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Equivalency of computer-based and paper-and-pencil testing.

This study examined the equivalence of computer- and paper-based versions of an examination through score differences across the two test formats as well as students' attitudes toward and perceptions of computer-based examinations. Thirty senior dental hygiene students were randomly divided into two equal groups. One took the first examination on computer, while the second took it on paper. Later, the groups were switched for a second examination. In completing the computer version, each student was asked to complete a survey that examined his or her experience with as well as attitude and perceptions toward computer-based testing. Students using the computer performed as well as or better than those using paper; the increase in performance was significant for the first examination (p < 0.05). Student acceptance of the computer format was mixed, possibly varying with prior exposures to such formats. Benefits of the computer-based examination included reduction in time required for scoring and recording of grades, quicker student progression through the examinations afforded by the digitizing of the visuals, and ease of item analysis for both individual students and the group.

Analysis of Variance↗

Detection of Mycobacterium tuberculosis from sputum collected on filter paper and stored at room temperature for 5 days by PCR assay and culture.

UNLABELLED: The efficacy of PCR assay and culture for direct detection of M. tuberculosis (MTB) from sputum specimens collected on filter paper and stored at room temperature for 5 days was evaluated in comparison with conventional culture of fresh sputum specimen. A total of 231 sputum specimens were examined. MTB was recovered from 124 samples by culture from fresh sputum samples before storage. The culture positivity rate was significantly decreased to 70 per cent after 5 day's storage on filter paper. For PCR assay, a fragment of 377-bp of the IS6110 sequence was amplified and detected using nested PCR. Compared with culture results performed on fresh sputum samples, the sensitivity, specificity, and efficiency for the nested PCR were 96.0, 97.2 and 96.5 per cent, respectively. The nested PCR showed sensitivity and specificity with no significant difference (p>0.05) from culture of fresh sputum specimens. CONCLUSION: The collection and storage of sputum on filter paper at room temperature for 5 days had no apparent effect on the performance of nested PCR. Sputum samples collected by this method could be sent by post in a minimum of space and inexpensive way and will enable a large number of samples collected in the field or from peripheral health centers to be sent to central laboratories for analysis by trained technicians and under a well-equipped and well-established quality control system. The rapid and reliable detection by PCR-based assay will be helpful for optimal patient management of therapy and effective control of tuberculosis.

Bacteriological Techniques↗

A discrimination method for paper by Fourier transform and cross correlation.

A non-destructive method for discriminating between different types of paper has been proposed, using image analysis, Fourier transformation, and cross-correlation matching. A fast Fourier transform (FFT) is used to extract the periodicity in the structure of paper that results from the manufacturing processes. The light-transmission images of the paper to be Fourier transformed are obtained from a flatbed image scanner. The similarity between the power spectrum of the FFT of the sample and that of a reference is quantified using a cross-correlation matching method. An advantage of using frequency analysis is that periodicity can be detected even if the sample is damaged or is printed on. The technique works on samples as small as 2 cm2.

Journal Article↗

[Personal suggestions to write and publish SCI cited papers].

The Science Citation Index (SCI) was introduced primarily as a method of information retrieval and has also been used as an objective measure of the quality of an academic journal. How to write and publish a SCI cited paper has been posed to the daily schedule of scientific researchers. This paper gives some suggestions according to the author's experience in writing and publishing SCI cited papers. In preparing a manuscript of high quality in English, one should possess an excellent English ability, carefully read the "Instructions for authors" of the journal which you will submit to, carefully and seriously prepare the manuscript in English and revise it according to the peer reviewed comments.

Databases, Bibliographic↗

Removal of paper-based health records from Norwegian hospitals: effects on clinical workflow.

Several Norwegian hospitals have, plan, or are in the process of removing the paper-based health record from clinical workflow. To assess the impact on usage and satisfaction of electronic health record (EHR) systems, we conducted a survey among physicians, nurses and medical secretaries at selected departments from six Norwegian hospitals. The main feature of the questionnaire is the description of a set of tasks commonly performed at hospitals, and respondents were asked to rate their usage and change of ease compared to previous routines for each tasks. There were 24 tasks for physicians, 19 for nurses and 23 for medical secretaries. In total, 64 physicians, 128 nurses and 57 medical secretaries responded, corresponding to a response rate of 68%, 58% and 84% respectively. Results showed a large degree of use among medical secretaries, while physicians and nurses displayed a more modest degree of use. Possibly suggesting that the EHR systems among clinicians still is considered more of an administrative system. Among the two latter groups, tasks regarding information retrieval were used more extensively than tasks regarding generating and storing information. Also, we observed large differences between hospitals and higher satisfaction with the part of the system handling regular electronic data than scanned document images. Even though the increase in use among clinicians after removing the paper based record were mainly in tasks where respondents had no choice other than use the electronic health record, the attitude towards EHR-systems were mainly positive. Thus, while removing the paper based record has yet to promote new ways of working, we see it as an important step towards the EHR system of tomorrow. Several Norwegian hospitals have shown that it is possible.

Diffusion of Innovation↗

A reading of Freud's Papers on Technique.

Freud's Papers on Technique (1911-1915) is the canonical description of the psychoanalytic procedure. It is a puzzling work because it is dominated by the original paradigm of treatment as memory-retrieval, while at the same time it introduces a new picture, more consistent with Freud's emerging theory of passions, according to which treatment is the stirring up and integration of wishes. I suggest that Papers on Technique becomes less puzzling if we assume that, when he wrote it, Freud was mainly concerned not with theory but with a crucial problem of practice. In exchange for some theoretical inconsistency Freud acquired an important practical advantage, and Papers on Technique uses that advantage to teach analysts how to divide the patient's consciousness into a passionately committed experience, on the one hand, and a detached contemplation, on the other hand, without worrying about the element of manipulation that is involved. The lesson is that a theoretical ambivalence of this sort is essential to the analytic stance.

Freudian Theory↗

[Usefulness of blood specimens on paper strips for serologic studies with inhibition ELISA].

To evaluate the usefullness of the collecting method of blood samples in filter paper strips for anti-dengue antibody detection using an ELISA Inhibition test which has been recently developed in our laboratory, blood samples collected on filter paper strips and serum samples were obtained from the same blood donors. Both samples were kept at -20 degrees C and tested at 15 days, 3 and 6 months. Titers were determined in positive samples. Comparing the results, no significant differences were found between serum samples and blood samples collected in filter paper strips in relation to the number of negative and positive cases. Nevertheless, it was observed in both types of samples a decrease of the antibody titers (one dilution) in the longest period of our study (6 months).

Antibodies, Viral↗

Paper clip stab wounds: four case reports.

Four prisoners recently evaluated at a county hospital sustained self-inflicted paper clip stab wounds of the abdomen on 22 occasions. Guidelines for management based on physical examination, abdominal films and wound exploration with paper clip extraction and short-term admission for observation have been successful in avoiding laparotomy in most instances. Evaluation and surgical treatment of penetrating abdominal injuries are controversial. Some authors propose mandatory laparotomy for all stab wounds violating the peritoneum, while others recommend selective management based on physical findings, local exploration of the wound and subsequent peritoneal lavage. Recently, four prisoners have inserted sharpened paper clips into and through the abdominal wall on 22 occasions, raising questions about the appropriate treatment of these injuries. These wounds differ from other stab wounds in several respects: 1) underlying psychiatric disturbances and the self-inflicted nature of the wound increase the difficulty of patient management; 2) attempts are often multiple, precluding repeated peritoneal lavage for evaluation; 3) the foreign body may be completely intraperitoneal; and 4) peritoneal penetration is similar to that incurred during a peritoneal tap with an 18-gauge needle. The differing presentations of these patients are reported, and a plan for management of these injuries is proposed.

Abdominal Muscles↗

Detection of the low density lipoprotein (LDL) receptor on nitrocellulose paper with colloidal gold-LDL conjugates.

Gold-low density lipoprotein (LDL) conjugates were used to detect the LDL receptor on nitrocellulose paper. Solubilized rat liver membrane proteins were subjected to electrophoresis and electroblotted onto nitrocellulose paper. The receptor was then detected as a red band (within 10 min) by overlaying with the LDL conjugates. The coloration was prevented by unlabeled LDL, EDTA, and suramin but not by unlabeled HDL3. In the dot blot assay, detection with the colloidal gold-LDL conjugates was as sensitive as both the autoradiographic method with 125I-labeled LDL and the biotinylated LDL method; the estimated limit of detection by scanning densitometry was 1.6 femtomoles of receptor protein. When the coloration obtained with the colloidal gold-LDL conjugates was intensified by photochemical silver staining, down to 200 attomoles of the LDL receptor could be detected. In this assay, the EDTA-sensitive binding of colloidal gold-LDL to solubilized hepatic membrane proteins was 12 times higher for rats treated with 17 alpha-EE than for normal rats. The use of colloidal gold-LDL conjugates is therefore a very easy, safe, inexpensive, fast and sensitive method for the detection of the LDL receptor on nitrocellulose paper. Furthermore, with silver staining and scanning densitometry, the colloidal gold-LDL conjugates could be used in a dot blot assay to quantify tissue and cell LDL receptors down to attomolar levels.

Animals↗

Comparison of the dried blood on filter paper and serum techniques for the diagnosis of bovine babesiosis utilizing the indirect fluorescent antibody (IFA) test.

A comparison between the techniques of dried blood on filter paper and serum for the diagnosis of babesiosis utilizing the indirect fluorescent antibody (IFA) test was evaluated. Dried blood on filter paper was used as a method to detect B. bigemina and B. argentina antibodies of Colombian cattle under laboratory and field conditions and the technique was compared with the serum of the same animals. A high relationship was found between the results of the dried blood and the serum from calves experimentally infected with Babesia spp. and calves from enzootic hemoparasites-free zones in Colombia. There were no significant differences in the sensitivity and specificity of both techniques. The samples on filter paper could be practical for field use due to their easy management and storage at different temperatures. This indicates that the use of dried blood may be a valuable aid for the epizootiologic studies of Babesia spp. infections in bovines.

Animals↗

Markers of hepatitis viruses A and B: direct comparison between whole serum and blood spotted on filter-paper.

The use of blood spotted on filter-paper is a cheap and convenient method for collecting, storing and transporting samples for analysis of markers of hepatitis virus B. Vaccine against viral hepatitis B is now available but is expensive, and, in order to make the best use of it, large-scale screening programmes need to be carried out in endemic areas prior to immunization campaigns. The sensitivity of the filter-paper method was compared with that of the analysis of whole serum, and the epidemiological data produced by the two methods were analysed. It was found that analysis of eluates of blood spotted on filter-paper cannot be recommended if accurate results are wanted, since large numbers of seropositive persons are likely to be missed; however, it may be a suitable method for detecting HBsAg-carriers and most anti-HBs-positive individuals prior to an immunization campaign.

Antigens, Viral↗

[Preservation of margarine in fungicidal paper].

The authors studied the effect of a new type of package material, fungicide paper with one side coated with sorbic acid (fungicide) at a rate of 0.08 g per square decimeter of the surface and other side coated with water- and gas-proof polymer film 60 to 80 microns thick, on the quality of margarine of storage. It was established that by the end of storage the surface of margarine samples packed in parchment and fungicide paper did not exhibit any mold. At the same time, however, the processes of oxidation and formation of the stuff layer were most pronounced in margarine packed in parchment. The amount of the stuff layer in margarine increased toward the end of storage, amounting to 6.63% in margarine packed in parchment and to 5.16% in that packed in fungicide paper.

Chemical Phenomena↗

[Problems encountered during intensive routine scale performace of paper T4 and TSH radioimmunoassays (author's transl)].

High sensitivity attained in radioimmunoassays explains the important role played by specialized laboratories as screening partners for early neonatal hypothyroidism detection. In this paper, the author tries to point out optimal technical conditions to be followed while performing at routine scale T4 and TSH paper immunoassays choice of filter paper, blood collection and storage, assay, quality control, assay mecanization, computer calculation of results).

Autoanalysis↗

Comparison of whole blood dried on filter paper and serum for measurement of the temporal antibody response to avian infectious bronchitis virus by enzyme-linked immunosorbent assay.

Two methods for collecting specimens for measuring sequential antibody activity of infectious bronchitis virus (IBV) were compared. Whole blood was collected on filter-paper strips, dried for 2 hr at 37 C, and then stored in plastic bags at 4 C or eluted overnight and tested immediately. Eluates of whole blood were paired with serum samples and tested for IBV antibody activity by enzyme-linked immunosorbent assay (ELISA) at four weekly intervals. Both sampling methods yielded ELISA antibody levels that were detectable at 7 days postinfection (PI), peaked at 21 days PI, and then began to decline by 28 days PI. The paired samples showed no significant difference (P less than 0.05) between ELISA titers at any time tested. Whole blood dried on filter paper could be stored sealed in plastic bags at 4 C for at least 2 weeks with no appreciable loss of antibody titers. Virus-neutralizing antibodies, measured in serum only, were not detectable until 14 days PI but then continued to rise through 28 days PI. It was concluded that eluates of whole blood dried on filter paper may be used as an alternative to sera in ELISA for measuring IBV antibodies.

Animals↗

Micromethod for estimating adenosine deaminase activity in dried blood spots on filter paper.

We describe a fluorometric micromethod for measuring adenosine deaminase activity in dried blood spots on filter paper. Earlier methods require venipuncture and preparation of washed erythrocytes; in the present method, whole capillary blood, spotted on filter paper and mailed (dried) to a central laboratory, is used. The stability of the enzyme in dried blood on filter paper was assessed. The results were compared with those of a spectrophotometric method. The presence of serum appears not to affect the estimation of the activity and the method may be useful in early detection of severe combined immunodeficiency disease and hereditary hemolytic anemia.

Adenosine Deaminase↗

[Family medicine research: analysis of papers accepted at national and international congresses].

OBJECTIVE: To analyse the thematic content and the origin of the free papers presented at four Family Medicine conferences (two national and two international) during 1992 and 1993; and to check the possibility of differences between Spanish and international lines of research. DESIGN: Descriptive study. MEASUREMENTS AND MAIN RESULTS: A total of 1,339 papers were classified. There were statistically significant differences (p < 0.001) in the thematic areas of Family Medicine (25.33% in international conferences, 7.77% national), Community Medicine (18.16% international, 28.20% national) and organisation of care (17.68% international, 30.16% national). The provinces with the highest number of contributions at national conferences were Barcelona, Madrid, Valencia and Zaragoza. At international conferences (WONCA) the greatest number of contributions came from the Scandinavian countries, Holland, the United Kingdom, Israel and Spain. CONCLUSIONS: Spanish investigators do not often tackle questions of under- and post-graduate training, professional attitude, clinical interviews or Bioethics. The papers at national conferences come mainly, in quantitative terms, from large provinces. The lower participation of liberal health systems like the German, French and North-American is noticeable.

Adult↗

White paper: Neuropsychiatric aspects of sensitivity to low-level chemicals: a neural sensitization model.

The present paper summarizes the proposed time-dependent sensitization (TDS) and partial limbic kindling model for illness from low-level chemicals; reviews and critiques prior studies on CNS aspects of multiple chemical sensitivity (MCS); and outlines possible experimental approaches to future studies. TDS is the progressive and persistent amplification of behavioral, neurochemical, endocrine, and/or immunological responses to repeated intermittent stimuli over time. Partial limbic kindling is a progressive and persistent lowering of the threshold for eliciting electrical afterdischarges, but not motor seizures, in certain brain structures such as amygdala and hippocampus; behavioral consequences include increased avoidant behaviors. The focus of the paper is the controversial claim of altered sense of smell and illness from low levels of environmental chemicals (i.e., "cacosmia"), levels that should not have any biologically harmful effects by the rules of classical neurotoxicology. A major perspective of this paper is that the phenomenology of MCS is similar to that of time-dependent sensitization (reverse tolerance) and tolerance as studied in the substance abuse literature. The TDS model for MCS proposes that neurobiological amplification underlies the symptoms and phenomenology of these patients, including their behavioral features of heightened affective and somatic distress. It is hypothesized that MCS patients, who are mostly women, may be individuals who sensitize to substances rapidly and to the extreme, to the point of aversive symptomatology with less complete capacity for development of tolerance. Possible parallels between MCS and TDS include: (a) initiation by single or multiple intermittent stimuli; (b) lasting changes in subsequent reactivity to low levels of chemically unrelated substances; (c) cross-sensitization between the stressors and pharmacological agents; (d) greater vulnerability of individuals who are female, who have certain genetic characteristics, and/or who may be hyperreactive to novelty (cf. trait shyness); (e) lack of obvious differences between sensitized and unsensitized individuals at baseline without eliciting exposures; (f) bidirectionality (bipolarity) of sensitized responses; (g) both context-dependent (conditioned) and context-independent (unconditioned) amplification of responses. To minimize variability between studies, research in this area needs (a) consensus on a working case definition of MCS or at least of cacosmia as a specific symptom in a subset of well-defined medical and psychiatric disorders; and (b) proper design of chemical challenge studies in MCS, controlling for individual differences in sensitizability and for the properties of sensitization (e.g., repeated intermittent exposure tests) and tolerance (e.g., removal from customary ambient air exposures prior to testing).

Central Nervous System↗

Antibodies to Toxoplasma gondii in eluates from filter paper blood specimens.

Blood and serum samples were tested directly for antibodies to Toxoplasma gondii, or as eluates from filter paper using the dye test, IgM enzyme-linked immunosorbent assay (ELISA) and IgM immunosorbent agglutination assay (ISAGA). The specificity and reproducibility of all three assays based on filter paper eluate was satisfactory. The sensitivity of testing eluates was 10 IU by the dye test and 53 EIU by IgM ELISA. IgM ISAGA findings, using eluate or sera, were comparable. Seroprevalence studies of congenital toxoplasmosis can be based on IgM measurement by ISAGA using eluates of filter paper stored infants' blood. Dye test and IgM ISAGA testing of eluate can be used to reduce the frequency of venepuncture when investigating infants for suspected congenital toxoplasmosis.

Animals↗