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Rapid method for screening dried blood samples on filter paper for human immunodeficiency virus type 1 DNA.

PCR is a highly sensitive method for the detection of human immunodeficiency virus type 1 (HIV-1) nucleic acids in blood mononuclear cells and plasma. However, blood separation techniques require extensive laboratory support systems and are difficult when a limited volume of blood is available, which is often the case for infants. The use of blood samples stored on filter paper has many advantages for the detection of perinatal HIV-1 infection, but current methods require extraction and purification of target DNA prior to PCR amplification. We report a highly sensitive and rapid method for the extraction and detection of HIV-1 DNA in infant blood samples stored on filter papers. Because this rapid protocol does not involve steps for the removal of potential inhibitors of the PCR, the highest sensitivity is achieved by testing the filter paper lysate in quadruplicate. Assays for HIV-1 DNA were done by using nested PCR techniques that amplify HIV-1 gag DNA from blood spot samples on filter paper and from corresponding viably frozen mononuclear cells separated from venous blood samples obtained from 111 infants born to HIV-1-seropositive mothers. PCR results with blood from filter papers showed 100% specificity (95% confidence internal [CI] 93.1 to 100%) and 96% (95% CI, 88.65 to 98.9%) and 88% (95% CI, 79.2 to 94.5%) sensitivity (for quadruplicate and duplicate tests, respectively) compared to PCR results with blood mononuclear cells. Moreover, this method could detect HIV-1 sequences of multiple subtypes.

Blood↗

Evaluating "payback" on biomedical research from papers cited in clinical guidelines: applied bibliometric study.

OBJECTIVES: To develop a methodology for evaluating the impact of research on health care, and to characterise the papers cited on clinical guidelines. DESIGN: The bibliographic details of the papers cited in 15 clinical guidelines, developed in and for the United Kingdom, were collated and analysed with applied bibliometric techniques. RESULTS: The median age of papers cited in clinical guidelines was eight years; most papers were published by authors living in either the United States (36%) or the United Kingdom (25%)-this is two and a half times more than expected as about 10% of all biomedical outputs are published in the United Kingdom; and clinical guidelines do not cite basic research papers. CONCLUSION: Analysis of the evidence base of clinical guidelines may be one way of tracking the flow of knowledge from the laboratory to the clinic. Moreover, such analysis provides a useful, clinically relevant method for evaluating research outcomes and different strategies in research and development.

Bibliometrics↗

Passing on the legacy: teaching capillary filtration and developing presentation skills using classic papers.

Capillary filtration is a key area in the understanding of cardiovascular function and has both physiological and pathophysiological relevance in nearly every organ system. This article describes how classic papers in the Legacy collection of American Physiological Society publications can be used in a teaching symposium exploring the evidence supporting current concepts of capillary fluid exchange. Individual students are given papers to read, edit, and present to the class. The appropriate selection and sequencing of these papers allows the development of important physiological concepts to be tracked. A series of papers concerned with capillary filtration is suggested, and the contribution of each to the developing story is outlined. This approach allows students to develop critical and presentation skills and provides them with a case study of the scientific method as it is applied to physiology as well as establishing an appropriate knowledge base concerning the role of hydrostatic and oncotic forces in capillary fluid exchange. Relevant teaching points are explored further using questions based on a figure from one of the three classic papers used: "Microinjection studies of capillary permeability: II. The relationship between capillary pressure and the rate at which fluid passes through the walls of single capillaries," by E. M. Landis (Am J Physiol 82: 217-238, 1927).

Capillary Permeability↗

Essential food hygiene certificate examination: examination papers reviewed.

One thousand papers for the Essential Food Hygiene examination, chosen consecutively from those being processed in RSH House on 6-7 April 1994, were reviewed. The purpose of the review was to assess the impact of the redesigned course and the new examination papers which were introduced from 1 January 1994. The pass rate for the sample was 96.7% which was somewhat lower than the pass rate of 99.2% for the whole of 1993 when the previous examination papers were in use. Out of 1000 papers 33 were failures. Eighteen candidates had obtained the 70% pass mark yet still failed because one of the two questions on temperature control had been answered incorrectly. The requirement to answer both those questions correctly in order to obtain a certificate was introduced with the new examination papers and marked a major change. The conclusion from this snapshot study was that the majority of Tutors and the candidates from their courses had achieved a high degree of examination success. In particular, Tutors had secured a major objective by ensuring that trainees had a clear understanding of the concepts of temperature control. Only a minority were having difficulty. Of the 33 individuals who failed, 18 came from just four of the 108 courses.

Certification↗

Screening newborns for multiple organic acidurias in dried filter paper urine samples: method development.

Screening urine for inherited and acquired organic acidurias in newborns has the potential of preventing severe disease, mental retardation, and death. A method for screening dried urine filter paper samples for acidic markers of at least 20 different metabolic conditions has been developed. These conditions include, among others, maple syrup urine disease; methylmalonic, propionic, isovaleric, glutaric, and hydroxymethylglutaric acidurias; methylcrotonylglycinuria; medium-chain acyl-CoA dehydrogenase deficiency; inherited vitamin responsive disorders B12, biotin, B2), and acquired deficiencies of these vitamins. The preparation of the urine extract is identical to the method we use to screen infants for neuroblastoma. Screening is based on a highly sensitive and specific determination of eight organic acid markers by an automated computerized gas chromatography mass spectrometry system using selected ion monitoring. The markers used for screening are methylmalonic acid, 2-hydroxyisocaproic acid, glutaric acid, propionylglycine, isovalerylglycine, 3-methylcrotonylglycine, hexanoylglycine, and 3-phenylpropionylglycine. The extraction efficiencies of these acids from dried filter paper were similar to extraction from water, ranging from about 40% to 80%, except for propionylglycine which showed a low extraction efficiency of 11-13%. The stability of these acids on filter paper exposed to room air and temperature over a period of 15 d was adequate for the use of this collection method for organic aciduria screening. Normal levels, adjusted to urinary creatinine, were established for these acids in 519 urine filter paper samples obtained from 3-wk-old newborns. This screening method was tested on samples obtained from 12 patients with known organic acidurias including stored urine filter paper collected at 3-wk of age from two infants later found to have organic acidurias.

Amino Acids↗

Simultaneous color constancy: paper with diverse Munsell values.

Arend and Reeves [J. Opt. Soc. Am. A 3, 1743 (1986)] described measurements of color constancy in computer simulations of arrays of colored papers of equal Munsell value under 4000-, 6500-, and 10,000-K daylight illuminants. We report an extension of those experiments to chromatic arrays spanning a wide range of Munsell values. The computer-simulated scene included a standard array of Munsell papers under 6500-K illumination and a test array, an identical array of the same papers under 4000 or 10,000 K. Observers adjusted a patch in the test array in order to match the corresponding patch in the standard array by one of two criteria. They either matched hue and saturation or they made surface-color matches, in which the test patch was made to "look as if it were cut from the same pice of paper as the standard patch." The test and the standard patches were surrounded by a single color (annulus display) or by many colors (Mondrian display). The data agreed with those of our previous equal-value experiment. The paper matches were often approximately color constant. The hue-saturation matches were in the correct direction for constancy but were always closer to a chromaticity match (no constancy) than to the chromaticity required for hue-saturation constancy.

Adaptation, Ocular↗

Teaching how to prepare a manuscript by means of rewriting published scientific papers.

The objective of the course described here is to train undergraduate students to write a scientific manuscript. The students participate in selection of a current topic in contemporary genetics or molecular biology by choosing the most interesting paper of a given year. After the teacher provides all essential background about the selected subject, he or she selects a recent article from the corresponding field and presents the students with all the necessary information contained in the paper without revealing its title and author. The data presented in the paper are reviewed by the class so that each student understands every experiment and the main points of the work. Simultaneously, the students are informed about the basic rules of writing the individual sections of a scientific paper. They are then asked to write and formally submit a manuscript summarizing the data. Finally, the students act as reviewers of their colleagues' manuscripts and compare their papers with the original published articles. This enables them to identify both the strengths and the weaknesses of their manuscripts and to gain confidence in the writing skills that will be so critical for their future scientific activities.

Biomedical Research↗

Paper versus computer: feasibility of an electronic medical record in general pediatrics.

BACKGROUND: Implementation of electronic medical record systems promises significant advances in patient care, because such systems enhance readability, availability, and data quality. Structured data entry (SDE) applications can prompt for completeness, provide greater accuracy and better ordering for searching and retrieval, and permit validity checks for data quality monitoring, research, and especially decision support. A generic SDE application (OpenSDE) to support documentation of patient history and physical examination findings was developed and tailored for the domain of general pediatrics. OBJECTIVE: To evaluate OpenSDE for its completeness, uniformity of reporting, and usability in general pediatrics. METHODS: Four (trainee) pediatricians documented data for 8 first-visit patients in the traditional, paper-based, medical record and immediately thereafter in OpenSDE (electronic record). The 32 paper records obtained served as the common data source for data entry in OpenSDE by the other 3 physicians (transcribed record). Data entered by 2 experienced users, with all patient information present in the paper record, served as the control record. Data entry times were recorded, and a questionnaire was used to assess users' experiences with OpenSDE. RESULTS: Clinicians documented 44% of all available patient information identically in the paper and electronic records. Twenty-five percent of all patient information was documented only in the paper record, and 31% was present only in the electronic record. Differences were found in patient history and physical examination documentation in the electronic record; more information was missing for patient history (38%) than for physical examination (15%). Furthermore, physical examination contained more additional information (39%) than did patient history (21%). The interobserver agreement of documentation of patient information from the same data source was fair to moderate, with kappa values of 0.39 for patient history and 0.40 for physical examination. Data entry times in OpenSDE decreased from 25 minutes to <15 minutes, indicating a learning effect. The questionnaire revealed a positive attitude toward the use of OpenSDE in daily practice. CONCLUSION: OpenSDE seems to be a promising application for the support of physician data entry in general pediatrics.

Documentation↗

Office paper recycling: A function of container proximity.

We investigated the effects of proximity of containers on pounds of office paper recycled and not recycled by 25 employees. During a memo and central container condition, one container for recyclable paper was provided; in a memo and local container condition, desktop recycling bins, announced by memo, were successively introduced across administrative, office, and instructional settings using a multiple baseline design. Only 28% of paper was recycled in the central container condition, but when recycling containers were placed in close proximity to participants, 85% to 94% of all recyclable paper was recycled. Follow-up assessments, conducted 1, 2, 3, and 7 months after all settings received local recycling containers, showed that 84% to 98% of paper was recycled. Providing desktop recycling containers was a cost-effective procedure with long-term maintenance and program survival.

Journal Article↗

Re-using text from one's own previously published papers: an exploratory study of potential self-plagiarism.

A preliminary, two-part study explored the extent to which authors reuse portions of their own text from previously published papers. All 9 articles from a recent issue of a psychology journal were selected as target papers. Up to 3 of the most recent references cited in each of the target articles and written by the same authors were also obtained. All target articles and their corresponding references were stored digitally. Then, using specialized software, each reference was compared to its target article to assess the number of strings of text identical to both papers. Only one of the nine target articles reused significant amounts of text from one of its references. To explore further the possibility of additional text reuse, the references in each of the 9 sets of papers were compared against each other. The new comparison identified 5 pairs of papers with a substantial number of identical strings of text of 6 consecutive words in length or longer, but most of the reused text was confined to the Method section. The results suggest that some of these authors reuse their own text with some frequency, but this was largely confined to complex methodological descriptions of a research design and procedure.

Authorship↗

A comparison of linear, fixed-form computer-based testing versus traditional paper-and-pencil-format testing in veterinary medical education.

Computerized testing has made significant inroads into veterinary education. Traditional paper-and-pencil examination formats are being replaced by computer-based testing (CBT). Computer-administered, fixed-form tests, because they mimic most closely the familiar fixed-response paper-and-pencil test formats, might intuitively seem to be inherently equivalent to their paper-and-pencil counterparts. However, research examining test-mode effects on student performance presents a very mixed picture. Additionally, students often report that they feel their performance is adversely affected by CBT and that their grades on the computer-based exams are lower than they would have been on the more familiar paper-and-pencil format. In order to address student perceptions of negative impact and the mixed nature of the published research results on the topic, a study was conducted to assess whether the transition from paper-and-pencil to equivalent linear CBT exams did, in fact, affect students' examination scores. This study found no evidence for significant test-mode effects on student scores as a result of the introduction of computer-based testing into the veterinary curriculum.

Computer Literacy↗

Effect of brooding paper on the performance of bobwhite quail.

Three experiments were conducted to determine the response of bobwhite quail chicks when reared in pens with and without brooding paper. Half the chicks in each experiment was brooded Days 1 to 7 on brooding paper, which covered the litter within a brooder ring. The other half was brooded on either new or reused litter without paper. Results of all three experiments showed a consistent trend of higher 1-week body weights and lower cumulative 1 to 3 week mortality when birds were reared in pens without paper. Overall, no net performance advantages were found for rearing quail with brooding paper at the termination of the 3-week trials.

Animal Husbandry↗

Single-tube-genotyping of gastric cancer related SNPs by directly using whole blood and paper-dried blood as starting material.

AIM: To demonstrate an inexpensive method for typing gastric cancer related single nucleotide polymorphisms (SNPs) using whole blood or paper-dried blood as starting materials. METHODS: PCR amplification is directly carried out from the whole blood or paper-dried blood sample without any DNA extraction step. Before PCR, a blood sample, four primers, and all of biological reagents necessary for PCR were added at a time; After PCR, the amplified products were directly separated by slab gel electrophoresis or microchip CE without any purification. SNP typing was performed by tetra-primer PCR with two inner primers specific to each allele and two outer primers defining the length of allele-specific amplicons. Genotypes were directly discriminated by the size of amplicons specific to each allele, thereby avoiding any post-PCR process. RESULTS: Using a special PCR buffer, inhibitory substances in blood (including the anticoagulant in blood) and filter paper were effectively suppressed; a "true" single-tube-genotyping is thus realized. We successfully determined genotypes IL-1B-511 and IL-1B-31 polymorphisms at the gene IL-1B by using whole-blood and paper-dried blood samples as starting materials respectively. The method is so sensitive that 0.5-1.0 microL of blood sample is enough to give a satisfactory typing results. The genotyping results were confirmed by RFLP-PCR using purified genome DNA, indicating that amplification specificity was not affected by inhibitory components (including coagulants) in blood or filter paper. CONCLUSION: Compared with SNP typing methods based on purified DNA, the proposed method is labor-saving, simple, inexpensive, and less cross-contaminated. It is promising to use this method to type other SNPs.

Cost Control↗

Choosing to write the paper format thesis.

Graduate students today may be faced with the option of writing either a traditional format thesis or a paper format thesis. In contrast to the traditional format in which the text body consists of four or five chapters, the body of the paper format thesis can be comprised of an introductory chapter, two or more papers written as publishable manuscripts, and a conclusion. In this article, an overview of the paper format thesis is presented and contrasted with the traditional format thesis. The description of the paper format thesis is followed by its advantages and disadvantages for writers and readers. It is by weighing all possible pros and cons, as well as considering one's individual situation, that the graduate student will be able to decide which format of thesis to write.

Academic Dissertations as Topic↗

How to read a research paper.

A research paper includes several sections, each section having a particular purpose and containing a particular kind of information. This paper is a guide to reading a research paper. It describes the prototypical research paper and explains the purpose for each section. Issues for the astute reader to note are indicated and illustrated with examples from a research paper published in this issue of the journal.

Reading↗

[Computerized transformation of the cardiotocographic paper record to its digital equivalent for computerised analysis].

OBJECTIVE: To analyze cardiotocograph by computer, the tracings recorded in paper form must first be converted into their digital equivalent. We developed a method by which this process may be performed. METHODS: Paper recordings were first scanned using a conventional flat bed scanner to obtain a digital image. Each image was firstly corrected for rotational misalignment error during scanning and, sceondly the grid was removed by performing logistic contrast enhancement to leave the discrete fetal heart rate and tocographic tracings. The method was validated by comparing differences between the fetal heart rate obtained from the paper record with that directly obtained from the fetal monitor. RESULTS: Forty recordings were analyzed. The mean difference per recording between the actual and derived values ranged from -0.26(-)-1.26 beats per minute. The 95% confidence interval for the pooled differences between the derived and actual fetal heart rate values was--7-5 beats per minute. CONCLUSION: By using the techniques described in this paper, it is now possible to convert the large number of paper records available so that they can be analyzed by computerized cardiotocograph interpreters.

Cardiotocography↗

A White Paper. Professional chaplaincy: its role and importance in healthcare.

This paper describes the role and significance of spiritual care and is the first joint statement on this subject prepared by the five largest healthcare chaplaincy organizations in North America representing over 10,000 members. As a consensus paper, it presents the perspectives of these bodies on the spiritual care they provide for the benefit of individuals, healthcare organizations and communities. Throughout this paper, the word spirituality is inclusive of religion; spiritual care includes pastoral care. Spiritual caregivers in healthcare institutions are often known as chaplains although they may have different designations in some settings, i.e. spiritual care providers. The paper contains four sections. 1. The Meaning and Practice of Spiritual Care This first section describes spirit as a natural dimension of all persons and defines the nature of spiritual care. With the basic premise that attention to spirituality is intrinsic to healthcare, the paper establishes their relationship and outlines the various environments in which it is provided. 2. Who Provides Spiritual Care? Professional chaplains provide spiritual care and this section describes their education, skills and certification. 3. The Functions and Activities of Professional Chaplains This section delineates the typical activities of professional chaplains within healthcare settings, focusing on their care of persons and their participation in healthcare teams. 4. The Benefits of Spiritual Care Provided by Professional Chaplains The materials here describe how professional chaplains benefit healthcare patients and their families, staff members, employing organizations, and communities.

Clergy↗

[Publication rate of original papers orally presented at the Journées Françaises de Radiologie 1996].

OBJECTIVE: The purpose of the present study was to determine the publication rate in Medline-indexed journals of papers originally presented at the Journées Françaises de Radiologie (JFR96). MATERIALS AND METHODS: Proceedings from the JFR 96 were reviewed by two observers in conference. A Medline search encompassing 1997-1999 was performed for the lead author of all abstracts of original papers. Publication year and the journal of publication were recorded. RESULTS: 456 oral presentations were analysed, 39 papers were subsequently published corresponding to a publication rate of 8.5%. 10 papers were published in Radiology, 4 in European Radiology and 4 in the Journal de Radiologie, the other 21 in other journals. Publication rate was significantly higher for two sessions: Research session (publication rate was 22%) and Bone and Joint session (publication rate was 16%). CONCLUSION: Less than 10% of abstracts presented at JFR 96 were subsequently published in Medline-indexed journals. This rate is lower than the publication rate of papers presented at other medical meetings.

Congresses as Topic↗