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PubMed2005

Polyrigid and polyaffine transformations: a novel geometrical tool to deal with non-rigid deformations - application to the registration of histological slices.

We describe in this paper a novel kind of geometrical transformations, named polyrigid and polyaffine. These transformations efficiently code for locally rigid or affine deformations with a small number of intuitive parameters. They can describe compactly large rigid or affine movements, unlike most free-form deformation classes. Very flexible, this tool can be readily adapted to a large variety of situations, simply by tuning the number of rigid or affine components and the number of parameters describing their regions of influence. The displacement of each spatial position is defined by a continuous trajectory that follows a differential equation which averages the influence of each rigid or affine component. We show that the resulting transformations are diffeomorphisms, smooth with respect to their parameters. We devise a new and flexible numerical scheme to allow a trade-off between computational efficiency and closeness to the ideal diffeomorphism. Our algorithms are implemented within the Insight Toolkit, whose generic programming style offers rich facilities for prototyping. In this context, we derive an effective optimization strategy of the transformations which demonstrates that this new tool is highly suitable for inference. The whole framework is exemplified successfully with the registration of histological slices. This choice is challenging, because these data often present locally rigid deformations added during their acquisition, and can also present a loss of matter, which makes their registration even more difficult. Powerful and flexible, this new tool opens up large perspectives, in non-rigid 3D rigid registration as well as in shape statistics.

Algorithms↗

PubMed2005

Riskard 2005. New tools for prediction of cardiovascular disease risk derived from Italian population studies.

BACKGROUND AND AIM: The need to update tools for the estimate of cardiovascular risk prompted the "Gruppo di Ricerca per la Stima del Rischio Cardiovascolare in Italia" to produce a new chart and new software called Riskard 2005. METHODS AND RESULTS: Data from 9 population studies in 8 Italian regions, for a grand total of 17,153 subjects (12,045 men and 5,108 women) aged 35-74 and for a total exposure of about 194,000 person/years were available. A chart for the estimate of cardiovascular risk (major coronary, cerebrovascular and peripheral artery disease events) in 10 years was produced for men and women aged 45-74 free from cardiovascular diseases. Risk factors employed in the estimate were sex, age (6 classes), systolic blood pressure (4 classes), serum cholesterol (5 classes), diabetes, and cigarette smoking (4 classes). Estimates were produced for absolute risk and for relative risk, the latter against levels expected in the general population that produced the risk functions. Software was produced for the separate estimate of major coronary, cerebrovascular and cardiovascular events (the latter made by coronary, cerebrovascular and peripheral artery disease of atherosclerotic origin) for follow-up at 5, 10 or 15 years, in men a women aged 35-74 years at entry and free from cardiovascular diseases. Risk factors employed here were sex, age, body mass index, mean physiological blood pressure, HDL cholesterol, non-HDL cholesterol, cigarette smoking, diabetes and heart rate. The output is based on several indicators: absolute risk, relative risk (as defined above), ideal risk (for a very favourable risk profile), biological age of risk, comparisons among the above indicators, the percent contribution of risk factors to the excess of estimated risk above the level of the ideal risk, and the description of trends in risk estimate in relation to repeated measurements. CONCLUSIONS: These tools represent progress compared to similar tools produced some years ago by the same Research Group.

Adult↗

PubMed2004

Development of a nutritional screening or assessment tool using a multivariate technique.

OBJECTIVE: The aims of this paper are to consider the important design stages required to develop a nutritional screening or assessment tool and to present an analysis for identifying important risk factors associated with malnutrition. METHODS: Design issues, such as sample selection and sample size, are addressed in relation to the study protocol. The various steps involved in tool development are outlined. Appropriate univariate and multivariate techniques are discussed with the non-statistician in mind. Emphasis is placed on the linear logistic regression method. Practical suggestions relating to the development of a tool for nutritional risk assessment are proposed, and methodology is illustrated with data from a published study. CONCLUSION: Guidelines for the standardization of the design, analyses, and publication of results are presented.

Analysis of Variance↗

PubMed2005

Simple two-part tool for screening of malnutrition.

OBJECTIVE: Malnutrition in hospitalized patients is a major problem that is underdiagnosed. Early recognition of malnutrition is important for nutritional support to be effective. Our aims were to determine the malnutrition rate at our center and to devise an effective screening tool for identifying patients at risk for malnutrition. METHODS: This prospective study included 2211 patients. Each subject was assessed for malnutrition by the Subjective Global Assessment (SGA), and combination criteria (CC), which included anthropometric measurements and laboratory testing. Findings based on these methods were compared with findings in a series of malnutrition screening tests (malnutrition screening tool, self-assessment portion of a mini-nutritional assessment, a question about unintentional weight loss, evaluation of loss of subcutaneous fat, and various combinations of these). RESULTS: The SGA and CC methods identified 242 (11.0%) and 345 (15.6%) patients as malnourished, respectively. Of the screening methods that were tested, the combination of unintentional weight loss and loss of subcutaneous fat proved to be the most valuable, with 93% accuracy for predicting malnutrition according to the SGA, and 82.9% accuracy for predicting malnutrition according to CC. The corresponding negative predictive values were 95.5% and 87.3%. CONCLUSIONS: The results show that this simple two-part nutritional screening tool (unintentional weight loss and loss of subcutaneous fat) is valuable for identifying malnutrition according to the SGA and CC at our institution; however, its validity must be confirmed at other centers.

Adipose Tissue↗

PubMed2004

Development of a primary-care tool to assess treatment success in COPD: consensus report from a closed meeting of respiratory and primary-care specialists.

A 1-day meeting, attended by invited respiratory and primary-care specialists all of whom had an international profile and a specific interest in Chronic Obstructive Pulmonary Disease (COPD), considered specific research recommendations from the Global Initiative in Obstructive Lung Disease (GOLD) workshop report. Attendees discussed developing a tool to complement spirometry and help primary-care physicians assess treatment success in patients with chronic obstructive pulmonary disease. Discussion focused on the requirement of such a tool, and the limitations of existing tools. Proposals followed for a simple, cost-effective checklist for primary-care. This paper is a consensus report of the discussions from the meeting. Decisions reached on the proposed questionnaire were unanimous.

Journal Article↗

PubMedDate not supplied

The Nurse Reinvestment Act: the impact of governmental and nongovernmental administrative tools.

The Nurse Reinvestment Act has ushered in a new wave of federal involvement intended to address the issue of the critical nursing shortage. To implement this act, administrators will rely on a series of governance tools often called upon to address issues related to the social welfare of the country. Included among these tools are grants and loans through which the intent of the legislation will be formalized. The purpose of this analysis is to provide an overview of the characteristics associated with these tools, specifically as they relate to nursing education. Consideration will be given to the political environment through which funding, and thus the ability to implement the Nurse Reinvestment Act, will be realized, and the potential obstacles when executing federal programs in a market-driven economy.

Community Participation↗

PubMed2004

Tools to assess (and achieve?) long-term asthma control.

Assessment tools are needed to monitor asthma control and to detect exacerbations before the alteration of functional parameters and the occurrence of symptoms. The ability to effectively monitor asthma control would enable clinicians to increase corticosteroid dose or to stop corticosteroid tapering before symptoms occur. As a few severe exacerbations are expected per year in treated patients, these tools must be suitable for long-term use. They must also be reproducible, acceptable to patients and be non-invasive. Tools currently available to assess asthma control include assessment of: clinical parameters (e.g. nocturnal awakenings; bronchodilator intake; symptom scores); lung function (e.g. peak expiratory flow and forced expiratory volume in 1 s); subjective parameters of asthma control (e.g. asthma control questionnaire (ACQ)); bronchial hyper-responsiveness; eosinophilia in induced sputum; and exhaled nitric oxide (NO) concentration. Clinical symptoms, lung function and the ACQ have proved to be inadequate markers of asthma control, as changes in these parameters occur at the same time as symptom manifestation. By contrast, sputum eosinophilia and exhaled NO concentrations are truly predictive of asthma exacerbations; monitoring these parameters are useful in preventing exacerbations from occurring in the first instance. They also assess, and help to achieve asthma control in the long term.

Asthma↗

PubMed2005

Combining HPLC pigment markers and ecological similarity indices to assess phytoplankton community structure: an environmental tool for eutrophication?

A new tool combining the use of HPLC pigment markers with ecological similarity indices, to provide a fast and effective environmental tool for monitoring water quality, was investigated. HPLC pigment concentrations from a 4-year time series data set (2000-2003) from the western English Channel were used to calculate six similarity indices to assess changes in phytoplankton community structure. Indices obtained from HPLC data were compared with those produced from the corresponding phytoplankton biomass derived from microscopic analysis. Multivariate RELATE analyses (P<0.001) suggested that there was little loss of information when species biomass data were grouped into higher taxonomic levels, thereby providing justification for the use of pigment markers. To test the proposed methodology, product moment (r) and Spearman's rank (r(s)) correlation analyses were performed. Highly significant correlations (P<0.01, Canberra Metric: P<0.05) between percentage similarities derived from phytoplankton class biomass and pigment markers were found for all indices when data were pooled (n=104). A Mann-Whitney U-test suggested that indices were more sensitive to changes in relative biomass than pigment concentrations; however, pigment data also produced statistically significant findings (P<0.05). Combining HPLC pigment markers and ecological similarity indices to assess phytoplankton community structure has advantages over microscopy in that it is rapid, reproducible and better suited to large-scale environmental monitoring. We present a basic protocol for implementing this new tool using a suite of similarity indices into environmental monitoring of phytoplankton communities.

Chromatography, High Pressure Liquid↗

PubMed2004

Two new tools for assessing patients' knowledge and beliefs about obstructive sleep apnea and continuous positive airway pressure therapy.

BACKGROUND AND PURPOSE: Patients' knowledge and beliefs about their illnesses are known to influence a range of health related variables, including treatment compliance. It may, therefore, be important to quantify these variables to assess their impact on compliance, particularly in chronic illnesses such as Obstructive Sleep Apnea (OSA) that rely on self-administered treatments. The aim of this study was to develop two new tools, the Apnea Knowledge Test (AKT) and the Apnea Beliefs Scale (ABS), to assess illness knowledge and beliefs in OSA patients. PATIENTS AND METHODS: The systematic test construction process followed to develop the AKT and the ABS included consultation with sleep experts and OSA patients. The psychometric properties of the AKT and ABS were then investigated in a clinical sample of 81 OSA patients and 33 healthy, non-sleep disordered adults. RESULTS: Results suggest both measures are easily understood by OSA patients, have adequate internal consistency, and are readily accepted by patients. A preliminary investigation of the validity of these tools, conducted by comparing patient data to that of the 33 healthy adults, revealed that apnea patients knew more about OSA, had more positive attitudes towards continuous positive airway pressure (CPAP) treatment, and attributed more importance to treating sleep disturbances than non-clinical groups. CONCLUSIONS: Overall, the results of psychometric analyses of these tests suggest these measures will be useful clinical tools with numerous beneficial applications, particularly in CPAP compliance studies and apnea education program evaluations.

Adult↗

PubMed2004

The neural bases of complex tool use in humans.

The behaviors involved in complex human tool use cut across boundaries traditionally drawn between social, cognitive, perceptual and motor processes. Longstanding neuropsychological evidence suggests a distinction between brain systems responsible for representing: (1) semantic knowledge about familiar tools and their uses, and (2) the acquired skills necessary for performing these actions. Contemporary findings in functional neuroimaging support and refine this distinction by revealing the distributed neural systems that support these processes and the conditions under which they interact. Together, these findings indicate that behaviors associated with complex tool use arise from functionally specialized networks involving temporal, parietal and frontal areas within the left cerebral hemisphere.

Behavior↗

PubMed2025

CRISPR tools for T cells: targeting the genome, epigenome, and transcriptome.

T cell therapy has curative potential for many cancers. Despite impressive clinical efficacy in hematological malignancies, current T cell therapy still faces challenges related to sustaining responses, antigen escape, cytotoxicity, limited accessibility, and difficulties in treating solid tumors. The advent of CRISPR (clustered regularly interspaced short palindromic repeats) technologies provides a promising solution to these challenges. CRISPR technologies have grown from merely tools for gene knockout to sophisticated tools that can engineer cells at various levels of the genome, epigenome, and transcriptome. In this review we discuss recent technological advancements and how their application to T cells has the potential to steer the next generation of cellular therapy. We highlight emerging applications and current technological limitations that future tool development aims to overcome.

Humans↗

PubMed2004

Prostate-specific antigen velocity at low prostate-specific antigen levels as screening tool for prostate cancer: results of second screening round of ERSPC (ROTTERDAM).

OBJECTIVES: To study retrospectively whether the prostate-specific antigen (PSA) velocity, that is, the change in PSA level over time, might serve as a screening tool in this PSA range. It is estimated that 40% of detectable prostate cancers are present in men with a PSA level of 4.0 ng/mL or less. Digital rectal examination and/or transrectal ultrasonography have been used as screening tools at these low PSA levels, but this approach is not very efficient. METHODS: The possible predictors (including PSA velocity) for biopsy outcome were studied using univariate and multivariate logistic regression analysis in 774 men who underwent biopsy between November 1997 and January 2002 in the second screening round of the European Randomised Study of Screening for Prostate Cancer (ERSPC). The clinical stage of the tumors was determined, and the Gleason scores of the biopsies were studied. RESULTS: A total of 149 cancers were found (positive predictive value 19.2%). The odds ratio for the PSA velocity determined by univariate logistic regression analysis was 2.2 (95% confidence interval 0.7 to 6.9, P = 0.19) and was 0.73 (95% confidence interval 0.20 to 2.6, P = 0.64) by multivariate analysis. The distribution of the clinical stage of the detected tumors was 64.4% T1c, 32.2% T2, and 3.4% T3. The biopsy Gleason score was 6 in 84.5%, 7 in 14.2%, and 8 in 1.3%. CONCLUSIONS: The number of cancers detected in this study and the distribution of clinical stage and biopsy Gleason score confirmed that a relatively large proportion of potentially curable cancers can be found in the low PSA ranges. The PSA velocity did not appear to be a useful screening tool for the identification of these cancers.

Adenocarcinoma↗

PubMed2006

Computational tools for isotopically instationary 13C labeling experiments under metabolic steady state conditions.

(13)C metabolic flux analysis (MFA) has become an important and powerful tool for the quantitative analysis of metabolic networks in the framework of metabolic engineering. Isotopically instationary (13)C MFA under metabolic stationary conditions is a promising refinement of classical stationary MFA. It accounts for the experimental requirements of non-steady-state cultures as well as for the shortening of the experimental duration. This contribution extends all computational methods developed for classical stationary (13)C MFA to the instationary situation by using high-performance computing methods. The developed tools allow for the simulation of instationary carbon labeling experiments (CLEs), sensitivity calculation with respect to unknown parameters, fitting of the model to the measured data, statistical identifiability analysis and an optimal experimental design facility. To explore the potential of the new approach all these tools are applied to the central metabolism of Escherichia coli. The achieved results are compared to the outcome of the stationary counterpart, especially focusing on statistical properties. This demonstrates the specific strengths of the instationary method. A new ranking method is proposed making both an a priori and an a posteriori design of the sampling times available. It will be shown that although still not all fluxes are identifiable, the quality of flux estimates can be strongly improved in the instationary case. Moreover, statements about the size of some immeasurable pool sizes can be made.

Biomedical Engineering↗

PubMed2000

Assessment of morbidity in Schistosoma haematobium infection: current methods and future tools.

Recently, new potential tools for assessment of Schistosoma haematobium related morbidity have emerged. The tools are based on detection of S. haematobium egg antigens in urine or detection of eosinophil cationic protein (ECP) in urine, which may reflect the inflammatory response in the urinary tract. So far two markers have been assessed in long-term post treatment follow-up studies, allowing for an evaluation both before treatment and during regression and reappearance of infection and urinary tract morbidity. The results from these studies and the usefulness of the markers as morbidity assessment tools are discussed.

Africa↗

PubMed2003

Immunodiagnostic tools for human and porcine cysticercosis.

The development of improved immunodiagnostic tools has contributed to our knowledge on the importance of taeniosis/cysticercosis by enabling sero-epidemiological surveys and community-based studies to be carried out. Immunodiagnostic techniques include detection methods for specific antibodies and for circulating parasite antigen in serum or cerebrospinal fluid. The antigens used in immunoblot and enzyme-linked immunosorbent assay (ELISA) for antibody detection have evolved from crude extracts to highly purified specific fractions and recombinant antigens of the glycoprotein family, increasing both the sensitivity and the specificity of the tests. The application of ELISA for the detection of circulating parasite antigens may present some diagnostic advantages since it demonstrates not only exposure but also active infections. Until now only a few of the current techniques have been standardised and fully validated, making comparisons between studies difficult. The lack of a gold standard is a serious drawback. In surveys on cysticercosis, antibody detection systems have been useful in identifying the risk factors associated with transmission of Taenia solium; a high seroprevalence in a community indicates a "hot spot" where preventive and control measures should be applied. In contrast, the potential use of immunodiagnostic tools to identify cases of neurocysticercosis (NCC) in man is subject to debate. The correlation between a positive serology and neurological symptoms and/or lesions indicative for NCC on neuro-imaging techniques is poor to fair in most studies. This may be explained by the unpredictable clinical outcome of the infection and the variable immunological response of the human host to infection. A major problem is that in many developing countries, neuro-imaging methods are inaccessible and/or too expensive for the rural population at risk. Under these conditions, serology may provide the only tool for diagnosis of the infection.

Animals↗

PubMed2001

Development and validation of a screening tool to identify eating disorders in female athletes.

OBJECTIVE: To develop and validate a screening tool to identify eating pathology in women athletes. DESIGN: Three cross-sectional subject groups were established: college women athletes diagnosed with eating disorders; college women athletes without eating pathology; college women who did not participate in athletics but were diagnosed with an eating disorder. The Female Athlete Screening Tool (FAST), and 3 valid psychometric measures were administered to subjects in all groups. Internal reliability, discriminant and concurrent validity were established. SUBJECTS/SETTINGS: Women college students between the ages of 18 and 23 years (n=41) from the University of Connecticut and St Joseph College were recruited. The athletes were screened for eating disorders by a sports medicine team. STATISTICAL ANALYSIS: Cronbach's alpha, one-way analysis of variance, and correlation analyses. RESULTS: Reliability analysis indicated a high internal consistency of the FAST (Cronbach's alpha = 0.87). Athletes with eating disorders scored significantly higher on the FAST as compared with athletes without eating pathology and nonathletes with eating disorders (P<.001), which demonstrated discriminant validity. Correlation analyses showed that the FAST was strongly correlated to the Eating Disorder Examination-Questionnaire (0.60, P<.05) and Eating Disorder Inventory (0.89, P<.001). APPLICATIONS/CONCLUSIONS: Early detection of eating disorders can help prevent the onset or severity of a clinical eating disorder. By using the screening tool that has been validated for use in women athletes, dietetic professionals can quickly identify those athletes who need assistance with their aberrant eating habits.

Adolescent↗

PubMed1996

Development and validation of the Cholesterol-Saturated Fat Index (CSI) Scorecard: a dietary self-monitoring tool.

OBJECTIVE: The Cholesterol-Saturated Fat Index (CSI) Scorecard was developed and tested as a self-monitoring tool for patients consuming a cholesterol-lowering diet. SUBJECTS/DESIGN: Twelve nutritionists used the CSI Scorecard to estimate the CSI score of the same five food records. Subsequently, using a revised tool, 12 subjects with hypercholesterolemia estimated the CSI score of their 4-day food records and 11 participated in evaluation meetings. STATISTICAL ANALYSES: Two-tailed, one-sample t tests and the Spearman rho correlation test were used, respectively, to compare CSI Scorecard estimates of nutritionists and participants to CSI scores obtained from computer calculations. RESULTS: The CSI scores estimated by the nutritionists were close to the computed scores at the 25th and 75th food record percentiles. The correlation of the estimated CSI scores of participants to the computed scores was rs = .8 (P < .05). APPLICATION: The CSI Scorecard is a new, simple, quick, and accurate dietary self-monitoring tool patients can use in research centers and primary care settings. By numerically illustrating the saturated fat and cholesterol content of foods, the CSI Scorecard facilitates dietary self-monitoring and, thus, self-efficacy in the adoption and maintenance of a cholesterol-lowering dietary pattern.

Adult↗

PubMed1999

Morbidity assessment index for newborns: a composite tool for measuring newborn health.

OBJECTIVE: The objective was to develop, validate, and recommend a scaling model for a discriminative obstetric outcome measure named the Morbidity Assessment Index for Newborns. The purpose of this tool is to allow comparison of obstetric therapeutic strategies on neonatal morbidity, particularly in the mild to moderate morbidity range. STUDY DESIGN: A list of 66 check-mark (yes or no) items of readily available clinical and laboratory data from the early neonatal period was compiled by a panel of obstetric and neonatal experts. These data were collected on 411 neonates born at >/=28 weeks' gestation and representing all grades of morbidity. Detailed psychometric testing included dimensionality testing and item analysis with the item response theory. The scores obtained with this new assessment tool were correlated with newborn and maternal disease conditions or events and with other measures of newborn morbidity. RESULTS: The Morbidity Assessment Index for Newborns is easy to apply in prospective or retrospective studies. Detailed psychometric evaluation resulted in modification of the list to 47 items, each item with a relative scale value according to severity of morbidity. The test was demonstrated to be a reliable and generalizable scaled index that performs optimally for the mild to moderate neonatal morbidity range. CONCLUSION: The Morbidity Assessment Index for Newborns is a validated outcome measurement scale of neonatal morbidity. This new tool may facilitate the conduct of obstetric clinical trials or epidemiologic population-based studies in obstetrics.

Birth Weight↗