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PubMedDate not supplied

Avoiding painful blood sampling in neonates by transcutaneous bilirubinometry.

BACKGROUND: Transcutaneous bilirubinometry, Bilicheck (kindly provided by Oxygen Care Company, Dublin) is a non-invasive, screening method for determining bilirubin levels in neonates. It has not previously been validated in Irish babies. AIMS: To determine the clinical accuracy and precision of Bilicheck measurements in comparison to total serum bilirubin (TSB) measurements in Irish neonates, and to determine whether Bilicheck is a useful non-invasive screening method of avoiding blood tests in neonates. METHODS: Correlation data were obtained from 53 neonates between simultaneous TSB and Bilicheck readings. Bilicheck was used to screen 100 neonates who were assessed as requiring serum bilirubin measurement. TSB was only performed on neonates whose Bilicheck was above the phototherapy line of a recognised serum bilirubin chart. RESULTS: Bilicheck and TSB were significantly correlated (r=0.890). Bland and Altman analysis showed that on average, Bilicheck read 30 micromol/l lower than TSB. Of 100 jaundiced neonates screened by Bilicheck, blood sampling was avoided in 70 because Bilicheck did not meet phototherapy guidelines. CONCLUSIONS: There is a good correlation between TSB and Bilicheck, although the latter tends to under-read by 30 micromol/l. Bilicheck may be a useful screening device to decrease the risks and discomfort associated with blood sampling in neonates.

Bilirubin↗

PubMed1981

The estimated age of staged human embryos and early fetuses.

The appearance of anatomic features during embryogenesis relative to menstrual history is not well established. The 621 staged human embryos and fetuses in the Carnegie Embryological Collection were examined, and morphologic features were recorded in 494 specimens in good condition, from 382 intrauterine, 49 ectopic, and 55 pregnancies of other or unknown source. There were menstrual data on 276 specimens, and for 10 the date of a single coitus was known. The embryo develops to 1 mm at the twenty-eighth menstrual day, after which its crown-rump length increases by 0.7 mm per day. Coital ages and postovulatory ages estimated from menstrual data correlated significantly (p less than 0.001) with crown-rump length and Carnegie stage, but estimated postovulatory age was highly variable (standard deviation, 10.5 days). Morphologic features appeared within a narrow interval (standard deviation, 0.0 to 1.5 Carnegie stages). Normal human embryogenesis is a stereotyped sequence with little statistical variation, but menstrual data in individual cases may be unreliable in dating this sequence.

Coitus↗

PubMed2005

Basic concepts of statistical analysis for surgical research.

Appropriate statistical analyses are an integral part of surgical research. The purpose of this work is to assist surgeons and clinicians with the interpretation of statistics by providing a general understanding of the basic concepts that lead to choosing an appropriate statistical test for common study designs. It is extremely important to understand the nature of the data before embarking on a statistical analysis. A researcher must design an appropriate study around the research hypothesis. Initially, data should be inspected using frequency distributions and graphical techniques. If the data are continuous, the normality of the distribution must be assessed. In addition, the data must be defined as independent or dependent. For normally distributed and independent samples, a two-sample t test is appropriate. A paired t test should be used for dependent data. The nonparametric counterpart to the t test is the Mann-Whitney U and the paired counterpart is the Wilcoxon signed rank. For binary data, contingency table methods such as a chi2 test apply unless the expected value is < 5; then, use the Fisher's exact test. The McNemar test applies to paired binary data. Correlation coefficients assess the association between two continuous distributions. Linear regression assesses trend. Multiple regression analysis is appropriate for multivariate analyses with a continuous outcome variable. Logistic regression methods would apply for binary outcomes. The quality of the analysis and subsequent results of any research project depend on an appropriate study design, data collection, and analysis to make meaningful conclusions.

Biomedical Research↗

PubMed1993

Typing method for N2-fixing bacteria based on PCR-RFLP--application to the characterization of Frankia strains.

DNA sequences of an intergenic spacer (IGS) and parts of genes in the nif cluster were amplified by the polymerase chain reaction (PCR) using two primers derived from nifD- and nifK-conserved sequences. The PCR products were cleaved by ten 4-base cutting restriction enzymes and the restriction patterns were used as fingerprints to type Frankia strains. The feasability of this PCR-RFLP method for typing Frankia strains was investigated on Frankia reference strains belonging mainly to the Elaeagnaceae infectivity group but also on new Frankia isolates and on other N2-fixing microorganisms. By modulating the stringency of the amplifications, we showed the method allowed to target either Frankia strains or the whole N2-fixing microbial community. DNA digestion patterns were used to estimate the sequence divergence between the Frankia nifD-K fragment. The estimated relationships deduced from these genotypic data correlated well with established Frankia taxonomic schemes.

Actinomycetales↗

PubMed1998

Identifying influential families using regression diagnostics for generalized estimating equations.

The Generalized Estimating Equations (GEE) is an approach to analyze correlated data. It is applied here to data from an epidemiological study of oesophageal cancer in a high incidence area in China to investigate familial aggregation. Regression diagnostics for mean structures and association structures are used to identify families that influence estimates of these structures. It is shown that most of the families influencing the mean structure have a low age of disease onset in common. Most families identified by regression diagnostics for the association structure influence the parent correlation. It is concluded that regression diagnostic techniques can be used to identify clusters influencing mean and association structures of the models.

China↗

PubMed2004

Zymographic detection and clinical correlations of MMP-2 and MMP-9 in breast cancer sera.

Matrix metalloproteinases, in particular the gelatinases MMP-2 and MMP-9, have received great attention in recent years as putative tumour markers for clinical applications. The main reason for the observed interest is their easy detection in body fluids. Moreover, recent evidence has shown multiple functions of MMPs, rather than simply degrading ECM, which include the mobilisation of growth factors and processing of surface molecules. Several authors have reported increased levels of MMPs in a number of cancers, but clinical correlations in breast cancer are still fragmentary. Thus, the aim of the present research was to investigate the activity levels of circulating gelatinases in the sera of breast cancer patients by means of zymographic analysis, and correlate data with clinicopathological parameters. In all, 80 patients and 22 healthy volunteers were involved in this study. Sera were obtained prior to surgery. The clinical variables were: grading of tumours, tumour size, lymph node involvement, tumour staging, oestrogen and progesterone receptor levels (76 out of 80 cases), and c-erbB-2 levels (46 cases). The densitometric measures of MMP-2 and MMP-9 activity levels indicated that the average values of both gelatinase activities were significantly higher in breast cancers than in control sera (P<0.0001). In addition, our analysis showed for the first time that elevated activity levels of both gelatinases correlated only with c-erbB-2 overexpression (P=0.0273 for MMP-2 and P=0.0075 for MMP-9). An inverse correlation was observed with regard to oestrogen receptor expression (P=0.0075 for MMP-2 and P=0.0273 for MMP-9). Moreover, a borderline inverse correlation was observed between the activity levels of both enzymes and nuclear grade (P=0.0511 for MMP-2 and P=0.0794 for MMP-9). In conclusion, the present data suggest that serum measures of MMP's activity may have diagnostic value for discriminating subgroups of breast cancer patients and support the hypothesis that ERBB2 amplification and/or overexpression enhance signalling pathways that may lead to increased production of gelatinases in c-erbB-2 positive breast cancers with higher metastatic potentialities.

Biomarkers, Tumor↗

PubMed2001

Use of the HARK autorefractor in children.

PURPOSE: We investigated the reliability, accuracy, and repeatability of an autorefractor with the capability of over-refracting and measuring visual acuity for use in children in a prospective study. METHODS: Before and after cycloplegia, 68 children (mean +/- SD age, 10 +/- 3 years, range 5-16 years) underwent autorefraction twice with the HARK 599 Autorefractor (Humphrey Instruments Inc., San Leandro, CA), subjective over-refraction through the HARK autorefractor, and subjective refraction using a phoro-optometer. After cycloplegia, retinoscopy was performed. Results are reported for one eye (left) of each child. RESULTS: For 68 eyes of 68 children, before and after cycloplegia, correlation coefficients (R) for autorefraction reproducibility exceeded 0.95 for all comparisons of sphere and cylinder. R for spherical values for autorefraction vs. over-refraction was 0.93 and vs. subjective refraction 0.83 before cycloplegia and 0.94 and 0.97 after cycloplegia. Comparing values before and after cycloplegia, autorefraction, over-refraction, and subjective refraction, the data correlated > 0.81 for sphere and 0.75 to 0.87 for cylinder. Cycloplegic retinoscopy compared with autorefraction, over-refraction, and subjective refraction had R > 0.86 for sphere and cylinder for all comparisons except one. Cycloplegia increased the proportion of spherical equivalent values within 0.625 D of the subjective refraction from 41 of 68 eyes (61%) for auto- and over-refraction to 64 (94%) and 51 (75%) of the 68 eyes, respectively. A visual acuity of 20/30 or better was produced in 50 of 68 (73%) eyes with automated refraction before and after cycloplegia and in 62 (92%) with subjective refraction before cycloplegia and subjective refraction and retinoscopy after cycloplegia. Subjective over-refraction did not significantly improve the visual acuity. CONCLUSIONS: In children, HARK autorefraction improved in accuracy, when compared to subjective refraction, and the level of visual acuity improved after cycloplegia. Over-refraction through the instrument did not improve the results before or after cycloplegia.

Adolescent↗

PubMedDate not supplied

Relationship between symptom dimensions and neurocognitive functioning in schizophrenia: a meta-analysis of WCST and CPT studies. Wisconsin Card Sorting Test. Continuous Performance Test.

Cognitive deficits have been hypothesized to be differentially related to the negative, positive and disorganization dimensions of schizophrenia symptoms. In this article, we quantitatively review the published literature on the relationships between symptom dimensions in schizophrenia and performance on the two most widely applied tests of executive functioning and sustained attention, the Wisconsin Card Sorting Test (WCST) and the Continuous Performance Test (CPT). Meta-analyses were conducted on studies that reported correlational data for the relations between performance on these tests and scales of positive and negative symptoms. The more recent distinction between disorganization and reality distortion was also taken into account. The results showed statistically significant relationships of negative symptoms with worse performance on the WCST and the CPT. Disorganization symptoms showed a significant positive correlation with perseverations on the WCST, but not with CPT performance. In contrast, reality distortion symptoms and general scores for all positive symptoms did not correlate with either measure. Although some correlations were statistically significant, the observed associations between psychiatric symptoms and cognitive performance were typically weak, suggesting relative independence of these disease processes.

Attention↗

PubMed1977

Correlation of serum ferritin and liver ferritin iron in the anemic, normal, iron-loaded rat.

We developed a two-site immunoradiometric assay for rat serum ferritin that uses antibody immobilized on agarose. Individual serum ferritin values were significantly correlated with iron stores as determined chemically by liver ferritin iron content. This group correlation was not sufficiently great, however, to allow confident prediction of iron stores in a given animal on the basis of serum ferritin alone. Significant differences in mean liver ferritin iron concentration between groups of rats raised on diets of differing iron content were not always reflected by differences in mean serum ferritin values. Data correlating the serum levels of ferritin and a liver-specific transaminase suggested that hepatocellular death may sometimes contribute ferritin to the serum. Strong postitive correlations between serum ferritin and iron stores in the rat were not observed when serum transaminase levels were in the normal range.

Alanine Transaminase↗

PubMed1996

Functions of fibroblast and transforming growth factors in primary organoid-like cultures of normal human urothelium.

Previous studies have indicated that growth factors such as epidermal growth factor, transforming growth factor alpha, and fibroblast growth factor 1 (FGF-1) have important regulatory functions in murine urothelial wound healing and tumorigenesis. Immunocytochemical analyses suggest that these factors are also involved in human urothelium. Yet, little is known about the functional effects of these growth factors on human urothelial cells. We established organoid-like primary cultures of normal human urothelium on porous membranes. Direct functional effects of growth factors were examined on confluent cultures reflecting intact urothelium. Immunocytochemistry was performed with a panel of specific antibodies against growth factors and their receptors on both cultures and the corresponding tissue sections. Lacking the appropriate antibodies, we performed reverse transcriptase PCR to detect FGF receptor mRNA in cultures and dissected tissue. The proliferation was stimulated by transforming growth factor alpha, FGF-1, and weakly by FGF-7, but not by FGF-2. TGF beta 1 inhibited proliferation. In contrast to mouse urothelium, none of the growth factors showed an effect on differentiation. The functional data correlate with the urothelial expression of epidermal growth factor receptors, TGF beta receptor types I and II, the (low) protein expression of FGF receptor 1, and the presence of FGF-7 receptor (FGF receptor 2 (IIIb)) mRNA. The organotypic nature of the cultures permits the study of growth factor interactions between urothelial cells. The data indicate that FGF-1, transforming growth factor alpha, and TGF beta 1 contribute differently to the maintenance of human urothelium.

Base Sequence↗

PubMed2007

Utility of the Psychological Screening Inventory: a review.

The Psychological Screening Inventory (PSI; R. I. Lanyon, 1970, 1973, 1978, 1993, 2006) was developed as a cost-effective screening device in identifying persons for whom a more complete psychological evaluation should be conducted. The author reviews data bearing on the utility of the PSI in this regard and in more general applications. The Alienation scale showed strong effect sizes in distinguishing psychiatric inpatients from controls, the Social Nonconformity scale in distinguishing incarcerated groups from control, and the Discomfort scale in identifying persons with general psychological distress. These findings were supported by correlational data with comparable scales, and by a variety of smaller comparison studies. Meaningful discriminations were also shown for adolescents and for college-age young adults. Findings in studies of substance abusers and medical problems were also reviewed. Response Distortion scales showed effectiveness similar to that of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) validity scales. Validity was also shown for several of the seven available foreign language translations. It was concluded that the PSI is effective for the tasks for which it was designed.

Adolescent↗

PubMed2006

Feasibility of simultaneous temperature and tissue stiffness detection by MRE.

Temperature and tissue stiffness are two indices that can be used to monitor MRI-guided focused ultrasound thermal therapy. It would be beneficial to have both measures available to monitor treatment progression during thermal therapy. MR Elastography (MRE) has already been shown to provide tissue stiffness information; the purpose of this work is to demonstrate how temperature can be derived from the same MRE data acquisition. MRE data were acquired from 1.5% agarose phantoms and ex vivo porcine muscle tissue (from a grocery store) while they were heated slowly. The temperatures were measured using a fluorescent thermometer. The phase average from the MRE acquisition was used to calculate the phase shift induced by the proton resonance frequency shift associated with the temperature change. The results show that the phase shift due to temperature extracted from MRE data correlate well with the temperature change recorded by thermometer, yielding a temperature coefficient of -0.0096 ppm/ degrees C for the agarose phantom, and -0.0103 ppm/ degrees C for the ex vivo porcine tissue. These results indicate that it is possible to simultaneously measure both temperature and tissue shear stiffness using a new method of MRE data reconstruction.

Animals↗

PubMed2006

2H NMR evidence for the formation of random mesh phases in nonionic surfactant-water systems.

Random mesh phases share many common features with the classical lamellar phase in that they are layered phases; but crucially, they possess nonuniform interfacial curvature, since the lamellae are pierced by water-filled pores. The introduction of curvature into the lamellae has been posited as a transitional precursor for other lyotropic phases. In this paper, we show that simple 2H nuclear magnetic resonance (NMR) experiments provide strong indication for the formation of the random mesh phase and the NMR data correlate well with literature results from small-angle X-ray scattering. The thermal evolution of the recorded quadrupolar splitting (DeltanuQ) is monitored within the lamellar phase of two nonionic surfactants, C16E6 and C12E5, as the samples are cooled or heated, and a marked and reversible change in the evolution of DeltanuQ is observed. Data from heavy water and deuterium labeled surfactant show the same temperature dependence and consequently report on the same structural changes with temperature. The formation of the random mesh phase is quantified in terms of an effective order parameter that is unity in the classical lamellar phase and takes values of <1 in the random mesh phase, reaching 0.6 at lower temperatures.

Journal Article↗

PubMed1992

Release of Small Polyuronides from Nitella Cell Walls during Ionic Exchange.

Mono-divalent ion exchange in isolated cell walls of Nitella flexilis (L.) Ag. induces a marked loss of wall polymers and a decrease in the wall cationic exchange capacity. These data correlate with the replacement in the walls of adsorbed Mn(2+) by Na(+) ions. Boiling wall samples in methanol for 1 h or keeping the ionic solutions chilled to 4 degrees C does not inhibit the cell wall polymer leakage but modifies the kinetics both of the ionic exchange and of the released polymers. These data are more compatible with physical rather than enzymic induced processes. The extracted polymers in the successively renewed NaCl solutions initially belong to the wall protein and pectin fractions and mainly to pectic fractions subsequently. Determination of the average degree of polymerization shows that the average molecular size of the lost acidic polysaccharides increases with extraction time up an average polymerization degree of 25. Enzyme-linked immunosorbent assay inhibition tests show the presence of homopolymer blocks equal to or higher than 10 in the released polymer fragments. Compositional analysis of released polysaccharides suggests that the pectin lost by action of monovalent ions was largely composed of rhamnogalacturonans whose acidic residue fraction is approximately 60% in association with galactose chains. Small quantities of glucuronylated xylans are also found.

Journal Article↗

PubMed2000

Impact of a mandatory physician reporting system for cardiac patients potentially unfit to drive.

CONTEXT: Sudden cardiac incapacitation of a driver may lead to the death or serious injury of passengers or bystanders. This has raised public safety concerns and has led to the creation of legislation to protect the public. Some jurisdictions in Canada and the United States have introduced mandatory physician reporting of patients who may be unfit to drive for medical reasons. The impact on motor vehicle accident (MVA)-related morbidity and mortality of mandatory physician reporting for at-risk cardiac patients is unknown. OBJECTIVE: To determine the impact of mandatory physician reporting legislation (for cardiac patients) in Ontario (population 10.3 million) on MVA-related morbidity and mortality. DATA SOURCES: Reporting data were obtained from the Ontario Ministry of Transportation. Incidence and prevalence data were taken from Ontario Ministry of Health sources and from the literature (MEDLINE). Data for modelling were taken from the literature (MEDLINE) and from the Canadian Cardiovascular Society's Consensus Conference document on cardiac illness and fitness to drive. DATA EXTRACTION: Licence suspension data (correlated with medical illness) were taken directly from government documents. These were then applied to a 'risk of harm' formula used to calculate the risk posed to bystanders and passengers by the suspended patients if they had continued to drive. Canadian licence suspension guidelines were then reviewed in conjunction with cardiac disease incidence and prevalence data to arrive at the number of patients who should have been suspended. Physician compliance with the legislation was then calculated, along with the potential impact on MVA-related morbidity and mortality in the scenario of 100% physician compliance. STUDY SELECTION: All Ontario drivers who had licence suspensions in 1996 for reasons of cardiac disease were included in the analysis. DATA SYNTHESIS: Nine hundred and ninety-four licences were suspended for cardiac reasons in 1996, compared with an estimated 72,407 that should have been suspended if Canadian guidelines had been followed (1.4%). Less than one death or serious injury was avoided as a result of the legislation (from the 'risk of harm' formula). If all drivers with cardiac illness had been suspended from driving, up to 29.2 such events could potentially have been avoided. However, only 13 of 929 (1.4%) road fatalities in Ontario in 1996 were attributed to a driver with a medical illness. CONCLUSIONS: Mandatory physician reporting of patients with cardiac illness has a negligible impact on MVA-related morbidity and mortality.

Accidents, Traffic↗

PubMed1998

Differential expression of inflammatory cytokines parallels progression of central nervous system pathology in two clinically distinct models of multiple sclerosis.

Multiple sclerosis is an immune-mediated demyelinating disease of unknown etiology that presents with either a chronic-progressive or relapsing-remitting clinical course. Theiler's murine encephalomyelitis virus-induced demyelinating disease (TMEV-IDD) and relapsing-remitting experimental autoimmune encephalomyelitis (R-EAE) in the SJL/J mouse are both relevant murine CD4+ T cell-mediated demyelinating models that recapitulate the multiple sclerosis disease phenotypes. To determine the cellular and molecular basis for these observed differences in clinical course, we quantitatively analyzed the temporal expression of pro- and antiinflammatory cytokine mRNA expression in the central nervous system (CNS) and the phenotype of the inflammatory mononuclear infiltrates. TMEV-infected SJL/J mice expressed IFN-gamma, TNF-alpha, IL-10, and IL-4 mRNA during the preclinical phase, and their levels continued to increase throughout the duration of the chronic-progressive disease course. These data correlated with the continued presence of both CD4+ T cells and F4/80+ macrophages within the CNS infiltrates. In contrast, SJL/J mice with PLP(139-151)-induced R-EAE displayed a biphasic pattern of CNS expression for the proinflammatory cytokines, IFN-gamma and TNF-alpha, with expression peaking at the height of the acute phase and relapse(s). This pattern correlated with dynamic changes in the CD4+ T cell and F4/80+ macrophage populations during relapsing-remitting disease progression. Interestingly, IL-4 message was undetectable until disease remission(s), demonstrating its potential role in the intrinsic regulation of ongoing disease, whereas IL-10 was continuously expressed, arguing against a regulatory role in either disease. These data suggest that the kinetics of cytokine expression together with the nature of the persistent inflammatory infiltrates are major contributors to the differences in clinical course between TMEV-IDD and R-EAE.

Animals↗

PubMed2026

Proportionality-based association metrics in count compositional data.

Compositional data comprise vectors that describe the constituent parts of a whole. Data arising from various -omics platforms such as 16S and RNA sequencing are compositional in nature. In this kind of data, correlations between features on raw counts have no meaningful interpretation. Metrics of proportionality were formulated to address this problem. However, an inherent bias arises when these metrics are calculated empirically on count-based measures due to variability in read depths. We quantify the bias introduced by empirically calculating proportionality-based association metrics in count data. Additionally, we propose a means of estimating these metrics within a logit-normal multinomial model in pursuit of more accurate estimates. The model-based estimates are shown to outperform empirical estimates in simulated data and are applied to a mouse embryonic stem cell single-cell sequencing dataset, as well as a pediatric-onset multiple sclerosis metagenomic dataset.

Animals↗

PubMedDate not supplied

Financial impact of health promotion programs: a comprehensive review of the literature.

PURPOSE: The purpose of this review is to summarize the literature on the ability of health promotion programs to reduce employee-related health care expenditures and absenteeism. SEARCH PROCESS: Using key words in a literature-searching program, a comprehensive search was conducted on the following databases: MEDLINE, Embase, HealthSTAR. SPORTDiscus, PsycINFO, SciSearch, ERIC, and ABI Inform. STUDY INCLUSION AND EXCLUSION CRITERIA: All data-based studies that appeared in peer reviewed journals in the English language. Theses, dissertations, or presentation abstracts that were not published in peer reviewed journals were excluded. The initial search identified 196 studies, but only 72 met the inclusion criteria and were included in the review. DATA EXTRACTION METHODS: Summary tables were created that include design classification, subject size, results, and other key information for each study. DATA SYNTHESIS: Both the nature of the findings and the overall quality of the literature were evaluated in an attempt to answer two questions: Do individuals or populations with high health risks have worse financial outcomes than individuals or populations with low health risks? Do health promotion programs improve financial outcomes? MAJOR CONCLUSIONS: There are good correlational data to suggest that high levels of stress, excessive body weight, and multiple risk factors are associated with increased health care costs and illness-related absenteeism. The associations between seat belt use, cholesterol, diet, hypertension, and alcohol abuse and absenteeism and health care expenditures are either mixed or unknown. Health promotion programs are associated with lower levels of absenteeism and health care costs, and fitness programs are associated with reduced health care costs.

Absenteeism↗