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The article offers the author's comments on the conditions under which biologists in Latin America are obliged to live and function. According to her, in most of the countries development in biology occurs in steps marred by instances of regressive political changes which interferes with human, hence scientific, freedom. However, she says that it would be ignorance to imagine that Latin America has no modern tools of research.

The article focuses on the reports of Heyworth Committee concerned with teaching and research in economics in Great Britain. In 1962-63 the Committee estimates that in all about £5 million was being spent on research in social sciences. Of this, about £2.9 million was financing university research. About £0.6 million was financing independent non-university research institutes. The research organizations of the government absorbed about £10 million. Official support of research in dependent overseas territories, work in technical colleges and by various other bodies and individuals absorbed the final £0.5 million. Of this total, possibly as much as £10 million may have been going to university and institute research in economics, including the research time of teachers. The Committee proposed that 400 awards for postgraduate research and advanced-course studentship should be made in 1965-66 as against about 220 in 1964. It also recommended the creation of 20 research fellowships.

In this paper we ,have approached the problem by estimating ex post the social benefits resulting from the support given by the National Research Development Corporation (N.R.D.C.) to the development of a potato harvester. In doing this we have encountered difficulties of estimation and we have gained some insight into the real problems which one would face if one had been trying to foresee these developments ex ante. Obviously each project would present its own set of problems in estimating future benefits, but the conceptual similarities in these problems made the study of a particular project useful. The paper has shown that in certain cases and under certain assumptions a monetary value can be put on the national benefits arising from innovation--the net benefits to purchasers and royalty income to public bodies. Detailed analysis showed that: (a) Royalty income (the private gain to the public bodies) from the successful innovation covered direct expenditure on it. (b) Royalty income was quite inadequate to cover also expenditure on failures, which are a feature of the overall process of innovation. (c) If the net benefits to farmers are included, then public support for this series of inventions seems justified. (d) Although an arbitrary assumption was made about the time saved due to N.R.D.C., it revealed the importance of rapid development of innovation. If the N.I.A.E. potato harvester had been delayed longer than about two years beyond what actually occurred we are doubtful whether the firm would have found the investment worthwhile. (e) By the time the bulk of royalties had been received interest charges formed a large part (52%) of the cumulative cost: first costs were incurred about 10 years before first benefits were received. [ABSTRACT FROM AUTHOR]

The article presents information on research and development (R&D) expenditures in the U.S. It is stated that R&D expenditures for the U.S. are expected to rise from $24 million in 1967 to $25 million in 1968. According to a report by the U.S. National Science Foundation (NSF), the average annual growth rate of R&D expenditures is decreasing. NSF started its survey program in 1953, which covers operating expenditures for all the research and development carried out by organizations in various sectors of the U.S. economy, including universities and colleges, industry, federal government agencies, and nonprofit organizations. The article also presents information on a NSF report on scientists and engineers who immigrated to the U.S. for permanent residence.

The article reports on the grantsmanship game titled "Funds for Undergraduate Biology Departments and How to Find Them" from the Commission on Undergraduate Education in the Biological Sciences in the U.S. It is explained that the steps in the process of obtaining funds include defining goals and priorities, locating the right funding agency, negotiating with the agency and writing the proposal itself. The acceptable format for the publication includes an abstract, a cover page, an introduction, the body of the proposal, a brief description of personnel and institutional setting, a statement of the duration of project, and the budget.

The article provides an overview on the hearings held by the House of Subcommittee on Science, Research and Development in the U.S. from July 7 to September 17, 1970. The hearings focused on a plea for stability in research funding and whether a future structured national science policy is desirable and what the constituent elements of that policy should be. The basic premises of this policy were the mutual dependency of government on science and science on government, the close ties between the government and universities and federal funding for research and development. It mentions that no one quarreled with this philosophy and questioned its place in the nation's future science policy.

The article discusses the first part of the founding history of the American Institute of Biological Sciences (AIBS) Journal from 1951 to 1964. AIBS first published the AIBS Bulletin, an outgrowth of its newsletter, on January 1, 1951. It was designed to be published quarterly with a fifth issue that served as the Annual Meeting Program. For the next 12 years, the Bulletin became a 48-page bi-monthly publication. During the Scientific Revolution from 1951 to 1963, federal aid to research helped flourish the industry. However, an internal crisis within AIBS occurred due to lack of administrative organization as a result of growing federal aid to research. The AIBS Bulletin was renamed and reformatted into a monthly journal called "BioScience" on January 1, 1964.

Factors affecting transmission of D. immitis between dogs are summarized in table 4. Although this list may not be exhaustive, it illustrates the complexity of heartworm epidemiology. There are interesting and provocative similarities in the epidemiology of canine and human filariasis. Ottesen (148) has described the spectrum of disease observed in regions endemic for lymphatic filariasis. It includes patients with 1) microfilariae, but no symptoms; 2) disease, but no microfilariae; 3) tropical pulmonary eosinophilia of filarial etiology; and 4) no disease and no evidence of infection. A dog population in areas endemic for D. immitis may show a similar range of clinical manifestations. For example, dogs with microfilariae may not demonstrate clinical disease; dogs with occult infection may show signs ranging from none to severe, including signs similar to the human tropical pulmonary eosinophilia syndrome. Although some dogs live in endemic areas and, apparently, are not infected, it is difficult to determine whether those dogs are resistant to infection or if they have not had adequate exposure. One study has explored the relationship between human W. bancrofti infection and genetic factors (149). Although familial clustering of cases was apparent, the authors were unable to distinguish with certainty whether this association was due to environmental or genetic influences. Carefully designed seroepidemiologic studies of canine heartworm infection may shed some light on genetic or other factors which confer resistance or susceptibility to filarial infections. Natural strain variation has been recognized in several filariae of medical importance including O. volvulus (150), B. malayi (151), and L. loa (2). Strain variation may be manifested as differences in behavior patterns such as microfilarial periodicity, vector and host affinities, and pathogenicity. A laboratory study (88) demonstrated how such strains could arise. In this study, a strain of Brugia patei was adapted to a new, normally refractory host, by artificial selection. The possible existence of different physiologic races of D. immitis should be investigated. Experimental infections with D. immitis have been achieved under laboratory conditions in numerous mosquito species (77).(ABSTRACT TRUNCATED AT 400 WORDS) [ABSTRACT FROM AUTHOR]

The plasmid content, antibiotic susceptibilities, and biochemical traits of fecal streptococci isolated from pigs during a tylosin feeding experiment were analyzed. The presence of tylosin in the feed did not select for a particular streptococcal strain or biochemical type but did select for multiple antibiotic resistance. A DNA probe obtained from Escherichia coli and containing a cloned macrolide-lincosamide-streptogramin B (MLS) resistance determinant from a streptococcal strain of human origin hybridized primarily to large plasmids among MLS-resistant streptococci from antibiotic-fed pigs. Patterns of hybridization were similar among MLS-resistant clinical isolates from human infections and isolates from other antibiotic-fed animals. The results of mating experiments indicated that tylosin selected for localization of the MLS determinants to large conjugative plasmids. These data established (1) a strong sequence homology between MLS resistance genes in isolates from humans and those from farm animals and (2) an increased potential for dissemination of MLS resistance as a consequence of tylosin feeding. [ABSTRACT FROM AUTHOR]

The relationship of a previously described, plasmid-encoded macrolide-lincosamide-streptogramin (MLS) resistance determinant to Bacteroides fragilis group clinical isolates from 11 different patients with bacteroides infections was assessed using in situ hybridization. Most of the strains were found to have DNA sequences homologous with the bacteroides MLS plasmid, pBF4, but this homology was exclusively to chromosomal DNA. Two organisms isolated from different sites in a single patient did not share homology with the plasmid, and probably represent a second type of MLS gene. The MLS resistance plasmids, pBF4 (from Bact. fragilis) and pE194 (from Staphylococcus aureus), did not share homologous sequences; therefore at least one of the bacteroids MLS genes is different from that found in Gram-positive organisms. [ABSTRACT FROM AUTHOR]

Reports on developments related to dermatology in Great Britain as of January 1985. Subjects covered in the Clinically Oriented Symposium on Therapeutic Photomedicine of the European Society for Dermatological Research on February 1985 in Vienna, Austria; Invitation of applications to the Skin Disease Research Fund; Contact information for the International Conference on Behcet's Disease on September 1985 in London, England.

Inhabitants of a remote Panamanian village were examined for clinical and serological evidence of pinta infection. Of 104 persons examined, 21 (20%) had clinical evidence of active or inactive pinta, and 54 (52%) were seropositive. Sera were evaluated for antibody to individual Treponema pallidum antigens. Sera from all four patients with active pinta contained antibody to the 47–48-kilodalton major antigen; the intensity of reactivity and the number of antigens recognized increased with age and, presumably, duration of infection. Sera from six children with inactive pinta reacted strongly with multiple T. pallidum antigens, whereas adults with inactive pinta had less intense reactivity against fewer molecules. Seronegative controls demonstrated only weak reactivity to fewer than five molecules. The development of antibody reactivity to the full spectrum of T. pallidum antigens during the course of infection demonstrates the high degree of antigenic relatedness of T. pallidum and Treponema carateum and is similar to the development of humoral responsiveness during syphilis infection. [ABSTRACT FROM PUBLISHER]

Improvements in the care of older people clearly depend upon both basic and clinical research findings that lead to greater independence and health maintenance. Conversely, research depends upon care, in that care-related priorities influence society's support for research. Additionally, the imaginative observations made while caring for older persons lead to new research questions. More leaders in the field of aging are needed with personalexperience in both care and research. [ABSTRACT FROM PUBLISHER]

We have measured the in-vitro activity of 27 antimicrobials against 211 clinical and ten reference strains of Pseudomonas pseudomallei. Imipenem was the most active antibiotic tested, followed by piperacillin, doxycycline, amoxycillin/clavulanic acid, cefixime, cefetamet, azlocillin and ceftazidime, all of which had MICs of less than or equal to 2 mg/l for the majority of strains. The measured MICs were dependent on the media and inocula used, to an extent which varied with the antibiotic class under test; MICs of ureidopenicillins were particularly inoculum-dependent. The beta-lactams and ciprofloxacin were bactericidal, whereas the agents conventionally used to treat melioidosis (doxycycline, chloramphenicol, sulphamethoxazole and trimethoprim) had bacteriostatic activity only. Strains highly resistant to chloramphenicol (MIC greater than or equal to 256 mg/l) emerged during treatment in 7.1% of patients. These strains were fully virulent, and frequently showed cross-resistance to tetracyclines, sulphamethoxazole, trimethoprim and ciprofloxacin, with paradoxical increased susceptibility to beta-lactams and aminoglycosides. Similar resistance patterns were seen in mutants generated in vitro and two reference strains. One strain with isolated ceftazidime resistance, reversible by clavulanic acid, emerged during treatment. Several of the new beta-lactam antibiotics are of potential value in the therapy of P. pseudomallei infections. Patients should be carefully monitored for the emergence of antibiotic-resistant strains during treatment of melioidosis. [ABSTRACT FROM AUTHOR]

Discusses the trends in the research budgets of the several U.S. natural resource agencies and the implications of these trends for resource management and policy. Background on the creation of federal research and development policy during administration of U.S. President Jimmy Carter; Capacity of agencies to act on fundamental problems with limited funds; Increase in the costs of reversing environmental problems.

We report a patient with fulminant Lassa fever who responded dramatically to a 2.5-litre exchange transfusion of whole blood. On admission he was semicomatose with facial oedema and oral haemorrhage; his platelets showed markedly depressed aggregation to ADP; and his plasma inhibited the aggregation responses of normal platelets in vitro. Exchange transfusion resulted in rapid clinical improvement, recovery of platelet function, and disappearance of platelet-inhibitory activity in plasma. The patient died 2 weeks later from an acute encephalopathy. His initial response was sufficiently impressive to suggest that further evaluation of this therapeutic approach is justified in selected patients with overwhelming Lassa virus infection. [ABSTRACT FROM AUTHOR]

Verbal autopsies (VA) are frequently used to determine causes of death for individuals for whom there is no reliable clinical information regarding the terminal illness. VA interviews are used to note key symptoms and signs recalled by relatives of the deceased and diagnoses ascribed according to the symptom complexes. The VA technique assumes that individual disease entities have discrete symptom complexes and that these can be accurately recognized and recalled by the interviewees. We have examined the accuracy with which specific symptoms are recalled over time by mothers or normal guardians of 491 children who died on the paediatric wards of two district hospitals in East Africa. Kwashiorkor, measles, trauma, generalized convulsions and neonatal tetanus were all reported with a high degree of accuracy for children who died of these conditions and had low false positive rates for children without these conditions. Recall was similar within 1 month of death compared to recall after 6 months for most symptoms and signs except neonatal tetanus where false positive reports by mothers increased with time since death. Symptoms and signs commonly used to describe malaria, respiratory tract and diarrhoea-related deaths were reported by mothers to have been present during the terminal illness in 43% of cases where these features were absent. Recall abilities differed between the two communities studied for some symptoms and signs highlighting the importance of such studies in every setting where VA are applied. [ABSTRACT FROM AUTHOR]

Objective: Assess the performance of the SAPHIRE automated information retrieval system.Design: Comparative study of automated and human searching of a MEDLINE test collection.Measurements: Recall and precision of SAPHIRE were compared with those attributes of novice physicians, expert physicians, and librarians for a test collection of 75 queries and 2,334 citations. Failure analysis assessed the efficacy of the Metathesaurus as a concept vocabulary; the reasons for retrieval of nonrelevant articles and nonretrieval of relevant articles; and the effect of changing the weighting formula for relevance ranking of retrieved articles.Results: Recall and precision of SAPHIRE were comparable to those of both physician groups, but less than those of librarians.Conclusion: The current version of the Metathesaurus, as utilized by SAPHIRE, was unable to represent the conceptual content of one-fourth of physician-generated MEDLINE queries. The most likely cause for retrieval of nonrelevant articles was the presence of some or all of the search terms in the article, with frequencies high enough to lead to retrieval. The most likely cause for nonretrieval of relevant articles was the absence of the actual terms from the query, with synonyms or hierarchically related terms present instead. There were significant variations in performance when SAPHIRE's concept-weighing formulas were modified. [ABSTRACT FROM AUTHOR]

The article presents a discussion on vitamin A between the authors of articles published in this issue of "Nutrition Reviews." The article discusses retinol-binding proteins and receptors, research on gene expression in transgenic mice embryos and adults, all-trans retinoic acid, the role of vitamin A and Β-carotene in cancer prevention, research focusing on vitamin A and leukemia, research funding, public health policy, vitamin A requirements, the transformation of Β-carotene into retinoids, and vitamin A deficiency.

Objective: A general framework for representation of clinical data that provides a declarative semantics of terms and that allows developers to define explicitly the relationships among both terms and combinations of terms.Design: Use of conceptual graphs as a standard representation of logic and of an existing standardized vocabulary, the Systematized Nomenclature of Medicine (SNOMED International), for lexical elements. Concepts such as time, anatomy, and uncertainty must be modeled explicitly in a way that allows relation of these foundational concepts to surface-level clinical descriptions in a uniform manner.Results: The proposed framework was used to model a simple radiology report, which included temporal references.Conclusion: Formal logic provides a framework for formalizing the representation of medical concepts. Actual implementations will be required to evaluate the practicality of this approach. [ABSTRACT FROM AUTHOR]

Background: Access to essential clinical services offered by district hospitals or health centres forms an important component of primary health care activities in the developing world. Utilization of hospital facilities during life-threatening childhood illnesses will affect survivorship.Methods: We have examined clinical, geographical, social, economic and demographic features of families of 49 children who consulted a hospital facility during a terminal illness and 88 who did not during a 1-year prospective demographic and hospital-based surveillance of a rural community on the Kenyan Coast.Results: Of children who died without admission, 15% had symptoms which lasted only 1 day compared to no children who were admitted (P = 0.004). Furthermore, those who died without admission tended to live further away from the nearest bus stage (P = 0.01) and had made greater use of traditional healers (P = 0.08). Mothers' education or household socioeconomic status did not influence admission to hospital.Conclusion: Health education is required to improve early recognition of clinical signs warranting hospital care and traditional healers should be included in any community-based education programmes. [ABSTRACT FROM AUTHOR]

Objective: To develop optimal MEDLINE search strategies for retrieving sound clinical studies of the etiology, prognosis, diagnosis, prevention, or treatment of disorders in adult general medicine.Design: Analytic survey of operating characteristics of search strategies developed by computerized combinations of terms selected to detect studies meeting basic methodologic criteria for direct clinical use in adult general medicine.Measures: The sensitivities, specificities, precision, and accuracy of 134,264 unique combinations of search terms were determined by comparison with a manual review of all articles (the "gold standard") in ten internal medicine and general medicine journals for 1986 and 1991.Results: Less than half of the studies of the topics of interest met basic criteria for scientific merit for testing clinical applications. Combinations of search terms reached peak sensitivities of 82% for sound studies of etiology, 92% for prognosis, 92% for diagnosis, and 99% for therapy in 1991. Compared with the best single terms, multiple terms increased sensitivity for sound studies by over 30% (absolute increase), but with some loss of specificity when sensitivity was maximized. For 1986, combinations reached peak sensitivities of 72% for etiology, 95% for prognosis, 86% for diagnosis, and 98% for therapy. When search terms were combined to maximize specificity, over 93% specificity was achieved for all purpose categories in both years. Compared with individual terms, combined terms achieved near-perfect specificity that was maintained with modest increases in sensitivity in all purpose categories except therapy. Increases in accuracy were achieved by combining terms for all purpose categories, with peak accuracies reaching over 90% for therapy in 1986 and 1991.Conclusions: The retrieval of studies of important clinical topics cited in MEDLINE can be substantially enhanced by selected combinations of indexing terms and textwords. [ABSTRACT FROM AUTHOR]

Background: Several reproductive factors appear to affect a women's risk of developing rheumatoid arthritis. This study's purpose was to determine whether use of non-contraceptive hormones is among them.Methods: A population-based case-control study was conducted in King County, Washington and Group Health Cooperative of Puget Sound, a prepaid health plan. New cases of rheumatoid arthritis in peri- or postmenopausal women (n = 135) were verified through clinical examination and compared with 592 controls. Both groups were interviewed in person about hormone use and demographic and reproductive factors.Results: The age-adjusted relative risk (RR) among women who had ever used non-contraceptive oestrogens was 1.04 (95% confidence interval [CI]: 0.70-1.55), and among women who had ever used progestins it was 0.66 (95% CI: 0.40-1.08). For current users of oestrogen only, the RR was 0.97 (95% CI: 0.62-1.53), and among current users of oestrogen plus progestin it was 0.81 (95% CI: 0.45-1.45). Multivariate analyses yielded similar results. There was little evidence of a dose-response relationship with duration of use or with frequency of progestin use.Conclusions: Use of non-contraceptive oestrogens appears to have little effect on the risk of developing rheumatoid arthritis in menopausal women. There may be a modest reduction in risk among progestin users. [ABSTRACT FROM AUTHOR]

Objective: To explore the software design issues involved in implementing an operational information sources map (ISM) knowledge base (KB) and system of navigational tools that can help medical users access network-based information sources relevant to a biomedical question.Design: A pilot biomedical ISM KB and associated client-server software (ISM/Explorer) have been developed to help students, clinicians, researchers, and staff access network-based information sources, as part of the National Library of Medicine's (NLM) multi-institutional Unified Medical Language System (UMLS) project. The system allows the user to specify and constrain a search for a biomedical question of interest. The system then returns a list of sources matching the search. At this point the user may request 1) further information about a source, 2) that the list of sources be regrouped by different criteria to allow the user to get a better overall appreciation of the set of retrieved sources as a whole, or 3) automatic connection to a source.Results: The pilot system operates in client-server mode and currently contains coded information for 121 sources. It is in routine use from approximately 40 workstations at the Yale School of Medicine. The lessons that have been learned are that: 1) it is important to make access to different versions of a source as seamless as possible, 2) achieving seamless, cross-platform access to heterogeneous sources is difficult, 3) significant differences exist between coding the subject content of an electronic information resource versus that of an article or a book, 4) customizing the ISM to multiple institutions entails significant complexities, and 5) there are many design trade-offs between specifying searches and viewing sets of retrieved sources that must be taken into consideration.Conclusion: An ISM KB and navigational tools have been constructed. In the process, much has been learned about the complexities of development and evaluation in this new environment, which are different from those for Gopher, wide area information servers (WAIS), World-Wide-Web (WWW), and MOSAIC resources. [ABSTRACT FROM AUTHOR]

Malaria has had an enormous impact on human history, not least in times of war. The disease has been treatable by a natural remedy, quinine, since the 17th century, but the production of synthetic antimalarial agents was first achieved in Germany in the wake of the Great War of 1914–1918, in which malaria had caused immense problems. In the 1920s research workers in the Bayer laboratories of the IG Farbenindustrie consortium developed the 8-aminoquinoline plasmoquine (the forerunner of primaquine). They went on to develop the acridine dye, atebrin (mepacrine) and the 4-aminoquinolines, Resochin (developed at the end of the Second World War in America as chloroquine) and Sontochin. British attempts to match the advances achieved by the Germans were at first unproductive, partly because collaboration between academic and industrial organizations in the UK was beset by concerns over patent rights. However, with the outbreak of World War II, when supplies of antimalarials were scarce, ICI succeeded in the large-scale production of mepacrine (essential to prosecution of the war, particularly in the Far East) and also initiated a programme of collaborative research that eventually led to the discovery of proguanil (Paludrine); this, in its turn led to the diaminopyrimidine, pyrimethamine. A massive cooperative screening programme in the USA during World War II eventually bore fruit in the realization of the therapeutic potential of chloroquine, and in the later development of amodiaquine and primaquine. Some of this work also influenced the subsequent discovery of mefloquine and halofantrine at the Walter Reed Army Institute of Research. [ABSTRACT FROM PUBLISHER]

The field of alcohol research is a multidisciplinary area of inquiry. Moreover the debate about alcohol issues is highly politicized, involving not only researchers but also ‘advocates’ and those with strong ideological orientations or who represent powerful vested interests. Researchers may easily be caught in the crossfire in polemics involving such people. From time to time ethical malpractice is evident, yet there are often neither clear guidelines to delineate which behaviours are unacceptable nor how ethical violations are to be handled. This paper considers a number of key issues currently topical in the field. These are specifically concerned with the relationships between funders or sponsors and policy makers and researchers. Such issues include the ownership of data, sponsor control and the divergent cultures and outlooks of researchers and sponsors/funders. It is concluded that the field of alcohol research requires a code of ethics to regulate the relationship between researchers and funders. This should provide protection for subjects, patients, clients, researchers and those who pay for research. Some tentative suggestions are put forward for discussion. [ABSTRACT FROM PUBLISHER]

The Internet is rapidly evolving from a resource used primarily by the research community to a true global information network offering a wide range of databases and services. This evolution presents many opportunities for improved access to biomedical information, but Internet-based resources have often been difficult for the non-expert to develop and use. The World Wide Web (WWW) supports an inexpensive, easy-to-use, cross-platform, graphic interface to the Internet that may radically alter the way we retrieve and disseminate medical data. This paper summarizes the Internet and hypertext origins of the WWW, reviews WWW-specific technologies, and describes current and future applications of this technology in medicine and medical informatics. The paper also includes an appendix of useful biomedical WWW servers. [ABSTRACT FROM AUTHOR]

Objective: To examine the issues involved in mapping an existing structured controlled vocabulary, the Medical Entities Dictionary (MED) developed at Columbia University, to an institutional vocabulary, the laboratory and pharmacy vocabularies of the Yale New Haven Medical Center.Design: 200 Yale pharmacy terms and 200 Yale laboratory terms were randomly selected from database files containing all of the Yale laboratory and pharmacy terms. These 400 terms were then mapped to the MED in three phases: mapping terms, mapping relationships between terms, and mapping attributes that modify terms.Results: 73% of the Yale pharmacy terms mapped to MED terms. 49% of the Yale laboratory terms mapped to MED terms. After certain obsolete and otherwise inappropriate laboratory terms were eliminated, the latter rate improved to 59%. 23% of the unmatched Yale laboratory terms failed to match because of differences in granularity with MED terms. The Yale and MED pharmacy terms share 12 of 30 distinct attributes. The Yale and MED laboratory terms share 14 of 23 distinct attributes.Conclusion: The mapping of an institutional vocabulary to a structured controlled vocabulary requires that the mapping be performed at the level of terms, relationships, and attributes. The mapping process revealed the importance of standardization of local vocabulary subsets, standardization of attribute representation, and term granularity. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the performance of tools for authoring patient database queries.Design: Query by Review, a tool that exploits the training that users have undergone to master a result review system, was compared with AccessMed, a vocabulary browser that supports lexical matching and the traversal of hierarchical and semantic links. Seven subjects (Medical Logic Module authors) were asked to use both tools to gather the vocabulary terms necessary to perform each of eight laboratory queries.Measurements: The proportion of queries that were correct; intersubject agreement.Results: Query by Review had better performance than AccessMed (38% correct queries versus 18%, p = 0.002), but both figures were low. Poor intersubject agreement (28% for Query by Review and 21% for AccessMed) corroborated the relatively low performance. Subjects appeared to have trouble distinguishing laboratory tests from laboratory batteries, picking terms relevant to the particular data type required, and using classes in the vocabulary's hierarchy.Conclusion: Query by Review, with its more constrained user interface, performed somewhat better than AccessMed, a more general tool. Neither tool achieved adequate performance, however, which points to the difficulty of formulating a query for a clinical database and the need for further work. [ABSTRACT FROM AUTHOR]

Clinical and environmental isolates of Aeromonas spp. (20 Aeromonas caviae, 33 Aeromonas veronii and 21 Aeromonas hydrophila) were examined for their ability to yield mutants derepressed for beta-lactamase production and for the distribution of the three chromosomally encoded beta-lactamase genes, ampS and cepS from A. veronii bv. sobria and cphA from A. hydrophila. Of these isolates, 100% and 96% of the isolates from A. hydrophila and A. caviae, respectively, yielded beta-lactamase derepressed mutants but only 38% of A. veronii isolates yielded the resistant phenotype at 37 degrees C. However, when tested at 30 degrees C, all isolates gave rise to the derepressed mutants, indicating a temperature effect on the control mechanism. All mutants had significantly higher beta-lactamase activity against ampicillin, oxacillin, cephaloridine and imipenem. Hybridization studies with cloned aeromonas beta-lactamase genes indicated that the cephalosporinase gene, cepS, is almost ubiquitous for the three species tested. The cphA gene cross-hybridized with all isolates of A. veronii and A. hydrophila but not to A. caviae isolates. In contrast, hybridization studies using ampS revealed that only 25% of A. caviae, 45% of A. veronii and 38% of A. hydrophila tested carried the ampS gene or one closely homologous to it. Nonetheless, strains that failed to hybridize with ampS showed two serine beta-lactamases when analysed by isoelectric focusing. [ABSTRACT FROM AUTHOR]

The approach taken by the Unified Medical Language System (UMLS), in which disparate terminology systems are integrated, has allowed construction of an electronic thesaurus (the Metathesaurus) that avoids imposing any restrictions upon the content, structure, or semantics of the source terminologies. As such, the UMLS has served as a unifying paradigm by providing appropriate links among equivalent entities that are used in different contexts or for different purposes. It accordingly provides a vehicle through which possibly orthogonal semantic models can co-exist within a single framework. This framework provides a model for the collaborative evolution of biomedical terminology and allows a synergistic relationship between the UMLS and its source terminology systems. [ABSTRACT FROM AUTHOR]

Objective: The National Library of Medicine's (NLM) Unified Medical Language System (UMLS) includes a Metathesaurus (Meta), which is a compilation of medical terms drawn from over 30 controlled vocabularies, and a Semantic Net, which contains the semantic types used to categorize Meta concepts and the semantic relations to connect them. Meta has been constructed through lexical matching techniques and human review. The purpose of this study was to audit the Meta using semantic techniques to identify possible inconsistencies.Methods: Five different techniques were applied: (1) detection of ambiguity in Meta concepts with two or more semantic types, (2) detection of interchangeable keyword synonyms, (3) detection of redundant pairs of Meta concepts (using lexical matching combined with keyword synonyms), (4) detection of inconsistent parent-child relationships in Meta (based on the semantic type information), and (5) discovery of pairs of semantic types for which relations could be added to the Semantic Net, based on "other" relationships between Meta concepts.Results: Of 57,592 concepts with multiple semantic types, 1817 (3.2%) were judged to be ambiguous. Keyword analysis showed 7121 pairs of interchangeable words. Using the keyword pairs, 5031 pairs of potentially redundant concepts were suggested, of which 3274 (65.1%) were judged to actually be redundant. Review of the 100,586 parent-child relationships revealed 544 (0.54%) that were incorrect. Review of the 219,664 "Other" relationships suggested 1299 places in the Semantic Net where relations between pairs of semantic types could be added.Conclusion: Semantic techniques, alone or in combination, can be used to audit the UMLS to detect inconsistencies that are not detectable through lexical techniques alone. Use of these methods to augment the UMLS maintenance process will lead to improvement in the UMLS. [ABSTRACT FROM AUTHOR]

Objective: A primary goal of the University of Pittsburgh's 1990-94 UMLS-sponsored effort was to develop and evaluate PostDoc (a lexical indexing system) and Pindex (a statistical indexing system) comparatively, and then in combination as a hybrid system. Each system takes as input a portion of the free text from a narrative part of a patient's electronic medical record and returns a list of suggested MeSH terms to use in formulating a Medline search that includes concepts in the text. This paper describes the systems and reports an evaluation. The intent is for this evaluation to serve as a step toward the eventual realization of systems that assist healthcare personnel in using the electronic medical record to construct patient-specific searches of Medline.Design: The authors tested the performances of PostDoc, Pindex, and a hybrid system, using text taken from randomly selected clinical records, which were stratified to include six radiology reports, six pathology reports, and six discharge summaries. They identified concepts in the clinical records that might conceivably be used in performing a patient-specific Medline search. Each system was given the free text of each record as an input. The extent to which a system-derived list of MeSH terms captured the relevant concepts in these documents was determined based on blinded assessments by the authors.Results: PostDoc output a mean of approximately 19 MeSH terms per report, which included about 40% of the relevant report concepts. Pindex output a mean of approximately 57 terms per report and captured about 45% of the relevant report concepts. A hybrid system captured approximately 66% of the relevant concepts and output about 71 terms per report.Conclusion: The outputs of PostDoc and Pindex are complementary in capturing MeSH terms from clinical free text. The results suggest possible approaches to reduce the number of terms output while maintaining the percentage of terms captured, including the use of UMLS semantic types to constrain the output list to contain only clinically relevant MeSH terms. [ABSTRACT FROM AUTHOR]

Objective: To allow exchange of clinical practice guidelines among institutions and computer-based applications.Design: The GuideLine Interchange Format (GLIF) specification consists of GLIF model and the GLIF syntax. The GLIF model is an object-oriented representation that consists of a set of classes for guideline entities, attributes for those classes, and data types for the attribute values. The GLIF syntax specifies the format of the test file that contains the encoding.Methods: Researchers from the InterMed Collaboratory at Columbia University, Harvard University (Brigham and Women's Hospital and Massachusetts General Hospital), and Stanford University analyzed four existing guideline systems to derive a set of requirements for guideline representation. The GLIF specification is a consensus representation developed through a brainstorming process. Four clinical guidelines were encoded in GLIF to assess its expressivity and to study the variability that occurs when two people from different sites encode the same guideline.Results: The encoders reported that GLIF was adequately expressive. A comparison of the encodings revealed substantial variability.Conclusion: GLIF was sufficient to model the guidelines for the four conditions that were examined. GLIF needs improvement in standard representation of medical concepts, criterion logic, temporal information, and uncertainty. [ABSTRACT FROM AUTHOR]

The authors surveyed existing standard codes for units of measures, such as ISO 2955, ANSI ×3.50, and Health Level 7′s ISO+. Because these standards specify only the character representation of units, the authors developed a semantic model for units based on dimensional analysis. Through this model, conversion between units and calculations with dimensioned quantities become as simple as calculating with numbers. All atomic symbols for prefixes and units are defined in one small table. Huge permutated conversion tables are not required. This method is also simple enough to be widely implementable in today's information systems. To promote the application of the method the authors provide an open-source implementation of this method in JAVA. All existing code standards for units, however, are incomplete for practical use and require substantial changes to correct their many ambiguities. The authors therefore developed a code for units that is much more complete and free from ambiguities. [ABSTRACT FROM PUBLISHER]

Nicotine is the primary compound present in tobacco that is responsible for establishing and maintaining tobacco dependence; dependent smokers adjust their smoking behavior to maintain peripheral and central nicotine levels. CYP2A6 is the enzyme responsible for the majority of the inactivation of nicotine in humans. This enzyme is also responsible for activating tobacco-related procarcinogens such as the nitrosamines. This paper outlines how genetic variation in the CYP2A6 gene may protect individuals from becoming nicotine-dependent smokers, and if dependent, how impairment of the CYP2A6 gene function decreases the number of cigarettes consumed by smokers (Pianezza M, Sellers EM, Tyndale RF. 1998. A common genetic defect in nicotine metabolism decreases smoking. Nature 393(6687):750). We also discuss recent findings which suggest that mimicking this gene defect by inhibiting CYP2A6 decreases nicotine metabolism and smoking. Further research is needed in order to improve our understanding of how genetic variation in CYP2A6 alters the risk for nicotine dependence and lowers nicotine consumption. This includes a better understanding of how the genetic variants alter nicotine metabolism in vivo in males and females as well as the role of CYP2A6 genetic variation in risk for tobacco-related cancers. In addition we need to gain a better understanding of how manipulating this enzyme could be used therapeutically in prevention and treatment of smoking as well as in exposure reduction. [ABSTRACT FROM AUTHOR]

The complexity of tobacco smoke leads to some confusion about the mechanisms by which it causes lung cancer. Among the multiple components of tobacco smoke, 20 carcinogens convincingly cause lung tumors in laboratory animals or humans and are, therefore, likely to be involved in lung cancer induction. Of these, polycyclic aromatic hydrocarbons and the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone are likely to play major roles. This review focuses on carcinogens in tobacco smoke as a means of simplifying and clarifying the relevant information that provides a mechanistic framework linking nicotine addiction with lung cancer through exposure to such compounds. Included is a discussion of the mechanisms by which tobacco smoke carcinogens interact with DNA and cause genetic changes--mechanisms that are reasonably well understood--and the less well defined relationship between exposure to specific tobacco smoke carcinogens and mutations in oncogenes and tumor suppressor genes. Molecular epidemiologic studies of gene-carcinogen interactions and lung cancer--an approach that has not yet reached its full potential--are also discussed, as are inhalation studies of tobacco smoke in laboratory animals and the potential role of free radicals and oxidative damage in tobacco-associated carcinogenesis. By focusing in this review on several important carcinogens in tobacco smoke, the complexities in understanding tobacco-induced cancer can be reduced, and new approaches for lung cancer prevention can be envisioned. [ABSTRACT FROM AUTHOR]

Reports on the fund-raising scheme conjured up by the executives at Prolume Ltd. for a research in bioluminescence. What started the interest in bioluminescence; Benefits of bioluminescence to cancer research.

The authors describe a methodology for helping computational biologists diagnose discrepancies they encounter between experimental data and the predictions of scientific models. The authors call these discrepancies data-model conflicts. They have built a prototype system to help scientists resolve these conflicts in a more systematic, evidence-based manner. In computational biology, data-model conflicts are the result of complex computations in which data and models are transformed and evaluated. Increasingly, the data, models, and tools employed in these computations come from diverse and distributed resources, contributing to a widening gap between the scientist and the original context in which these resources were produced. This contextual rift can contribute to the misuse of scientific data or tools and amplifies the problem of diagnosing data-model conflicts. The authors' hypothesis is that systematic collection of metadata about a computational process can help bridge the contextual rift and provide information for supporting automated diagnosis of these conflicts. The methodology involves three major steps. First, the authors decompose the data-model evaluation process into abstract functional components. Next, they use this process decomposition to enumerate the possible causes of the data-model conflict and direct the acquisition of diagnostically relevant metadata. Finally, they use evidence statically and dynamically generated from the metadata collected to identify the most likely causes of the given conflict. They describe how these methods are implemented in a knowledge-based system called GRENDEL and show how GRENDEL can be used to help diagnose conflicts between experimental data and computationally built structural models of the 30S ribosomal subunit. [ABSTRACT FROM AUTHOR]

Smoking cessation usually results in weight gain. Nicotine gum therapy has been found to reduce weight gain in the first months after cessation, but its long-term effects are not fully known. The present study randomly assigned 608 smokers to receive placebo, 2 or 4 mg nicotine gum. In a follow-up analysis to the short-term weight change results reported in a previous paper [Doherty, Militello, Kinnunen, & Garvey (1996), Journal of Consulting and Clinical Psychology 64:799-807], we examined the effects of the nicotine gum on weight change for 1 year after cessation among the 92 1-year abstainers. We found that weight change showed some variation with gum dose (active vs. placebo), but that weight change appeared to depend more strongly on the percentage of pre-cessation cotinine levels replaced by the nicotine gum. Participants who replaced higher proportions of their pre-cessation cotinine during the gum therapy period gained less weight during the first year post-cessation than those who replaced less cotinine, with those who replaced greater than 90% of their cotinine gaining only 1.7 kg by 1 year post-cessation. These findings suggest that future research is warranted to determine whether sufficiently high levels of nicotine replacement can help to permanently reduce cessation-related weight gain. [ABSTRACT FROM AUTHOR]

Offers American Institute of Biological Sciences-related (AIBS) news briefs. Announcement of the availability of articles from 'BioScience' on the Internet; Appointment of AIBS public policy representative Ellen Paul; Efforts of AIBS and other United States scientific, engineering, and business organizations to increase US scientific research funding; Others.

A variety of methods have been proposed for presenting medical data visually on computers. Discussion of and comparison among these methods have been hindered by a lack of consistent terminology. A taxonomy of medical data presentations based on object-oriented user interface principles is presented. Presentations are divided into five major classes—list, table, graph, icon, and generated text. These are subdivided into eight subclasses with simple inheritance and four subclasses with multiple inheritance. The various subclasses are reviewed and examples are provided. Issues critical to the development and evaluation of presentations are also discussed. [ABSTRACT FROM PUBLISHER]

Objective: To develop a model for Bayesian communication to enable readers to make reported data more relevant by including their prior knowledge and values.Background: To change their practice, clinicians need good evidence, yet they also need to make new technology applicable to their local knowledge and circumstances. Availability of the Web has the potential for greatly affecting the scientific communication process between research and clinician. Going beyond format changes and hyperlinking, Bayesian communication enables readers to make reported data more relevant by including their prior knowledge and values. This paper addresses the needs and implications for Bayesian communication. FORMULATION: Literature review and development of specifications from readers', authors', publishers', and computers' perspectives consistent with formal requirements for Bayesian reasoning.Results: Seventeen specifications were developed, which included eight for readers (express prior knowledge, view effect size and variability, express threshold, make inferences, view explanation, evaluate study and statistical quality, synthesize multiple studies, and view prior beliefs of the community), three for authors (protect the author's investment, publish enough information, make authoring easy), three for publishers (limit liability, scale up, and establish a business model), and two for computers (incorporate into reading process, use familiar interface metaphors). A sample client-only prototype is available at http://omie.med.jhmi.edu/bayes.Conclusion: Bayesian communication has formal justification consistent with the needs of readers and can best be implemented in an online environment. Much research must be done to establish whether the formalism and the reality of readers' needs can meet. [ABSTRACT FROM AUTHOR]

We describe past NIH funding for tobacco/nicotine-related research, using data from the CRISP computerized database of NIH grants awarded in 1975, 1980, 1985, 1990, and 1995 (last year available). Two independent raters identified extramural grants whose investigators listed a nicotine/tobacco-related keyword as a primary descriptor for 1975, 1980, 1985, 1990, and 1995. From 1975 to 1985 extramural funding for nicotine/tobacco research (corrected for inflation) increased almost fourfold. From 1985 to 1995, funding increased minimally (< 20%). In 1995, NIH expended $92.1 million on research whose primary interest was nicotine or tobacco. This represented 1.1% of the overall NIH extramural budget. Over time, when contract funding increased, investigator-initiated R01 funding decreased. Nicotine/tobacco research was spread across 18 institutes. Although tobacco use accounts for 20% of all US mortality, historically only 1% of the NIH's budget has focused on nicotine or tobacco. Among nicotine/tobacco grants funded, investigator-initiated research appears to have been limited due to large contracts for clinical trials. Nicotine/tobacco research has no home institute. Funding for nicotine/tobacco research needs to be increased and better coordinated. [ABSTRACT FROM AUTHOR]

This paper provides a “viewpoint discussion” based on a presentation made to the 2000 Symposium of the American College of Medical Informatics. It discusses potential opportunities for researchers in health informatics to become involved in the rapidly growing field of bioinformatics, using the activities of the Yale Center for Medical Informatics as a case study. One set of opportunities occurs where bioinformatics research itself intersects with the clinical world. Examples include the correlations between individual genetic variation with clinical risk factors, disease presentation, and differential response to treatment; and the implications of including genetic test results in the patient record, which raises clinical decision support issues as well as legal and ethical issues. A second set of opportunities occurs where bioinformatics research can benefit from the technologic expertise and approaches that informaticians have used extensively in the clinical arena. Examples include database organization and knowledge representation, data mining, and modeling and simulation. Microarray technology is discussed as a specific potential area for collaboration. Related questions concern how best to establish collaborations with bioscientists so that the interests and needs of both sets of researchers can be met in a synergistic fashion, and the most appropriate home for bioinformatics in an academic medical center. [ABSTRACT FROM PUBLISHER]

For the past decade, Stanford Medical Informatics has combined clinical informatics and bioinformatics research and training in an explicit way. The interest in applying informatics techniques to both clinical problems and problems in basic science can be traced to the Dendral project in the 1960s. Having bioinformatics and clinical informatics in the same academic unit is still somewhat unusual and can lead to clashes of clinical and basic science cultures. Nevertheless, the benefits of this organization have recently become clear, as the landscape of academic medicine in the next decades has begun to emerge. The author provides examples of technology transfer between clinical informatics and bioinformatics that illustrate how they complement each other. [ABSTRACT FROM AUTHOR]

Objective: To assess age differences in children's beliefs about the long-term health effects of alcohol and cocaine, to use such beliefs to predict attitudes toward and intentions to use these substances, and to establish whether accurate beliefs are more predictive than inaccurate ones.Methods: Children ages 6 to 12 (N: = 217) responded to an open-ended question about the effects of long-term alcohol and cocaine use and to 12 structured questions asking whether each produces alcohol-like, cocaine-like, and tobacco-like effects.Results: Differentiation among alcohol, cocaine, and tobacco effects was limited but increased with age. Beliefs about health effects had no impact on alcohol attitudes and intentions, but intentions to drink were stronger among older and white children. Anti-cocaine attitudes and intentions were associated with being older and non-White and with having accurate knowledge of cocaine's true health effects-but also with believing falsely that cocaine has tobacco-like effects and that drugs in general have catastrophic effects.Conclusions: With age, and as predicted by Werner's orthogenetic principle, children differentiated more sharply between substances. Although negative misconceptions can contribute to anti-drug attitudes and intentions, children should nonetheless be taught about the distinct effects of different substances on health. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study was to evaluate the uses of handheld computers (also called personal digital assistants, or PDAs) in family practice residency programs in the United States.Study Design: In November 2000, the authors mailed a questionnaire to the program directors of all American Academy of Family Physicians (AAFP) and American College of Osteopathic Family Practice (ACOFP) residency programs in the United States.Measurements: Data and patterns of the use and non-use of handheld computers were identified.Results: Approximately 50 percent (306 of 610) of the programs responded to the survey. Two thirds of the programs reported that handheld computers were used in their residencies, and an additional 14 percent had plans for implementation within 24 months. Both the Palm and the Windows CE operating systems were used, with the Palm operating system the most common. Military programs had the highest rate of use (8 of 10 programs, 80 percent), and osteopathic programs had the lowest (23 of 55 programs, 42 percent). Of programs that reported handheld computer use, 45 percent had required handheld computer applications that are used uniformly by all users. Funding for handheld computers and related applications was non-budgeted in 76percent of the programs in which handheld computers were used. In programs providing a budget for handheld computers, the average annual budget per user was 461.58 dollars. Interested faculty or residents, rather than computer information services personnel, performed upkeep and maintenance of handheld computers in 72 percent of the programs in which the computers are used. In addition to the installed calendar, memo pad, and address book, the most common clinical uses of handheld computers in the programs were as medication reference tools, electronic textbooks, and clinical computational or calculator-type programs.Conclusions: Handheld computers are widely used in family practice residency programs in the United States. Although handheld computers were designed as electronic organizers, in family practice residencies they are used as medication reference tools, electronic textbooks, and clinical computational programs and to track activities that were previously associated with desktop database applications. [ABSTRACT FROM AUTHOR]

This review summarizes the author's smoking cessation research from the 1960s into the 21st century. Both contextual and personal factors that led the author to undertake cessation research and to move from intensive clinical interventions to brief, population-focused interventions, especially in healthcare settings, are described. Suggestions are offered as to how research can address the problem of inconsistent delivery of effective interventions in healthcare settings. [ABSTRACT FROM AUTHOR]

Does obesity affect mental health? Two waves of data from a panel study of community residents 50 years and older were used to investigate the association between obesity and eight indicators of mental health: happiness, perceived mental health, life satisfaction, positive affect, negative affect, optimism, feeling loved and cared for, and depression. For none of the eight mental health outcomes examined did we observe a protective effect for obesity. Either no association was observed between obesity and psychological functioning, or the obese were worse off. Using 1994-1999 prospective data, the obese were at increased risk for poorer mental health on five of the outcomes examined using bivariate analyses. However, controlling for mental health problems at baseline and using statistical controls for covariates, the increased relative risk was limited to depression. There has been sufficient disparity of results thus far to justify further research on this question. [ABSTRACT FROM AUTHOR]