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PubMed1976

[User-oriented programs for semi-automated evaluation of radio in vitro tests].

Most of the programmes for the evaluation of radio in vitro tests proceed from the anticipation that the best method should give an approximation of standard values by a curve as perfect as possible. According to our experiences this demand, however, is not decisive for a good standard curve, as in principle all standard values can be incorrect. The application of relatively simple linearising transformations and an additional curve (recovery of a normal serum) guarantees the necessary precision in the programme described. After a short description of the contents of the system, the programme for the assessment of CPBA - methods is shown, by help of which the sample changer - calculator-system determines the absolute concentration of the substance to be measured. This makes the starting point for the more complex RIA programme which methodologically takes into consideration the special problems of these tests.

Diagnosis, Computer-Assisted↗
PubMed2001

Alabama coronary artery bypass grafting project: results of a statewide quality improvement initiative.

CONTEXT: Efforts to improve quality of care in the cardiac surgery field have focused on reducing the risk-adjusted mortality associated with common surgical procedures, such as coronary artery bypass grafting (CABG). However, the best methodological approach to improvement is under debate. OBJECTIVE: To test an intervention to improve performance of CABG surgery. DESIGN AND SETTING: Quality improvement project based on baseline (July 1, 1995-June 30, 1996) and follow-up (July 1-December 31, 1998) performance measurements from medical record review for all 20 Alabama hospitals that provided CABG surgery. PATIENTS: Medicare patients discharged after CABG surgery in Alabama (n = 5784), a comparison state (n = 3214), and a national sample (n = 3758). INTERVENTION: Confidential hospital-specific performance feedback and assistance with multimodal improvement interventions, including the option to share relevant experience with peers. MAIN OUTCOME MEASURES: Duration of intubation, reintubation rate, aspirin therapy at discharge, use of the internal mammary artery (IMA), hospital readmission rate, and risk-adjusted in-hospital mortality. RESULTS: Proportion of extubation within 6 hours increased from 9% to 41% in Alabama, decreased from 40% to 39% in the comparison state, and increased from 12% to 25% in the national sample. Use of IMA increased from 73% to 84%, 48% to 55%, and 74% to 81%, respectively, in the 3 samples, but aspirin use increased only in Alabama (from 88% to 92%). The amount of improvement in all 3 of these process measures was greater in Alabama than in the other samples (IMA use for Alabama vs comparison state was P =.001 and for Alabama vs national sample, P =.02; and P<.001 for all other comparisons). Risk-adjusted mortality decreased in Alabama (4.9% to 2.9%), but this decrease was not statistically significantly different from mortality changes in the other groups (odds ratio, 0.76; 95% confidence interval, 0.54-1.07 vs national sample). CONCLUSION: Confidential peer-based regional performance feedback and process-oriented analysis of shared experience are associated with some improvement in quality of care for patients who underwent CABG surgery.

Aged↗
PubMed2006

Protein extraction and fingerprinting optimization of bacterial communities in natural environment.

Recent development in molecular approaches allows access to genetic structure and diversity of indigenous microbial communities. In contrast, the functional analysis of microorganisms in their environment is still hampered by methodological limitations. Analysis of total proteins expressed at the whole community level (metaproteome) has been proposed to characterize the functional structure of microbial communities in their environment. However, developments are still required to perform such analysis. Our aim was to optimize methods to extract and characterize metaproteome of indigenous microbial communities. Experiments were first conducted in monoxenic bacterial cultures, and various methods were examined to define a procedure of protein extraction ensuring an efficient recovery regardless of the taxonomic affiliation of the cells. These developments were next applied to characterize the metaproteome from indigenous bacterial communities in freshwater samples. Bacterial cells were recovered from water using a high-speed density gradient centrifugation method before protein extraction and fingerprinting. The reactivity and sensitivity of this metaproteomic approach were tested by analyzing the variations of protein fingerprints according to perturbations (cadmium or mercury contamination). The genetic structure of the corresponding communities was also characterized by automated ribosomal spacer analysis (ARISA) DNA fingerprinting. Both protein and DNA fingerprints were statistically analyzed. Results obtained showed that the method developed for protein recovery and fingerprinting was efficient, sensitive, and reproducible. Both the functional and genetic structures of the freshwater bacterial community were complex and varied with perturbations. These variations occurred at both population and protein expression levels and were specific to the perturbation applied.

Bacteria↗
PubMed1981

Lipid A induction of cytotoxic antibody to cultured syngeneic rat kidney tubular cells.

Syngeneic Fischer rat kidneys repeatedly injected with lipid A induced a cytotoxic antibody to cultured syngeneic rat kidney tubular cells. To test for antibodies in the serum of immunized animals, we disaggregated syngeneic rat kidney tubular cells with collagenase and trypsin and established them in short-term culture. Cultured kidney tubule cells were then radiolabeled 24 hours later with chromium 51 and cultured for an additional 24 hours. Rabbit antirat kidney tubule cell antibody served as the positive control antisera in a complement-dependent antibody cytotoxicity assay. Serum samples from animals whose kidneys were innoculated with Re glycolipid were then tested for antibody cytotoxicity. Autoantibody to syngeneic cultured kidney tubule cells was presented in the serum from these animals (P less than 0.01) as well as in the serum of animals injected i.p. with Re glycolipid when compared with saline controls. The cytotoxic antibody could be removed by absorbing with syngeneic cultured kidney tubule cell membranes. These results suggest that the glycolipid from the mutant strain Re 595 of Salmonella minnesota stimulates a crossreactive antibody to cultured rat kidney tubular cells. The methodology used in these experiments provides an in vitro models for investigating the importance of the immune system in the pathogenesis of pyelonephritis.

Animals↗
PubMed2003

Q-methodology: a systematic approach to assessing learners in palliative care education.

Q-methodology is a qualitative research method that has increasingly been used to identify the complex attributes and behaviors that impact learning within medicine. Because learners bring a lifetime of experiences, values, and beliefs to a palliative care education, this method is ideal for identifying the typology of learner's present, thus making it possible to adapt the palliative care curriculum to meet the identified needs of each subgroup of learners. A step-by-step overview of the methodology using an example from pediatric graduate medical education illustrates the process. Potential uses of Q-methodology in palliative care are outlined including its application to the assessment of affective learning competencies, before and after a palliative care curriculum. The development of a universal palliative care education Q-sample, a collection of subjective opinion statements reflecting the spectrum of opinions on the topic, would advance the use of the Q-methodology in palliative medicine education.

Education, Medical↗
PubMed1995

Cancer incidence among women in the workplace: a study of the association between occupation and industry and 11 cancer sites.

Few studies of the occupational etiology of cancer have focused upon the risks that women experience in the workplace. In this case-referent study of 11 cancer sites (lung, colon, rectum, bladder, esophagus, liver, salivary gland, stomach, eye, melanoma of the skin, mesothelioma), 7686 women in the Detroit area were interviewed to obtain lifetime histories of employment, tobacco use, and adult health, as well as demographic information. The results provide both methodologic and substantive leads for future investigations of the association between women's employment and their risk of cancer. We found that 63% of respondents had a usual occupation of housewife. Methodologic issues are discussed about the implications of this finding for sample size and statistical analysis when conducting such studies. New observations that merit further investigation include an association between salivary gland cancer and employment in hairdressing shops, esophageal cancer and employment in restaurants, and bladder cancer and employment in computer manufacturing. Further research is needed to understand the occupational etiology of cancer among women; such studies must consider specific methodologic issues.

Case-Control Studies↗
PubMed2002

Oral health in Kuwait before the Gulf War.

OBJECTIVE: The aim of this oral health survey was to determine the oral health status and oral health behavior in the whole population in Kuwait. This survey was part of the Kuwait Health Survey, which was conducted by the Ministry of Public Health. The original data were destroyed during the Gulf War (1990/1991), but the aim of this report is to publish the main findings concerning oral health and related factors. METHODOLOGY: The data were collected between April 1984 and April 1985. The sample consisted of 3,358 households and 26,530 individuals. The survey consisted of interviews and clinical examinations (> 12-year-olds). WHO (1977) criteria were used for examinations. RESULTS: Females were more often brushing their teeth at least once a day than males and non-Kuwaitis slightly more often than Kuwaitis. Over one third (39%) had visited a dentist during the previous 12 months. The proportion of subjects with soft deposit was 66%, calculus 45%, intensive gingivitis 46% and advanced periodontitis 18%. The caries experience was prevalent (52%) in primary dentition (< 8-year-olds) and in permanent dentition, highest (95%) among the 60- to 64-year-olds. CONCLUSION: Preventive programs for periodontal diseases and for dental caries are urgently needed. The coverage of curative care of both diseases also needs to be improved. Health behavior improvement should be targeted by oral health promotion activities.

Adolescent↗
PubMed1985

Metabolism and pharmacokinetics of phenelzine: lack of evidence for acetylation pathway in humans.

Earlier studies have suggested that patients with slow acetylation phenotype were more likely to respond to phenelzine treatment and more likely to experience side effects. The metabolism of phenelzine has not been extensively investigated in humans because of limitations in analytical methodology. A labeled form of phenelzine is required for metabolite identification because these same compounds can arise from endogenous substances e.g., phenylacetic acid. The use of a stable isotope-labeled compound has the advantage that in vivo studies can be performed without radiation exposure. Site-specific, stable isotope-labeled phenelzine analogs were synthesized and used in metabolic and pharmacokinetic studies in humans. The authors were unable to detect N-acetylphenelzine in any urine or plasma samples. The major metabolites phenylacetic acid and parahydroxyphenylacetic acid constitute up to 79% of the administered dose excreted via the urine in the first 96 hours. These studies indicate that N-acetylation of phenelzine is not a significant metabolic pathway in humans, which helps explain recent clinical studies that failed to find an association between acetylation phenotype and clinical effects of phenelzine.

Acetylation↗
PubMed1997

Analysis of randomized controlled trials in laparoscopic surgery.

BACKGROUND: Randomized controlled studies of surgical procedures are difficult, but can be done to acceptable standards. There are few published objective assessments of such trials. METHODS: The original articles that involved a randomized controlled trial including at least one laparoscopic procedure were reviewed and evaluated with special interest in their methodology. An assessment form containing 11 generic questions and three additional criteria (assessment of quality of life, cost analysis and laparoscopic experience required) was used. Forty trials were retrieved including 12 on cholecystectomy, 12 on hernia repair and 12 on appendicectomy. Each trial was scored by two assessors. RESULTS: The agreement among the two independent assessors was very good. Six of the trials were well conducted but 22 had a poor score. The trials on cholecystectomy were scored the best in contrast to those on hernia repair or appendicectomy. Few trials provided an adequate prospective calculation of the sample size, an unbiased assessment of endpoints, evaluation of the quality of life and a study of the economic aspects. CONCLUSION: Readers should be cautious when interpreting the results of some of these trials and their impact on daily surgical practice.

Humans↗
PubMed1997

The 1996 Schering Lecture. An inquiry into the experience of oncology patients who leave biomedicine to use alternate therapies.

Minimal attention has been given to the experiences of oncology patients who abandon biomedicine to use alternate therapies. This presentation explores the abandonment experience. It also examines this group's emotions, perceived stress, and coping strategies through stress theory. Congruent with past research these patients tend to be younger, attain higher education, and are interested in changing their health regimens. Analysis suggests that anger precipitates the abandonment and remains a residual force for these patients. While their expressed initial fear of cancer changes to hope with the use of an alternate therapy, the hope for cure seems to be carried to the extremes of illusion and denial of possible death. The study, conducted with a network sample, included individual interviews and a focus group. The value of this ethnography lies in the revelation that a) some similar experiences appear for patients who remain in biomedicine and patients who abandon biomedicine, and b) insights are provided for health professionals wishing to avoid situations of abandonment and wishing to facilitate estranged patients' return to biomedicine.

Adaptation, Psychological↗
PubMed2006

Sensitivity of Escherichia coli O157 detection in bovine feces assessed by broth enrichment followed by immunomagnetic separation and direct plating methodologies.

In order to more precisely predict food safety risks, the fecal presence of food-borne pathogens among animals at slaughter must be correctly determined. Quantification of Escherichia coli O157 is also desirable. In two separate experiments, detection and enumeration of a nalidixic acid-resistant strain of E. coli O157 in bovine feces was assessed by culture on MacConkey agar supplemented with nalidixic acid (MACnal) and compared to overnight broth enrichment followed by immunomagnetic separation (IMS) and to direct plating of dilutions of bovine feces onto sorbitol MacConkey agar containing cefixime and tellurite (SMACct). The sensitivity of detection of E. coli O157 by both direct plating and IMS was highly dependent upon the initial concentration of the target organism in the sample. Sensitivity of detection by IMS was poor below 100 CFU/g but was better, and not affected by initial E. coli O157 numbers, above this concentration. Sensitivity of detection of E. coli O157 in bovine feces at low initial concentrations is very poor for both direct plating and IMS. Direct plating of dilutions of bovine feces on SMACct can be used to determine the magnitude of fecal E. coli excretion among cattle excreting greater than 100 CFU/g. Among positive samples identified by direct plating on SMACct, the direct counts of E. coli O157:H7 were highly correlated with the estimates obtained with the MACnal plates (r = 0.88, P < 0.001). Because the majority of cattle excrete less than 10(2) CFU E. coli O157/g feces, most studies, including those using IMS methods, probably grossly underestimate the prevalence of E. coli O157 in cattle.

Animals↗
PubMed2026

Acceptability of capillary point-of-care testing: a systematic review.

OBJECTIVE: To identify and synthesise evidence on the acceptability and perceived experience of finger-prick point-of-care testing (POCT) among patients and clinicians across healthcare settings. DESIGN: Systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. DATA SOURCES: Medline, Embase, PsycInfo, CINAHL, Cochrane and Web of Science were searched from inception to January 2024 and re-run in July 2025, supplemented by citation tracking of relevant studies. ELIGIBILITY CRITERIA: Studies reporting patient and clinicians' experiences, perceptions, satisfaction or acceptability relating to finger-prick POCT for any health condition or blood parameter were eligible. Quantitative, qualitative and mixed-methods designs were included. DATA EXTRACTION AND SYNTHESIS: Data were extracted independently by two reviewers and synthesised using thematic analysis and narrative synthesis. Methodological quality was appraised using the Mixed-Methods Appraisal Tool. RESULTS: 21 studies met the inclusion criteria, encompassing 9128 participants (17 quantitative, 3 qualitative, 1 mixed methods). Across diverse clinical contexts, finger-prick POCT was reported as generally acceptable, less distressing and perceived as a convenient alternative to venous sampling in comparative studies. Thematic synthesis identified two major themes: (1) enhancing the patient-clinician relationship through improved engagement, communication and understanding of care and (2) clinical implications of finger-prick POCT on clinicians' workflow, confidence and skill acquisition. Finger-prick POCT was perceived to promote personalised consultations, enable immediate discussion of results and streamline decision-making. Clinicians highlighted its potential to expand task sharing, improve efficiency and strengthen continuity of care, although concerns regarding training, reliability and quality assurance were identified. CONCLUSIONS: Finger-prick POCT is generally acceptable to patients and clinicians, improving comfort, convenience, engagement and perceived efficiency. Implementation should prioritise training, infrastructure and quality assurance frameworks to maximise clinical and experiential benefits. PROSPERO REGISTRATION NUMBER: CRD42024512130.

Humans↗
PubMed2006

Selective molecularly imprinted polymer obtained from a combinatorial library for the extraction of bisphenol A.

In the present work, an analytical methodology based on molecularly imprinted solid-phase extraction (MISPE) has been developed for the determination of bisphenol A (BPA) in environmental and food samples. In order to select the optimum material, a combinatorial library of molecularly imprinted polymers in small-scale (mini-MIPs) was prepared using BPA as template. Different monomers (methacrylic acid or 4-vinylpyridine), crosslinkers (ethylene glycol dimethacrylate or trimethylolpropane trimethacrylate) and porogens (methanol, acetonitrile or toluene) were used leading to 24 different polymerisation mixtures. After BPA removal, the ability of mini-MIPs to recognise BPA was evaluated by equilibrium rebinding-elution experiments. The copolymer of 4-vinylpyridine (4-VP) and trimethylolpropane trimethacrylate (TRIM) prepared in toluene showed the higher affinity for the template. Subsequently, a scaled-up version of the optimum polymer was prepared and used in the development of MISPE procedures for the extraction of BPA. The optimised MISPE protocols were successfully applied to the selective extraction of BPA from soils and aqueous canned peas samples.

Benzhydryl Compounds↗
PubMedDate not supplied

Transitions in chronic illness: rheumatoid arthritis in women.

This article describes transition theory as it relates to a qualitative study of women with rheumatoid arthritis (RA) and the importance of this theory in nursing practice. Rheumatoid arthritis is prototypical of many chronic illnesses because it has a profound impact on activities of daily living. It frequently occurs during a person's most productive years and continues throughout life. Because a person with RA typically experiences a number of exacerbations and remissions over the course of many years, transition theory was chosen as a framework for this study. The study sample consisted of 30 women with RA, who were interviewed about their experiences of living with this chronic illness. The women described four distinct phases in learning to live with RA, which began with awareness and proceeded to mastery. These findings are consistent with the stages of transition described by other investigators.

Adaptation, Psychological↗
PubMed2003

Exploring the patient's experience of a day hospital chemotherapy service: preliminary fieldwork.

This paper describes some preliminary findings from a Heideggerian hermeneutic phenomenological study exploring patients' experiences of a day hospital chemotherapy service. Phenomenology has been described as both a philosophical perspective and a research method. Following a review of the literature, it was apparent that there is a paucity of qualitative studies regarding the experience of chemotherapy treatment. The aim of the study was to explore patients' experiences of receiving treatment within a day hospital setting and to compare this with previously having received treatment as an inpatient. Purposeful sampling and face-to-face interviews were conducted. Preliminary data analysis from the pilot study has identified themes for patients relating to the need to maintain hope associated with treatment; feelings of adjustment; incorporating treatment as 'part of life'; need for closure following treatment; thoughts of comradeship and sharing the experience.

Ambulatory Care Facilities↗
PubMed2004

Making sense of the metabolome using evolutionary computation: seeing the wood with the trees.

One should perhaps start off by asking the question, 'But what wood is it we want to see?' There are so many trees that make up the wood; within a post-genomics context, genes, transcripts, proteins, and metabolites are the more tangible ones. Rather than studying these components in isolation, a more holistic approach is to unravel the interactions between the myriad of subcellular components and this is vital to systems biology. Moreover, this will help define the phenotype of the organism under investigation. Metabolomics is complementary to transcriptomics and proteomics, and despite the immense metabolite diversity observed in plants, metabolomics has been embraced by the plant community and in particular for studying metabolic networks. Whilst post-genomic science is producing vast data torrents, it is well known that data do not equal knowledge and so the extraction of the most meaningful parts of these data is key to the generation of useful new knowledge. A metabolomics experiment is guaranteed to generate thousands of data points (e.g. samples multiplied by the levels of particular metabolites) of which only a handful might be needed to describe the problem adequately. Evolutionary computational-based methods such as genetic algorithms and genetic programming are ideal strategies for mining such high-dimensional data to generate useful relationships, rules, and predictions. This article describes these techniques and highlights their usefulness within metabolomics.

Algorithms↗