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Digital tools for collecting data from cervigrams for research and training in colposcopy.

Colposcopy is a critical part of gynecologic practice but has documented deficiencies, including lack of correlation between the colposcopic appearance and the severity of underlying neoplasia, limited reproducibility, and difficulty in the optimal placement of colposcopically directed biopsies. In a collaborative effort to improve colposcopy, we are analyzing digitized cervigram images from National Cancer Institute-funded studies. Specifically, the National Cancer Institute has collected close to 100,000 cervigrams, digitized to create a database of images of the uterine cervix for research, training, and education. In addition to the cervigram images, this database contains clinical, cytologic, and molecular information at multiple examinations of 15,000 women, with password and ID labeling strategies to protect patient privacy. The National Library of Medicine has designed two web-accessible software tools. The Boundary Marking Tool allows experts on colposcopy to perform an evaluation of the pictures and to mark boundary regions of normal and abnormal regions of the uterine cervix; these evaluations are collected and saved in the database. The Multimedia Database Tool enables retrieval of test and image biomedical data according to specific queries, for example, all women with cervical intraepithelial neoplasia 3 whose cytologic results are atypical squamous cells of undetermined significance. The resource soon will be available as an open resource, via a teaching tool coordinated by a database manager, which will permit a variety of applications for teaching and research. In this article, we describe the perceived need for the resource and its components.

Biomedical Research↗

Appropriate time frames for data collection in quality of life research among cancer patients at the end of life.

Longitudinal research has been recommended as the most appropriate research design to ensure the validity of quality of life assessments. However, high attrition and non-random missing data in quality of life studies for terminal cancer patients raise questions about generalizability of the study, and at worst they may jeopardize interpretation of the results. Appropriate time frames for eliciting information directly from terminal cancer patients can ensure the internal and external validity of quality of life research in end-of-life care, allow health care professionals to detect sensitively the effects of end-of-life care within the shortest intervention period, and make comparisons across studies possible. From a review of the literature, it is recommended that the appropriate time frame for interviewing terminal cancer patients about their quality of life be a weekly assessment schedule based on the following factors: (a) the median survival of terminal cancer patients enrolling in a hospice/palliative care program is approximately 30 days and there are substantial number of patients who die in each week; (b) at the final weeks of life, quality of life and symptoms of some terminal cancer patients change dramatically; and (c) the shortest intervention period that is likely to give a clinically significant effect of end-of-life care management is 1 week after the enrollment in end-of-life care.

Humans↗

[Magnetic resonance tomography in data collection in biomechanics].

Invasive measurement of internal loads is either not possible at all, or is extremely difficult. A non-invasive method for use in the clinical setting might be the computer-aided simulation of a mechanical model. All the geometrical data required can be obtained, at a level of accuracy not previously attainable, with the aid of magnetic resonance imaging.

Biomechanical Phenomena↗

An evaluation of the reliability of time sampling versus continuous observation data collection.

Thirty (10 male, 20 female) children, ages 41 to 71 months, were observed simultaneously in a freeplay setting by two observers using a validated assessment of physical activity in children (i.e. the FATS). One observer utilized a whole interval time sampling method of data recording and the second observer used a hand-held computer and continuously entered observations whenever a child's activity level changed, while the computer simultaneously calculated elapsed time (in tenths of seconds) spent in each behavioral category. Overall activity scores generated by the two approaches correlated 0.90 although the time sampling method produced lower estimates of physical activity. It is concluded that whole interval time sampling is a reliable cost-effective method of assessing physical activity levels in children and may be preferable to the continuous computer-assisted approach that was utilized.

Adult↗

Crystallization and X-ray data collection on human growth hormone.

Single crystals of natural sequence human growth hormone have been grown from media containing ethanol, acetone or paraldehyde. Recombinant growth hormone in its native and desamidated form and pituitary hormone have been crystallized. A full native set of diffraction data extending to 3.5 A resolution has been obtained with synchrotron radiation for crystals of recombinant human growth hormone grown from ethanol. The identity of the material in these crystals has been established by anion-exchange chromatography.

Chromatography, Ion Exchange↗

Wisconsin Birth Defects Registry collecting data.

Wisconsin Statute 253.12 was enacted in May 2000 to create the Wisconsin Birth Defects Registry (WBDR), replacing the Birth and Developmental Outcome Monitoring Program, a previous birth defects and developmental disabilities reporting system initiated in 1989. In the summer of 2004, the new registry began collecting demographic, diagnostic, and identifying information for children from birth to 2 years of age who are born with reportable birth defects and/or are receiving health care services for them in Wisconsin. This article describes the development of the registry and outlines expectations for reporting of birth defects.

Congenital Abnormalities↗

Influence of pH, water activity and acetic acid concentration on Listeria monocytogenes at 7 degrees C: data collection for the development of a growth/no growth model.

Growth/no growth models can be used to determine the chance that microorganisms will grow in specific environmental conditions. As a consequence, these models are of interest in the assessment of the safety of foods which can be contaminated with food pathogens. In this paper, growth/no growth data for Listeria monocytogenes (in a monoculture and in a mixed strain culture) are presented. The data were gathered at 7 degrees C in Nutrient Broth with different combinations of environmental factors pH (5.0-6.0, six levels), water activity (0.960-0.990, six levels) and acetic acid concentration (0-0.8% (w/w), five levels). This combination of environmental factors for the development of a growth/no growth model was based on the characteristics of sauces and mayonnaise based salads. The strains used were chosen from screening experiments in which the pH, water activity and acetic acid resistance of 26 L. monocytogenes strains (LFMFP culture collection) was determined at 30 degrees C in Brain Heart Infusion broth. The screening showed that most L. monocytogenes strains were not able to grow at a(w)<0.930, pH<4.3 or a total acetic acid concentration >0.4% (w/w). Among these strains, the ones chosen were the most resistant to one of these factors in the hope that, if the resulting model predicted no growth at certain conditions for those more resistant strains, then these predictions would also be valid for the less resistant strains. A mixed strain culture was also examined to combine the strains that were most resistant to one of the factors. A full factorial design with the selected strains was tested. The experiments were performed in microtiter plates and the growth was followed by optical density measurements at 380 nm. The plates were inoculated with 6 log CFU/ml and twenty replicates were made for each treatment combination. These data were used (1) to determine the growth/no growth boundary and (2) to estimate the influence of the environmental conditions on the time to detection. From the monoculture and mixed strain data, the growth boundary of L. monocytogenes is shown not to be a straight cut-off but a rather narrow transition zone. The experiments also showed that in the studied region, a(w) did not have a pronounced influence on the position of the growth/no growth boundary while a low concentration of acetic acid (0.2% (w/w)) and a pH decrease from 6.0 to 5.8 was sufficient to significantly reduce the possibility of growth. The determination of the time to detection showed a significant increase at the combinations of environmental conditions near the 'no growth zone'. For example, at 0.2% (w/w) acetic acid, there was an increase from +/-10 days to 30 days by lowering pH from 5.8 to 5.6 at a(w) values of 0.985 and 0.979, while at pH 5.4 less than 50% growth occurred for all a(w) values.

Acetic Acid↗

Evaluation of optimal age at first conception in gilts from data collected in commercial swine herds.

The purpose of this study was to find the economically optimal period of first conception in gilts, addressing the issues of lifetime reproductive performance and expected herd life. A profit equation was used to combine the effects into one economic parameter. The data were from 14,910 gilts on 54 farms throughout The Netherlands. The average number of pigs born alive in the first litter increased with older age at conception. In the second litter a similar, but much smaller, effect was observed. Age at first conception had no effect on number of pigs born alive in the third or greater litter. Gilts bred at an older age had a shorter expected herd life than gilts bred at a younger age. Evaluating the reasons for culling revealed that infertility became a more important reason with increasing age at first conception. The proportion culled for infertility increased linearly from 18% at conception on d 200 to 24.5% at conception on d 300. Combining the effect of litter size and herd life led to the conclusion that the profit per gilt (sow) was not significantly affected by her age at first conception. It is concluded that the optimal economic age at first conception was considered to be approximately 200 to 220 d of age when the cost of housing and feed of the gilt from entry to first conception were taken into account.

Aging↗

Usage and data collection patterns for a novel web-based foodborne-disease surveillance system.

This paper discusses the traditional system of foodborne-illness surveillance and provides a justification for increased syndromic surveillance of foodborne illness. A new Internet-based method for reporting foodborne disease is explained, and data entered by 7,500 visitors to the pilot Web site are described with respect to completeness and basic demographic factors. Data entry patterns show that visitors are willing to report a suspected case of foodborne illness online and do so in greater detail than is commonly obtained from traditional reports made over the telephone.

Adult↗

Origin and distribution anomalies of the left anterior descending artery in 70,850 adult patients: multicenter data collection.

OBJECTIVES: To present the clinical and angiographic properties of the left anterior descending artery anomalies. BACKGROUND: Coronary artery anomalies are discovered in less than 1% of angiography series. Since the number of angiographies and coronary bypass operations are increasing significantly every day, these anomalies are of clinical importance. However, data about left anterior descending artery anomalies in literature is still scarce. METHODS: We reviewed the records of 70,850 patients who had undergone coronary angiographies at 4 different cardiology center from 1999 to 2005 years. RESULTS: Major congenital coronary anomalies were discovered in 171 of these cases (0,24%). The mean age of these patients was 61 +/- 11 (18-84) years. Ninety nine patients (58%) were male. Left anterior descending artery was involved in 12 patients (0.017%). In nine patients with the anomalous LAD there were concomittant congenital coronary artery anomalies. Concurrent coronary artery anomalies encountered were double left anterior descending artery type 4 (2 cases), double left anterior descending artery type 4 with double right coronary artery (1), double right coronary artery (1), double circumflex artery with anomalous left anterior descending artery (1), circumflex artery from right sinus of Valsalva (1), separate septal perforator and myocardial bridging of posterior descending artery (1), intercoronary communication, and ostial atresia of the left anterior descending artery and anomalous circumflex artery (1). CONCLUSION: Our series is the biggest series where relatively sufficient clinical and angiographic information about the LAD anomalies were provided.

Adolescent↗

Clinical comparison of 180-degree and 360-degree data collection of technetium 99m sestamibi SPECT for detection of coronary artery disease.

BACKGROUND: With multihead gamma cameras both 180- and 360-degree acquisitions of myocardial perfusion are feasible. However, with 99mTC-labeled sestamibi (99mTC-sestamibi) the optimal clinically relevant demonstration of the superiority of 180- versus 360-degree data acquisition has not been performed. METHODS: Seventy-two consecutive patients undergoing 99mTC-sestamibi imaging at rest and stress who had coronary angiography performed within 3 months were enrolled. The results of blinded interpretation of 13 segments per patient for the 180- and 360-degree data were compared for interobserver variability. Sensitivity and specificity of defect localization in the left anterior descending, right coronary, and left circumflex territories for detection of 50% or greater or 70% or greater stenoses by coronary angiography were compared. RESULTS: There was significant segmental agreement of the stress perfusion images between observers for 180-degree (Kappa = 0.63) and 360-degree data (Kappa = 0.58), but the agreement was significantly higher for 180-degree data (p < 0.05). Overall sensitivity for the detection of coronary artery disease as a 50% or greater stenosis in 62 patients was 79% with 180-degree acquisition and 77% with 360-degree acquisition. The specificity for absence of coronary artery disease in 10 patients was also similar at 70% and 80%, respectively. There was no overall difference in detection of individual stenoses with a sensitivity of 54% with 180-degree acquisition and 50% with 360-degree acquisition. Specificity was also similar at 78% and 81%, respectively. CONCLUSION: There is no difference in clinically relevant detection of overall coronary artery disease or individual stenoses using 180- or 360-degree acquisition of 99mTC-sestamibi myocardial perfusion images. However, 180-degree acquisition has superior interobserver reproducibility.

Coronary Angiography↗