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PubMed2006

Labeling solutions and medications in sterile procedural settings.

BACKGROUND: Confusion resulting from unlabeled solutions and medications during sterile procedures can result in serious medication errors. CASE STUDY: During elective surgery; a seven-year-old boy was mistakenly injected with 100 times the intended dose of epinephrine. Cardiac arrest ensued, and the child died the next day. HOW ONE HOSPITAL MET THE CHALLENGE: At Marion General Hospital (Marion, Ohio), sterile procedures are performed in the surgery department, the cardiac catheterization lab, the labor and delivery area, intensive care unit rooms, and the emergency department. MGH's surgical services management team developed a policy and protocol for medication safety that refers to labeling of medications in sterile procedural settings. DISCUSSION: Sterile procedures often require medications or solutions to be placed in syringes or sterile basins. Facilities can eliminate the need for some solutions by using commercially available applicators or swabs, and can purchase some medications in sterile, labeled syringes. Sterile marking pens and blank sterile labels are available, as are preprinted sterile labels. The Association of periOperative Registered Nurses has helpful guidance statements and a medication safety toolkit. CONCLUSION: This requirement can be challenging to meet, but good resources are available.

Child↗

PubMed2004

Communicating original research in chemistry and related sciences.

The availability of scientific information in electronic form is the convergence of traditional journal publishing, electronic communications, and the widespread availability of computer technology. This revolution in scientific communication has its roots in developments that started in the mid-19th century and culminated with the extraordinary progress in telecommunications and computer technology in the latter years of the 20th century. Eighty-three percent of scientific journals are now available online. The benefits of electronic journals include rapid publication, instantaneous linking to external information sources, and the capability to deliver new types of information. To date neither electronic-only nor preprint servers have been well received by the chemical sciences community. Continued advances in telecommunications, computer technology, and acquisition of scientific data in structured formats hold promise for even greater advances in communication of scientific information.

Journal Article↗

PubMedDate not supplied

Poly(N,N,N-trimethylammoniumalkyl acrylamide chloride) based hydrogels for serum cholesterol reduction.

Hydrogels present an attractive alternative to nanoscale block copolymer aggregates and microscale resin beads as potential asystemic serum cholesterol reduction materials. Not only would the oral delivery of these materials be more pleasant than the sand-like bile salt anion sequestrant beads but also the hydrogel preparation is much simpler than the copolymer aggregate analogues [Cameron, N. S.; Eisenberg, A.; Brown, G. R. Biomacromolecules 2002, 3, 116-123. Cameron, N. S.; Eisenberg, A.; Brown, G. R. Biomacromolecules 2002, 3, 124-132]. Our goal was to explore these materials building on our experience with bulk resins and self-assembled copolymers. In this paper, following a brief introduction to hydrogels and their application to hypercholesterolemia, the synthesis, characterization, and preliminary glycocholate binding properties of poly(N,N,N-trimethylammoniumalkyl acrylamide chloride)gel are presented [Cameron, N. S.; Eisenberg, A.; Brown, G. R. Polym. Preprints 2002, 43, 771-772].

Acrylic Resins↗

PubMed2004

Finding extraterrestrial sites for thermophiles.

Virtually our entire knowledge of the universe comes from two sorts of measurement of the electromagnetic radiation from the stars and galaxies within it; either their flux through relatively wide bandpasses (photometry), or measurements of the shape and wavelength of relatively narrow lines via spectroscopy. These techniques are now being used to discover planets outside our solar system, and perhaps in the next 10 years will begin to characterize them. If a serious search is to be made for extraterrestrial thermophiles, we need predictions for the effects of thermophiles on their host planets that are observable with these techniques. In this paper I shall outline what sorts of observation are likely to be used in the next 15 years for extra-solar planet work. All of the journal articles quoted here can be found through http://adsabs.harvard.edu/abstract_service.html, and often also accessed as preprints at http://uk.arxiv.org/form/astro%20ph?MULTI=form%20+/-%20interface.

Astronomical Phenomena↗

PubMed2001

What nutritional support literature do hospital nursing staff require?

BACKGROUND: Many patients require nutritional intervention to help treat and/or prevent malnutrition. Nursing staff play a key role in identifying malnourished patients. To improve the management of artificial nutritional support, the Hammersmith Hospital NHS Trust has produced guidelines. This audit aimed to assess the need and adequacy of these guidelines and to examine any additional information required. METHODS: The dietetic department and nursing practice group developed a questionnaire. A total of 260 questionnaires were distributed by dietitians, 10 copies of the questionnaire to nurses on 26 wards. The completed forms were returned by internal post or collected the dietitian. RESULTS: The response rate was 29%. All 77 nurses who responded felt there was a need for nutrition literature. Seventy-three per cent of nurses were aware that the guidelines existed; however, referral to the resource was poor. Requests for additional information encompassed tube feeding and catering information. To provide this information, 84% requested a nutrition tutorial, 81% a preprinted care plan and 96% a ward manual specific to their speciality. CONCLUSIONS: All nurses who were surveyed requested nutrition information. The current guidelines already reflect the requested information, but usage is poor. We aim to improve access and awareness by the hospital intranet, nutrition education and induction programme. The next update will cover gaps identified and additional requirements outside the guidelines remit will be discussed with the nursing practice group.

Continuity of Patient Care↗

PubMed2001

The reliability of logbook data of medical students: an estimation of interobserver agreement, sensitivity and specificity.

OBJECTIVE: Logbooks are widely used in medical schools as an evaluation tool to assess students' progress towards objectives. To estimate whether students fill in their logbooks reliably, we measured interobserver agreement by comparing doctors' data and students' data. METHOD: Completed logbooks were collected at two subdivisions of the department of Internal Medicine at the University Hospital of Groningen. The logbook contains 231 preprinted diseases. Doctors and students recorded the diseases they had encountered. Interobserver agreement, expressed by the Jaccard coefficient (J), was calculated for the complete set of diseases and for a subset of core diseases. To assess the kinds of errors which students made, sensitivity and specificity were determined. RESULTS: Logbook data of doctors and students are not fully consistent (mean J for the complete set of diseases was.23 and for the core diseases.36). The quality of the logbook data is high in the sense that students do not record many false identifications (mean specificity for the complete set of diseases and for the core diseases were.96 and.93, respectively); the quality is poor in the sense that students do not record all the diseases which could be seen at the department (mean sensitivity for the complete set of diseases is.36 and for the core diseases it is.51). CONCLUSION: This study shows inconsistencies in recording diseases in a logbook by students compared with doctors. In particular the diseases which are present at a department are under-reported by students. Supervision and feedback are important mechanisms to optimize the students' use of (1) all diseases which could be encountered and (2) the logbook.

Curriculum↗

PubMed2003

Initiation and monitoring of class III antiarrhythmic agents.

Initiation and Monitoring of Class III Agents. Dofetilide is a Class III antiarrhythmic agent that is approved by the United States Food and Drug Administration (FDA) for use in the conversion of atrial fibrillation, as well as in the maintenance of normal sinus rhythm. Because of the risk of torsades de pointes associated with dofetilide, the FDA mandated in-hospital initiation of therapy and initially restricted dofetilide's availability to institutions and prescribers who completed appropriate educational forums. The use of dofetilide within health care systems requires specific procedures for prescribing, dispensing, and monitoring, as well as a format for educating personnel who will be involved in the care of these patients. Several models have demonstrated success in initiating dofetilide and are also used for sotalol, which also can cause torsades de pointes. The utilization of nonphysician personnel, such as nurse practitioners and clinical pharmacists, in conjunction with a team approach were essential components for the success of these models. Preprinted order forms or procedural guidelines, as well as computer-assisted dosing programs, can be utilized to prevent inappropriate or miscalculated dosing of these agents, which potentially can cause life-threatening ventricular arrhythmias.

Anti-Arrhythmia Agents↗

PubMed1998

Exponential asymptotic expansions and approximations of the unstable and stable manifolds of singularly perturbed systems with the Henon map as an example.

The subject of this paper is the construction of the exponential asymptotic expansions of the unstable and stable manifolds of the area-preserving Henon map. The approach that is taken enables one to capture the exponentially small effects that result from what is known as the Stokes phenomenon in the analytic theory of equations with irregular singular points. The exponential asymptotic expansions were then used to obtain explicit functional approximations for the stable and unstable manifolds. These approximations are compared with numerical simulations and the agreement is excellent. Several of the main results of the paper have been previously announced in A. Tovbis, M. Tsuchiya, and C. Jaffe ["Chaos-integrability transition in nonlinear dynamical systems: exponential asymptotic approach," Differential Equations and Applications to Biology and to Industry, edited by M. Martelli, K. Cooke, E. Cumberbatch, B. Tang, and H. Thieme (World Scientific, Singapore, 1996), pp. 495-507, and A. Tovbis, M. Tsuchiya, and C. Jaffe, "Exponential asymptotic expansions and approximations of the unstable and stable manifolds of the Henon map," preprint, 1994]. (c) 1998 American Institute of Physics.

Journal Article↗

PubMed1996

Hyperplane arrangements, interval orders, and trees.

A hyperplane arrangement is a finite set of hyperplanes in a real affine space. An especially important arrangement is the braid arrangement, which is the set of all hyperplanes xi - xj = 1, 1 </= i < j </= n, in Rn. Some combinatorial properties of certain deformations of the braid arrangement are surveyed. In particular, there are unexpected connections with the theory of interval orders and with the enumeration of trees. For instance, the number of labeled interval orders that can be obtained from n intervals I1,..., In of generic lengths is counted. There is also discussed an arrangement due to N. Linial whose number of regions is the number of alternating (or intransitive) trees, as defined by Gelfand, Graev, and Postnikov [Gelfand, I. M., Graev, M. I., and Postnikov, A. (1995), preprint]. Finally, a refinement is given, related to counting labeled trees by number of inversions, of a result of Shi [Shi, J.-Y. (1986), Lecture Notes in Mathematics, no. 1179, Springer-Verlag] that a certain deformation of the braid arrangement has (n + 1)n-1 regions.

Journal Article↗

PubMed2000

Tropical medicine, the Internet and current trends in biomedical communication.

Largely unknown only a decade ago, the Internet has now become totally indispensable to biomedical practice and research, as a means of disseminating and retrieving information. Electronic mail, list servers and newsgroups make rapid, personal, targeted and broadcast communication around the globe possible. Hundreds of millions of World Wide Web pages, organized by hierarchically structured web directories, and dissected by general web indexes, give access to an unprecedented amount of information. More and more scientists find their way to factual and bibliographical databases using the Internet. In addition to outlining some of the more relevant resources for the tropical-medicine and international-health communities, this review pays special attention to recent and future changes in the transfer of formal biomedical information. An interesting issue is the future role and position of the published article--either in electronic editions of traditional, peer-reviewed journals, or in even more revolutionary formats, such as electronic preprint servers--and the implications for authors, reviewers, editors, publishers and, ultimately, the readers.

Communication↗

PubMed1994

Fruit and vegetable food frequencies by fourth and fifth grade students: validity and reliability.

OBJECTIVE: Due to the increased emphasis on fruit and vegetable (F+V) consumption and a desire to use the simplest dietary assessment method appropriate to determine F+V intake, we assessed the reliability and validity of weekly and monthly fruit and vegetable food frequency questionnaires (F+V FFQ) among fourth and fifth grade students by comparing them to food records previously validated through school lunch observations. METHODS: The multiethnic sample (primarily African-American and Caucasian) included predominantly lower-middle socioeconomic students from 10 classes at one elementary school. F+V FFQ were printed on optical scanning forms and classroom administered on two occasions. Students completed preprinted food record forms at school and received new forms weekly. To allow comparison between the F+V FFQ and food records, a dietitian abstracted information from the records according to a written protocol and transferred it to F+V FFQ forms covering respective time periods. F+V FFQ were converted to estimated daily servings and aggregated to create five F+V indices plus three summary indices. Statistical analyses included Spearman correlations and paired t-tests. RESULTS: Students demonstrated acceptable reliability in completing food records as well as weekly and monthly F+V FFQ; however, validity was unacceptable for both F+V FFQ versions due to significant overreporting. CONCLUSION: Of the two methods studied, the food record procedure is preferred over the FFQ procedure for collecting self-reported F+V consumption data among fourth and fifth grade students.

Child↗

PubMed1997

Increased parenteral nutrition calcium and phosphorus for very-low-birth-weight infants using computer software assisted ordering.

BACKGROUND: Providing adequate calcium (Ca) and phosphorus (P) in an appropriate ratio to preterm very-low-birth-weight (VLBW: BW < 1500 g) infants receiving parenteral nutrition (PN) is difficult because Ca:P solubility in PN is relatively low. Computer software assisted ordering (CSAO) was developed to integrate PN Ca:P solubility with clinical data to improve parenteral Ca and P administration. Our hypothesis was that CSAO would improve the system of designing PN by increasing the amount of Ca and P ordered without Ca:P precipitation. METHODS: Control PN orders were designed using proprietary preprinted PN forms which incorporated predefined PN Ca and P concentrations to prevent precipitation, independent of patient Ca or P administration. CSAO assessed total daily fluids and correlated parenteral volume with Ca:P solubility during order entry to recommend daily Ca and P doses. PN orders which provided > or = 80% of total nutrition volume as PN were analyzed. RESULTS: PN was designed with more Ca (60.3 +/- 16.7 mg/k/day, mean +/- 1 SD) and P (32.8 +/- 13.9 mg/k/day) using CSAO compared to control group Ca (50.0 +/- 17.1 mg/k/day) and P (25.1 +/- 9.1 mg/k/day), both Ca and P, p < 0.001, CSAO provided > or = 80% of the minimum recommended daily Ca in 82% of PN orders compared to 51% of the control orders, p < 0.001. No PN mixture demonstrated Ca:P precipitation. CONCLUSION: The system of designing PN was improved using computer software assisted ordering indicated by increased PN Ca and P content without Ca:P precipitation.

Calcium↗

PubMed2025

Emerging protein sequencing technologies: proteomics without mass spectrometry?

INTRODUCTION: Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has been a leading method for proteomics for 30 years. Advantages provided by LC-MS/MS are offset by significant disadvantages, including cost. Recently, several non-mass spectrometric methods have emerged, but little information is available about their capacity to analyze the complex mixtures routine for mass spectrometry. AREAS COVERED: We review recent non-mass-spectrometric methods for sequencing proteins and peptides, including those using nanopores, sequencing by degradation, reverse translation, and short-epitope mapping, with comments on bioinformatics challenges, fundamental limitations, and areas where new technologies will be more or less competitive with LC-MS/MS. In addition to conventional literature searches, instrument vendor websites, patents, webinars, and preprints were also consulted to give a more up-to-date picture. EXPERT OPINION: Many new technologies are promising. However, demonstrations that they outperform mass spectrometry in terms of peptides and proteins identified have not yet been published, and astute observers note important disadvantages, especially relating to the dynamic range of single-molecule measurements of complex mixtures. Still, even if the performance of emerging methods proves inferior to LC-MS/MS, their low cost could create a different kind of revolution: a dramatic increase in the number of biology laboratories engaging in new forms of proteomics research.

Proteomics↗

PubMed1997

Radioiodine dispensing and usage in a centralized hospital nuclear pharmacy.

131I sodium iodide is the radiopharmaceutical of choice for both diagnosis and therapy in patients with various thyroid abnormalities. The radioiodide capsule has been the preferred dosage form, primarily because it provides a more convenient and safer vehicle for radioiodine administration. However, encapsulated 131I costs approximately twice as much a liquid 131I and does not provide as much flexibility as 131I solution in dosage selection. Also, the bioavailability of the capsular radioiodide preparation is inferior to that of the aqueous dosage form. The patient must swallow multiple capsules when a large amount of 131I activity is used. Capsule form is not suitable for any patient who has difficulty swallowing a capsule, has a feeding tube, or requires intravenous injection of 131I solution. In addition, radioiodide capsules must be analyzed statistically to ensure that the dosage units meet the United States Pharmacopeia uniformity requirements. If liquid radioiodine is used, distilled water rather than tap water should be used for dose preparation. It also is recommended that an antioxidant (e.g., sodium thiosulfate, sodium bisulfite), disodium edetate, and a pH adjustment of 7.5-9.0 be used to reduce radioiodide volatility. Due to the acceleration of the oxidative reaction caused by heat and light, 131I should be stored in a dark, cool environment. To comply with the quality management program implemented by the US Nuclear Regulatory Commission on January 27, 1992, all of the required information (e.g., prescribed dosage, procedure date, and signature of the authorized user) for a valid written directive is preprinted to ensure that the written directive is completed entirely and appropriately. Before each administration of therapeutic 131I solution, the calculated dose is verified by the prescribing physician, and the measured dose of 131I is reconfirmed by a second nuclear medicine technologist. Each patient's identity is verified by two methods (i.e., patient's full name and birth date).

Biological Availability↗

PubMed2025

Lit-OTAR framework for extracting biological evidences from literature.

SUMMARY: The lit-OTAR framework, developed through a collaboration between Europe PMC and Open Targets, leverages deep learning to revolutionize drug discovery by extracting evidence from scientific literature for drug target identification and validation. This novel framework combines named entity recognition for identifying gene/protein (target), disease, organism, and chemical/drug within scientific texts, and entity normalization to map these entities to databases like Ensembl, Experimental Factor Ontology, and ChEMBL. Continuously operational, it has processed over 39 million abstracts and 4.5 million full-text articles and preprints to date, identifying more than 48.5 million unique associations that significantly help accelerate the drug discovery process and scientific research >29.9 m distinct target-disease, 11.8 m distinct target-drug, and 8.3 m distinct disease-drug relationships. AVAILABILITY AND IMPLEMENTATION: The results are accessible through Europe PMC's SciLite web app (https://europepmc.org/) and its annotations API (https://europepmc.org/annotationsapi), as well as via the Open Targets Platform (https://platform.opentargets.org/). The daily pipeline is available at https://github.com/ML4LitS/otar-maintenance, and the Open Targets ETL processes are available at https://github.com/opentargets.

Drug Discovery↗

PubMed2006

Functional genomics via multiscale analysis: application to gene expression and ChIP-on-chip data.

UNLABELLED: We present a fast, versatile and adaptive-multiscale algorithm for analyzing a wide-variety of DNA microarray data. Its primary application is in normalization of array data as well as subsequent identification of 'enriched targets', e.g. differentially expressed genes in expression profiling arrays and enriched sites in ChIP-on-chip experimental data. We show how to accommodate the unique characteristics of ChIP-on-chip data, where the set of 'enriched targets' is large, asymmetric and whose proportion to the whole data varies locally. SUPPLEMENTARY INFORMATION: Supplementary figures, related preprint, free software as well as our raw DNA microarray data with PCR validations are available at http://www.math.umn.edu/~lerman/supp/bioinfo06 as well as Bioinformatics online.

Algorithms↗

PubMed1988

The role of three-dimensional computed tomography in the management of maxillofacial trauma.

Open reduction and internal fixation of facial fractures demand a detailed understanding of the three-dimensional pattern of injury. This is difficult if not impossible to obtain with present radiographic methods. The purpose of this study was to define the role of three-dimensional computerized tomography (3DCT) in surgical management of facial fractures. The two-part investigation: 1) compared the diagnostic accuracy of 3DCT with conventional CT and plain film studies; and 2) examined the clinical usefulness of 3DCT to surgeons. Twenty-four acute trauma patients suspected of having facial fractures were examined radiographically with analysis of every facial bone and specific facial regions. Particular attention was directed to the course of the fracture lines and the number, size, and displacement of fracture fragments. The surgeons were then asked to conceptualize the reported and the personally observed radiographic information and document their impressions on preprinted diagrams of the facial skeleton. They also completed questionnaires designed to indicate whether patient management would be influenced by the 3DCT. The radiographic findings were correlated with intraoperative observations. The 3DCT provided superior definition of fracture lines (especially horizontal) and the extent of comminution was better appreciated. This additional information improved the surgeons' ability to plan placement of interfragmentary wires and/or plates. Surgeons were also able to more accurately predict those patients requiring immediate bone grafting. Large, life-size 3D images of the facial skeleton made intraoperative conceptualization of the injury pattern easier. The accuracy of the 3DCT images corroborated the intraoperative findings in all cases. The following conclusions are offered: 1) The diagnosis of most mandibular fractures can be made equally well with conventional and 3DCT techniques. 2) Improved diagnosis of fracture lines and the specific patterns of comminution in midface fractures is made possible with 3DCT. 3) If open reduction and internal fixation is the mode of treatment, 3DCT is desirable because the added information makes preoperative planning more accurate and thereby facilitates surgical intervention.

Facial Injuries↗

PubMed2001

Therapeutic efficacy of the Epley canalith repositioning maneuver.

OBJECTIVES/HYPOTHESES: The hypotheses of the current study are as follows: 1) That if the Epley canalith repositioning maneuver is an effective treatment for benign positional vertigo (BPV), relief from the vertigo should occur virtually immediately after the performance of the maneuver; 2) that the Epley canalith repositioning maneuver does provide almost immediate relief in BPV and should be the established treatment of choice for this disorder in both primary and tertiary care settings; and 3) that residual symptoms of lightheadedness and imbalance do persist after the resolution of the vertigo. The distinction of these symptoms from the vertigo is required for the accurate evaluation of the efficacy of positional maneuvers. STUDY DESIGN: Prospective cohort study in a tertiary care balance center. METHODS: Eighty-six patients (95 cases) with a history and physical examination consistent with active BPV were entered in the study. Patients were treated with a modified Epley canalith repositioning maneuver. A modified 360 degrees roll was used to treat those patients with horizontal canal BPV. Patients were provided with a preprinted diary in which they were to circle the answer most relevant to their symptoms for 14 days after the maneuver. Patients were then re-evaluated in the office at 2 weeks after the maneuver. RESULTS: The mean duration of the BPV before treatment was 9 weeks. Seventy-four percent of cases that were treated with one or two canalith repositioning maneuvers had a resolution of vertigo as a direct result of the maneuver. A resolution attributable to the first intervention was obtained in 70% of cases within 48 hours of the maneuver. An additional 14% of cases that were treated had a resolution of vertigo; however, it is not possible to say that these patients definitely benefited from the canalith repositioning maneuver. Only 4% of cases (three patients) manifested BPV that persisted after four treatments. Residual symptoms of lightheadedness or imbalance, or both, were frequent (47% of cases) but rarely required formal intervention with vestibular rehabilitation physical therapy. CONCLUSIONS: The Epley canalith repositioning maneuver results in a resolution of vertigo in the majority of patients (70% of cases) immediately after one treatment. It is safe and requires no special equipment or investigations. It should be established as the treatment of choice for BPV in both primary and tertiary care settings.

Aged↗