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Biomedical subjects

A Capitano

Publications and source records attributed to A Capitano.

3 recordsLinked to original sources

Imaging of three-dimensional epithelial architecture and function in cultured CaCo2a monolayers with two-photon excitation microscopy.

The principal functions of the gastrointestinal tract mucosa include nutrient absorption, protein and fluid secretion, and the regulated symbiosis with intraluminal contents. Research in epithelial biology has benefited significantly from the use of cultured monolayer preparations, which closely replicate the structure and function of normal gastrointestinal mucosa. Given the explicit importance of epithelial architecture to its physiology, investigations of epithelial biology should be enhanced by the capacity to track microscopic structures and substances in live cells. In order to achieve this goal, it is necessary to employ a microscopic technique with the capability of imaging deep into the tissue or cell preparation, without adversely affecting its physiology. Two-photon excitation microscopy may constitute such a technique, due to its ability to provide fluorescence excitation of fluorophores using near infrared radiation, that has lower tissue absorption and scattering coefficients. This allows the efficient collection of light energy from sites hundreds of microns deep, with only minimal tissue damage. In this report, we have presented an introduction to the theory and practice of two-photon microscopy for imaging the GI tract epithelium, and have presented examples of its utility in discerning three-dimensional structure and function in CaCo2A epithelial cell monolayers.

Caco-2 Cells↗

Changes in diagnostic decision-making after a computerized decision support consultation based on perceptions of need and helpfulness: a preliminary report.

We examined the degree to which attending physicians, residents, and medical students' stated desire for a consultation on difficult-to-diagnose patient cases is related to changes in their diagnostic judgments after a computer consultation, and whether, in fact, their perceptions of the usefulness of these consultations are related to these changes. The decision support system (DSS) used in this study was ILIAD (v4.2). Preliminary findings based on 16 subjects' (6 general internists, 4 second-year residents in internal medicine, and 6 fourth-year medical students) workup of 136 patient cases indicated no significant main effects for 1) level of experience, 2) whether or not subjects indicated they would seek a diagnostic consultation before using the DSS, or 3) whether or not they found the DSS consultation in fact to be helpful in arriving at a diagnosis (p > .49 in all instances). Nor were there any significant interactions. Findings were similar using subjects or cases as the unit of analysis. It is possible that what may appear to be counter-intuitive, and perhaps irrational, may not necessarily be so. We are currently examining potential explanatory hypotheses in our ongoing current, larger study.

Attitude to Computers↗

Effects of a decision support system on the diagnostic accuracy of users: a preliminary report.

OBJECTIVES: To assess the effects of incomplete data upon the output of a computerized diagnostic decision support system (DSS), to assess the effects of using the system upon the diagnostic opinions of users, and to explore if these effects vary as a function of clinical experience. DESIGN: Experimental pilot study. Four clusters of nine cases each were constructed and equated for case difficulty. Definitive findings were omitted from the case abstracts. Subjects were randomly assigned to one of four clusters and were trained on the DSS prior to use. SUBJECTS: The study involved 16 physicians at three levels of clinical experience (six general internists, four residents in internal medicine, and six fourth-year medical students), from three academic medical centers. PROCEDURE: Each subject worked up nine cases, first without and then with ILIAD consultation. They were asked to offer up to six potential diagnoses and to list up to three steps that should be the next items in the diagnostic workup. Effects of DSS consultation were measured by changes in the position of the correct diagnosis in the lists of differential diagnoses, pre- and post-consultation. RESULTS: The DSS lists of diagnostic possibilities contained the correct diagnosis in 38% of cases, about midway between the levels of accuracy of residents and attending general internists. In over 70% of cases, the DSS output had no effect on the position of the correct diagnosis in the subjects' lists. The system's diagnostic accuracy was unaffected by the clinical experience of the users.

Decision Making↗