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Workgroup report: Review of genomics data based on experience with mock submissions--view of the CDER Pharmacology Toxicology Nonclinical Pharmacogenomics Subcommittee.

Over the past few years, both the U.S. Food and Drug Administration (FDA) and the pharmaceutical industry have recognized the potential importance of pharmacogenomics and toxicogenomics to drug development. To resolve the uncertainties surrounding the use of microarray technology and the presentation of genomics data for regulatory purposes, several pharmaceutical companies and genomics technology providers have provided the FDA with reports of genomics studies that included supporting toxicology data (e.g., serum chemistry, histopathology). These studies were not associated with any active drug application and were exploratory or hypothesis generating in nature. For training purposes, these reports were reviewed by the Nonclinical Pharmacogenomics Subcommittee consisting of the Center for Drug Evaluation and Research pharmacology and toxicology researchers and reviewers. In this article, we describe some of these submissions and report on our assessment of data content, format, and quality control metrics that were useful for evaluating these nonclinical genomics submissions, specifically in relation to the proposed MIAME/MINTox (minimum information about a microarray experiment/minimum information needed for a toxicology experiment) recommendations. These genomics submissions allowed both researchers and regulators to gain experience in the process of reviewing and analyzing toxicogenomics data. The experience will allow development of recommendations for the submission and review of these data as the state of the science evolves.

Animals↗

Artificial intelligence in medicine.

INTRODUCTION: Artificial intelligence is a branch of computer science capable of analysing complex medical data. Their potential to exploit meaningful relationship with in a data set can be used in the diagnosis, treatment and predicting outcome in many clinical scenarios. METHODS: Medline and internet searches were carried out using the keywords 'artificial intelligence' and 'neural networks (computer)'. Further references were obtained by cross-referencing from key articles. An overview of different artificial intelligent techniques is presented in this paper along with the review of important clinical applications. RESULTS: The proficiency of artificial intelligent techniques has been explored in almost every field of medicine. Artificial neural network was the most commonly used analytical tool whilst other artificial intelligent techniques such as fuzzy expert systems, evolutionary computation and hybrid intelligent systems have all been used in different clinical settings. DISCUSSION: Artificial intelligence techniques have the potential to be applied in almost every field of medicine. There is need for further clinical trials which are appropriately designed before these emergent techniques find application in the real clinical setting.

Artificial Intelligence↗

Are neutrons involved in the pathogenesis of life-threatening cardiac arrhythmias?

Geomagnetic fields protect the earth from the adverse effects of cosmic rays, whose activity can be indirectly measured by monitoring the level of neutrons in the environment. The number and days of discharges from automatic implantable cardioverter defibrillators (ICD) in patients with cardiac arrhythmias are inversely correlated with the daily level of geomagnetic activity (GMA). The aim of the present was to determine whether neutron levels on days of AICD discharges are higher than average. Days on which discharges occurred were recorded in 31 patients bearing ICDs for managing ischemic cardiomyopathy. Daily neutron levels obtained from the monitoring data of the Russian Academy of Sciences in Moscow were analyzed using Student's t test. The mean (+/-SD) daily neutron level for the 1096-day period was 8299.29 +/- 294.236 imp/min (median 8252), and for days of ACID discharge, 8423.93 +/- 274.187 imp/min (median 8443) (p = 0.0002). The mean neutron activity on days of AICD discharges in response to ventricular disturbances was significantly higher than the mean level over the 1096-day study period. Whether this relation is a direct result of low GMA or due to an independent role of neutrons in the pathogenesis and timing of cardiac arrhythmias is unknown.

Arrhythmias, Cardiac↗

Warning research: an integrative perspective.

We developed an integrative perspective on the empirical evidence supporting the influence of particular variables on the warning process based on a broad review of the warning literature. The warning process is described in terms of the following four components: notice, encode, comprehend, and comply. Relevant variables are classified as person variables (characteristics of the individual interacting with the warning) and warning variables (characteristics of the warning itself or the context in which the warning appears). This integrative perspective yields general principles about the variables that influence the warning process and serves as a resource for warning developers and as a guide to facilitate effective analysis of warnings. We also identify aspects of the warning process that are not well understood, directions for effective methods of intervention, and a research agenda for future efforts. Actual or potential applications of this research include improving the design of warnings.

Cognitive Science↗

Estimating recombination rates from single-nucleotide polymorphisms using summary statistics.

We describe a novel method for jointly estimating crossing-over and gene-conversion rates from population genetic data using summary statistics. The performance of our method was tested on simulated data sets and compared with the composite-likelihood method of R. R. Hudson. For several realistic parameter values, the new method performed similarly to the composite-likelihood approach for estimating crossing-over rates and better when estimating gene-conversion rates. We used our method to analyze a human data set recently genotyped by Perlegen Sciences.

Computer Simulation↗

[Age-related changes in hematological and serum biochemical values in cynomolgus monkeys (Macaca fascicularis) bred and reared using the indoor individually-caged system].

Blood samples were collected from 1000 or more apparently healthy cynomolgus monkeys of different ages. All the monkeys had been bred and reared under uniform environmental conditions at the Tsukuba Primate Center for Medical Science, NIH, Japan. Biochemical and hematological data were determined with these samples. The calculated arithmetic means and standard deviations were listed for each item of measurement performed (Tables 3, 4 and 5). The correlation between the obtained value and the age was analyzed using a statistical significance level of 0.1% (Table 6). It was revealed that hemoglobin concentration, mean corpuscular volume, alubuminglobulin ratio and triglyceride concentration increased with age, whereas red blood cell count and serum alkaline phosphatase activity decreased with age in both sexes.

Aging↗

[Mercury and health in the dental practice].

Mercury is a heavy metal widely used by man. It is considered very toxic causing conditions in the central nervous system, behavior disturbances, and renal and sexual disorders. For a century, mercury has been used in the dental practice for its capacity of joining metals (amalgamate), its low cost and its rapid fixing in dental pieces repair. Currently, there is much controversy about the safety of dental amalgams and it has been demonstrated it poses occupational risks to dental practitioners and their assistants. The objective of this study is review aspects related to metallic mercury toxicity for personnel involved in the dental practice and patients with dental amalgams. Routes of mercury exposure in dentistry, occupational risks and measures to prevent mercury poisoning are presented here. A literature review was conducted mostly on data from Biological Abstracts and the Science Citation Index for the period between 1990 and 2000.

Dental Amalgam↗

Research process in the health sciences: a focus on methods.

Research in the health sciences is becoming increasingly challenging as data and methods advance in complexity. This article was written to provide an overview of the research process for complex and intricate projects, with a focus on methods. The insights regarding structuring and managing research projects are intended to guide researchers through all phases of the research process. Our key suggestions include the following: (1) conceptual and methodological complexity must be balanced, (2) skilled project managers and statisticians are needed, and can be rewarded for their contributions to projects in part through authorship, and (3) grants involving multiple investigators present problems related in part to the abstruseness of integrated methods and so require special solutions for effective management. Overall, we conclude that researchers are rewarded in a variety of ways when they remain focused on the original study aims, keep methods simple, utilize skilled staff, and engage in strategic planning.

Authorship↗

Impact of a regional infant dispatch center on neonatal mortality.

In 1976, a regional Infant Medical Dispatch Center (IMDC) was implemented in Southern California to improve the lives and well-being of the critically ill newborn infants by expediting location of beds in neonatal intensive care units. Comparison of birth weight-specific neonatal mortality rates among 701-2000 grams neonates before and after the program showed a six-fold improvement in hospitals served by the Center over hospitals not served by the Center during the two-year period. From 1975 to 1977, a 43.7 per cent improvement in neonatal mortality among the 701-2000 grams neonates with hyaline membrane disease was observed in the transported infants served by the Infant Medical Dispatch Center as compared to a 22.9 per cent improvement in the group of transported infants not served by IMDC. Both indicators had consistently shown a marked improvement associated with the IMDC program beyond the improvement of medical sciences over the two years. The data suggest that the improved outcome of the neonates referred by IMDC might be related to the improved efficiency of locating available neonatal intensive care beds.

California↗

Use and misuse of multiple comparisons in animal experiments.

The objective of many animal experiments is to detect meaningful relationships among treatments and associated responses. Types of comparisons of means include pairwise multiple comparisons, planned orthogonal or nonorthogonal contrasts, and orthogonal polynomials. Some procedures are appropriate only for specific types of treatment designs and specific types of objectives. Pairwise, multiple comparisons are appropriate only for comparing unstructured, qualitative treatments. Planned comparisons partition the overall set of treatment effects into independent or nonindependent subsets, with special application to factorials. Orthogonal polynomial (regression) procedures assess relationships between quantitative treatments and response when a full range of responses or an optimal dose is of interest. Recommendations for appropriate use of each mean comparison procedure are illustrated using data from three Journal of Animal Science articles. Also mentioned are a number of computer graphics packages that provide creative ways to display biological relationships and can be linked to statistical packages for input and to word processors or 35-mm cameras for output.

Analysis of Variance↗

Changes in location of centre of pressure and hoof-unrollment pattern in relation to an 8-week shoeing interval in the horse.

REASONS FOR PERFORMING STUDY: In order to optimise shoeing and shoeing conditions, it is essential to know how the horse adapts to a common shoeing interval. OBJECTIVES: To measure changes in location of the centre of pressure (CoP) and hoof-unrollment pattern during a shoeing interval and to assess whether these changes in CoP result directly from changes in hoof conformation or are also influenced by compensatory mechanisms. METHODS: Eighteen horses were trotted over a pressure-force measurement system shortly after shoeing and 8 weeks later. The position of the CoP was measured and also predicted using calculations based on changes in hoof conformation. RESULTS: The measured shift in CoP was less than calculated. This difference was largest in the hind feet. The hoof-unrollment pattern stayed basically the same in the front feet, but in the hind feet there was a substantial lateral shift of the trajectory of the CoP. CONCLUSIONS: Horses can compensate, to a certain extent, for changes in hoof conformation that develop during 8 weeks on shoes. As the capacity to compensate is less in the forelimbs, the relative increase in loading of these limbs during a shoeing interval is larger than in the hindlimbs. POTENTIAL RELEVANCE: This study provides essential basic data for the development of science-based shoeing techniques.

Animals↗

Traps in the route to models of memory and decision.

It is proposed that the products of investigations of learning, memory, and decision over the last half century that are most likely to endure have resulted from interactions between models and experimental research. In this article, some of the traps that must be coped with to make fruitful interactions possible are examined and illustrated with case studies from research on probability learning, category learning, and recognition memory. Topics addressed include functions of models in research; the logic of model testing; fitting models to signal plus noise; values and hazards of averaging data; and potential contributions of neural science to the development of cognitive models.

Decision Making↗

Visualization of multiple influences on ocellar flight control in giant honeybees with the data-mining tool Viscovery SOMine.

Viscovery SOMine is a software tool for advanced analysis and monitoring of numerical data sets. It was developed for professional use in business, industry, and science and to support dependency analysis, deviation detection, unsupervised clustering, nonlinear regression, data association, pattern recognition, and animated monitoring. Based on the concept of self-organizing maps (SOMs), it employs a robust variant of unsupervised neural networks--namely, Kohonen's Batch-SOM, which is further enhanced with a new scaling technique for speeding up the learning process. This tool provides a powerful means by which to analyze complex data sets without prior statistical knowledge. The data representation contained in the trained SOM is systematically converted to be used in a spectrum of visualization techniques, such as evaluating dependencies between components, investigating geometric properties of the data distribution, searching for clusters, or monitoring new data. We have used this software tool to analyze and visualize multiple influences of the ocellar system on free-flight behavior in giant honeybees. Occlusion of ocelli will affect orienting reactivities in relation to flight target, level of disturbance, and position of the bee in the flight chamber; it will induce phototaxis and make orienting imprecise and dependent on motivational settings. Ocelli permit the adjustment of orienting strategies to environmental demands by enforcing abilities such as centering or flight kinetics and by providing independent control of posture and flight course.

Animals↗

Socio-cultural deterrents to family planning practices among Swazi women.

To investigate deterrents to family planning practices among Swazi women, 205 structured interviews were conducted with conveniently selected women in the four geographical regions of Swaziland. The Statistical Package for Social Sciences (SPSS) was used to analyse data. These results revealed that cultural practices, religious beliefs, gender issues and health care practices were the main barriers to the use of contraceptives among Swazi women. Recommendations were suggested regarding the education of men, women, adolescents and the entire society about contraceptive practices.

Attitude to Health↗

Therapeutic urogenital modalities during the last three years of the Iran and Iraq War (1985-1987).

OBJECTIVE: Research projects in the field of military medicine have a central role in medical logistical planning. Treatment of traumatic lesions (including urogenital system injuries) is an important aspect of military medicine. Triage for urogenital injuries has specific problems and points of concern. The purpose of this study was to evaluate the role and different types of therapeutic modalities in the treatment of urogenital injuries during the final 3 years of the Iran and Iraq War (1985-1987). METHODS: In a descriptive-analytical study, records of 1,094 patients with urogenital injuries hospitalized from 1985 to 1987 were studied. A checklist and the Statistical Program for the Social Sciences (version 6) were used for data collection and analysis, respectively. A chi 2 test interpreted part of the data. RESULTS: The highest incidence of urogenital injuries and the highest rate of surgical interventions for urogenital injuries were in 1986 and 1987, respectively. The total incidence of urogenital injuries was 0.51%. Among all surgical interventions, bladder repair was most frequent and ureteral repair was least frequent. Partial nephrectomy was the second most frequent surgical intervention and was performed more often than total nephrectomy. There was a significant difference between the urogenital surgery rate and the total surgery rate (chi 2 = 148, p = 0.000). CONCLUSION: The results suggest progress in the triage of patients with urogenital injuries. The lower incidence of urogenital injuries, however, should be interpreted cautiously because it may be attributable to different combat field conditions. Follow-up studies in this group of patients are necessary.

Cross-Sectional Studies↗

Recommended data elements for the descriptive cataloging of computer-based educational materials in the health sciences.

A large part of the mission of the National Library of Medicine is to collect, index, and disseminate the world's biomedical literature. Until recently, this related only to serial and monographic material, but as new forms of information appear responsibility for bibliographic control of these also must be assumed by the National Library of Medicine. This paper briefly describes the type of information that will be necessary before descriptive cataloging of computer-based educational materials can be attempted.

Cataloging↗

[The ecology of communities of related animal species (research approaches and methods exemplified by terrestrial vertebrates)].

The review is dedicated to some old and modern problems in studying of the assemblages of phylogenetically related species among terrestrial vertebrates. The classical approach by Robert Mac-Arthur, discussed elsewhere summarized briefly. Although an explanative potential of competition theory seems exhausted there is no new paradigm that can simply explain species diversity in natural communities. From the beginning of 90's community ecology became very complex and controversial discipline. At the same time it is still a pioneering science. We have not enough comparative data on geo2 graphically distinct communities studied under the unified methods of data collection and analysis. Some recent results of intercontinental comparisons signify to the high degree of individualism in structure of geographically isolated communities. This makes doubtful any extrapolation from one region to another. Examination and explanation of processes is still the most contradictory field in community ecology. Confusion of causes and effects is continuing to be serious methodological problem. Much of attention was paid recently to the macroecological approach. A desire for reconsideration of some "old rules" of biodiversity is explained by advances in paleozoology, biogeography and systematic, as well as by some unsatisfactory explanations within the framework of competition theory.

Animals↗

Interventions to prevent HIV risk behaviors. National Institutes of Health Consensus Development Conference Statement February 11-13, 1997.

OBJECTIVE: To provide health care providers, patients, and the general public with a responsible assessment of behavioral intervention methods that may reduce the risk of HIV infection. PARTICIPANTS: A non-Federal, nonadvocate, 12-member panel representing the fields of psychiatry, psychology, behavioral and social science, social work, and epidemiology. In addition, 15 experts in psychiatry, psychology, behavioral and social science, social work, and epidemiology presented data to the panel and a conference audience of 1000. EVIDENCE: The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. CONSENSUS PROCESS: The panel, answering predefined questions, developed its conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. CONCLUSIONS: Behavioral interventions to reduce risk for HIV/AIDS are effective and should be disseminated widely. Legislative restriction on needle exchange programs must be lifted because such legislation constitutes a major barrier to realizing the potential of a powerful approach and exposes millions of people to unnecessary risk. Legislative barriers that discourage effective programs aimed at youth must be eliminated. Although sexual abstinence is a desirable objective, programs must include instruction on safer sex behaviors. The erosion of funding for drug abuse treatment programs must be halted because research data clearly show that such programs reduce risky drug abuse behavior and often eliminate drug abuse itself. Finally, new research must focus on emerging risk groups such as young people, particularly those who are gay and who are members of ethnic minority groups, and women, in whom transmission of HIV virus to their children remains a major public health problem.

Female↗