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At least 631 records · Page 35Linked to original sources
PubMed2007

Pronase-immobilized enzyme reactor: an approach for automation in glycoprotein analysis by LC/LC-ESI/MSn.

An automated analytical approach is proposed for simultaneous characterization of glycan and peptide moieties in pronase-generated glycopeptides. The proposed method is based on the use of a new pronase-immobilized enzyme reactor for the on-line rapid digestion of the target glycoprotein. By coupling the bioreactor to a Hypercarb chromatographic trap column, on-line selective glycopeptide enrichment prior to normal-phase liquid chromatography-mass spectrometry was obtained. A detailed study was carried out for integration and automation of each phase of the proposed analytical procedure. On-line digestion allowed extensive cleavage of the model protein (ribonuclease B), yielding to glycopeptides with peptide moieties up to eight amino acids, carrying the Man5-Man9 N-glycans each, selectively resolved on an Amide-80 column. The use of a linear ion trap instrument resulted in efficient ion capture and led to MS3 acquisition times and spectra quality similar to those for MS2, allowing the unambiguous identification of glycan (MS2) and peptide (MS3) sequences. The proposed procedure reduces the glycoprotein analysis time from approximately 3 days, as in most of the traditional off-line methods, to approximately 1 h.

Automation↗
PubMed2003

Probability analysis for diagnosis of endometrial hyperplasia and cancer in postmenopausal bleeding: an approach for a rational diagnostic workup.

OBJECTIVE: To develop an analytical approach to estimate the probability of endometrial hyperplasia and cancer in women with postmenopausal bleeding, using a combination of patient history and tests. METHODS: A prospectively collected database of 428 postmenopausal women investigated for abnormal uterine bleeding in an outpatient rapid access clinic was used. The probability of disease was estimated using multivariable logistic regression models considering a combination of age and the use of hormone replacement therapy (HRT) and tests (ultrasound and hysteroscopy) in keeping with the actual clinical process. RESULTS: The prevalence or prior probability of endometrial cancer in the sample studied was 4.4%. Hysteroscopy alone performed better than ultrasound alone. In all patients, a negative hysteroscopy reduced the probability of cancer to 1.3%. In women less than 60 years of age who use HRT, a negative hysteroscopy further reduced this probability to 0.1%. Overall, a positive hysteroscopy raised the probability of cancer to 38.9%. However, in women over 60 years of age not using HRT, a positive hysteroscopy increased this probability to 59.4%. Combining ultrasound results with hysteroscopy did not meaningfully alter the diagnostic probability. CONCLUSION: The combination of information obtained from patient history and tests allows generation of specific disease probabilities in postmenopausal bleeding. This type of multivariable analysis puts diagnostic information gained from history and other tests into a perspective that reflects actual clinical practice.

Databases, Factual↗
PubMed2003

Narrating practice: reflective accounts and the textual construction of reality.

BACKGROUND: Two approaches dominate current thinking in health and welfare: evidence-based practice and reflective practice. Whilst there is debate about the merits of evidence-based practice, reflective practice is generally accepted with critical debate as an important educational tool. Where critique does exist it tends to adopt a Foucauldian approach, focusing on the surveillance and self-regulatory aspects of reflective practice. AIM: This article acknowledges the critical purchase on the concept of reflective practice offered by Foucauldian approaches but argues that microsociological and discourse analytic approaches can further illuminate the subject and thus serve as a complement to them. METHODS: The claims of proponents of reflective practice are explored, in opposition to the technical-rational approach of evidence-based practice. FINDINGS: Reflective practice tends to adopt a naive or romantic realist position and fails to acknowledge the ways in which reflective accounts construct the world of practice. CONCLUSIONS: Microsociological approaches can help us to understand reflective accounts as examples of case-talk, constructed in a narrative form in the same way as case records and presentations.

Communication↗
PubMed2005

Wanted: a new ethics field for health policy analysis.

Ethics guidance and ethical frameworks are becoming more explicit and prevalent in health policy proposals. However, little attention has been given to evaluating their roles and impacts in the policy arena. Before this can be investigated, fundamental questions must be asked about the nature of ethics in relation to policy, and about the nexus of the fields of applied ethical analysis and health policy analysis. This paper examines the interdisciplinary stretch between bioethics and health policy analysis. In particular, it highlights areas of scholarship where a health policy ethics specialization--as distinctive from bioethics--might develop to address health policy concerns. If policy and ethics both ask the same question, that question is: "What is the good, and how do we achieve (create, protect, cultivate) it?" To answer this question, the new field of "health policy ethics" requires development. First, we should develop a full set of ethical principles and complementary ethical theories germane to public policy per se. Second, we must understand better how explicit attention to ethical concerns affects policy dynamics. Third, we require new policy and ethical analytic approaches that contribute to constructive (not obstructive) policy making. Finally, we need indicators of robust, high quality ethical analysis for the purpose public policy making.

Benchmarking↗
PubMed1998

Ethical issues in technology assessment. Conceptual categories and procedural considerations.

The practice of health care technology assessment involves ethical considerations in all of its varied functions and techniques. Ethical issues in technology assessment can be grouped into the broad categories of normative concepts, diagnosis, prevention and therapy, research and the advancement of knowledge, and allocation of resources. Moreover, the ethics of the assessment process itself must be evaluated in terms of the integrity of the project's goals, procedures, and effects, and evaluators' open and self-critical acknowledgment of their purposes. As a relatively new field, technology assessment can benefit from using a variety of analytic approaches as it works to develop its own methods for evaluating ethical issues related to technology.

Biomedical Research↗
PubMed1995

Modeling superhelical DNA: recent analytical and dynamic approaches.

During the past year, a variety of diverse and complementary approaches have been presented for modeling superhelical DNA, offering new physical and biological insights into fundamental functional processes of DNA. Analytical approaches have probed deeper into the effects of entropy and thermal fluctuations on DNA structure and on various topological constraints induced by DNA-binding proteins. In tandem, new kinetic approaches--by molecular, Langevin and Brownian dynamics, as well as extensions of elastic-rod theory--have begun to offer dynamic information associated with supercoiling. Such dynamic approaches, along with other equilibrium studies, are refining the basic elastic-rod and polymer framework and incorporating more realistic treatments of salt and sequence-specific features. These collective advances in modeling large DNA molecules, in concert with technological innovations, are pointing to an exciting interplay between theory and experiment on the horizon.

Computer Graphics↗
PubMed1989

Artificial feeding for severely disoriented, elderly patients.

The issue of artificial feeding for patients with dementia who refuse feeding by hand is a wrenching emotional problem that can cloud clinical judgement. It is helpful to apply an analytic approach to decision making. There are five steps: gathering a comprehensive clinical database; defining the goal of treatment; knowing the treatment options available, their burdens and potential benefits; understanding the law; and defining the moral framework in which care is being given. Such an approach can be used to formulate a plan of treatment in the best interests of incompetent elderly patients who cannot speak for themselves.

Advance Directives↗
PubMed2006

Comparison of the linear finite element prediction of deformation and strain of human cancellous bone to 3D digital volume correlation measurements.

The mechanical properties of cancellous bone and the biological response of the tissue to mechanical loading are related to deformation and strain in the trabeculae during function. Due to the small size of trabeculae, their motion is difficult to measure. To avoid the need to measure trabecular motions during loading the finite element method has been used to estimate trabecular level mechanical deformation. This analytical approach has been empirically successful in that the analytical models are solvable and their results correlate with the macroscopically measured stiffness and strength of bones. The present work is a direct comparison of finite element predictions to measurements of the deformation and strain at near trabecular level. Using the method of digital volume correlation, we measured the deformation and calculated the strain at a resolution approaching the trabecular level for cancellous bone specimens loaded in uniaxial compression. Smoothed results from linearly elastic finite element models of the same mechanical tests were correlated to the empirical three-dimensional (3D) deformation in the direction of loading with a coefficient of determination as high as 97% and a slope of the prediction near one. However, real deformations in the directions perpendicular to the loading direction were not as well predicted by the analytical models. Our results show, that the finite element modeling of the internal deformation and strain in cancellous bone can be accurate in one direction but that this does not ensure accuracy for all deformations and strains.

Anisotropy↗
PubMed1992

The problem of discrimination in health care priority setting.

Increasingly stringent fiscal restrictions on the scope of medical services available to patients have resulted in calls for explicit health care priority setting. Several commentators have called for the application of decision-analytic principles to such efforts, which would assign services priority based on the extent to which they produce preferred health outcomes. The Oregon Medicaid exercise is an example of such a process. An important challenge to these utilitarian efforts is the need to avoid discrimination against people with medical disabilities. Both of the key elements entailed by decision-analytic approaches to priority setting--estimation of outcomes and assignment of values to those outcomes--are vulnerable to charges of discrimination, primarily because both the medical outcomes expected in disabled individuals and the values they place on those outcomes may differ from the general public. Priority-setting efforts must proceed carefully to avoid the appearance (and reality) of discrimination.

Civil Rights↗
PubMed2002

Fuzzy multiple-criteria decision-making approach for industrial green engineering.

This paper describes a fuzzy hierarchical analytic approach to determine the weighting of subjective judgments. In addition, it presents a nonadditive fuzzy integral technique to evaluate a green engineering industry case as a fuzzy multicriteria decision-making (FMCDM) problem. When the investment strategies are evaluated from various aspects, such as economic effectiveness, technical feasibility, and environmental regulation, it can be regarded as an FMCDM problem. Since stakeholders cannot clearly estimate each considered criterion in terms of numerical values for the anticipated alternatives/strategies, fuzziness is considered to be applicable. Consequently, this paper uses triangular fuzzy numbers to establish weights and anticipated achievement values. By ranking fuzzy weights and fuzzy synthetic utility values, we can determine the relative importance of criteria and decide the best strategies. This paper applies what is called a lambda fuzzy measure and nonadditive fuzzy integral technique to evaluate the synthetic performance of green engineering strategies for aquatic products processors in Taiwan. In addition, we demonstrate that the nonadditive fuzzy integral is an effective evaluation and appears to be appropriate, especially when the criteria are not independent.

Conservation of Natural Resources↗
PubMed1977

[Psychological approach to Céline's obscenity].

The aim of the psycho-analytical approach the author attempts is the obscene character of Céline's dependent of the writer's whole personality. The obscenity of the celinian language proceeds from several causes. It can be explained by the lucid and the phallic-narcistical features of Céline's personality in relation with psycho-sociological factors. Obscenity is lecherous and sullen in regard to women and virulent towards men: it may then be interpreted as a mean of struggle against the anxiety of death. It is also used to translate the celinian contempt of the human being.

History of Medicine↗
PubMed2003

Seven vulnerabilities in the pediatric research subject.

Most recent thinking about the vulnerability of research subjects uses a "subpopulation" focus. So conceived, the problem is to work out special standards for prisoners, pregnant women, the mentally ill, children, and similar groups. In contrast, an "analytical" approach would identify characteristics that are criteria for vulnerability. Using these criteria, one could support a judgment that certain individuals are vulnerable and identify needed accommodations if they are to serve as research subjects. Seven such characteristics can be evident in children: they commonly lack the capacity to make mature decisions; they are subject to the authority of others; they (and their parents) may be deferential in ways that can mask underlying dissent; their rights and interests may be socially undervalued; they may have acute medical conditions requiring immediate decisions not consistent with informed consent; they may have serious medical conditions that cannot be effectively treated; and they (and their parents) may lack important socially distributed goods. Each of these vulnerabilities can call for special care in the design and implementation of research protocols.

Child↗
PubMed2004

Does elimination of placebo responders in a placebo run-in increase the treatment effect in randomized clinical trials? A meta-analytic evaluation.

The use of a placebo run-in phase, in which placebo responders are withdrawn from a study before random assignment to treatment condition, has been criticized as favoring the active treatment in clinical trials. We compared the effect size of randomized, placebo-controlled clinical trials (in the treatment of depression with selective serotonin reuptake inhibitors [SSRIs]) that include a placebo run-in phase with those that do not, using a meta-analytic approach. This study differed from earlier meta-analytic studies in that it considered only SSRIs and included only studies using continuous measures of depression, allowing for a more refined assessment of effect size. An extensive literature search identified 43 datasets published between 1980 and 2000 comparing placebo with SSRI and using a continuous measure of depression (usually the Hamilton Depression Rating Scale). We included only studies of at least 6 weeks' duration focusing on treatment for primary acute major depression in adults 18-65 years of age. Studies focusing on depression in specific medical illnesses were not included. Analysis of efficacy was based on 3047 subjects treated with an SSRI antidepressant and 3740 subjects treated with a placebo. There was no statistically significant difference in effect size between the clinical trials that had a placebo run-in phase followed by withdrawal of placebo responders and those trials that did not. Despite the lack of a statistically significant difference between studies of withdrawing early placebo responders and those not using this procedure, this approach is likely to continue to be used widely because it produces large absolute effect sizes. It is recommended that future studies clearly describe these procedures and report the number of subjects dropped from the study for early placebo response and other reasons.

Antidepressive Agents, Second-Generation↗
PubMed2001

Quantitative analysis of the principle soy isoflavones genistein, daidzein and glycitein, and their primary conjugated metabolites in human plasma and urine using reversed-phase high-performance liquid chromatography with ultraviolet detection.

Soy isoflavones are becoming of increasing interest as nutritional agents which can be used to combat osteoporosis and hyperlipidemia, and are also being considered as potential cancer chemopreventive compounds. However, prior to their formulation and distribution as therapeutic agents, thorough pharmacokinetic and toxicological assessment needs to be completed in men and women in a variety of health conditions in order to ensure their therapeutic efficacy and safety. At this time, studies of purified soy isoflavones are possible, and are being designed to fully evaluate the pharmacological utility of these preparations. In support of these studies, quantitative analysis of soy isoflavones in biological fluids can be accomplished with a wide variety of methods and analytical instrumentation. However, the relatively ubiquitous presence of high-performance liquid chromatography with ultraviolet detection (HPLC-UV) in most analytical laboratories, the relative ease of its operation, and the lesser expense of this instrumentation as compared to more sophisticated techniques such as liquid chromatography-mass spectrometry, offers some distinct advantages for its use in pharmacokinetic studies. In this manuscript, the development and validation of an HPLC-UV method for the quantitation of the principal soy isoflavones, genistein, daidzein, and glycitein, and their primary metabolites, in human plasma and urine is described. This analytical approach allows for pharmacologically relevant concentrations of the analytes and their principle metabolites to be detected, and has been validated in close agreement with the US Food and Drug Administration's guidelines for the validation of methods to be used in support of pharmacokinetic studies.

Chromatography, High Pressure Liquid↗
PubMed1997

Reliable determination of binding affinity and kinetics using surface plasmon resonance biosensors.

Progress has been made in the identification of experimental and analytical procedures that allow for a more reliable determination of equilibrium and kinetic constants. Possible origins of the frequently observed deviations of the measured binding progress from that expected for chemical binding of pseudo-first order, and appropriate experimental controls have been proposed. Improved analytical approaches include the application of global analysis and analytical corrections for the influence of mass transport.

Binding Sites↗
PubMed2006

Activation of the PKB/Akt pathway in histological benign prostatic tissue adjacent to the primary malignant lesions.

In order to evaluate the molecular heterogeneity of prostate cancer, this study examined the expression of Akt-pathway related parameters within the cancerous prostate gland. PTEN, p-Akt and p27kip1 are known to be altered in prostate cancer. Tissue samples from malignant, tumor adjacent benign and benign areas of 25 whole mounted prostate cancer specimens were processed to 583 tissue microarray cores. Immunohistochemically determined biomarker expression was correlated to the different localizations. p-Akt and p27kip1 showed increased staining in malignant tissue compared to the respective benign tissue (p < 0.01 and p < 0.05). The adjacent but histologically benign tissue had increased levels (p < 0.05 and p < 0.01), whereas no significant difference was found between the adjacent and malignant regions. A highly significant correlation of p-Akt and p27kip1 in benign tissue (p < 0.001) was lost in the adjacent areas and in the malignant tissue (p = 0.054 and p = 0.12). In tendency, PTEN expression was decreased in the malignant regions and revealed the highest staining in the adjacent zone. According to the results obtained, the expression of p-Akt and p27kip1 was increased in both the adjacent microscopically benign tissue as well as the primary tumors when compared with the histologically benign tissue specimens that served as biological control. The increased expression of PTEN indicates its regulatory function in the initial steps of a deteriorated cell cycle control as well as uncontrolled cellular proliferation, for example, which seem to be present in the normal prostatic tissue surrounding the primary malignant lesion. The addition of molecular markers to a 'classical' histopathological approach might contribute to an enhanced sensitivity of analytical approaches aimed at the detection of malignant or premalignant lesions within prostatic biopsies.

Aged↗
PubMed1976

A dynamic synthesis of analytic and behavioral approaches to symptoms.

The symptom-formation process involves a complex interaction between internal symbolic expression and secondary reinforcing consequences in the patient's environment. Symptoms are considered from a practical clinical perceptive integrating behavioral and analytic approaches and the implications for diagnosis, disposition, and treatment are outlined.

Behavior Therapy↗
PubMed2004

Analytical coupling detection in the presence of noise and nonlinearity.

A rigorous analytical approach is developed to test for the existence of a continuous nonlinear functional relationship between systems. We compare the application of this nonlinear local technique to the existing analytical linear global approach in the setting of increasing additive noise. For natural systems with unknown levels of noise and nonlinearity, we propose a general framework for detecting coupling. Lastly, we demonstrate the applicability of this method to detect coupling between simultaneous, experimentally measured, intracellular voltages between neurons within a mammalian neuronal network.

Animals↗