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Determining sequence length or content in zero, one, and two dimensions.

High-throughput assays are essential for the practical application of mutation detection in medicine and research. Moreover, such assays should produce informative data of high quality that have a low-error rate and a low cost. Unfortunately, this is not currently the case. Instead, we typically witness legions of people reviewing imperfect data at astronomical expense yielding uncertain results. To address this problem, for the past decade we have been developing methods that exploit the inherent quantitative nature of DNA experiments. By generating high-quality data, careful DNA-signal quantification permits robust analysis for determining true alleles and certainty measures. We will explore several assays and methods. In a one-dimensional readout, short tandem repeat (STR) data display interesting artifacts. Even with high-quality data, PCR artifacts such as stutter and relative amplification can confound correct or automated scoring. However, by appropriate mathematical analysis, these artifacts can be essentially removed from the data. The result is fully automated data scoring, quality assessment, and new types of DNA analysis. These approaches enable the accurate analysis of pooled DNA samples, for both genetic and forensic applications. On a two-dimensional surface (comprised of zero-dimensional spots) one can perform assays of extremely high-throughput at low cost. The question is how to determine DNA sequence length or content from nonelectrophoretic intensity data. Here again, mathematical analysis of highly quantitative data provides a solution. We will discuss new lab assays that can produce data containing such information; mathematical transformation then determines DNA length or content.

Artifacts↗

The European Thoracic Surgery Database project: modelling the risk of in-hospital death following lung resection.

OBJECTIVE: To identify pre-operative factors associated with in-hospital mortality following lung resection and to construct a risk model that could be used prospectively to inform decisions and retrospectively to enable fair comparisons of outcomes. METHODS: Data were submitted to the European Thoracic Surgery Database from 27 units in 14 countries. We analysed data concerning all patients that had a lung resection. Logistic regression was used with a random sample of 60% of cases to identify pre-operative factors associated with in-hospital mortality and to build a model of risk. The resulting model was tested on the remaining 40% of patients. A second model based on age and ppoFEV1% was developed for risk of in-hospital death amongst tumour resection patients. RESULTS: Of the 3426 adult patients that had a first lung resection for whom mortality data were available, 66 died within the same hospital admission. Within the data used for model development, dyspnoea (according to the Medical Research Council classification), ASA (American Society of Anaesthesiologists) score, class of procedure and age were found to be significantly associated with in-hospital death in a multivariate analysis. The logistic model developed on these data displayed predictive value when tested on the remaining data. CONCLUSIONS: Two models of the risk of in-hospital death amongst adult patients undergoing lung resection have been developed. The models show predictive value and can be used to discern between high-risk and low-risk patients. Amongst the test data, the model developed for all diagnoses performed well at low risk, underestimated mortality at medium risk and overestimated mortality at high risk. The second model for resection of lung neoplasms was developed after establishing the performance of the first model and so could not be tested robustly. That said, we were encouraged by its performance over the entire range of estimated risk. The first of these two models could be regarded as an evaluation based on clinically available criteria while the second uses data obtained from objective measurement. We are optimistic that further model development and testing will provide a tool suitable for case mix adjustment.

Adult↗

Control charts 101: a guide to health care applications.

A control chart can be an effective way to display process data over time. It can differentiate common cause variation from special cause variation through the application of several probability-based interpretation rules. In addition, a control chart can be helpful in evaluating the effectiveness of a change. There are numerous types of control charts, and this tutorial was developed to guide the user through the selection process.

Data Collection↗

A multimedia perioperative record keeper for clinical research.

OBJECTIVE: To develop a multimedia perioperative recordkeeper that provides: 1. synchronous, real-time acquisition of multimedia data, 2. on-line access to the patient's chart data, and 3. advanced data analysis capabilities through integrated, multimedia database and analysis applications. DESIGN: To minimize cost and development time, the system design utilized industry standard hardware components and graphical. software development tools. The system was configured to use a Pentium PC complemented with a variety of hardware interfaces to external data sources. These sources included physiologic monitors with data in digital, analog, video, and audio as well as paper-based formats. DEVELOPMENT: The development process was guided by trials in over 80 clinical cases and by the critiques from numerous users. As a result of this process, a suite of custom software applications were created to meet the design goals. The Perioperative Data Acquisition application manages data collection from a variety of physiological monitors. The Charter application provides for rapid creation of an electronic medical record from the patient's paper-based chart and investigator's notes. The Multimedia Medical Database application provides a relational database for the organization and management of multimedia data. The Triscreen application provides an integrated data analysis environment with simultaneous, full-motion data display. CONCLUSION: With recent technological advances in PC power, data acquisition hardware, and software development tools, the clinical researcher now has the ability to collect and examine a more complete perioperative record. It is hoped that the description of the MPR and its development process will assist and encourage others to advance these tools for perioperative research.

Database Management Systems↗

The stigma of burns Perceptions of burned patients' relatives when facing discharge from hospital.

The objective of this ethnographic study was to investigate the cultural meanings reported by 25 relatives of burned patients about their loved one's impending hospital discharge. Data were collected by means of participant observation and semi-structured interviews conducted during hospital visiting hours, and support group meetings with relatives. The following inter-related phases were considered in the analysis process: reading of the material and data reduction (selection of data using the objective of the study as a guide), data display, conclusion outlining, and verification. Following this process, the data were coded and similar codes were grouped into categories. It was found that the relatives of burned patients felt afraid when faced with the prospect of hospital discharge. Their descriptions reveal the family's feelings and attitudes in face of other people's reactions, and in face of the patient's own reactions in the context of possible changes in their social roles.

Adolescent↗

An application system for automation of constant-time radio frequency electron paramagnetic resonance imaging.

A Windows based application system for data collection, Fourier reconstruction and analysis of pure phase encoded constant-time radio frequency electron paramagnetic resonance (EPR) images, is described. The graphical user interface (GUI) of the system was written in MATLAB version 5.0, using its built-in GUI utilities. Design considerations of the application system included speed, flexibility and user-friendly data display and analysis. To maximize the speed of image data collection, MATLAB's built-in C interface system, MEX was not used for data collection. Instead, MATLAB programs call the C programs from the DOS prompt directly, based on the data collection parameters entered through the GUI. Computational procedures included various digital signal-processing steps such as filtering, interpolation etc. for the Fourier reconstruction of 2D, and 3D EPR images from the pure phase encoded data. Examples of 2D images illustrating the performance of the system are presented. Although the application system has been developed for the specific purpose of EPR imaging, it can easily be adapted to other areas such as magnetic resonance microscopy as well.

Electron Spin Resonance Spectroscopy↗

Global monitoring of influenza: potential contribution of national networks from a French perspective.

The aim of global monitoring of influenza is to help decision making in regular seasonal influenza and in the case of a new pandemic. FluNet is the main tool for information sharing among the WHO Global Influenza Surveillance Network, as well as the public. It allows 112 WHO National Influenza Centers in 83 countries access to remote data entry. Weekly information on recent isolates and epidemiological situations are available to the public through many functionalities, for example, maps (animated or static), charts and raw data are embedded in the system for data display. Thus far, FluNet has collected weekly influenza surveillance data from up to 1997. A major outcome of this global network is the influenza vaccine composition, which is proposed twice a year (i.e., for both hemispheres) on the basis of the collected data. However, FluNet is far from performing comprehensive monitoring of influenza at a global level; 109 WHO member states still do not participate in the network and participating national influenza centers have only limited resources, which do not allow them to implement a reliable, accurate and real-time epidemiology of influenza in the areas they deserve. By following the time and space dynamics of an influenza strain, an epidemiologically valid system would make assessment of decisions after adopting preventive measures (e.g., closing schools, travel restriction, use of antivirals or of protective masks and mass immunization) possible. This international cooperation in public health fields must be considerably reinforced in the future, and should encourage database linkage with environmental information, allowing for the evaluation of the role of climate change, animal behavior or pollution involvement in disease.

Disease Outbreaks↗

Computerized graphic display of physiological data collected during human stereotactic surgery.

An on-line computerized graphic display has been developed for use during stereotactic operations. This depicts in the form of figurine charts and alph-numeric symbols, appropriately oriented on saggital brain diagrams, the results of serial threshold stimulation of the brain. The display facilitates choice of target sites and the data can be stored in a tape library from which search-and-plot programs can be activated for any type or combination of types of response.

Brain↗

Left ventricular pressure and volume data acquisition and analysis using LabVIEW.

To automate analysis of left ventricular pressure-volume data, we used LabVIEW to create applications that digitize and display data recorded from conductance and manometric catheters. Applications separate data into cardiac cycles, calculate parallel conductance, and calculate indices of left ventricular function, including end-systolic elastance, preload-recruitable stroke work, stroke volume, ejection fraction, stroke work, maximum and minimum derivative of ventricular pressure, heart rate, indices of relaxation, peak filling rate, and ventricular chamber stiffness. Pressure-volume loops can be graphically displayed. These analyses are exported to a text-file. These applications have simplified and automated the process of evaluating ventricular function.

Analog-Digital Conversion↗

An overview of data transformation.

There is an increasing awareness of the need to examine data distribution or assumptions prior to performing statistical analyses. If the data display evidence of violating assumption(s), the researcher can perform data transformation. This article focuses on explaining data transformations, discussing common transformations, providing rationale for performing them, and discussing interpretation of the transformation when results are presented.

Data Interpretation, Statistical↗

Accuracy of the volume and pressure displays of high frequency oscillators.

OBJECTIVE: To determine the effect of frequency on the accuracy of volume and pressure displays of high frequency oscillators. METHODS: The effect of frequency on the displayed volume of the Stephanie, Dräger Babylog 8000 Plus, and SLE 5000 oscillators was assessed. A sine wave pump delivered a constant tidal volume at frequencies of 5-15 Hz to the patient manifold of the oscillators. The displayed volumes at each frequency were compared with the delivered volume. The effect of frequency on displayed pressure was assessed by connecting the oscillator's patient manifold to a lung model; three types of oscillator were studied (SensorMedics 3100A, SLE 5000, and Stephanie). Airway pressure was measured from the manifold using a pressure transducer and non-compliant tubing; the pressure measuring system had a flat frequency response to 30 Hz. RESULTS: The SLE 5000 volume display overread the delivered volume (by about 5%), but was not affected by frequency. At 5 Hz, the Dräger Babylog 8000 Plus and the Stephanie underread the delivered volume (by about 20%). Increasing frequency resulted in a greater discrepancy between the delivered and displayed volume with the Stephanie, but a smaller discrepancy with the Dräger Babylog 8000 Plus. Altering frequency had a small effect (maximum difference 6%) on the relation between the displayed and delivered pressure for all three oscillators. CONCLUSION: Frequency affects the accuracy of displayed volumes and, to a lesser extent, displayed pressures of high frequency oscillators. The results emphasise that data displayed by new devices should not be uncritically accepted.

Chronic Disease↗

Observing gay, lesbian and heterosexual couples' relationships: mathematical modeling of conflict interaction.

Two samples of committed gay and lesbian cohabiting couples and two samples of married couples (couples in which the woman presented the conflict issue to the man, and couples in which the man presented the conflict issue to the woman) engaged in three conversations: (1) an events of the day conversation (after being apart for at least 8 hours), (2) a conflict resolution conversation, and (3) a pleasant topic conversation. The observational data were coded with a system that categorized specific affects displayed. Data were weighted and two time-series created, one for the husband and one of the wife. The time series were modeled with nonlinear difference equations (Cook et al., 1995), and parameters were estimated that indexed uninfluenced steady state, influenced steady state, emotional inertia, repair effectiveness and threshold, and the power of positive and negative affect of one partner to affect the other partner.

Adult↗

Challenges in systematic reviews that assess treatment harms.

An evidence synthesis of a medical intervention should assess the balance of benefits and harms. Investigators performing systematic reviews of harms face challenges in finding data, rating the quality of harms reporting, and synthesizing and displaying data from different sources. Systematic reviews of harms often rely primarily on published clinical trials. Identifying important harms of treatment and quantifying the risk associated with them, however, often require a broader range of data sources, including unpublished trials, observational studies, and unpublished information on published trials submitted to the U.S. Food and Drug Administration. Each source of data has some potential for yielding important information. Criteria for judging the quality of harms assessment and reporting are still in their early stages of development. Investigators conducting systematic reviews of harms should consider empirically validating the criteria they use to judge the validity of studies reporting harms. Synthesizing harms data from different sources requires careful consideration of internal validity, applicability, and sources of heterogeneity. This article highlights examples of approaches to methodologic issues associated with performing systematic reviews of harms from 96 Evidence-based Practice Center evidence reports.

Evidence-Based Medicine↗

A convenient procedure for transfer blotting of coomassie blue stained proteins from PAGE gels to transparencies.

Proteins stained with Coomassie Brilliant Blue I were transferred effectively by blotting from polyacrylamide gel electrophoresis (PAGE) gels to transparencies of the type used in plain-paper copiers. The details of the original electropherogram were retained on transfer and did not fade over a period of three years. Both the protein and the associated dye transfer; however, protein does not transfer in the absence of dye. Protein patterns present in several types of gels--sodium dodecyl sulfate (SDS)-PAGE, non-denaturing PAGE, isoelectric focusing PAGE and SDS-agarose--all transferred successfully after staining with dye 1. Proteins visualized with other organic dyes such as Fast Green FCF 2, Uniblue A 3 and Procion Blue MX-R 4 also transferred, but proteins stained with Stains-all 5 or silver did not. This transfer provides a simple, economical way to preserve data from slab gel electrophoresis and a convenient method to display data using an overhead projector. The blotted transparencies are also excellent substrates for use with gel scanning densitometers.

Coloring Agents↗

Visualization and interactive analysis of blood parameters with InfoZoom.

This paper describes the application of the data analysis tool InfoZoom to a database containing the results of blood examinations for about 400 patients with a suspect of thrombosis. The main goal was to find correlations between the measurements and the occurrence of a thrombosis. No automatic method for data mining is used. Instead, InfoZoom uses a novel technique to display data sets as highly compressed tables which always fit completely onto the screen. The user can interactively explore animated tabular views of the data. In this way, the user gets a feeling of the data, detects interesting knowledge, and gains a deep understanding of the data set.

Databases, Factual↗