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Aldose reductase and the importance of experimental design.

Kinetic studies on the AR (aldose reductase) protein have shown that it does not behave as a classical enzyme in relation to ring aldose sugars. As with non-enzymatic glycation reactions, there is probably a free-radical element involved derived from monosaccharide autoxidation. In the case of AR, there is free radical oxidation of NADPH by autoxidizing monosaccharides, which is enhanced in the presence of the NADPH-binding protein. Thus any assay for AR based on the oxidation of NADPH in the presence of autoxidizing monosaccharides is invalid, and tissue AR measurements based on this method are also invalid, and should be reassessed. AR exhibits broad specificity for both hydrophilic and hydrophobic aldehydes that suggests that the protein may be involved in detoxification. The last thing we would want to do is to inhibit it. ARIs (AR inhibitors) have a number of actions in the cell which are not specific, and which do not involve them binding to AR. These include peroxy-radical scavenging and effects of metal ion chelation. The AR/ARI story emphasizes the importance of correct experimental design in all biocatalytic experiments. Developing the use of Bayesian utility functions, we have used a systematic method to identify the optimum experimental designs for a number of kinetic model data sets. This has led to the identification of trends between kinetic model types, sets of design rules and the key conclusion that such designs should be based on some prior knowledge of K (m) and/or the kinetic model. We suggest an optimal and iterative method for selecting features of the design such as the substrate range, number of measurements and choice of intermediate points. The final design collects data suitable for accurate modelling and analysis and minimizes the error in the parameters estimated, and is suitable for simple or complex steady-state models.

Aldehyde Reductase↗

A controlled study of postpartum depression among Nepalese women: validation of the Edinburgh Postpartum Depression Scale in Kathmandu.

OBJECTIVES: To measure the prevalence of depression amongst postpartum and non-postpartum Nepalese women in Kathmandu using the Edinburgh Postpartum Depression Scale (EPDS) and to assess the ease of use and validity of the scale compared with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression. METHODS: We screened 100 women 2-3 months post-delivery and 40 control women using the EPDS. All those who screened positive for depression and 20% of the negatives also underwent a structured interview to assess depression by DSM-IV criteria. RESULTS: Predictive errors were minimized by using an EPDS score > or =13 to define depression. Using this threshold, there was no difference in depression prevalence between postpartum women (12%) and the control group (12.5%) (Fisher's exact test, P > 0.05). Compared with DSM-IV, the sensitivity, specificity and positive predictive values were 100, 92.6 and 41.6%, respectively. CONCLUSIONS: The prevalence of postpartum depression (PPD) in Nepalese women and the validity and ease of use of the EPDS in the setting of a postnatal clinic in Kathmandu are all surprisingly similar to the results of numerous studies in developed countries. Despite poor living conditions, PPD is no more common than the background depression rate amongst Nepalese women. It can be reliably detected by trained clinical nurses using the EPDS screening test. These results may have implications for the planning of mental health resources for women in other developing countries.

Case-Control Studies↗

Endometrial thickness as measured by transvaginal sonography: interobserver variation.

Transvaginal sonography of the uterus has become an important tool for diagnosing endometrial pathology in women with postmenopausal bleeding. One parameter that has been claimed to be important for curly detection of endometrial pathology in this group of women is the endometrial thickness. The purpose of this study was to evaluate the reproducibility of measurements of endometrial thickness as performed by five inexperienced doctors and one doctor experienced in the transvaginal sonography technique. The endometrial thickness as measured by the experienced doctor was regarded as the 'true measurement', and the mean discrepancy from this true measurement was 1.5 mm for the inexperienced doctors. No endometrial pathology was found at the histopathological examination after dilatation and curettage (D & C) when the endometrial thickness was measured as <or= 4 mm by both the inexperienced and the experienced doctors. However, there were considerable differences between the results obtained by the five inexperienced doctors. If this method is to be used for identifying those women who will not have a D & C performed, based on the findings of a thin endometrium (<or= 4 mm), training is needed in order to minimize the error. We believe that this will make measurement more accurate and it may then be used to exclude endometrial abnormality in women with postmenopausal bleeding.

Journal Article↗

Catheter performance.

Venous catheters differ from peripheral arteriovenous (AV) access devices in many important ways. This discussion focuses on their performance as a conduit for blood flow between the patient and the dialyzer and on how catheter function is both limited and enhanced relative to the more common peripheral accesses. Catheter flow is limited by the high resistance inherent in the extended length of venous catheters relative to dialysis needles, but the high rate of flow in central veins also diminishes the opportunity for access recirculation. Cardiopulmonary recirculation is absent in patients with catheter access unless the patient also has a peripheral access. In the latter case, the same detrimental effect on urea clearance is seen regardless of which access device is used. Flow-dependent recirculation through circuits other than the peripheral AV access reduces the efficiency of dialysis (regardless of the type of access, catheter, or peripheral AV device used) across both catheters and peripheral AV devices. The inside diameter of the catheter plays a sensitive role in determining catheter resistance to flow. Slight increases in diameter under the same pressure head are associated with large increases in flow. Negative pressure at the catheter inflow port generated by the blood pump is magnified relative to peripheral devices, predisposing to partial collapse of the pump tubing segment and erroneous blood flow readings by the pump motor speed indicator. Setting a limit on prepump negative pressure can minimize this error. Future applications of dialysis may require lower pump speeds, which would allow more liberal use of catheter access if their potential for infection and clotting can be reduced.

Blood Flow Velocity↗

Automatic recognition of abnormal respiratory events during sleep by a pacemaker transthoracic impedance sensor.

INTRODUCTION: A number of pacemakers use transthoracic impedance to derive minute ventilation as a sensor for rate adaptation. Transthoracic impedance is also able to track fluctuations in tidal volume occurring in sleep apnea/hypopnea syndromes (SAS). We evaluated the feasibility of a transthoracic impedance-derived pacemaker algorithm for monitoring sleep respiratory disturbances. METHODS AND RESULTS: Forty-two patients who presented with a conventional indication for DDD pacing or cardiac resynchronization underwent conventional polysomnography 1 month after implantation of a Talent trade mark 3 pacemaker (ELA Medical). The respiratory disturbance index (RDI) stored in the pacemaker memory was compared to the apnea/hypopnea index (AHI) derived from polysomnography. The ability of the pacemaker to identify severe SAS patients (AHI > or = 30) was assessed. A minimal systematic error was observed from a Bland and Altman plot (bias = 0.9 events/hour). The ability of the pacemaker RDI to identify severe SAS patients was determined by analysis of the receiver operator characteristic. A cutoff RDI value of 30.6/hour of recording was found to yield 75% sensitivity, 94% specificity, 75% positive predictive value, and 94% negative predictive value. CONCLUSION: The RDI monitoring function appears to be of value in screening pacemaker patients for SAS. Its performance is comparable to existing simple screening techniques. The ability to permanently monitor respiration, in combination with other diagnostic capabilities (such as Holter functions), presents a unique opportunity to monitor the association between arrhythmias and disturbances of breathing during sleep.

Aged↗

[Impact of the eye's cyclorotation on axial orientation analysis of toric intraocular lenses: recommendations for an optimized evaluation of rotational stability of toric IOLs].

BACKGROUND: After the implantation of toric intraocular lenses (tIOLs) significant postoperative tIOL rotation angles were measured occasionally. We investigated the rotational stability of eyes during standardized photography and recommend two methods for an enhanced evaluation of tIOL rotation. PATIENTS AND METHODS: 1. The cyclorotation of the eye was investigated using standard fundus photography. A sequence of two fundus photographic slides was taken in 550 phakic eyes of 275 consecutive patients with a time interval of at least 6 months. With characteristic markers on the fundus photograph, the axial orientation of the eyes was defined and the cyclorotation between the two slides of each eye was measured. 2. Using bifocal photography (HRA II - Heidelberg Retina Angiograph), a sequence of anterior segment and fundus images was taken considering stable head position in 19 pairs of photographs of eyes with implanted tIOLs. The angle between reference fundus axis and tIOL axis was measured at both time stages (mean: after 3 months). The difference of the angle between bifocal-image samples was defined as the real tIOL rotation angle. 3. Ten pairs of anterior segment photographs of eyes with a tIOL were investigated using the Axenfeld loop analysis. In each photograph, the angle between the axis connecting two Axenfeld loops and the tIOL axis was measured. The difference of two angles of two photographs was defined as the rotational tIOL angle. RESULTS: 1. The mean absolute eye's rotation angle was 2.3 +/- 1.7 degrees (range: 0 to 11.5 degrees) in all 550 eyes. Only 9.1 % of the eyes did not rotate. In 57.3 % of the eyes a rotation of less than 3 degrees and in 33.6 % of more than or equal to 3 degrees was detected. The eye's cyclorotation correlated (p < 0.04) with an age older than 39 years and higher astigmatism (> 1.5 D). Because of the significant amount of spontaneous globe rotation we developed the following enhanced methods to minimize measurement errors of tIOL rotation: 2. Bifocal photography: comparing the 19 HRA anterior segment images, the amount of mean tIOL rotation was 5.4 +/- 4.8 degrees (range: 0 - 20.0 degrees). Using the bifocal photography, the mean tIOL rotation was 1.9 +/- 1.3 degrees (range: 0 - 5.0 degrees). The overestimated rotation of the tIOL (only anterior segment tIOL comparison) correlated with higher amounts of the eye's cyclorotation (r = 0.94; p = 0.01) and higher corneal astigmatism (r = 0.54; p = 0.05). 3. The simultaneous analysis of Axenfeld loops revealed significantly smaller amounts of tIOL rotation (2.3 +/- 2.5 degrees range: 0 - 7.0 degrees ) in 10 pairs of anterior segment photographs in contrast to the single analysis of tIOL axis (5.5 +/- 4.8 degrees range: 1 - 13.0 degrees p = 0.09). A reduction of up to 18.0 degrees tIOL rotation measurement failure was possible in single cases by applying the bifocal photography or simultaneous Axenfeld loop analysis. CONCLUSIONS: Head inclination, head rotation, and incyclo- or excyclorotation of the eye may have a significant impact on the tIOL axis evaluation. Besides the bifocal photography the simultaneous Axenfeld loop analysis could be a promising alternative to the conventional axis evaluation of tIOLs.

Artifacts↗

[Significance of aniseikonia following implantation of posterior chamber lenses].

Posterior chamber lenses with angled haptics were implanted in one eye of each of 53 patients with senile cataract. Dioptric aniseikonia was calculated between 1 month and 24 months after surgery (with Gruber's and Huber's computer program) on the basis of most recently obtained values (bulb axis length, depth of the anterior chamber, lens thickness, necessary refraction), and compared with subjective measurements taken with the phase difference haploscope. The agreement between the calculated and subjective aniseikonia was greatest when tested in a vertical meridian. However, it was not possible to predict any correlation between dioptric and subjective aniseikonia with confidence. On the basis of the test results it seems justified to aim for a minimal refractive error in the pseudophakic eye of about +/- 0.5 D in patients with hypermetropia or myopia up to 4 D, even if subjective aniseikonias of over 10% can be proved. The latter manifest great meridional differences and hardly interfere with binocular single vision.

Adult↗

Cyclic oscillations of basal plasma glucose and insulin concentrations in human beings.

In a study of whether oscillations in plasma glucose and insulin occur in human beings, plasma samples were taken at one-minute intervals from 10 normal subjects for periods lasting between one and two hours. In five subjects the basal plasma insulin concentrations cycled regularly, with a mean period of 13 minutes and mean amplitude of 1.6 mU per liter (11.5 pmol per liter). A concurrent plasma glucose cycle was demonstrated, with a mean amplitude (after averaging to minimize random error) of 0.05 mmol per liter (1 mg per decliter). The average plasma glucose cycle was two minutes in advance of the plasma insulin. In the subjects with less regular plasma insulin cycles, a similar plasma glucose rise was demonstrated two minutes before the insulin rise. These phase relations are compatible with the presence of a negative-feedback loop between the liver and pancreatic beta cells that regulates both basal plasma insulin and glucose concentrations, although the cyclic beta-cell secretion could be independent of plasma glucose.

Adult↗

On the calculation of absolute free energies from molecular-dynamics or Monte Carlo data.

We propose a method for calculating absolute free energies from Monte Carlo or molecular-dynamics data. The method is based on the identity that expresses the partition function Q as a Boltzmann average: 1Q=w(p,x)exp[betaH(p,x)], where w(p,x) is an arbitrary weight function such that its integral over the phase space is equal to 1. In practice, to minimize statistical errors the weight function is chosen such that the regions of the phase space where sampling statistics are poor are excluded from the average. The "ideal" weight function would be the equilibrium phase-space density exp[-betaH(p,x)]Q itself. We consider two methods for constructing the weight function based on different estimates of the equilibrium phase-space density from simulation data. In the first method, it is chosen to be a Gaussian function, whose parameters are obtained from the covariance matrix of the atomic coordinates. In the second, a clustering algorithm is used to attempt partitioning the data into clusters corresponding to different basins of attraction visited by the system. The weight function is then constructed as a superposition of Gaussians calculated for each cluster separately. We show that these strategies can be used to improve upon previous methods of estimating absolute entropies from covariance matrices.

Algorithms↗

The correlation consistent composite approach (ccCA): an alternative to the Gaussian-n methods.

An alternative to the Gaussian-n (G1, G2, and G3) composite methods of computing molecular energies is proposed and is named the "correlation consistent composite approach" (ccCA, ccCA-CBS-1, ccCA-CBS-2). This approach uses the correlation consistent polarized valence (cc-pVXZ) basis sets. The G2-1 test set of 48 enthalpies of formation (DeltaHf), 38 adiabatic ionization potentials (IPs), 25 adiabatic electron affinities (EAs), and 8 adiabatic proton affinities (PAs) are computed using this approach, as well as the DeltaHf values of 30 more systems. Equilibrium molecular geometries and vibrational frequencies are obtained using B3LYP density functional theory. When applying the ccCA-CBS method with the cc-pVXZ series of basis sets augmented with diffuse functions, mean absolute deviations within the G2-1 test set compared to experiment are 1.33 kcal mol(-1) for DeltaHf,0.81 kcal mol(-1) for IPs, 1.02 kcal mol(-1) for EAs, and 1.51 kcal mol(-1) for PAs, without including the "high-level correction" (HLC) contained in the original Gn methods. Whereas the HLC originated in the Gaussian-1 method as an isogyric correction, it evolved into a fitted parameter that minimized the error of the composite methods, eliminating its physical meaning. Recomputing the G1 and G3 enthalpies of formation without the HLC reveals a systematic trend where most DeltaHf values are significantly higher than experimental values. By extrapolating electronic energies to the complete basis set (CBS) limit and adding G3-like corrections for the core-valence and infinite-order electron correlation effects, ccCA-CBS-2 often underestimates the experimental DeltaHf, especially for larger systems. This is desired as inclusion of relativistic and atomic spin-orbit effects subsequently improves theoretical DeltaHf values to give a 0.81 kcal mol(-1) mean absolute deviation with ccCA-CBS-2. The ccCA-CBS method is a viable "black box" method that can be used on systems with at least 10-15 heavy atoms.

Journal Article↗

Ribosomal protein L7/L12 is required for optimal translation.

We have tested the performance in vitro of Escherichia coli ribosomes containing or lacking the protein L7/L12. When the experiments are performed in an optimized mixture of ions (polymix), L7/L12 is required for maximal rate of synthesis as well as for minimal missense error frequency. The results in conventional Tris/Mg2+/NH4Cl buffers are different; in these buffers, only the rate of synthesis is strongly dependent on the presence of L7/L12. In addition, we show that there is a large difference between the optimal Mg2+ concentration required for speed of translation and that for accuracy of translation in conventional buffer. These optima are very close in polymix. Finally, we show that the contribution of L7/L12 to the speed of translation is obscured in translation systems that are limited by substrates. We conclude that it is not possible to analyze details of the mechanism of translation in conventional buffers.

Bacterial Proteins↗

Improved free-energy parameters for predictions of RNA duplex stability.

Thermodynamic parameters for prediction of RNA duplex stability are reported. One parameter for duplex initiation and 10 parameters for helix propagation are derived from enthalpy and free-energy changes for helix formation by 45 RNA oligonucleotide duplexes. The oligomer sequences were chosen to maximize reliability of secondary structure predictions. Each of the 10 nearest-neighbor sequences is well-represented among the 45 oligonucleotides, and the sequences were chosen to minimize experimental errors in delta GO at 37 degrees C. These parameters predict melting temperatures of most oligonucleotide duplexes within 5 degrees C. This is about as good as can be expected from the nearest-neighbor model. Free-energy changes for helix propagation at dangling ends, terminal mismatches, and internal G X U mismatches, and free-energy changes for helix initiation at hairpin loops, internal loops, or internal bulges are also tabulated.

Hydrogen Bonding↗

Performance of cognitively normal African Americans on the RBANS in community dwelling older adults.

Recent research suggests that cognitively normal African Americans are more likely to be misdiagnosed as impaired compared to Caucasians due to lower neuropsychological test scores (e.g., Manly et al., 1998). Given this, the present study sought to determine whether such racial discrepancies exist on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Performances of 50 cognitively normal older African Americans on the RBANS were compared to those of 50 Caucasians matched on age, education, and gender. The African Americans scored significantly lower on 10 of 12 subtests, 3 of 5 Index scores, and the Total Scale score. Results underscored the utility of demographically appropriate norms when serving minority clients. Given that there remains a paucity of normative data for minority groups, RBANS normative data for older African Americans are provided. Although preliminary, it is hoped that data presented will offer the practitioner assistance with clinical diagnosis and decision-making in a manner that will help minimize diagnostic errors.

Black or African American↗

Redistribution of vitamin A in tissues of rats with imposed chronic confinement stress.

1. The effect of confinement stress on the metabolism of vitamin A was studied in rats by following changes in tissue distribution of the vitamin for 29 d. In order to minimize predicted errors which might result from fluctuation of vitamin A intake, the effect of the stress was investigated in rats fed on a vitamin A-free diet. 2. Daily stress for 6 h induced an enlargement of the adrenals with a concomitant involution of the thymus and spleen, values returning to normal within 11-15 d. 3. The stress caused an immediate decrease in the content of vitamin A in serum. 4. Feeding rats a vitamin A-free diet resulted in significant increase in the vitamin A content of the kidney. Imposing stress on these rats inhibited markedly the increase in kidney vitamin A content. 5. The stress produced no appreciable change in levels of the vitamin in the liver and testes. 6. There was a preferential accumulation of the vitamin in the adrenals of the stress-imposed rats even though they were fed on a vitamin A-free diet. 7. In conclusion, the results of the present study demonstrated that chronic immobilization stress produced marked tissue-dependent changes in their vitamin A content.

Animals↗

Terminal accuracy of unexpectedly loaded rapid movements: evidence for a mass-spring mechanism in programming.

Experiments using rapid-positioning movements in humans, where the subject is suddenly and unexpectedly provided with a change in the load characteristics of the limb, are described. Taken together, the pattern of results supports a mass-spring model of unidirectional limb action, where the limb moves to a position defined by the relative tensions in the agonist and antagonist. As well, various results provide evidence contrary to predictions from an impulse-timing viewpoint, where the motor program times the onset of impulses to the musculature, and against a feedback-processing viewpoint, where limb position is defined by minimizing positioning error indicated by feedback. The evidence suggests that the role of phasing in motor programs may be different for unidirectional actions on the one band and multi-directional and/or multi-component actions on the other.

Journal Article↗

Experimental determination of baseball spin and lift.

The aim of this study was to develop a new method for the determination of lift on spinning baseballs. Inertial trajectories of (a) ball surface markers during the first metre of flight and (b) the centre of mass trajectory near home-plate were measured in a pitch using high-speed video. A theoretical model was developed, incorporating aerodynamic Magnus-Robins lift, drag and cross forces, which predicts the centre of mass and marker trajectories. Parameters including initial conditions and aerodynamic coefficients were estimated iteratively by minimizing the error between predicted and measured trajectories. We compare the resulting lift coefficients and spin parameter values with those of previous studies. Lift on four-seam pitches can be as much as three times that of two-seam pitches, although this disparity is reduced for spin parameters greater than 0.4.

Baseball↗

A method for the quantitative evaluation of SAR distribution in deep regional hyperthermia.

The Specific Absorption Rate (SAR) distribution pattern visualization by a matrix of E-field light-emitting sensors has demonstrated to be a useful tool to evaluate the characteristics of the applicators used in deep regional hyperthermia and to perform a quality assurance programme. A method to quantify the SAR from photographs of the sensor array--the so-called 'Power Stepping Technique'--has already been proposed. This paper presents a new approach to the quantitative determination of the SAR profiles in a liquid phantom exposed to electromagnetic fields from the Sigma-60 applicator (BSD-2000 system for deep regional hyperthermia). The method is based on the construction of a 'calibration curve' modelling the light-output of an E-field sensor as a function of the supplied voltage and on the use of a reference light source to 'normalize' the light-output readings from the photos of the sensor array, in order to minimize the errors introduced by the non-uniformity of the photographic process. Once the calibration curve is obtained, it is possible, with only one photo, to obtain the quantitative SAR distribution in the operating conditions. For this reason, this method is suitable for equipment characterization and also for the control of the repeatability of power deposition in time.

Calibration↗

Test-retest stability of the Task and Ego Orientation Questionnaire.

Establishing stability, defined as observing minimal measurement error in a test-retest assessment, is vital to validating psychometric tools. Correlational methods, such as Pearson product-moment, intraclass, and kappa are tests of association or consistency, whereas stability or reproducibility (regarded here as synonymous) assesses the agreement between test-retest scores. Indexes of reproducibility using the Task and Ego Orientation in Sport Questionnaire (TEOSQ; Duda & Nicholls, 1992) were investigated using correlational (Pearson product-moment, intraclass, and kappa) methods, repeated measures multivariate analysis of variance, and calculating the proportion of agreement within a referent value of +/-1 as suggested by Nevill, Lane, Kilgour, Bowes, and Whyte (2001). Two hundred thirteen soccer players completed the TEOSQ on two occasions, 1 week apart. Correlation analyses indicated a stronger test-retest correlation for the Ego subscale than the Task subscale. Multivariate analysis of variance indicated stability for ego items but with significant increases in four task items. The proportion of test-retest agreement scores indicated that all ego items reported relatively poor stability statistics with test-retest scores within a range of +/-1, ranging from 82.7-86.9%. By contrast, all task items showed test-retest difference scores ranging from 92.5-99%, although further analysis indicated that four task subscale items increased significantly. Findings illustrated that correlational methods (Pearson product-moment, intraclass, and kappa) are influenced by the range in scores, and calculating the proportion of agreement of test-retest differences with a referent value of +/-1 could provide additional insight into the stability of the questionnaire. It is suggested that the item-by-item proportion of agreement method proposed by Nevill et al. (2001) should be used to supplement existing methods and could be especially helpful in identifying rogue items in the initial stages of psychometric questionnaire validation.

Adolescent↗