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At least 523 records · Page 29Linked to original sources

PubMed2000

Should weaker study designs ever be preferred over randomised controlled trials.

Randomised controlled trials are typically cited as the 'best' form of study design to be used when comparing the efficacy or effectiveness of different devices such as pressure-redistributing beds and mattresses. This article presents a RCT that compared two forms of alternating pressure air mattress. No statistically significant differences were found between the incidence of sores upon the two mattresses. However the study was under-powered, and so was unlikely to identify differences in efficacy should they have existed. In discussion it is suggested that randomised controlled trials may be less useful to those purchasing mattresses than 'weaker' study designs that capture the experience of the users of such devices.

Adult↗

PubMed2006

Blood blockages and scolding nurses: barriers to adolescent contraceptive use in South Africa.

A third of adolescent girls in South Africa become pregnant before the age of 20, despite contraception being free and mostly accessible. This qualitative study was undertaken in Limpopo Province in 1997 on the barriers to adolescent girls accessing clinic services for contraception. Thirty-five in-depth interviews and five group discussions were conducted with girls aged 14-20, and interviews with nursing staff at 14 clinics. Many of the girls described pressure from male partners and family members to have a baby or prove their fertility. Other barriers to sustained contraceptive use included medically inaccurate notions about how conception occurs and fears about the effects of contraception on fertility and menstruation, which were not taken seriously by nurses. Nurses' attempts to stigmatise teenage sexuality, their scolding and harsh treatment of adolescent girls, and their unwillingness to acknowledge adolescents' experiences as contraceptive users, undermined the effective use of contraception by girls. Youth need better information on reproductive physiology and sexual health, and detailed information on contraception. Tools to enhance the accuracy and availability of knowledge in the clinic setting have a role, but need to be introduced along with initiatives to ensure that services are adolescent-friendly and do not stigmatise adolescent sexual activity.

Adolescent↗

PubMedDate not supplied

Retrieval of crystallographically-derived molecular geometry information.

The crystallographically determined bond length, valence angle, and torsion angle information in the Cambridge Structural Database (CSD) has many uses. However, accessing it by means of conventional substructure searching requires nontrivial user intervention. In consequence, these valuable data have been underutilized and have not been directly accessible to client applications. The situation has been remedied by development of a new program (Mogul) for automated retrieval of molecular geometry data from the CSD. The program uses a system of keys to encode the chemical environments of fragments (bonds, valence angles, and acyclic torsions) from CSD structures. Fragments with identical keys are deemed to be chemically identical and are grouped together, and the distribution of the appropriate geometrical parameter (bond length, valence angle, or torsion angle) is computed and stored. Use of a search tree indexed on key values, together with a novel similarity calculation, then enables the distribution matching any given query fragment (or the distributions most closely matching, if an adequate exact match is unavailable) to be found easily and with no user intervention. Validation experiments indicate that, with rare exceptions, search results afford precise and unbiased estimates of molecular geometrical preferences. Such estimates may be used, for example, to validate the geometries of libraries of modeled molecules or of newly determined crystal structures or to assist structure solution from low-resolution (e.g. powder diffraction) X-ray data.

Journal Article↗

PubMed2003

Disability or end-of-life? Competing narratives in bioethics.

Bioethics, and indeed much ethical writing generally, makes its point through narratives. The religious parable no less than the medical teaching case uses a simple story to describe appropriate action or the application of a critical principle. While powerful, the telling story has limits. In this paper the authors describe a simple teaching case on "end-of-life" decision making that was ill received by its audience. The authors ill-received example, involving the disconnection of ventilation in a patient with ALS (Lou Gherig's Disease) was critiqued by audience members with long-term experience as ventilation users. In this case, the supposedly simple narrative of the presenters conflicted with the life histories of the audience. The lessons of this story, and the conflict that resulted, speak critically to the limits of simple teaching cases as well as the strengths of narrative analysis as a tool for the exploration of bioethical case histories.

Amyotrophic Lateral Sclerosis↗

PubMed2004

Breast cancer with different prognostic characteristics developing in Danish women using hormone replacement therapy.

The aim of this study is to investigate the risk of developing prognostic different types of breast cancer in women using hormone replacement therapy (HRT). A total of 10 874 postmenopausal Danish Nurses were followed since 1993. Incident breast cancer cases and histopathological information were retrieved through the National Danish registries. The follow-up ended on 31 December 1999. Breast cancer developed in 244 women, of whom 172 were invasive ductal carcinomas. Compared to never users, current users of HRT had an increased risk of a hormone receptor-positive breast cancer, but a neutral risk of receptor-negative breast cancer, relative risk (RR) 3.29 (95% confidence interval (CI): 2.27-4.77) and RR 0.99 (95% CI: 0.42-2.36), respectively (P for difference=0.013). The risk of being diagnosed with low histological malignancy grade was higher than high malignancy grade with RR 4.13 (95% CI: 2.43-7.01) and RR 2.17 (95% CI: 1.42-3.30), respectively (P=0.063). For breast cancers with other prognostic characteristics, the risk was increased equally for the favourable and non favourable types. Current users of HRT experience a two- to four-fold increased risk of breast cancer with various prognostic characteristics, both the favourable and non favourable types. For receptor status, the risk with HRT was statistically significantly higher for hormone receptor-positive breast cancer compared to receptor-negative breast cancer.

Aged↗

PubMed2001

Unexpected ICD pulse generator failure due to electronic circuit damage caused by electrical overstress.

Because it is a lifesaving device, the unexpected failure of an ICD can be catastrophic. We report ICD electronic circuit failure due to electrical overstress damage (EOS) to the high voltage hybird circuit and other electronic components in a series of ICD pulse generator models. Data were obtained from the Multicenter Registry of Pacemaker and ICD Pacemaker and Lead Failures, and from the manufactures' adverse event reports, that were in the FDA's Manufacturer and User Facility Device Experience (MAUDE) database. Of 16 nonbattery Guidant/CPI ICD pulse generator failures reported to the registry, 6 (38%) have been confirmed by the manufacturer to be EOS related, and Guidant/CPI has reported 273 such failures to the FDA as of 12/29/00. The signs of failure included loss of telemetry and inability to deliver therapy, and some patients have experienced serious adverse events. Hybrid circuit damage may have occurred during capacitor charging or reform, and the majority appears to have happened during normal ICD function. While the incidence of this problem is unknown, a management strategy should be adopted that includes routine follow-up every 3 months and device evaluation after a shock or exposure to external defibrillation or electrosurgical devices. This study suggests that additional data are needed to determine the incidence of this problem, and that our present methods for monitoring the performance of ICD's following market release are inadequate.

Defibrillators, Implantable↗

PubMed2003

Intra-articular hyaluronans: a review of product-specific safety profiles.

BACKGROUND AND OBJECTIVES: Intra-articular (IA) hyaluronans (HAs) are indicated for pain relief of osteoarthritis (OA) of the knee. Hyalgan (sodium hyaluronate), Supartz (sodium hyaluronate), and Synvisc (hylan G-F 20) are Food and Drug Administration-approved HA products. They are derived from rooster combs; Hyalgan and Supartz are naturally derived (unmodified); Synvisc is chemically modified to increase its molecular weight. This article reviews and updates the safety data for IA HAs used for the treatment of knee OA. METHODS: References were taken from Medline through July 2002; respective product information services and information from the searchable United States Food and Drug Administration Manufacturer and User Facility Device Experience Database also were used. RESULTS: All products demonstrated favorable safety profiles in clinical trials and practice compared to other standard therapies for management of OA knee pain. The most common adverse event associated with HAs is mild injection site pain and swelling. Each product has had rare reports of pseudogout and anaphylactoid reactions. Product-specific adverse events, severe acute inflammatory reactions (pseudoseptic knee), in patients receiving Synvisc have been reported. One such patient developed antibodies to chicken proteins and hylan, suggesting an immunologic basis for the severe acute inflammatory reaction. Data from an animal study support a possible immunogenic difference between Synvisc and Hyalgan. CONCLUSIONS AND RELEVANCE: Overall, HA therapy is a safe treatment for OA knee pain, although there may be interproduct variability in safety profiles.

Adjuvants, Immunologic↗

PubMed1997

The effect of cocaine on mitogen-induced lymphyocyte proliferation in pregnant women.

Cocaine use during pregnancy is associated with increased risk of sexually transmitted diseases, including syphilis and HIV. Many sociological and economic factors related to cocaine use have been shown to contribute to this increased risk. Cocaine may also affect immunological function thereby increasing risk for sexually transmitted diseases. The objective of this study was to determine if cocaine suppresses mitogen-induced lymphocyte proliferation in pregnant women. Peripheral blood mononuclear cells were obtained from 39 pregnant women. Lymphocyte proliferation was stimulated with concanavalin A (conA, 1 microg/mL). Cocaine was added at time zero to one set of cultures and at 0, 24, and 48 hr to a second set of cultures (to correct for cocaine degradation in culture). Three doses of cocaine were used: 0.1, 1 and 10 microg/mL. The cells were pulsed with 1 microCi 3H thymidine at 72 hr and harvested 19 hr after addition of the isotope. Lymphocyte proliferation, as determined by radioactivity (cpm) was assessed. Cocaine had no statistically significant effect on conA-stimulated lymphocyte proliferation when added at time = 0 or when added daily. Cocaine, in concentrations similar to those found in clinical experiments with drug users, does not suppress in vitro concanavalin A-induced lymphocyte proliferation in cells obtained from pregnant women.

Cell Division↗

PubMedDate not supplied

Pulmonary artery rupture: serious complication associated with pulmonary artery catheters.

An analysis of the Manufacturer and User Facility Device Experience database of the Food and Drug Administration was conducted to identify adverse event reports associated with pulmonary artery catheter use between 1993 and 1999. Of 714 adverse event reports, there were 48 deaths of which 42 (88%) were related to pulmonary artery rupture. A further analysis of risk factors was conducted and found "postmenopausal female" was a most significant finding. Further study is recommended to establish a causal relationship.

Adult↗

PubMed2002

Usability of the revised NIOSH lifting equation.

Following the revision of the 1981 National Institute for Occupational Safety and Health (NIOSH) lifting equation, research needs related to the new equation were outlined. Aside from epidemiological studies, the need to evaluate the usability of the 1991 NIOSH equation in realistic work environments was expressed. This paper reports on extensive experiences with training users and application of the equation in varied work settings. Qualitative results from training sessions indicated that frequency, asymmetry and duration were the parameters that required relatively longer instruction periods and resulted in the most questions. Field applications indicated that the variable nature of lifting/lowering demands found in many jobs resulted in difficulty applying the equation. Approximately 35% of 1103 lifting and lowering tasks had at least one parameter outside of acceptable ranges, while a majority of workers (62.8%) reported other manual handling tasks that are counter to assumptions made in the development of the equation. The practical implications of the findings are discussed.

Guideline Adherence↗

PubMed2003

Formats of image data files that can be used for routine digital light micrography. Part one.

Failing to open computer files that describe image data is not the most frustrating experience that the user of a computer can suffer, but it is high on list of possible aggravations. To ameliorate this, the structure of uncompressed image data files is described here. The various ways in which information that describes a picture can be recorded are related, and a primary distinction between raster or bitmap based and vector or object based image data files is drawn. Bitmap based image data files are the more useful of the two formats for recording complicated images such as digital light micrographs, whereas object based files are better for recording illustrations and cartoons. Computer software for opening a very large variety of different formats of digital image data is recommended, and if these fail, ways are described for opening bitmap based digital image data files whose format is unknown.

Computer Graphics↗

PubMed2005

Proving the concept of a data broker as an emergent alternative to supra-enterprise EPR systems.

Electronic Patient Records systems configured into large enterprise models have become the assumed best route forward. In England, as in several other countries, this has expanded to a major meta-enterprise procurement programme. However, concerns are raised that such systems lack user ownership, and experience from other sectors shows difficulties with large enterprise systems. At a time of great change and once again shifting organizations, is this move simply building large and ponderous edifices with unstable materials? Latest software engineering research is now demonstrating the potential of an alternative model, enabling trusted information brokers to search out in real time at point of use data held in registered local and departmental systems. If successful, this could enable a new and less cumbersome paradigm. The data could move where needed whatever the service configuration. A concept demonstrator has been built set in the context of health and social care in England. It is important for all technological support to the health sector to be reviewed as new technologies emerge so as to identify and exploit new opportunities, and the results of this 3 year project show that the health record information broker route merits further investigative research.

Efficiency, Organizational↗

PubMed2006

Data standards for flow cytometry.

Flow cytometry (FCM) is an analytical tool widely used for cancer and HIV/AIDS research, and treatment, stem cell manipulation and detecting microorganisms in environmental samples. Current data standards do not capture the full scope of FCM experiments and there is a demand for software tools that can assist in the exploration and analysis of large FCM datasets. We are implementing a standardized approach to capturing, analyzing, and disseminating FCM data that will facilitate both more complex analyses and analysis of datasets that could not previously be efficiently studied. Initial work has focused on developing a community-based guideline for recording and reporting the details of FCM experiments. Open source software tools that implement this standard are being created, with an emphasis on facilitating reproducible and extensible data analyses. As well, tools for electronic collaboration will assist the integrated access and comprehension of experiments to empower users to collaborate on FCM analyses. This coordinated, joint development of bioinformatics standards and software tools for FCM data analysis has the potential to greatly facilitate both basic and clinical research--impacting a notably diverse range of medical and environmental research areas.

Cell Separation↗

PubMed1995

SAM: a system for iteratively building marker maps.

SAM (system for assembling markers) is a system which supports man-machine problem solving for iteratively ordering a set of markers. SAM aids the user in partially ordering a set of markers based on incomplete and uncertain data. As data is added and modified, SAM aids the user in updating the previously assembled maps. The input is a file of clones and for each clone, a list of the markers contained within it. The objective is to order the set of markers such that the markers contained in each clone are consecutive. The user directs the map building by selecting functions to assemble a region of markers, order the clones to fit the order of the markers and position new markers within an ordered set of markers. The user can edit the input data, edit the assembled map and add clones to the map based on their marker content. The results are displayed graphically and can be saved in a solution file. Based on the partial map, the user designs new experiments or edits the existing data to fill gaps and resolve ambiguities. When a previously assembled map is loaded into SAM, it is automatically updated with the new or altered data. SAM treats all markers as points, but has special features for multiple copy and long markers so that they can be used in the map building process. This system has supported the building of a YAC map of human chromosome 22 at the Sanger Centre, where use of Alu-PCR product markers is a major component in determining clone overlap and where we have an on-going effort to accumulate data from various sources. SAM is also being used at various other laboratories.

Algorithms↗

PubMed2002

Oligodb--interactive design of oligo DNA for transcription profiling of human genes.

MOTIVATION: The increasing use of customized oligo-DNA-microarrays has created a demand for convenient design of oligo nucleotides. The oligo-nucleotides have to serve as specific templates in the hybridization reaction. RESULTS: We have devised a web-based system for interactive design of suitable oligos for transcription profiling experiments with user-defined parameters. Oligodb is based on predicted human gene transcripts from the ENSEMBL project. The web interface allows the user to retrieve oligos for human transcripts in a flexible manner. Criteria for selecting the oligos are low similarity to all other known human genes, the absence of stable secondary structures, the length of the oligo, and the absence of low complexity regions. Furthermore, the user may select oligos corresponding to the desired position in the 5'-3' direction of the transcript, and based on the melting temperature. All data and results are tightly web-linked to the corresponding data entries of ENSEMBL project.

Algorithms↗

PubMed2002

Xdigitise: visualization of hybridization experiments.

UNLABELLED: Xdigitise is a software system for visualization of hybridization experiments giving the user facilities to analyze the corresponding images manually or automatically. Images of the high-density DNA arrays are displayed as well as the results of an external image analysis bundled with Xdigitise, e.g. the spot locations are marked and the duplicate correlations are shown by a color scale. AVAILABILITY: Xdigitise can be downloaded from http://www.molgen.mpg.de/~xdigitise.

Algorithms↗

PubMed2004

A tool for gene expression based PubMed search through combining data sources.

UNLABELLED: We present a new tool for the semi-automated querying of PubMed using a batch of tens to thousands of GenBank accession numbers or UniGene cluster ids. By combining information from UniGene and SWISS-PROT, microGENIE obtains information on the biological relevance of expressed genes, as identified by micro-array experiments, with minimal user intervention and time investment. AVAILABILITY: microGENIE is freely available from http://www.cs.vu.nl/microgenie SUPPLEMENTARY INFORMATION: The web site above supplies examples of input and output files.

Database Management Systems↗

PubMed1997

Working memory for sign language: a window into the architecture of the working memory system.

Traditionally, working memory has been divided into two major domains: verbal and visuo-spatial. The verbal domain of working memory can be characterized either by its relationship to language or by its grounding in auditory processing. Because of this ambiguity, languages that are not auditory and vocal (i.e., signed languages) pose a challenge to this conception of working memory. We describe several experiments with deaf users of American Sign Language (ASL) that explore the extent to which the architecture of working memory is determined by the constraints of auditory and visual processing and the extent to which it is determined by the characteristics of language. Various working memory effects were investigated: phonological similarity, word length, and articulatory suppression. The pattern of evidence strongly supports the existence of a sign-based 'rehearsal loop' mechanism parallel to the speech-based rehearsal loop. However, we also discuss evidence pointing to differences between the speech loop and the sign loop from forward and backward digit span tasks with deaf and hearing subjects. Despite their similarities based on linguistic properties, the speech loop and the sign loop appear to diverge due to the differing processing demands of audition and vision. Overall, the results suggest that the architecture of working memory is shaped both by the properties of language structure and by the constraints imposed by sensorimotor modality.

Journal Article↗