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PubMed1984

Tracer microspheres as compliance markers in clinical research.

Tracer microspheres are small, ceramic-like particles (50 micron) containing one of several radionuclide markers. We have utilized them over a period of 9 years as quantitative fecal markers for recovery measurements in metabolic studies. The markers have been administered daily for up to 2 weeks, during which time the marker concentration per unit dry weight of feces remains fairly constant. Data on the markers and our experience with them are presented along with the concerns that must be addressed in considering them as compliance markers.

Clinical Trials as Topic↗

PubMed2005

[The neurobehavioral rating scale-revised: assessment of concurrent validity].

UNLABELLED: Cognitive and behavioral impairment are a major source of disability in daily living of patients with traumatic brain injury (TBI). The Neurobehavioral Rating Scale-Revised (NRS-R) is a short, easy-to administer interview tool developed to improve assessment by clinicians. Data are available on its criterion validity and reliability, but the concurrent validity of the French NRS-R was not yet documented. OBJECTIVE: To assess the concurrent validity of the NRS-R with current psychometric tests. METHOD: One hundred and four patients with TBI enrolled in a community adjustment program underwent concurrent examination with the NRS-R, cognitive tests assessing memory, attention, and executive functions, and scales of anxiety (STAI) and depressive mood (CES-D). Intercorrelations were undertaken between these variables and the five factors of the NRS-R: F1, intentional behavior; F2, lowered emotional state; F3, survival-oriented behaviour/hightened emotional state; F4, arousal state; and F5, language. Patients were 82 men and 22 women, the mean age was 28.5 years, and 70% had severe TBI (Glasgow coma score [GCS] below 8 on admission). They were assessed 52 months on average after their injury. RESULTS: Factor F1 was correlated with results on the GCS (P<0.05), the Tower of London test (TL, P<0.01), the Trail Making Test (TMT, P<0.01), divided attention (DA) and inhibition (IN) subscales of the Zimmermann and Fimm's Attention battery (TEA) (P<0.01) and reverse digit span (DS, P<0.05). Factor F2 was positively related to age at injury, time since injury (TSI) (P<0.05) and CESD and STAI scores (P<0.001). Factor F3 was related to DA (P<0.01) TL scores and TSI (P<0.05). Factor F4 was related to TL, TMT, DA, flexibility, DS (P<0.05), TSI, duration of post-traumatic amnesia, CES-D score (P<0.05) and STAI scores (P<0.01). Factor F5 was related to GCS, DA (P<0.05), and reaction time on the subscales IN and Go/nogo (GO) of the TEA battery (P<0.01). The NRS-R total score was related to CESD, STAI scores, TMT score, DA (P<0.01) and TL score, IN and GO scores and TSI (P<0.05). DISCUSSION: As McCauley et al found with the English version of the NRS-R, significant relationships were found between NRS-R factor scores, cognitive tests and emotional scales. Relationships were also found between factor scores and indicators of injury severity and time since injury. These data suggest fair concurrent validity of the NRS-R.

Adolescent↗

PubMed2006

Half-life evaluations for 3H, 90Sr, and 90Y.

A recent paper has reviewed methods for the evaluation of discrepant sets of data and demonstrated the results of applying these methods to the published half-life data of 90Sr and 137Cs [MacMahon, T.D., Pearce, A., Harris, P., 2004. Convergence of techniques for the evaluation of discrepant data. Appl. Radiat. Isot. 60, 275-281]. The half-life data for 3H has been subject to a comprehensive review and critical evaluation by Lucas and Unterweger [2000. Comprehensive review and critical evaluation of the half-life of tritium. J. Res. Natl. Inst. Stand. Technol. 105, 541-549]. The current paper reports the results of applying the various evaluation procedures of MacMahon et al. Convergence of techniques for the evaluation of discrepant data. Appl. Radiat. Isot. 60, 275-281] to the data of Lucas and Unterweger [Comprehensive review and critical evaluation of the half-life of tritium. J. Res. Natl. Inst. Stand. Technol. 105, 541-549], resulting in a recommended half-life of 4497(4) days. MacMahon et al. [Convergence of techniques for the evaluation of discrepant data. Appl. Radiat. Isot. 60, 275-281] highlighted problems in the evaluation of the discrepant half-life data of 90Sr, in particular the worrying upward trend in the data, where the weighted mean of all the measurements increases, on average, by 35 days each time a new measurement result is added. The current paper reports on further analyses of these data. New measurements of the half-life of 90Y have been reported by Kossert and Schrader [2004. Standardization by liquid scintillation counting and half-life measurements of 90Y. Appl. Radiat. Isot. 60, 741]. This has prompted a new evaluation of all available published 90Y half-life data. The data are fairly consistent, and a value of 64.063(16) h is recommended.

Computer Simulation↗

PubMed2006

Removal of Ni(II), Zn(II) and Cr(VI) from aqueous solution by Alternanthera philoxeroides biomass.

Alternanthera philoxeroides biomass, a type of freshwater macrophyte, was used for the sorptive removal of Ni(II), Zn(II) and Cr(VI) from aqueous solutions. Variables of the batch experiments include solution pH, contact time, particle size and temperature. The biosorption capacities are significantly affected by solution pH. Higher pH favors higher Ni(II), Zn(II) removal, whereas higher uptake of Cr(VI) is observed as the pH is decreased. A two-stage kinetic behavior is observed in the biosorption of Ni(II), Zn(II) and Cr(VI): very rapid initial biosorption in a few minutes, followed by a long period of a slower uptake. It is noted that an increase in temperature results in a higher Ni(II), Zn(II) and Cr(VI) loading per unit weight of the sorbent. Decreasing the particle sizes of the Alternanthera philoxeroides biomass leads to an increase in the Ni(II), Zn(II) and Cr(VI) uptake per unit weight of the sorbent. All isothermal data are fairly well fitted with Langmuir equations. The thermodynamic parameter, DeltaG degrees, were calculated. The negative DeltaG degrees values of Cr(VI), Ni(II) and Zn(II) at various temperatures confirm the adsorption processes are spontaneous.

Adsorption↗

PubMed2006

Modeling fire-induced smoke spread and carbon monoxide transportation in a long channel: Fire Dynamics Simulator comparisons with measured data.

Smoke and toxic gases, such as carbon monoxide, are the most fatal factors in fires. This paper models fire-induced smoke spread and carbon monoxide transportation in an 88m long channel by Fire Dynamics Simulator (FDS) with large eddy simulation (LES). FDS is now a well-founded fire dynamics computational fluid dynamic (CFD) program, which was developed by National Institute of Standards and Technology (NIST). Two full scale experiments with fire sizes of 0.75 and 1.6MW were conducted in this channel to validate the program. The spread of the fire-induced smoke flow together with the smoke temperature distribution along the channel, and the carbon monoxide concentration at an assigned position were measured. The FDS simulation results were compared with experimental data with fairly good agreement demonstrated. The validation work is then extended to numerically study the carbon monoxide concentration distribution, both vertically and longitudinally, in this long channel. Results showed that carbon monoxide concentration increase linearly with the height above the floor and decreases exponentially with the distance away from the fire source.

Carbon Monoxide↗

PubMed2001

Rock matrix diffusivity determinations by in-situ electrical conductivity measurements.

A fast method to determine rock matrix diffusion properties directly in the bedrock would be valuable in the investigation of a possible site for disposal of nuclear waste. An "effective diffusivity borehole log" would provide important information on the variability of this entity over the area studied. As opposed to traditional matrix diffusion laboratory experiments, electrical conductivity measurements are fast, inexpensive and also easy to carry out in-situ. In this study, electrical resistivity data from borehole logging, as well as from measurements on the actual core, is evaluated with the purpose of extracting matrix diffusivity data. The influence of migration of ions in the electrical double layer, which can be of great importance in low ionic strength pore water, is also considered in evaluating the in-situ data to accurately determine the effective pore diffusivity. The in-situ data compare fairly well to those measured in the rock core.

Diffusion↗

PubMed2002

Communicative competence in the delivery of bad news.

Grounded in the Cegala and Waldron (Communication Studies 43 (1992) 105) model of communicative competence, the present study applied the McNeilis (Health Communication 13 (2001) 5) provider-patient coding scheme to video tapes of 3rd year medical students delivering bad news to a standardized patient. The goal of the study was to understand the specific communicative moves that are associated with perceptions of competence during bad news delivery. The coding scheme assesses Content, Acknowledgment Tokens, Interruptions, Alignment, and Function of the message. Naïve observers also evaluated the tapes on several items, assessing empathy and communicative effectiveness. Nonmedical talk was the most common type of content, followed by discussion of the current health problem. Neither acknowledgment tokens nor interruptions were frequent. The most common function of a message was a closed question, followed by explanations, assertions, and open questions. Summing across the functions indicated that information giving was the nost common behavior. The perceivers' data showed fairly neutral assessments of the medical students--they were generally not evaluated very positively, although they were not disliked. Regression analyses indicated numerous specific communicative behaviors that were associated with judgments of competence. Statements falling into the Nonspecific Content category were associated with more positive perceptions, while relational statements, moderately closed questions, solicited answers, expansions, restatements, assertions, explanations, open questions, bracketing, and small talk as well as information verifying, seeking, and giving (summed functions) led to more negative perceptions. The results indicate that the delivery of bad news requires communicative moves that differ from other kinds of medical communication. Depending on the results of future analyses of this topic health are providers may be well advised to focus little of their communication information seeking, giving, or verifying during the initial lab news delivery consultation, but rather to save most communication information for a follow-up scheduled shortly afterwards.

Clinical Clerkship↗

PubMed2001

Childhood malignancies in the EUROCARE study: the database and the methods of survival analysis.

This paper describes the database of children with cancer in the EUROCARE study and the methodology used to analyse and report survival. This is the first systematic evaluation of survival after childhood cancer on a large scale in Europe: approximately 45,000 cases were included, diagnosed between 1978 and 1992 (34,814 cases diagnosed in 1978--1989 and an additional set of 9495 cases diagnosed in 1990--1992) and followed-up until 1995. Data were provided from 34 population-based registries (four specialised for childhood cancer registrations and one specialised registry for childhood leukaemia) in 17 countries of Europe (where there was national coverage in 10 countries). Quality of the data was fairly good, given the general differences among the countries and their health systems, thereby allowing for comparisons between them. Among cases diagnosed in 1978--1989, overall 2.0% were lost to follow-up, 91.8% were microscopically diagnosed and 93.4% of alive cases had at least 5 years of observation. Survival proportions (observed survival) were calculated for each of the countries involved, by age group (0, 1--4, 5--9, 10--14 years), gender, different time periods and selected diagnostic groups. Age-standardised cumulative survival rates and European averages (weighted and pooled) were also computed. Cox regression models were used to evaluate geographical and temporal differences. The EUROCARE database represents a unique source of information on survival of childhood cancer patients in Europe, intercountry differences and time trends in survival.

Adolescent↗

PubMed2002

Quality assurance in the EORTC 22921 trial on preoperative radiotherapy with or without chemotherapy for resectable rectal cancer: evaluation of the individual case review procedure.

The aim of this study was to assess any inconsistency with the protocol guidelines for preoperative radiotherapy for rectal cancer among radiotherapy institutions participating in the framework of a multicentre phase-III European Organization for Research and Treatment of Cancer (EORTC) clinical trial. Twelve radiotherapy departments with more than 10% of the evaluable patients recruited in the trial, were invited to participate in this individual case review. Participating institutions were asked to send five full patient records with the chemotherapy charts, surgical and pathology reports, radiation treatment charts, treatment planning calculations, computed tomography (CT) scans, portal images and follow-up charts. The sample of the 5 patients per institution was randomly selected at the EORTC Data Center. All 12 departments participated. In 21 (35%) of the cases, a three-field technique with two lateral opposed wedge fields and a posterior field was used, while in 39 (65%) of the cases a four-field pelvic box technique was used. All participants used linear accelerators with a minimum of 6 MeV photon-beam energy. In general, the patients were eligible, documentation of clinical data was fair to good and there were no systematic major protocol deviations. The actual total dose was 44.7+/-a standard deviation (S.D.) of 4.6 Gy. Some variation was found in the fraction size. All institutions complied with the protocol in specifying the reference dose at the ICRU point. The clinical target volume (CTV) drawn on the CT scan was narrow in 7 (12%) cases, but eventually the actually treated volumes in terms of planned treatment volume (PTV) were correct. In two institutions, although the CTV was drawn correctly, the fields appeared to be narrow especially in cranio-caudal direction. Variations in treated volumes and total radiation dose were encountered in the individual case review. By providing recommendations early during the course of the trial, we expect to improve the inter-institutional consistency and to promote a high quality treatment in all of the participating institutions.

Clinical Protocols↗

PubMed1991

Inter-observer agreement in assessing comatose children.

Inter-observer agreement was evaluated for twelve items used in the neurological assessment of comatose children. Data were obtained prospectively on fifteen patients examined independently by two observers in a double-blind fashion. Observer variability was measured by using the Disagreement Rate and Kappa statistic. The Disagreement Rate ranged from 0.01 to 0.12 for all items. Values for Kappa statistic were generally in accordance with those for Disagreement Rate. The data suggest fair to almost perfect inter-observer agreement for the items used to assess comatose children in this study.

Adolescent↗

PubMed2006

Hydrogen and deuterium atoms in octasilsesquioxanes: experimental and computational studies.

The rate of detrapping of atomic hydrogen from several octasilsesquioxanes is the same for dissolved and solid samples and is independent of the presence of other species such as free radicals or oxygen; varying the cage substituents leads to only minor differences in the activation parameters. Hydrogen atoms are found to be more strongly stabilized in homosubstituted octasilsesquioxanes compared with singly Ge-substituted cages. A kinetic isotope effect observed for the detrapping of H and D from MeT(8) is ascribed to the difference in the zero-point energies of the trapped atoms. There is a secondary H/D isotope effect in the temperature dependence of the (29)Si-superhyperfine splitting constants in the range 228-353 K. Cage relaxation has a substantial effect on the detrapping barrier but little influence on the intracage potential. Calculations using a rigid cage approximation give satisfactory agreement with zero-point parameters extracted from experimental data. Different model chemistries yield qualitatively different pictures of the dependence of the hyperfine coupling constant of the trapped H atom upon the detrapping coordinate. Within an isotropic approximation of the vibrational displacements, the B3LYP data give fairly close agreement with the experimental temperature dependence, subject to a shift of the absolute value related to known weaknesses of the method. For the Si(7)Ge cage, it is found that the transition state in which the H atom passes through a Ge-containing face is strongly favored, accounting for the larger detrapping rate parameters observed experimentally for this species.

Journal Article↗

PubMedDate not supplied

Antioxidant vitamins in the prevention of cancer.

Cancer is a leading cause of morbidity and mortality in the United States and other developed countries. In searching for preventive strategies against this disease, researchers have postulated that antioxidant vitamins may play a role in preventing cancer since several plausible biological mechanisms exist. This article reviews the epidemiological evidence for a role of antioxidant vitamins (in particular, beta-carotene, vitamin E, and vitamin C) in the development of cancer. Observational studies provide fairly consistent data for an inverse association between high intake of antioxidant vitamins, especially beta-carotene and vitamin C, and cancer risk. However, randomized trials generally have not supported the hypothesis. Several explanations for these inconsistent findings are possible. These include: 1) confounding by other healthy dietary and nondietary habits in observational studies; 2) the protective role of a combination of many different nutrients present in fruits and vegetables, rather than the single nutrient or combination of two nutrients that most trials have tested; 3) inadequate duration of follow-up in most randomized trials; and 4) heterogeneity of the populations studied. Reliable epidemiological evidence regarding whether antioxidant vitamins play a role in preventing cancer will have to come from both observational studies and randomized trials since these different study designs each have unique strengths and limitations. Based on the available evidence, it seems prudent to advocate a diet rich in fruits and vegetables, rather than the consumption of specific antioxidant vitamin supplements, in order to decrease the risk of developing cancer.

Antioxidants↗

PubMed1990

[Cataract diagnosis using scattered light at 700 nm].

The present study was undertaken to determine whether the scattered light of lenses measured with the Opacity Lensmeter 701 can be used for objective, quantitative assessment of lens opacities, and how far pupillary diameter and the type of lens opacity affect the measurement. Visual acuity and scattered light were determined in 150 eyes with the Opacity Lensmeter set at 700 nm. In the group with nuclear cataract there was a significant correlation between visual acuity and the amount of scattered light measured by the Lensmeter. In the groups with cataracta scutellaris posterior and cortical cataract there was no significant correlation between visual acuity and scattered light measurements. While the Interzeag Opacity Lensmeter 701 is capable of furnishing data on fairly large populations with nuclear cataract, it is of limited value for assessing individual cases. The influence of pupillary diameter on the scattered light measurement was examined in 50 selected eyes. In all 30 of the eyes with cataract, significant correlations were found between pupillary diameter and scattered light measurements, while this was the case in only 10 of the 20 normal eyes. Therefore, when measuring stray light in cataract cases, the pupillary diameter should be stated.

Cataract↗

PubMed2000

Relationship between cellular radiosensitivity and non-repaired double-strand breaks studied for different growth states, dose rates and plating conditions in a normal human fibroblast line.

PURPOSE: The aim of this study was to test under which conditions non-repaired DNA double-strand breaks (dsb) could be used as an indicator of cellular radiosensitivity of normal human fibroblasts. MATERIALS AND METHODS: The experiments were performed with a primary normal skin fibroblast line (NFHH) derived from a healthy donor. Cells were X-irradiated either in exponential or confluent state with high (4 Gy/min) or low dose rate (0.04 Gy/min) and either plated immediately or delayed after irradiation. The fraction of clonogenic cells was determined after doses up to 12 Gy using colony forming assay and the number of non-repaired dsb were measured 24 h after X-irradiation with doses up to 180 Gy using constant-field gel electrophoresis. RESULTS: Cellular radiosensitivity of NFHH cells was found to depend on all three conditions tested. In contrast, the number of non-repaired dsb was found to depend on dose rate and growth state only. There were, however, no differences for the plating conditions tested. This result was attributed to the almost complete inhibition of cell-cycle progression when cells were plated immediately after irradiation. For the two dose rates and growth conditions, differences in non-repaired dsb were found to correspond with the respective differences measured for the cellular radiosensitivity, and these data agreed fairly well with the correlation previously found for 11 fibroblast lines varying in dsb repair capacity. CONCLUSIONS: For irradiation followed by delayed plating only, non-repaired dsb can be used to predict the cellular radiosensitivity.

Cell Division↗

PubMed1996

Trends in cancer incidence and mortality in Vaud, Switzerland, 1974-1993.

BACKGROUND: Comparing incidence of and mortality from cancer within a given population yields several benefits. One of these is the opportunity, when trends in incidence differ from those in mortality, to derive inferences about the potential role of improved diagnosis in the rise of incidence rates, and about therapeutic advancements in reducing mortality. MATERIALS AND METHODS: Trends in incidence of and mortality from various cancers or groups of cancers (comprising 55,682 new malignant tumours and 26,528 certified cancer deaths) over the period 1974-1993 were compared using, respectively, data from the Cancer Registry of the Swiss Canton of Vaud (with about 600,000 inhabitants) and those provided by the Swiss Federal Statistical Office. RESULTS: The overall cancer incidence increased by 10% to 30% in both sexes and various age groups, whereas mortality remained approximately the same. The sites primarily responsible for these divergent trends were breast, prostate and colorectal, three sites where cancers have been less frequently diagnosed since the advent of certain technical advancements and the introduction of screening. Other contributors to the divergent trends were testicular cancer, Hodgkin's disease and leukaemias, i.e., the sites for which the most substantial therapeutic advancements have been achieved. CONCLUSIONS: These data are fairly reassuring, since they are inconsistent with an ongoing cancer epidemic in this European population. However, they are also incompatible with the presence of major advancements in the prevention and treatment of cancer.

Adult↗

PubMed2002

Cell growth in a pinned soap froth.

Experimental kinetic data on soap froth cell growth in a random array of fixed pinning centers is reported. The scaling of our two-dimensional data is analyzed and compared with pinning-free growth. The obtained data agree fairly well with a proposed cell growth law. We also discuss the relationship between the pin concentration and the final cell size.

Journal Article↗

PubMed1976

A validation of cause-of-death certification in 1,156 deaths.

Swedish twins have been followed for mortality since 1961, when the Swedish Twin Registry was formed. During the years 1961-73 there were 1290 deaths among twins born in 1901-25. In 1156 cases the cause of death could be established from collected records and classified according to the 1965 revision of ICD. Using the review of records as the standard, rates of detection and confirmation relating to the death certificate diagnoses were calculated. It is concluded that Swedish death certificate data are fairly valid for use in epidemiological studies and mortality statistics with regard to most cancer forms, cerebrovascular disease, ischemic heart disease, bronchitis, asthma and emphysema, accidents and suicides, but not for diabetes mellitus, alcoholism, mental diseases, rheumatic heart diseases and other heart diseases. However, in selected clinical-epidemiological studies it is often necessary to collect all available documents prior to judging the cause of death.

Aged↗

PubMed2005

Evaluation by dental students of a communication skills course using professional role-players in a UK school of dentistry.

This paper reports student (n = 180) feedback on the role-play teaching methodology used in behavioural sciences teaching at The School of Dentistry in Birmingham (UK). The feedback received on this well-established (since 1995) educational programme was collected via questionnaire (100% response rate), requiring Likert scale and free text responses. Generally students reported that they had enjoyed and valued the session. Over two-thirds (69.7%) of students rated the role-players as 'very real' and over three-quarters (78.9%) rated their feedback as 'very fair'. The data collected from this study will inform future curriculum development. Student feedback was very positive and demonstrated that the cohort (86% of all students studying in years 1, 2 and 3) found the use of professional role-players involved in behavioural sciences teaching to be both acceptable and valuable.

Attitude↗