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Calculation of agonist efficacy, apparent affinity, and receptor population changes after administration of insurmountable antagonists: comparison of different analytical approaches.

The determination of the affinity and efficacy of an agonist in functional (as opposed to radioligand binding) experiments is necessary to explain its potency. Using modeled dose-response data both in their ideal form and with an added average deviation as well as previously published experimental data, a variety of analytical approaches were compared which differed in goodness-of-fit, ease of handling, and range of successful application. A nonlinear curve-fitting algorithm that analyzed several dose-response curves simultaneously and fitted them to an extended version of the operational model of Black and Leff (1983) (Proc R Soc Lond B 220:141-162) was demonstrated to be superior to the other approaches using the above criteria. However, judging from the limitations of the analytical approaches, claims of efficacy or affinity differences between agonists that are based on less than 10-fold numerical differences in the same behavioral paradigm should be viewed with skepticism. It was also found that simple inspection of dose-response curves obtained before and after administration of an insurmountable antagonist give estimates of fair accuracy under most circumstances.

Adrenergic alpha-Agonists↗

Decision analytic approach to severe head injury management.

Severe head injury management in the intensive care unit is extremely challenging due to the complex domain, the uncertain intervention efficacies, and the time-critical setting. We adopt a decision analytic approach to automate the management process. We document our experience in building a simplified influence diagram that involves about 3000 numerical parameters. We identify the inherent problems in structuring a model with unclear domain relationships, numerous interacting variables, and real-time multiple inputs. We analyze the effectiveness and limitations of the decision analytic approach and present a set of desiderata for effective knowledge acquisition in this setting. We also propose a semi-qualitative approach to parameter elicitation.

Craniocerebral Trauma↗

A population-based analytical approach to assessing patterns, determinants, and outcomes of health care with application to ectopic pregnancy.

OBJECTIVE: Health care has variable features, specific determinants, and consequences on people's health that should be investigated in a population perspective. We present a population-based analytical approach to assessing patterns, determinants, and outcomes of health care. METHODS: The approach uses standard epidemiological methods for sample selection and analysis, as well as statistical methods concerning model fitting and validation strategy. It also uses psychometric methods allowing pattern identification: factor analysis, cluster analysis, and polytomous logistic regression to investigate the factors associated with identified patterns of care. The approach is illustrated with an application to ectopic pregnancy (EP). RESULTS: EP diagnostic and therapeutic procedures appeared to be closely related, suggesting 3 differentiated patterns of care. Predictors of these patterns were not only the clinical features and the woman's prior gynecological history but also center characteristics and location. These patterns were found to influence immediate and middle-term outcomes and risk of recurrence of EP. CONCLUSIONS: We illustrate the feasibility and profitability of a population-based analytical approach to identify patterns, determinants, and consequences of care. This approach could be used to analyze other pathological conditions and health care systems.

Adolescent↗

Measuring health and disease: progress in analytical approaches.

In this paper, Dr. Martin reviews the progress in analytical approaches used in veterinary medicine between the 1970s and today. The newer applications are used in such activities as monitoring/surveillance, analysis of observational study data, evaluation of tests in the absence of gold standards, the analysis of clustered data (including geographically clustered data) and modeling disease in populations. Future work will be more complex but will demand an increased emphasis on ways to enhance our biological understanding of the results of data analysis and modeling.

Animals↗

[Anxiety as an existential phenomenon. An existential analytic approach to understanding and therapy of anxieties].

From the existential analytical point of view, anxiety is considered to be a basic theme of existence. The experience of being threatened is most commonly related to the physical and material aspects of life. But on a deeper level anxiety deals with the search for foundational and supporting structures for existence. When one loses the sense of safety of being held and of having shelter in a world that does not offer ultimate securities, one is prone to anxiety. Anxiety can therefore be perceived as a subjective parameter of feeling threatened in the existential structures. This paper gives an outline of an existential analytical approach to the understanding of fear and anxiety, a basic classification of anxieties, and an overview of the following specific methods of an existential treatment search for foundational structures of existence, personal position-taking, dereflexion (Frankl) and paradoxical intention (Frankl).

Anxiety Disorders↗

A semi-analytic approach to determine dose rate constant of brachytherapy sources in compliance with AAPM TG 60 formalism.

Values of dose rate constant (DRC) in compliance with AAPM TG 60 formalism recommended for intravascular brachytherapy (IVBT) were calculated for different point isotropic mono-energetic photon sources in the energy range E = 20-1000 keV using a semi-analytic model. Based on these DRC values, DRC of some existing models of 192Ir and 125I brachytherapy sources were then calculated using (1) bare energy spectra and (2) a single energy parameter which represents mean energy (photon number weighted or air-kerma weighted) for bare and actual sources or the most probable energy of the spectra (energy line with the highest probability of emission) of the investigated sources (192Ir and 125I). Applicability of the semi-analytic approach was examined by also computing the values of DRC of the investigated sources using MCNP Monte Carlo simulation code (Version 3.1) that involved modeling of the sources accurately. A comparison of values of DRC resulting from MCNP calculations with those resulting from the semi-analytic approach showed that for 192Ir sources the agreement was within 0.40% and for 125I sources it was within 2.3%.

Brachytherapy↗

Application of new methods and analytical approaches to research on polyunsaturated fatty acid homeostasis.

New methods and analytical approaches are important to challenge and/or validate established beliefs in any field including the metabolism of polyunsaturated fatty acids (PUFA; polyunsaturates). Four methods that have recently been applied toward obtaining a better understanding of the homeostasis of PUFA include the following: whole-body fatty acid balance analysis, magnetic resonance imaging (MRI), 13C nuclear magnetic resonance (NMR) spectroscopy, and gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS). Whole-body balance studies permit the measurement of both the percentage of oxidation of linoleate and alpha-linolenate and their conversion to long-chain PUFA. This method has shown that beta-oxidation to CO2 is normally the predominant metabolic fate of linoleate and alpha-linolenate. Furthermore, models of experimental undernutrition in both humans and animals show that beta-oxidation of linoleate and alpha-linolenate markedly exceeds their intake, despite theoretically sufficient intake of linoleate or alpha-linolenate. Preliminary results suggest that by using MRI to measure body fat content, indirect whole-body linoleate balance can be done in living humans. 13C NMR spectroscopy provided unexpected evidence that linoleate and alpha-linolenate were metabolized into lipids synthesized de novo, an observation later quantified by tracer mass balance done using GC-C-IRMS. This latter method showed that within 48 h of dosing with 13C-alpha-linolenate, >80% underwent beta-oxidation to CO2 by suckling rats, whereas 8-9% was converted to newly synthesized lipids and <1 % to docosahexaenoate. Further application of these recently developed methods in different models should clarify the emerging importance of beta-oxidation and carbon recycling in PUFA homeostasis in mammals including humans.

Animals↗

Verification of scale sub-domains in elderly patients with dementia: a confirmatory factor-analytic approach.

OBJECTIVE: Use of cognitive, psychiatric and behavioral domains to assess the effectiveness of a pharmacological or behavioral intervention in the treatment of neurodegenerative disorders (e.g., Alzheimer disease) aids the identification of specific types of impairment or distress in behavioral status and quality-of-life issues in this population. With confirmatory approaches to subscale development readily available, we can obtain a more precise understanding of the sub-components of a scale, potentially providing the basis for selecting behavioral and/or quality-of-life outcome measures that may be more sensitive to the effects of pharmacological or behavioral interventions. METHODS: The authors illustrate the use of a confirmatory factor-analytic approach to verify scale sub-domains of the Neurobehavioral Rating Scale (NBRS) in elderly patients with dementia. With data collected from two groups of patients being treated for significant psychiatric and behavioral symptoms, authors investigated the relationships among scale items in order to test several competing models, including a general one-factor model, a first-order multifactor model, and a second-order factor model. RESULTS: The first-order model, with seven factors, provided the best fit to the correlations among items in the NBRS, indicating the multidimensionality of problematic behaviors and symptoms exhibited by dementia patients. CONCLUSION: Authors advocate the use of a confirmatory factor-analytic approach to verify scale sub-domains in other, more widely used rating scales for patients with dementia.

Aged↗

Update of the Preclinical Situation of Anticancer Platinum Complexes: Novel Design Strategies and Innovative Analytical Approaches

Research in the field of bioinorganic chemistry has been stimulated by the worldwide success of the anticancer drug cisplatin. 40 years after the first report about its biological activity, carboplatin and oxaliplatin are in routine clinical use today, whereas nedaplatin, lobaplatin, and heptaplatin (SKI2053R) are only approved in Japan, China, and South Korea, respectively. Up to now, about 35 platinum complexes entered clinical trials in order to circumvent the side-effects and the problem of tumor resistance to cisplatin. Additionally, improvement of tumor selectivity as well as the need for a broader spectrum of indications are the motivations for tremendous efforts in the development of novel anticancer platinum-based drugs. New synthetic strategies and innovative analytical approaches provide a basis for a deeper understanding of the pharmacological profile of cisplatin and analogues (biodistribution, clearance, detoxification, side-effects, tumor specificity, cellular uptake, acquired or intrinsic resistance, platinum-DNA adduct removal by the cellular machinery) and give rise to a rational design of promising anticancer platinum coordination compounds. This article reviews the recent development of preclinical platinum complexes with interesting in vitro and in vivo tumor inhibiting properties. It focuses also on innovative synthetic strategies leading to novel classes of platinum complexes. A small part of the review is dedicated to new analytical approaches which have been supplied to or emerged in this field of research.

Antineoplastic Agents↗

Analytical approach for the Floquet theory of delay differential equations.

We present an analytical approach to deal with nonlinear delay differential equations close to instabilities of time periodic reference states. To this end we start with approximately determining such reference states by extending the Poincaré-Lindstedt and the Shohat expansions, which were originally developed for ordinary differential equations. Then we systematically elaborate a linear stability analysis around a time periodic reference state. This allows us to approximately calculate the Floquet eigenvalues and their corresponding eigensolutions by using matrix valued continued fractions.

Journal Article↗

Cost-effectiveness analysis of colorectal cancer screening strategies in Singapore: a dynamic decision analytic approach.

A dynamic decision analytic framework using local statistics and expert's opinions is put to study the cost-effectiveness of colorectal cancer screening strategies in Singapore. It is demonstrated that any of the screening strategies, if implemented, would increase the life expectancy of the population of 50 to 70 years old. The model also determined the normal life expectancy of this population to be 76.32 years. Overall, Guaiac Fecal Occult Blood Test (FOBT) is most cost effective at SGD162.11 per life year saved per person. Our approach allowed us to model problem parameters that change over time and study the utility measures like cost and life expectancy for specific age within the range of 50- 69 through to 70 years old.

Aged↗

What Can Studies of Problem-Based Learning Tell Us? Synthesizing and Modeling PBL Effects on National Board of Medical Examination Performance: Hierarchical Linear Modeling Meta-Analytic Approach.

This meta-analytic study 1) examines outcomes from primary research comparing the impact of problem-based learning (PBL) and traditional curricula on medical students' National Board of Medical Examiners (NBME) I and II performance and 2) explores the use of Hierarchical Linear Modeling (HLM) in identifying study and PBL implementation characteristics that predict these outcomes. NBME I and II overall scores were used as dependent variables, with study design (randomized/non-randomized), publication year, and PBL experience (number of years since the adoption of PBL as an instructional method at the time of the reported NBME results) as explanatory variables. Initial unconditional HLM (i.e., without inclusion of potential explanatory variables) results indicated PBL curricula had: 1) a positive, albeit not statistically significant, effect on NBME II, with an average effect size of 0.16; and 2) a negative effect on NBME I, with an average effect size of -0.15. Including explanatory variables in HLM analyses explained additional variability in NBME I effect sizes, and identified study design (gamma^1 = 0.82, p = 0.01) and PBL experience (gamma^3 = 0.07, p = 0.02) as significant predictors of positive PBL effects. Publication year, in contrast, had significant negative effects (gamma^2 = -0.06, p = 0.02). This study explained variability in NBME I effect sizes and clarified the impact of PBL discerned in previous reviews. Implications for future research include the need to examine curriculum features that operationally define PBL, as well as extend the consideration of outcomes on which PBL's impact can be examined.

Journal Article↗

Analytic approaches for assessing long-term treatment effects. Examples of empirical applications and findings.

Analytic approaches, including the structural equation model (autoregressive panel model), hierarchical linear model, latent growth curve model, survival/event history analysis, latent transition model, and time-series analysis (interrupted time series, multivariate time-series analysis) are discussed for their applicability to data of different structures and their utility in evaluating temporal effects of treatment. Methods are illustrated by presenting applications of the various approaches in previous studies examining temporal patterns of treatment effects. Recent advancements in these longitudinal modeling approaches and the accompanying computer software development offer tremendous flexibility in examining long-term treatment effects through longitudinal data with varying numbers and intervals of assessment and types of measures. A multimethod assessment will contribute to a more complete understanding of the complex phenomena of the long-term courses of substance use and its treatment.

Alcoholism↗

Theory of the BOLD effect in the capillary region: an analytical approach for the determination of T2 in the capillary network of myocardium.

This article presents an analytical approach for the quantification of the blood oxygen level dependent (BOLD) effect in the capillary region. The capillary geometry of myocardium is considered. The relaxation rate R*2 is determined as a function of the capillary radius Rc, the intracapillary volume fraction RBV, and the diffusion coefficient D. When the intracapillary volume fraction is small, the approximation R*2 = RBV x tau(-1) x (square root of (1+(taudeltaomega)2)-1) is valid, with the correlation time tau = (Rc2/4D) x (absolute value (ln RBV)/(1 - RBV)). The predictions of this model agree well with numerical simulations and experimental data of others and with data recently measured by our group.

Animals↗

Analytical approach to heterogeneity correction factor calculation for brachytherapy.

In brachytherapy treatment planning, the effects of tissue and applicator heterogeneities are commonly neglected due to lack of accurate, general, and fast three-dimensional (3D) dose-computational algorithms. A novel approach, based on analytical calculation of scattered photon fluxes inside and around a disk-shaped heterogeneity, has been developed for use in the three-dimensional scatter-subtraction algorithm. Specifically, our model predicts the central-ray dose distribution for a collimated photon isotropic source or brachytherapy "minibeam" in the presence of a slab of heterogeneous material. The model accounts for the lateral dimensions, location, composition, density, and thickness of the heterogeneity using precalculated scatter-to-primary ratios (SPRs) for the corresponding homogeneous problem. The model is applicable to the entire brachytherapy energy range (25 to 662 keV) and to a broad range of materials having atomic numbers of 13 to 82, densities of 2.7 g.cm-3 (Al) to 21.45 g.cm-3 (Pt) and thicknesses up to 1 mean free path. For this range of heterogeneous materials, the heterogeneity correction factors (HCFs) vary from 0.09 to 0.75. The model underestimates HCF when multiple scattering prevails and overestimates HCF when absorption dominates. However, the analytic model agrees with Monte Carlo photon transport (MCPT) benchmark calculations within 1.8% to 10% for 125I, 169Yb, 192Ir, and 137Cs for a wide variety of materials, with the exception of Ag. For 125I shielded by Ag, where the mean discrepancy can exceed 25%, the error is due to K-edge characteristic x rays originating within the heterogeneity. The proposed approach provides reductions in CPU time required of 5 x 10(4)-10(5) and 100 in comparison with direct MCPT simulation and 1D numerical integration, respectively. The limitations of model applicability, as determined by the physical properties of heterogeneity material and accuracy required, are also discussed.

Algorithms↗

Confocal Raman-spectroscopy: analytical approach to solid dispersions and mapping of drugs.

PURPOSE: To compare the physical state of a drug in a liquid with a polymeric matrix. METHODS: Solid solutions of ibuprofen in polyvinylpyrrolidone were obtained from the hot melt extrusion technique. In order to investigate the physicochemical stability, content, and homogeneity of the formulation, the tablets produced by a subsequent calendering step were examined using confocal Raman spectroscopy. In addition, a dimeric vinylpyrrolidone was synthesized and used to compare the physical state of embedding in a polymeric matrix with a physical solution of the active in a solvent, i.e. the dimeric vinylpyrrolidone. The spatial resolution of confocal Raman spectroscopy was used to image the drug distribution in the final form. RESULTS: Confocal Raman spectroscopy has been successfully used to determine the state of ibuprofen in a solid matrix showing equivalence to a physical solution. Moreover, the physicochemical stability of the formulation under stress conditions and content, as well as homogeneity of drug distribution in the formulation matrix, has been examined with the same method, proving the efficiency of the approach. CONCLUSIONS: Confocal Raman spectroscopy offers a new approach for the analytical assessment of solid dispersions both covering the physical state as well as the distribution of the drug via its spatial resolution. Moreover, it is a promising tool for observing changes in a formulation due to physicochemical processes, e.g. recrystallisation and at the same time for locating the area where changes occur. Therefore, it may contribute to standard analytical methods to evaluate content and homogeneity.

Administration, Oral↗

Static, oscillating modulus, and moving pulses in the one-dimensional quintic complex Ginzburg-Landau equation: an analytical approach.

By means of a matching approach we study analytically the appearance of static and oscillating-modulus pulses in the one-dimensional quintic complex Ginzburg-Landau equation without nonlinear gradient terms. When considering nonlinear gradient terms the method enables us to calculate the velocities of the stable and unstable moving pulses. We focus on this equation since it represents a prototype envelope equation associated with the onset of an oscillatory instability near a weakly inverted bifurcation. The results obtained using the analytic approximation scheme are in good agreement with direct numerical simulations. The method is also useful in studying other localized structures like holes.

Journal Article↗