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Comparison of in vitro anticancer-drug-screening data generated with a tetrazolium assay versus a protein assay against a diverse panel of human tumor cell lines.

The National Cancer Institute (NCI) is implementing a large-scale in vitro drug-screening program that requires a very efficient automated assay of drug effects on tumor cell viability or growth. Many laboratories worldwide have adopted a microculture assay based on metabolic reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). However, because of certain technical advantages to use of the protein-binding dye sulforhodamine B (SRB) in a large-scale screening application, a detailed comparison of data generated by each type of assay was undertaken. The MTT and SRB assays were each used to test 197 compounds, on simultaneous days, against up to 38 human tumor cell lines representing seven major tumor categories. On subsequent days, 38 compounds were retested with the SRB assay and 25 compounds were retested with the MTT assay. For each of these three comparisons, we tabulated the differences between the two assays in the ratios of test group values to control values (T/C) for cell survival; calculated correlation coefficients for various T/C ratios; and estimated the bivariate distribution of the values for IC50 (concentration of drug resulting in T/C values of 50%, or 50% growth inhibition) for the two assays. The results indicate that under the experimental conditions used and within the limits of the data analyses, the assays perform similarly. Because the SRB assay has practical advantages for large-scale screening, however, it has been adopted for routine use in the NCI in vitro antitumor screen.

Antineoplastic Agents↗

Biased random mutagenesis of peptides: determination of mutation frequency by computer simulation.

Cassette mutagenesis is a method of protein engineering which generates a wide diversity of genetic variants that can be subjected to either selection or screening. As long as the target sequence to be modified is kept short (corresponding to four to six amino acids), complete combinatorial libraries can be produced. A major problem arises when longer peptides are to be engineered for desired functions. In such situations the production of a limited collection of variants can be helpful; thus, biased random mutagenesis and 'doping schemes' have been reported previously. Here we describe a computer algorithm that enables the determination of the degree of phosphoramidite contamination of nucleotide precursor reservoirs. Through simulation of biological translation, the algorithm allows the prediction of the effect of contamination levels on the number of mutations to occur for any given peptide sequence. In this study the cholinergic binding site was used as a model sequence (22 amino acids). Considerations, based on the computer program, are discussed regarding the efficient design of phage-display combinatorial libraries.

Algorithms↗

A model for peer tutoring in the medical school setting.

For the past several years, the University of Maryland School of Medicine has operated a successful and efficient basic science peer tutorial program through the management of the Office of Medical Education. During the 1981-82 and 1982-83 academic years, 122 tutoring dyads were formed to take advantage of the tutoring program in nine of the 10 basic science courses encountered during the first two years of medical training. The success of the program is evident in that tutored students received passing grades in 102 (84 percent) of the courses in which they were tutored. In this paper, the authors discuss the systematic procedure of managing a peer tutorial program and the potential positive effects the program has on student tutors as well as on the medical student in academic difficulty.

Education, Medical↗

Psychiatric disorders in a representative sample of incarcerated boys in the Netherlands.

OBJECTIVE: To determine the prevalence of psychiatric disorders among incarcerated male adolescents and to investigate the influence of psychopathology on allocation to either plain detention or detention with compulsory treatment. METHOD: A cross-sectional study of a representative sample (N = 204) of incarcerated boys aged 12 to 18, using the Diagnostic Interview Schedule for Children (DISC). Data were collected from December 1998 to December 1999. RESULTS: Of the eligible subjects, 79% agreed to participate. Ninety percent reported at least one psychiatric disorder: disruptive behavior disorder 75% (95% confidence interval [CI]: 68-81%), substance use disorder 55% (95% CI: 48-63%), psychotic symptoms 34% (95% CI: 27-41%), ADHD 8% (95% CI: 5-13%), anxiety disorder 9% (95% CI: 6-15%), and affective disorder 6% (95% CI: 3-10%). After controlling for a broad range of sociodemographic characteristics and former treatment parameters, the presence of a psychiatric disorder was not associated with allocation to compulsory treatment. CONCLUSIONS: Compared with North American studies, relatively low rates of anxiety and affective disorders were found, probably due to the better availability of mental health services to disadvantaged youths with internalizing problems in the Netherlands. It should be examined whether standardized psychiatric assessments can improve the efficiency of allocation to detention programs with or without psychiatric treatment options.

Adolescent↗

Six principles of public health information.

The collection and analysis of data has been a fundamental activity of public health since the earliest times. Automated systems have enabled public health agencies to accumulate vast amounts of data. This data becomes useless without a systematic approach to convert it into information that directs action. Public health systems that manage service delivery should be integrated to maximize efficiency and minimize burdens upon program staff.

Communication↗

SeqHelp: a program to analyze molecular sequences utilizing common computational resources.

Here we describe a tool to analyze molecular sequences utilizing the internet and existing computational resources for molecular biology. The computer program SeqHelp organizes information from database searches, gene structure prediction, and other information to generate multiply aligned, hypertext-linked reports to allow for fast analysis of molecular sequences. The efficient and economical strategy in this program can be employed to study molecular sequences for gene cloning, mutation analysis, and identical sequence search projects.

Algorithms↗

GERMINATE. a generic database for integrating genotypic and phenotypic information for plant genetic resource collections.

The extensive germplasm resource collections that are now available for major crop plants and their wild relatives will increasingly provide valuable biological and bioinformatics resources for plant physiologists and geneticists to dissect the molecular basis of key traits and to develop highly adapted plant material to sustain future breeding programs. A key to the efficient deployment of these resources is the development of information systems that will enable the collection and storage of biological information for these plant lines to be integrated with the molecular information that is now becoming available through the use of high-throughput genomics and post-genomics technologies. The GERMINATE database has been designed to hold a diverse variety of data types, ranging from molecular to phenotypic, and to allow querying between such data for any plant species. Data are stored in GERMINATE in a technology-independent manner, such that new technologies can be accommodated in the database as they emerge, without modification of the underlying schema. Users can access data in GERMINATE databases either via a lightweight Perl-CGI Web interface or by the more complex Genomic Diversity and Phenotype Connection software. GERMINATE is released under the GNU General Public License and is available at http://germinate.scri.sari.ac.uk/germinate/.

Computational Biology↗

Ab initio protein phasing at 1.4 A resolution.

All the techniques today available for the ab initio crystal structure solution of proteins require that the atomicity condition is satisfied. Accordingly, diffraction data at resolution equal or better than 1.2 A are necessary. This condition reduces the role of the ab initio techniques in macromolecular crystallography. The computer program SIR2002 has been modified in such a way that it may succeed also with 1.4 A resolution diffraction data. The modifications concern all the modules of the program: the modified program also benefits by the efficiency of a figure of merit.

Collagen↗

Capacity in Thai public hospitals and the production of care for poor and nonpoor patients.

OBJECTIVE: To assess the capacity of Thai public hospitals to proportionately expand services to both the poor and the nonpoor. This is accomplished by measuring the production of services provided to poor, relative to nonpoor, patients and the plant capacity of individual public hospitals to care for the patient load. STUDY SETTING: Thai public hospitals operating in 1999, following the economic crisis when public hospitals were required to treat all patients irrespective of ability to pay. STUDY DESIGN AND DATA COLLECTION: Input and output data for 68 hospitals were collected using databases and questionnaire surveys. A distinction was made between inpatient and outpatient services to both poor and nonpoor patients and the data were assessed statistically. DATA ANALYSIS: Congestion and capacity indices to measure poor/nonpoor service trade-offs and capacity utilization were estimated. The analysis was undertaken by data envelopment analysis (DEA), a nonparametric linear programming approach used to derive efficiency and productivity estimates. Principal Findings. Increases in the amount of services provided to poor patients did not reduce the amount of services to nonpoor patients. Overall, hospitals are producing services relatively close to their capacity given fixed inputs. Possible increases in capacity utilization amounted to 5 percent of capacity. CONCLUSIONS: Results suggest that some increased public hospital care can be accomplished by reallocation of resources to less highly utilized hospitals, given the budgetary constraints. However, further expansion and increase in access to health services will require plant investments. The study illustrates how DEA methodologies can be used in planning health services in data constrained settings.

Data Collection↗

Results after 1 year of non-operative occlusal caries treatment of erupting permanent first molars.

The aim of this study was to evaluate a treatment program designed to control occlusal caries on the basis of intensive patient education and professional toothcleaning. The sample consisted of 56 6-8-yr-old children with their permanent right first molars in different stages of eruption. Data from the program were compared with previous data recorded in a similar sample of children. After 1 yr the majority of children in the study group had their permanent right first molars in full occlusion. A significant decrease of surfaces with easily detectable plaque and an increase of surfaces without plaque was observed. The proportion of arrested lesions increased and active enamel lesions decreased. Fissure sealing was only needed in two teeth in contrast to more than 2/3 of molars in a comparable sample of children. The program proved to be an efficient alternative to fissure sealing in preventing occlusal caries in erupting teeth.

Child↗

Identification of a microsatellite on chromosome 7B showing a strong linkage with yellow pigment in durum wheat (Triticum turgidum L. var. durum).

The objective of this study is to identify QTLs linked to yellow pigment content in durum wheat. A durum-dicoccoides genetic linkage map was constructed using 124 microsatellites, 149 amplified fragment length polymorphism (AFLPs), and six seed storage proteins (SSP) in a population of 114 recombinant inbred lines (F8). The population has been obtained from a cross between a durum cultivar Omrabi5 and Triticum dicoccoides600545 and backcrossed to Omrabi5. The map consists of 14-durum chromosomes plus an unknown group; and shows a good synteny to the previously published wheat maps. Yellow pigment was measured in the population in three different locations during 3 seasons. Analysis of QTLs was based on simple and simplified composite interval mapping (SIM and sCIM). Three QTLs for yellow pigment were detected on the chromosomal group 7 (7AL and 7BL telomeres) explaining 62% of the total variation. On 7BL, a major microsatellite (Xgwm344) explained by itself 53%, whereas on 7AL, the other two QTLs have contributed 13 and 6%. All determined QTLs showed a strong genetic effect and a weak QTL x E effect. The QTLs effect was consistent across all environments and showed a large effect. Consequently, promising QTLs will be used in the marker assisted breeding program to enhance the selection efficiency for yellow pigment.

Chromosomes↗

QALYs for resource allocation: probably not and certainly not now.

Quality-adjusted life years (QALYs) have the attractive characteristic of combining morbidity and mortality into a single index which purports to measure the outcomes of health interventions. Their primary aim, when combined with cost, is to permit comparisons across candidate spending programs and thereby promote economic efficiency in the use of rationed funds. QALYs, in fact, comprise a family of measures with major differences in approach and many variations in construction, process and methods of measurement. A necessary unifying characteristic is the ethical assumption of utilitarianism. The paper examines the state of the art in the development of QALY measures. It concludes that they fall far short of requirements for their advocated use in resource allocation decisions. Furthermore, their demands on measurement for this purpose are such that it is unlikely that methodological problems can be solved.

Australia↗

Efficient selection of tests for bacteriological typing schemes.

To simplify the selection of tests for bacteriological typing methods, such as bacteriophage, bacteriocin, and biotyping, a computerised method was assessed. This uses a numerical index of discrimination (D) to facilitate the selection of an efficient typing set. The computer programs take the most discriminatory test as the initial test in the partial typing set, and then select the next test by combining each of the remaining candidates with the partial set and choosing the test which maximises D. This cycle is repeated until the remaining candidates do not increase the discriminatory power of the typing set. Options are provided for the investigator to pre-select certain tests for inclusion or exclusion from the typing set. It is concluded that the numerical index D is a simple means of test selection, but it must be emphasised that it is important to combine its use with data on the incidence of reaction in each test, on reproducibility, and on the similarity among tests.

Bacterial Typing Techniques↗

Analysis of breakthrough pain in 50 patients treated with intrathecal morphine infusion therapy. Development of tolerance or infusion system malfunction.

Fifty patients with intractable benign pain were treated with intrathecal morphine (IT-MS) infusion therapy. Median follow-up was 39 months (range 5-70). Breakthrough pain was reported in 45 (90%) patients in 75 outpatient clinic events. A diagnostic algorithm was developed to evaluate and efficiently treat these patients. A programmed bolus (50% of daily dose) identified that 50 (67%) breakthrough events where due to partial tolerance to the IT-MS. Radiographic survey of the catheters identified malfunctions in 11 patients. Attempts to withdraw CSF from the side-port demonstrated obstruction in 7 due to kinking not seen on X-rays. Side-port myelography demonstrated scarring that obstructed the flow of morphine to the spinal cord in 2 patients. Benefits were regained after all surgical catheter corrections. In total, partial tolerance was seen in 23 patients (46%) during 50 (67%) breakthrough events, 15 patients (30%) required 22 catheter revisions during 27% of breakthrough events and 2 patients had progressive disease. True tolerance was encountered in only 5 patients (10%) during 5 (7%) breakthrough pain events.

Adult↗

Examining the effects of prevention programs on the incidence of new cases of mental disorders: the lack of statistical power.

OBJECTIVE: In the past few decades about 1,000 controlled studies have examined the effects of mental health prevention programs, but few studies have examined the effects of such programs on the incidence of new cases of mental disorders defined according to diagnostic criteria. A major reason why so few studies have examined this important question is that very large numbers of subjects are needed to provide sufficient statistical power for these studies. In this article this power problem is explored. METHOD: Power calculations are presented for studies examining universal prevention (aimed at the general population regardless of risk status), selective prevention (aimed at high-risk groups), and indicated prevention (aimed at subjects who have some symptoms of a disorder without meeting full diagnostic criteria). RESULTS: Studies examining universal prevention are hardly feasible, as the number of subjects required amounts to tens of thousands at least. Research examining selective prevention is more feasible, but the number of subjects needed for these studies is still very high. Studies of indicated prevention are possible. Three major studies of indicated prevention examining the effects on the incidence of new cases of mental disorders are described. CONCLUSIONS: There are several strategies for increasing statistical power in prevention studies: 1) focus on high-incidence groups (by concentrating on indicated prevention, by targeting high-risk groups with multiple risk factors, by targeting groups with multiple disorders), 2) strengthen the effects of prevention programs, and 3) make more efficient use of other trials through cumulative meta-analyses.

Adolescent↗

Triple therapy for acute deep thrombophlebitis.

Therapy for patients with extensive thrombophlebitis is ofter inadequate with available methods. The reluctance of most physicians in private practice to use streptokinase or urokinase is understandable when one considers the cost, hospitalization, length of stay and risks involved. This article discusses a unique and previously unreported mode of drug therapy in these patients, consisting of a combination of drugs designed to combine the antithrombotic and thrombusantipropagating effects of warfarin, the anti-inflammatory effect of trypsin-chymotrypsin enzymes, and the antiplatelet aggregating, antiadhesion, and possible enhanced fibrinolytic effects of aspirin with added buffered protection (Ascriptin A/D). This treatment program has been a safe, efficient, economical, and highly effective one for a very costly, common, and disabling disease. It therefore fulfills the ideal criteria for any form of therapy, provided one is knowledgable of its content, and adheres to its contraindications as well as to the basic application of the drugs involved. It is hoped that further investigations along these lines will continue until an ideal solution is reached. Although this is a preliminary report, this study will continue in its present form, and will be expanded to include a series of patients on the aspirin-enzyme combination without the use of warfarin.

Acute Disease↗

Differential maturation of murine bone-marrow derived dendritic cells with lipopolysaccharide and tumor necrosis factor-alpha.

Dendritic cells (DCs) play a key role in the interface between the innate and acquired immune systems. In response to both exogenous as well as endogenous signals, DCs undergo a programmed maturation to become an efficient, antigen-presenting cell. Yet little is known regarding the differential responses by endogenous versus exogenous stimuli on DC maturation. In the present report, we have compared the phenotypic, functional, and genome-wide expression responses associated with maturation by bone marrow derived DCs to either an endogenous danger signal, tumor necrosis factor-alpha (TNF-alpha), or a microbial product, bacterial lipopolysaccharide (LPS). Examination of the cell surface expression of DCs as well as cytokine production demonstrated that patterns of DC maturation varied dramatically depending upon the stimulus. Whereas LPS was highly effective in terms of inducing phenotypic and functional maturation, TNF-alpha exposure produced a phenotypically distinct DC. Gene expression patterns in DCs 6 and 24 h after LPS and TNF-alpha exposure revealed that these activation signals produce fundamentally different genomic responses. Supervised analysis revealed that the expression of 929 probe sets discriminated among the treatment groups, and the patterns of gene expression in TNF-alpha stimulated DCs were more similar to unstimulated cells at both 6 and 24 h post-stimulation than to LPS-stimulated cells at the same time points. These findings reveal that DCs are capable of a varying phenotypic response to different antigens and endogenous signals.

Animals↗

Developing global climate anomalies suggest potential disease risks for 2006-2007.

BACKGROUND: El Niño/Southern Oscillation (ENSO) related climate anomalies have been shown to have an impact on infectious disease outbreaks. The Climate Prediction Center of the National Oceanic and Atmospheric Administration (NOAA/CPC) has recently issued an unscheduled El Niño advisory, indicating that warmer than normal sea surface temperatures across the equatorial eastern Pacific may have pronounced impacts on global tropical precipitation patterns extending into the northern hemisphere particularly over North America. Building evidence of the links between ENSO driven climate anomalies and infectious diseases, particularly those transmitted by insects, can allow us to provide improved long range forecasts of an epidemic or epizootic. We describe developing climate anomalies that suggest potential disease risks using satellite generated data. RESULTS: Sea surface temperatures (SSTs) in the equatorial east Pacific ocean have anomalously increased significantly during July - October 2006 indicating the typical development of El Niño conditions. The persistence of these conditions will lead to extremes in global-scale climate anomalies as has been observed during similar conditions in the past. Positive Outgoing Longwave Radiation (OLR) anomalies, indicative of severe drought conditions, have been observed across all of Indonesia, Malaysia and most of the Philippines, which are usually the first areas to experience ENSO-related impacts. This dryness can be expected to continue, on average, for the remainder of 2006 continuing into the early part of 2007. During the period November 2006 - January 2007 climate forecasts indicate that there is a high probability for above normal rainfall in the central and eastern equatorial Pacific Islands, the Korean Peninsula, the U.S. Gulf Coast and Florida, northern South America and equatorial east Africa. Taking into consideration current observations and climate forecast information, indications are that the following regions are at increased risk for disease outbreaks: Indonesia, Malaysia, Thailand and most of the southeast Asia Islands for increased dengue fever transmission and increased respiratory illness; Coastal Peru, Ecuador, Venezuela, and Colombia for increased risk of malaria; Bangladesh and coastal India for elevated risk of cholera; East Africa for increased risk of a Rift Valley fever outbreak and elevated malaria; southwest USA for increased risk for hantavirus pulmonary syndrome and plague; southern California for increased West Nile virus transmission; and northeast Brazil for increased dengue fever and respiratory illness. CONCLUSION: The current development of El Niño conditions has significant implications for global public health. Extremes in climate events with above normal rainfall and flooding in some regions and extended drought periods in other regions will occur. Forecasting disease is critical for timely and efficient planning of operational control programs. In this paper we describe developing global climate anomalies that suggest potential disease risks that will give decision makers additional tools to make rational judgments concerning implementation of disease prevention and mitigation strategies.

Africa↗