Medicine and Health Sciences Commons^™

Improved Peak Detection And Quantification Of Mass Spectrometry Data Acquired From Surface-Enhanced Laser Desorption And Ionization By Denoising Spectra With The Undecimated Discrete Wavelet Transform, Kevin R. Coombes, Spiros Tsavachidis, Jeffrey S. Morris, Keith A. Baggerly, Henry M. Kuerer

Jeffrey S. Morris

Background: Mass spectrometry, especially surface enhanced laser desorption and ionization (SELDI) is increasingly being used to find disease-related proteomic patterns in complex mixtures of proteins derived from tissue samples or from easily obtained biological fluids such as serum, urine, or nipple aspirate fluid. Questions have been raised about the reproducibility and reliability of peak quantifications using this technology. For example, Yasui and colleagues opted to replace continuous measures of the size of a peak by a simple binary indicator of its presence or absence in their analysis of a set of spectra from prostate cancer patients.

Methods: We collected nipple …

Pooling Information Across Different Studies And Oligonucleotide Microarray Chip Types To Identify Prognostic Genes For Lung Cancer., Jeffrey S. Morris, Guosheng Yin, Keith A. Baggerly, Chunlei Wu, Li Zhang

Jeffrey S. Morris

Our goal in this work is to pool information across microarray studies conducted at different institutions using two different versions of Affymetrix chips to identify genes whose expression levels offer information on lung cancer patients’ survival above and beyond the information provided by readily available clinical covariates. We combine information across chip types by identifying “matching probes” present on both chips, and then assembling them into new probesets based on Unigene clusters. This method yields comparable expression level quantifications across chips without sacrificing much precision or significantly altering the relative ordering of the samples. We fit a series of multivariable …

Accounting For Missing Data In End-Of-Life Research, Paula Diehr, Laura Lee Johnson

Paula Diehr

End-of-life studies are likely to have missing data because sicker persons are less likely to provide information and because measurements cannot be made after death. Ignoring missing data may result in data that are too favorable, because the sickest persons are effectively dropped from the analysis. In a comparison of two groups, the group with the most deaths and missing data will tend to have the most favorable data, which is not desirable. Results based on only the available data may not be generalizable to the original study population. If most of the missing data are absent because of death, …

Human Telomerase Reverse Transcriptase Expression In Oral Carcinogenesis - A Preliminary Report, Kumar S. K. S., Rosnah Binti Zain, Ismail S. M., Cheong S. C.

Prof. Dr. Rosnah Binti Zain

Human telomerase reverse transcriptase (hTERT), the catalytic subunit of telomerase, is strongly associated with telomerase activity implicated in cellular immortalization and tumorigenesis. In situ detection of hTERT will aid in determining the localization of telomerase positive cells. The aim of this study was to detect hTERT protein expression in multistep oral carcinogenesis using paraffin embedded tissue samples, and to study the relationship of hTERT expression with different histological stages in oral carcinogenesis. Normal (n=4), hyperplastic (n=4), dysplastic (n=4) and neoplastic (n=10) oral epithelia representing different histological stages in oral carcinogenesis were included in the study. hTERT protein detection was done …

Methods For Incorporating Death Into Health-Related Variables In Longitudinal Studies, Paula Diehr

Paula Diehr

BACKGROUND AND OBJECTIVES: Longitudinal studies of health over time may be misleading if some people die. Self-rated health (excellent to poor) and the SF-36 profile scores have been transformed to incorporate death. We applied the same approaches to incorporate death into activities of daily living difficulties (ADLs), IADLs, mini-mental state examination, depressive symptoms, blocks walked per week, bed days, the timed walk, body mass index and blood pressure. STUDY DESIGN AND SETTING: The Cardiovascular Health Study of 5,888 older adults, was followed up to 9 years. Mean age was 73 at baseline, and 658 had an incident stroke during follow-up. …

Rotators In The Emergency Department: Conference Attendance, Duty Hours Compliance, Sick Call, And Other Issues. A Survey Of Academic Emergency Medicine Programs, Paris B. Lovett

Paris B Lovett

Rotators in the Emergency Department: Conference Attendance, Duty Hours Compliance, Sick Call, and Other Issues. A Survey of Academic Emergency Medicine Programs

Lovett PB, Lera L, Sturmann KM,

Columbia Presbyterian Medical Center, New York, NY; Beth Israel Medical Center, New York, NY

Study Objectives: To document rules, practices and perceptions regarding Internal Medicine (IM) residents who rotate in emergency departments (EDs), and Emergency Medicine (EM) residents on rotating with other services.

Methods: We mailed a survey to program directors (PDs) and chief residents of 132 EM residency programs. Surveys were returned by mail, with follow-up via telephone and internet.

Results: …

Community Hospital Risk Management, Vikas Singh

Vikas Singh

EXECUTIVE SUMMARY:

The Panacea community hospital in the Hot springs County, Arkansas is a big community hospital 52-inpatient beds providing medical. Surgical, mental health, pediatrics, Ob-gyn services and emergency care.

Of late there has been serious concern about the patient safety and quality of patient care delivered by the hospital. Close examination for the causes of the unsatisfactory quality of care and patient safety reveals that the hospital lacks proper and adequately supported risk management department. One employee only who is a part of the Quality Improvement cell sees the risk management program of the hospital and there is lack …

Expression Of G-Protein Inwardly Rectifying Potassium Channels (Girks) In Lung Cancer Cell Lines, Howard Plummer 3rd, Madhu Dhar, Maria Cekanova Ms, Rndr, Phd, Hildegard Schuller

Maria Cekanova MS, RNDr, PhD

BACKGROUND: Previous data from our laboratory has indicated that there is a functional link between the beta-adrenergic receptor signaling pathway and the G-protein inwardly rectifying potassium channel (GIRK1) in human breast cancer cell lines. We wanted to determine if GIRK channels were expressed in lung cancers and if a similar link exists in lung cancer. METHODS: GIRK1-4 expression and levels were determined by reverse transcription polymerase chain reaction (RT-PCR) and real-time PCR. GIRK protein levels were determined by western blots and cell proliferation was determined by a 5-bromo-2'-deoxyuridine (BrdU) assay. RESULTS: GIRK1 mRNA was expressed in three of six small …

Inequalities In Neighbourhood Socioeconomic Characteristics: Potential Evidence-Base For Neighbourhood Health Planning., Agricola Odoi, R Wray, M Emo, S Birch, B Hutchison, J Eyles, T Abernathy

Agricola Odoi

BACKGROUND: Population health planning aims to improve the health of the entire population and to reduce health inequities among population groups. Socioeconomic factors are increasingly being recognized as major determinants of many aspects of health and causes of health inequities. Knowledge of socioeconomic characteristics of neighbourhoods is necessary to identify their unique health needs and enhance identification of socioeconomically disadvantaged populations. Careful integration of this knowledge into health planning activities is necessary to ensure that health planning and service provision are tailored to unique neighbourhood population health needs. In this study, we identify unique neighbourhood socioeconomic characteristics and classify the …

Book Review 5 Confidence: How Winning Streaks And Losing Streaks Begin And End By Rosabeth Moss Kanter, William C. Mcpeck

William C. McPeck

This is my personal review of Confidence: How Winning Streaks and Losing Streaks Begin and End by Rosabeth Moss Kanter and published by Crown Business in 2004.

How Well Can Signs And Symptoms Predict Ami In The Malaysian Population?, Awang Bulgiba

Awang Bulgiba Awang Mahmud

The aim of the study was to use data from an electronic medical record system (EMR) to look for factors that would help us diagnose acute myocardial infarction (AMT) with the ultimate aim of using these factors in a decision support system for chest pain. We extracted 887 records from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. We cleaned the data, extracted 69 possible variables and performed univariate and multivariate analysis. From the univariate analysis we find that 22 variables are significantly associated with a diagnosis of AMT. However, multiple logistic regression reveals that only 9 of …

The Two Faces Of Intercountry Adoption: The Significance Of The Indian Adoption Scandals, David M. Smolin

David M. Smolin

This article summarizes international law, and the law of India and the United States, relevant to intercountry adoption. The article then presents extensive information and analysis of a major series of adoption scandals in Andhra Pradesh, India. The article uses this analysis of law and a major series of adoption scandals to present the "two sides of intercountry adoption:" positively, as a humanitarian act, and negatively as a form of child trafficking. The weaknesses and vulnerabilities of the intercountry adoption system that led to the Indian adoption scandals are extensively analyzed.

Intercountry Adoption As Child Trafficking, David M. Smolin

David M. Smolin

This article analyzes when intercountry adoption constitutes a form of child trafficking, particularly under international law. The article reviews relevant Treaties on the subjects of slavery and human trafficking, as well as analyzing the problem of money and adoption within the domestic (United States) adoption system.

Book Review 4 Leadership And Self Deception: Getting Out Of The Box, William C. Mcpeck

William C. McPeck

This is my personal review of Leadership and Self Deception: Getting Out of the Box by the Arbinger Institute and published by Berrett-Koehler Publishers in 2002.

Matlab Code For Bayesian Fitting Of Adaptive P-Splines In Regression, Veera Baladandayuthapani

Veera Baladandayuthapani

No abstract provided.

Validation Of The Caregiving At Life’S End Questionnaire, Jennifer R. Salmon, Jung Kwak, Kimberly D. Acquaviva, Kathleen A. Egan, Katherine E. Brandt

Kimberly D. Acquaviva, PhD, MSW

The researchers in this study developed and validated a questionnaire to measure the needs of end-of-life (EOL) caregivers. The model is used to facilitate meaningful and supportive experiences for both the patient and caregiver. The questionnaire was developed using existing scales of meaning, self acceptance, burden, and gain as well as new scales of caregiver comfort, importance of caregiving tasks, and caregiver closure. The sample included 34 current and 17 bereaved caregivers affiliated with The Hospice Institute of the Florida Suncoast. The scales performed well in terms of concurrent validity, internal consistency, and reliability.

The Economics Of Open Access Publishing In The Sciences - Recent Reports For Health Librarians, Lindsay K. Harris

Lindsay Harris

Australian health librarians would be familiar with the general background to the origins of open access publishing. These encompass the escalating costs of periodical prices that are far in excess of national inflation rates, the unending pressure on library budgets, the consequent incapacity of libraries to keep pace with mounting subscription costs and the emergence during the past decade of huge STM (scientific, technology and medical) publishers which have reduced competitive forces in the market place. That STM publishing is big business is unquestionable. In 2002 the merchant bankers Morgan Stanley estimated the global STM publishing market to be a …

Proliferative And Apoptotic Activity At The Tumour Invasive Front In Oral Squamous Cell Carcinoma, W.C. Ngeow, R. B. Zain, Z. Abidin, K. S. Phaik, S. Kumar

Wei Cheong Ngeow

Introduction: the tumour invasive front of squamous cell carcinoma (OSCC) has long been recognized as an important area which harbour prognostic information. The aim of the present study was to describe the expression of K1-67, MDM2 and Bcl-2 at the tumour invasive front in the buccal mucosa and also to investigate whether there is any association between the expression of K1-67, MDM2 and Bcl-2 with the certain sociodemographic characteristics, clinical and histopathological parameters. Materials and Methods: The sample of this study consisted of 31 biopsy cases of OSCC from the buccal mucosa. Immunohistochemistry was used with specific antibodies to K1-67, …

Oral Cancer And Precancer Research In Malaysia - The Database And Tissue Resource Bank, Rosnah Binti Zain

Prof. Dr. Rosnah Binti Zain

Introduction: Uncoordinated data collection by different research groups prompted the initiation of Malaysian oral cancer Research Initiative (MOCRI) group. Objectives: To coordinate and standardize data and tissue collection and storage, develop a minimum dataset on risk factors, intervention techniques and quality of life of oral cancer patients. Materials and Methods: A computer software programme is currently being developed to accommodate multi-centre data collection and research activities in eight hospitals. The complete dataset includes parameters on sociodemographic, clinical, pathological, quality of life measures, details of treatment methods, vital status and dietary intake. Tissues are being collected, stored and catalogued as fresh …

Immunohistochemical Localization Of Htert Protein In Oral Carcinogenesis, Kumar S., Ismail S. M., Rosnah Binti Zain, Abraham M. T., Cheong S. C.

Prof. Dr. Rosnah Binti Zain

Introduction: Human telomerase reverse transcriptase (hTERT) the catalytic subunit of telomerase is associated with cellular immortalization and tumorigenesis .In situ detection of hTERT using immunohistochemistry (IHC) allows localizing the hTERT- positive cells and also overcomes the limitation of requirement of fresh tissues for molecular techniques such as Telomeric Repeat Amplification Protocol (TRAP) for telomerase/ hTERT detection. The objectives of this study are to detect hTERT protein expression using immunohistochemistry in different histological stages in oral carcinogenesis with paraffin embedded tissue samples and cultured cells and to relate the hTERT expression with different histological stages in oral carcinogenesis. Materials and Methods: …

Expression Of P53, Prb, Ki-67 And Bcl-2 In Betel Quid Induced Oral Mucosal Lesions, Kipli N. P., Kumar S. K. S., Rosnah Binti Zain, Fan C. Y., Boon P. K.

Prof. Dr. Rosnah Binti Zain

Introduction: Alterations in p53, pRb, KI-67 and bcl-2 have been implicated the development of oral cancer although their combined expression in betel quid induced oral mucosal lesions as not clear. The objective of this study is to investigate the expressions of p53, pRb, K1-67 and bcl-2 m oral mucosa of betel quid chewing subjects. Materials and Methods: A total of 64 tissue sections were obtained from biopsy samples of 50 subjects clinically diagnosed with betel chewer's mucosa (BCM, n=32), BCM with leukoplakia (n=12) and leukoplakia (n=6). Oral squamous cell carcinoma (OSCC, 11=10) and normal oral mucosa (n=4) section were used …

Clinical Pathological Evaluation And Risk Factors Of Oral Cancer Cases Of East Coast Of Peninsular Malaysia, Farini M. S., Azlina A., Rushdan I., Manoharan M., Rosnah Binti Zain, Samsudin A. R.

Prof. Dr. Rosnah Binti Zain

Introduction: Oral cancer is one of the common cancers in Malaysia. Tile population of east coast of Peninsular Malaysia has a different hfestyle and Malay is the predominant race. Oral cancer research in this area started since the Malaysian National Oral Cancer group was established. The aim: of this study is to evaluate the clinical pathological findings and to investigate the role of tobacco smoking, alcohol consurnption and betel quid chewing as tile risk factors among oral cancer cases in east coast of peninsular Malaysia. Materials and Methods: Fifty case records of only treated/operated cases of patients with oral cancer …

Serum Proteomics Profiling: A Young Technology Begins To Mature, Kevin R. Coombes, Jeffrey S. Morris, Jianhua Hu, Sarah R. Edmondson, Keith A. Baggerly

Jeffrey S. Morris

No abstract provided.

Asthma Awareness/Evironmental Practices In Childcare Centers, Michelle G. Goveia, Nazerah Shaikh, Gayle Windham, Oliver Bembom, Katherine Feldman, Richard Kreutzer

Oliver Bembom

Asthma prevalence is increasing. Child care centers can play an important role in controlling asthma morbidity in young children. Therefore, we assessed asthma-related environmental practices in licensed centers and asthma awareness among child care staff. Two cross-sectional surveys were mailed to 1,250 randomly selected California licensed facility child care centers in 2002. Site directors were asked about the presence of items that can trigger asthma and asthma experience in their centers and were requested to distribute surveys to three child care staff members. Staff surveys assessed asthma knowledge, attitudes, and beliefs using previously validated questions. Univariate and multivariate analyses examined …

Signal In Noise: Evaluating Reported Reproducibility Of Serum Proteomic Tests For Ovarian Cancer, Keith A. Baggerly, Jeffrey S. Morris, Sarah R. Edmonson, Kevin R. Coombes

Jeffrey S. Morris

Proteomic profi ling of serum initially appeared to be dramatically effective for diagnosis of early-stage ovarian cancer, but these results have proven diffi cult to reproduce. A recent publication reported good classifi cation in one dataset using results from training on a much earlier dataset, but the authors have since reported that they did not perform the analysis as described. We examined the reproducibility of the proteomic patterns across datasets in more detail. Our analysis reveals that the pattern that enabled successful classifi cation is biologically implausible and that the method, properly applied, does not classify the data accurately. We …

Reliability, Effect Size, And Responsiveness Of Health Status Measures In The Design Of Randomized And Cluster-Randomized Trials, Paula Diehr

Paula Diehr

BACKGROUND: New health status survey instruments are often described by their psychometric (measurement) properties, such as Validity, Reliability, Effect Size, and Responsiveness. For cluster-randomized trials, another important statistic is the Intraclass Correlation (ICC) for the instrument within clusters. Studies using better instruments can be performed with smaller sample sizes, but better instruments may be more expensive in terms of dollars, opportunity cost, or poorer data quality due to the response burden of longer instruments. METHODS: We defined the psychometric statistics in terms of a mathematical model, and examined the power of a two-sample test as a function of the test-retest …

Transformative Aspects Of Caregiving At Life's End, Jennifer Salmon, Jung Kwak, Kimberly D. Acquaviva, Katherine Brandt, Kathleen Egan

Kimberly D. Acquaviva, PhD, MSW

We do not know to what extent the needs of caregivers involved with patients at the end of life are being met by care providers and whether caregiving at life’s end can be a positive experience. We used the Hospice Experience Model of Care as a framework for understanding the effect of transformative tasks on caregiving at life’s end. We compared current and bereaved caregivers and then, holding background characteristics constant, tested the independent effects of three transformative mediators: self-acceptance, meaning, and closure, as well as comfort with caregiving on several stressors when explaining differences in caregiver burden and gain. …

Book Review 3 What Is Lean Six Sigma By Michael L. George, William C. Mcpeck

William C. McPeck

This is my personal review of What is Lean Six Sigma by Michael L. George and published by McGraw-Hill in 2003.

Use Of Critical Incident Reports In Medical Education: A Perspective, William T. Branch Jr. Md, Macp

William T.Branch Jr.MD

Critical incident reports are now being widely used in medical education. They are short narrative accounts focusing on the most important professional experiences of medical students, residents, and other learners. As such, critical incident reports are ideally suited for addressing values and attitudes, and teaching professional development. This manuscript describes critical incident reports and gives examples of their use, provides a theoretical underpinning that explains their effectiveness, and describes the educational impacts of critical incident reports and similar methods that use reflective learning. The author recommends critical incident reports as an especially effective means to address learners' most deeply held …

Higher Burden Of Hemorrhagic Stroke Among Women An Autopsy-Based Study In São Paulo, Brazil, Paulo A. Lotufo

Paulo A Lotufo

The aim of this study was to verify the gender difference in sudden cardiovascular death, mainly comparing brain infarction and hemorrhagic stroke. We analyzed 970 autopsy cases from a total of 3,802 nonviolent deaths (448 considered as sudden deaths, 296 undetermined, and 226 non-sudden deaths) including patients aged 30–69 years. All cardiovascular diseases were responsible for 69% of sudden deaths, and all types of stroke for only 14%. The proportions of sudden death for all cardiovascular diseases, coronary heart disease and ischemic stroke deaths were similar for both sexes. However, sudden deaths due to all types of stroke (women 20.0%; …