes for creative expression. CONCLUSIONS: Nobel laureates in the natural sciences do not manifest direct inheritance of creativity from their parents; instead, congruent-sex parents are predominantly in applied or performance-equivalent occupations, with unfulfilled creative and scientific wishes. Early developmental influences on motivation involving identification and competition with the congruent-sex parent are suggested.

Achievement↗
PubMed2004

Angioplasty and stents in coronary artery disease: a systematic review and meta-analysis.

OBJECTIVES: To undertake a systematic review of the clinical effectiveness of routine percutaneous transluminal coronary angioplasty (PTCA) plus stenting vs PTCA alone. DATA SOURCES: MEDLINE; EMBASE; Science Citation Index; The Cochrane Library; cardiovascular journals and conference proceedings; Internet resources (including industry supported web pages); and reference lists of included studies and relevant reviews. REVIEW METHODS: Study selection included published and unpublished randomized controlled trials (RCTs) comparing the use of coronary stents to PTCA. Outcome measures assessed included death, acute myocardial infarction (AMI), event rate (such as major cardiac adverse events (MACE) or other composite measures), and binary restenosis (BR). Data extraction and quality assessment were conducted according to internationally recognized methods. Data synthesis included meta-analysis of assessed outcomes, reported as odds ratios (ORs). RESULTS: Fifty RCTs involving 16,500 patients met the inclusion criteria (39 full articles, 11 abstracts). Of these, 23 studies compared stenting with PTCA in patients with non-specific coronary artery disease (CAD), 11 compared stents with PTCA following AMI, 8 included patients with small coronary arteries and 8 included patients whose vessels had chronic total occlusion. There were no differences in rates of death or AMI. There were reductions in the rates of MACE (death, AMI or revascularization) with stents compared to PTCA (at 6 months, for non-specific group OR: 1.64, 95% CI 1.44-1.87; for AMI group OR: 2.36, 95% CI 1.92-2.89; for small vessel group OR: 1.38, 95% CI 1.10-1.74; at 12 months, for non-specific group OR: 1.31, 95% CI 1.11-1.55; for AMI OR: 2.26, 95% CI 1.47-3.46). Reporting of combined major adverse cardiac events was inconsistent across studies. Most events were revascularizations that may have been partly driven by protocol-required angiograms. Stents reduced BR rates at angiogram at 6 months compared to PTCA in all groups. CONCLUSION: We found no differences in mortality or AMI, but the studies were not powered to identify changes in these endpoints. Coronary stenting is associated with reduced restenosis and combined adverse cardiac events, primarily revascularizations. However, the frequency of revascularization may have been distorted by protocol-dictated angiography.

Age Distribution↗