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Wrestling injuries.

OBJECTIVE: The purpose of this chapter is to review critically the existing studies on the epidemiology of pediatric wrestling injuries and to discuss suggestions for injury prevention and further research. DATA SOURCES: Data were obtained from the sports medicine and science literature since 1951. Literature searches were performed using the National Library of Medicine, Pubmed, Medline, Grateful Med, Sports Sciences, SportsDiscus. Keywords used included "Wrestling, Wrestle, Wrestling Injuries, Fractures, and Dermatologic". MAIN RESULTS: Only eight prospective or retrospective studies were found dealing with pediatric wrestling injuries and that provided sufficient information to allow the estimation of injury rates. Exposure-based injury rates were between 6.0 and 7.6 injuries per 1,000 athletic-exposures. Injury rates increased with age, experience, and level of participation. The head/spine/trunk was the body region that incurred the greatest frequency of injuries, followed by the upper and lower extremities. CONCLUSIONS: There are several potential areas for decreasing injury risk in wrestlers, including equipment, coaching, officiating and training. However, informed decisions with regard to preventing injuries are dependent upon the quality of the basic epidemiological data available, and at this time, analyses of risk factors and potential preventive measures are lacking.

Adolescent↗

Environment-specific amino acid substitution tables: tertiary templates and prediction of protein folds.

The local environment of an amino acid in a folded protein determines the acceptability of mutations at that position. In order to characterize and quantify these structural constraints, we have made a comparative analysis of families of homologous proteins. Residues in each structure are classified according to amino acid type, secondary structure, accessibility of the side chain, and existence of hydrogen bonds from the side chains. Analysis of the pattern of observed substitutions as a function of local environment shows that there are distinct patterns, especially for buried polar residues. The substitution data tables are available on diskette with Protein Science. Given the fold of a protein, one is able to predict sequences compatible with the fold (profiles or templates) and potentially to discriminate between a correctly folded and misfolded protein. Conversely, analysis of residue variation across a family of aligned sequences in terms of substitution profiles can allow prediction of secondary structure or tertiary environment.

Amino Acid Sequence↗

[Physiotherapists in French-speaking Switzerland--basic data].

In the framework of health services research sponsored by the Swiss National Science Foundation, a survey was made among the physiotherapists of the French-speaking part of Switzerland (six cantons), in order to gather information on --their personal and professional characteristics, --conditions of professional practice, --therapeutic methods used, medical indications of treatments and some data on the patients seen --the personnel, facilities and equipment of physiotherapy offices, institutes (several professionals) and services (in hospitals). Out of a total of 771 physiotherapists (i.e. 5.4 per 10,000 persons, in an area with 1.5 million population), 40% of them answered the questionnaire which was sent. They are a representative sample as regards region of practice, sex, age, employment status, and working environment. Physiotherapy is experiencing in Switzerland since the middle 1970's a quantitative increase and an accelerated diversification in the modes of practice. One observes in particular that many women enter the profession, working often part-time. According to the data gathered, it appears that, in spite of a marked differentiation in structural terms, physiotherapy is able to conserve its unity as regards therapeutic methods and types of care, thanks to keeping a practice of a generalist character. Thus, this discipline shows a potential for adaptation which could be of interest to other health professions. This paper introduces the main axes of a research in a yet largely undocumented field.

Adult↗

Partially supervised learning using an EM-boosting algorithm.

Training data in a supervised learning problem consist of the class label and its potential predictors for a set of observations. Constructing effective classifiers from training data is the goal of supervised learning. In biomedical sciences and other scientific applications, class labels may be subject to errors. We consider a setting where there are two classes but observations with labels corresponding to one of the classes may in fact be mislabeled. The application concerns the use of protein mass-spectrometry data to discriminate between serum samples from cancer and noncancer patients. The patients in the training set are classified on the basis of tissue biopsy. Although biopsy is 100% specific in the sense that a tissue that shows itself to have malignant cells is certainly cancer, it is less than 100% sensitive. Reference gold standards that are subject to this special type of misclassification due to imperfect diagnosis certainty arise in many fields. We consider the development of a supervised learning algorithm under these conditions and refer to it as partially supervised learning. Boosting is a supervised learning algorithm geared toward high-dimensional predictor data, such as those generated in protein mass-spectrometry. We propose a modification of the boosting algorithm for partially supervised learning. The proposal is to view the true class membership of the samples that are labeled with the error-prone class label as missing data, and apply an algorithm related to the EM algorithm for minimization of a loss function. To assess the usefulness of the proposed method, we artificially mislabeled a subset of samples and applied the original and EM-modified boosting (EM-Boost) algorithms for comparison. Notable improvements in misclassification rates are observed with EM-Boost.

Algorithms↗

SoFAR: software for fully automatic evaluation of real-time PCR data.

Quantitative real-time PCR has proven to be an extremely useful technique in life sciences for many applications. Although a lot of attention has been paid to the optimization of the assay conditions, the analysis of the data acquired is often done with software tools that do not make optimum use of the information provided by the data. Particularly, this is the case for high-throughput analysis, which requires a careful characterization and interpretation of the complete data by suitable software. Here we present a software solution for the robust, reliable, accurate, and fast evaluation of real-time PCR data, called SoFAR. The software automatically evaluates the data acquired with the LightCycler system. It applies new algorithms for an adaptive background correction of signal trends, the calculation of the effective signal noise, the automated identification of the exponential phases, the adaptive smoothing of the raw data, and the correction of melting curve data. Finally, it provides information regarding the validity of the results obtained. The SoFAR software minimizes the time required for evaluation and increases the accuracy and reliability of the results. The software is available upon request.

Algorithms↗

Association of the progesterone receptor gene with breast cancer risk: a single-nucleotide polymorphism tagging approach.

Association studies on susceptibility to breast cancer using single nucleotide polymorphisms (SNP) in the progesterone receptor (PGR) gene have been previously published, but the results have been inconclusive. We used a comprehensive SNP-tagging approach to search for low-penetrance susceptibility alleles in a study of up to 4,647 cases and 4,564 controls, in a two-stage study design. We identified seven tagging SNPs using genotype data from the National Institute of Environmental Health Sciences (NIEHS) Environmental Genome Project and typed these, and an additional three SNPs, in 2,345 breast cancer cases and 2,284 controls (set 1). Three SNPs showed no evidence for association and were not studied further, whereas seven SNPs (rs11571171, rs7116336, rs660149, rs10895068, rs500760, rs566351, and rs1042838) exhibited significant associations at P < 0.1 using either a heterogeneity or trend test and progressed to be genotyped in set 2. After both stages, only one SNP was significantly associated with an increased risk of breast cancer - the PGR-12 (rs1042638) V660L valine to leucine polymorphism [VL heterozygotes (odds ratio, 1.13; 95% confidence interval, 1.03-1.24) and the LL homozygotes (odds ratio, 1.30; 95% confidence interval, 0.98-1.73), P(het) = 0.008, P(trend) = 0.002]. Similar estimates were obtained in a combined analysis of our data with those from three other published studies. We conclude that the 660L allele may be associated with a moderately increased risk of breast cancer, but that other common SNPs in the PGR gene are unlikely to be associated with a substantial risk of breast cancer.

Aged↗

Blood pressure monitoring by cellular telephone in patients on continuous ambulatory peritoneal dialysis.

We have developed a new telemedicine system that uses a cellular telephone and Internet Web site to monitor changes of blood pressure (BP) in patients on continuous ambulatory peritoneal dialysis (CAPD). An I-converter data collection system directly transmits all data on BP and heart rate (HR) measured by a fully automatic device (HEM-705IT: Omron Life Science, Tokyo, Japan) to a cellular telephone. The cellular telephone then sends the data directly to the main server at the NTT DoCoMo data center. All data, including BP and HR from each patient, are accumulated in the server. Application service provider technology (ASP) connects that system directly to the Internet. Any time and anywhere, each patient can use a cellular telephone or the Internet Web site to monitor, in graph form, changes in their data. The average data at each collection point are calculated and shown on the Web site. All data collected by cellular telephone are also calculated and sent directly, in real time, to the physician's office. Currently, we are using this telemedicine system for 44 hypertensive patients on CAPD at our center. In the present study, we used the telemedicine system to evaluate changes in 24-hour BP. We followed 20 CAPD patients, monitoring changes in BP for 3 months. At the end of study, we found that the average daytime home BP was 137 +/- 8 mmHg over 80 +/- 4 mmHg and that the average nighttime BP was 128 +/- 7 mmHg over 72 +/- 4 mmHg. The overall average home BP was 132 +/- 7 mmHg over 76 +/- 3 mmHg. The average outpatient clinic BP was 155 +/- 9 mmHg over 86 +/- 5 mmHg. The measured systolic and diastolic BP at the out-patient clinic were significantly higher than those measured at home. As measured at the outpatient clinic, BP indicated that 7 CAPD patients (35%) were hypertensive (> 160/95 mmHg). However, as measured at home, BP indicated that only 4 CAPD patients (20%) were truly hypertensive (> 135/85 mmHg). We were therefore able to determine that 43% of our hypertensive patients had "white coat" hypertension. Our new telemedicine system that monitors BP by cellular telephone provides great advantages in monitoring BP at home in patients on CAPD.

Adult↗

Strength diagnosis: the use of test data to determine specific strength training.

The aim of this study was to determine if pre-training strength and power tests could provide data that effectively discriminated between subjects whose cycling performance improved considerably from training, from those who did not. Twenty active healthy male subjects performed 10 weeks of plyometric or weight training. Prior to and at the completion of the training, the following tests were performed: (1) a 6-s cycle ride; (2) isokinetic leg extension at 1.05 and 5.24 rads s-1; and (3) a maximum isometric squat. The subjects in the two training groups were separated into those whose cycling performance improved significantly as a result of the training (good) and those who did not (poor). The pre-training muscular function tests of the good versus poor achievers were then compared, individually for each form of training, to determine if they could be used to discriminate between the two subject groups. The pre-training isometric data effectively discriminated between those individuals who improved their cycling performance significantly as a consequence of training and those who did not. While this finding has practical implications for the exercise science field, further research is required before generally useful normative data can be used with confidence to prescribe individual specific training programmes.

Adult↗

Pancreatectomy for pancreatic disease and quality of life.

The aim of this paper was to review the data existing in the English literature on the quality of life in patients who undergo surgical resection of the pancreatic gland either for benign or for malignant diseases. MEDLINE, Web of Science, and ScienceDirect were browsed in order to select the data existing in the literature on quality of life and pancreatic surgery. Alerts received by e-mail were also taken into account. Only full text papers were selected. Of the 161 papers found, only 13 papers were evaluated for the purpose of this study: 11 focused on surgical resective procedures in chronic pancreatitis and two focused their interest on assessing the quality of life related to resective procedures in pancreatic neoplasms. Despite the scarcity of studies assessing the quality of life in patients who underwent pancreatic surgery, there is the need to routinely assess well-being in patients who have been operated on.

Humans↗

Identifying soil cleanup criteria for dioxins in urban residential soils: how have 20 years of research and risk assessment experience affected the analysis?

This article reviews the scientific evidence and methodologies that have been used to assess the risks posed by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and presents a probabilistic analysis for identifying virtually safe concentrations of TCDD toxicity equivalents (TEQ) in residential soils. Updated data distributions that consider state-of-the-science cancer and noncancer toxicity criteria, child soil ingestion and dermal uptake, bioavailability in soil, and residential exposure duration are incorporated. The probabilistic analysis shows that the most sensitive determinants of dose and risk are childhood soil ingestion, exposure duration, and the selected TCDD cancer potency factor. It also shows that the cancer risk at 1 per 100,000 predicted more conservative (lower) soil criteria values than did the noncancer hazard (e.g., developmental and reproductive effects). In this analysis, acceptable or tolerable soil dioxin concentrations (TCDD TEQ) ranged from 0.4 to 5.5 ppb at the 95th percentile for cancer potency factors from 9600 to 156,000 (mg/kg/d)(-1) with site-specific adjustments not included. Various possible soil guidelines based on cancer and noncancer risks are presented and discussed. In the main, the current toxicology, epidemiology, and exposure assessment data indicate that the historical 1 ppb TEQ soil guidance value remains a reasonable screening value for most residential sites. This analysis provides risk managers with a thorough and transparent methodology, as well as a comprehensive information base, for making informed decisions about selecting soil cleanup values for PCDD/Fs in urban residential settings.

Biological Availability↗

Seeds of discontent: expert opinion, mass media messages, and the public image of agricultural biotechnology.

Survey data are presented on opinions about agricultural biotechnology and its applications held by agricultural science faculty at highly ranked programs in the United States with and without personal involvement in biotechnology-oriented research. Respondents believed biotech holds much promise, but policy positions vary. These results underscore the relationship between opinion and stakeholder interests in this research, even among scientific experts. Media accounts are often seen as causes, rather than artifacts, of the existence of public controversy; European and now U.S. opposition to food biotechnology is often explained away in terms of such a relationship. The authors argue that where even experts are divided, public opposition cannot reasonably be attributed to poor public understanding or sensationalistic media accounts. Ethical implications for communicating science are explored.

Agriculture↗

Perception of students in the south of Brazil of status of psychology as a science.

73 university students (M age=20.5 yr., SD=4.8; range 17-44 yr.) from the southern state of Paraná took the Psychology as Science scale to assess whether they view psychology as a rigorous science. Analysis showed the students considered psychology to be a science, agreed study of psychology should be part of a university curriculum, not many believed that psychological research may contribute to the solution of psychological problems, and few believed obtaining a Bachelors of Science degree in Psychology was useful in obtaining employment. Data were compared with a previous study conducted on a northeastern sample.

Adolescent↗

Cross-platform comparability of microarray technology: intra-platform consistency and appropriate data analysis procedures are essential.

BACKGROUND: The acceptance of microarray technology in regulatory decision-making is being challenged by the existence of various platforms and data analysis methods. A recent report (E. Marshall, Science, 306, 630-631, 2004), by extensively citing the study of Tan et al. (Nucleic Acids Res., 31, 5676-5684, 2003), portrays a disturbingly negative picture of the cross-platform comparability, and, hence, the reliability of microarray technology. RESULTS: We reanalyzed Tan's dataset and found that the intra-platform consistency was low, indicating a problem in experimental procedures from which the dataset was generated. Furthermore, by using three gene selection methods (i.e., p-value ranking, fold-change ranking, and Significance Analysis of Microarrays (SAM)) on the same dataset we found that p-value ranking (the method emphasized by Tan et al.) results in much lower cross-platform concordance compared to fold-change ranking or SAM. Therefore, the low cross-platform concordance reported in Tan's study appears to be mainly due to a combination of low intra-platform consistency and a poor choice of data analysis procedures, instead of inherent technical differences among different platforms, as suggested by Tan et al. and Marshall. CONCLUSION: Our results illustrate the importance of establishing calibrated RNA samples and reference datasets to objectively assess the performance of different microarray platforms and the proficiency of individual laboratories as well as the merits of various data analysis procedures. Thus, we are progressively coordinating the MAQC project, a community-wide effort for microarray quality control.

Databases, Genetic↗

A toolkit for dermal risk assessment and management: an overview.

The European Research project RISKOFDERM (QLK4-CT-1999-01107) has two major goals. One is the development of a conceptual model for dermal risk assessment for regulatory purposes, such as the registration of new chemicals. The other goal is to develop a simple-to-use toolkit for assessment and management of health risks from occupational dermal exposure. This toolkit was constructed by analysing the major determinants of dermal hazard and dermal exposure. The results were combined in the form of a decision-tree that leads the user of the toolkit through a number of questions on the hazardous properties of the chemical in use, and on the exposure situation. The toolkit translates the information given by the user into broad data categories of hazard and exposure that lead to a rough estimate of health risk from dermal exposure. This is done separately for local skin effects and skin allergy on the one hand, and systemic effects after skin penetration on the other hand. After going through the decision-tree, the user is advised to act to control the risk, and to read general information on dermal exposure and a statement describing the uncertainty of the risk estimate produced by the toolkit. The final version of the toolkit will be available for use on portable or stationary computers and runs the decision algorithms in the background so that the non-expert user only will see the judgements, the recommendations and the general information. The toolkit will be evaluated before release by experts on the various elements included in the toolkit and by field experts in its practical use. The toolkit is an attempt to adapt elements of exact science to a situation where the necessary input data are of limited quality and are only estimates. The toolkit does not claim to give precise answers based on imprecise information. The purpose is to enable the user to estimate the order of magnitude of hazard, exposure and risk, and to encourage the user to deal with the issues of dermal hazard, exposure and control.

Humans↗

Anatomical informatics: Millennial perspectives on a newer frontier.

One of the most ancient of sciences, anatomy has evolved over many centuries. Its methods have progressively encompassed dissection instruments, manual illustration, stains, microscopes, cameras and photography, and digital imaging systems. Like many other more modern scientific disciplines in the late 20th century, anatomy has also benefited from the revolutionary development of digital computers and their automated information management and analytical capabilities. By using newer methods of computer and information sciences, anatomists have made outstanding contributions to science, medicine, and education. In that regard, there is a strong rationale for recognizing anatomical informatics as a proper subdiscipline of anatomy. A high-level survey of the field reveals important anatomical applications of computer sciences methods in imaging, image processing and visualization, virtual reality, modeling and simulation, structural database processing, networking, and artificial intelligence. Within this framework, computational anatomy is a developing field focusing on data-driven mathematical models of bodily structures. Mastering such computer sciences and informatics methods is crucial for new anatomists, who will shape the future in research, clinical knowledge, and teaching.

Anatomy↗

User and carer involvement in the training and education of health professionals: a review of the literature.

BACKGROUND: Health policy requires consumer involvement in services, research and education but little is known about how consumers are being involved in healthcare education, the effect on learning and practice, nor how involvement initiatives are being evaluated. OBJECTIVES: To describe methods of involving consumers in healthcare education, discuss ways in which initiatives have been evaluated, and identify areas for development in education, practice and research. DESIGN: All papers reporting specific initiatives involving consumers in health care worker training and education were included. Viewpoint articles and studies of consumers training consumers were excluded. DATA SOURCES: Cinahl, Medline, Assia, PsycINFO, British Nursing Index, Social Science Citation Index, citations from reference lists, relevant websites and personal communication with key people known to be working in this area. REVIEW METHODS: A narrative approach was taken with categorisation of data to reflect objectives of selected studies; method of involvement; process issues and evaluation. RESULTS: Thirty-eight papers were included; most provide small-scale qualitative studies of mental health service users and focus on process rather than outcome. Various methods of involvement are described and consumers consistently prioritise the need for training in interpersonal skills over 'technical' skills. There is little research into organisational strategies and no studies investigate the effect of consumer involvement on practice. Two studies indicated that students exposed to consumer involvement demonstrate more empathic understanding and better communication skills. CONCLUSIONS: There is tentative evidence that consumer involvement in training enhances workers' skills in the manner prioritised by consumers. However, if consumer involvement in training and education is to facilitate services that reflect the priorities of the people using them, it must be developed in partnership with service providers; further research is needed to explore the impact of consumer involvement and to track the development of organisational consumer involvement strategies, also systems for supporting consumers need to be established, including training for both consumers and staff.

Attitude of Health Personnel↗

AVS software for visualization in molecular microscopy.

AVS (Application Visualization System) is commercially available software for analyzing and viewing data. AVS is primarily used in the physical sciences and engineering, and here we describe the application of AVS for examining three-dimensional density maps generated by electron microscopy and image processing. For this purpose, AVS can be applied with relative ease, even though the software is indeed quite sophisticated. The primary advantage is that visualization applications can be generated by combining software components, called modules, into executable flow networks. Simple networks are described for generating ribbon diagrams of macromolecules, surface-shaded views, and contour maps. Easy to use dials, bar sliders, and buttons provide tremendous versatility for real-time manipulation of isosurface values, depth cueing, view orientation, size, and animation. In addition, AVS supplies a framework for building new modules in C or FORTRAN. Modules for excavation and cropping provide tools that are particularly useful for extracting segments of a map and for examining maps of supramolecular complexes such as viruses. We describe a number of modules we have designed for analysis of three-dimensional data sets, as well as modules for importing image data from other software packages into AVS. We also describe xformat, a stand-alone file conversion utility designed to allow import of a variety of image and map file formats into AVS.

Capsid↗

Caffeine and cardiac arrhythmias.

PURPOSE: To review the evidence supporting the belief that caffeine causes cardiac arrhythmias. DATA SOURCES: Studies published since 1982 identified through computerized searches of MEDLINE, TOXLINE, and Chemical Abstracts and a review of bibliographies of relevant articles on the subject of caffeine and cardiac arrhythmias. STUDY SELECTION: All clinical studies examining caffeine as a cause of cardiac arrhythmias and a selection of basic science experiments to illustrate caffeine's effects in vitro. DATA EXTRACTION: Study quality was assessed and all available clinical data pertaining to caffeine as a cause of arrhythmias were summarized. RESULTS OF DATA ANALYSIS: In one electrophysiologic study, caffeine was associated with an increased susceptibility to provoked cardiac arrhythmias. In five placebo-controlled trials, caffeine in doses up to 500 mg daily (equivalent to 5 to 6 cups of coffee) did not increase the frequency or severity of ventricular arrhythmias. One large epidemiologic study reported an increase in the frequency of ventricular extrasystoles in persons consuming 9 or more cups of coffee daily. CONCLUSION: Moderate ingestion of caffeine does not increase the frequency or severity of cardiac arrhythmias in normal persons, patients with ischemic heart disease, or those with pre-existing serious ventricular ectopy.

Animals↗