Condition-specific outcome measures for low back pain: Part I: Validation

A literature review of the nine most widely used, condition-specific, self-administered assessment questionnaires for low back pain has been undertaken. General and historic aspects, reliability, responsiveness and minimum clinically important difference, external validity, floor and ceiling effects and available languages were analysed for the nine most-used outcome tools. When considering which condition-specific measure to employ, the present overview on assessment tools should provide the necessary information to define the technical aspects of the nine questionnaires. These criteria, however, are only part of the consideration. In part II the construction of these scales in relationship to the measurement domains will be evaluate

Condition-specific outcome measures for low back pain: Part II: Scale construction

A literature review of the most widely used, condition-specific, self-administered assessment questionnaires for low back pain has been undertaken. In part I, technical issues such as validity, reliability, availability and comparability were analyzed for the nine most widely used outcome tools. This second part focuses on the content and wording of questions and answers in each of the nine questionnaires, and an analysis of the different score results is performed. The issue of score bias is discussed and suggestions are given in order to increase the construct validity in the practical use of the individual questionnaire

Computational flow cytometry as a diagnostic tool in suspected-myelodysplastic syndromes

The diagnostic work-up of patients suspected for myelodysplastic syndromes is challenging and mainly relies on bone marrow morphology and cytogenetics. In this study, we developed and prospectively validated a fully computational tool for flow cytometry diagnostics in suspected-MDS. The computational diagnostic workflow consists of methods for pre-processing flow cytometry data, followed by a cell population detection method (FlowSOM) and a machine learning classifier (Random Forest). Based on a six tubes FC panel, the workflow obtained a 90% sensitivity and 93% specificity in an independent validation cohort. For practical advantages (e.g., reduced processing time and costs), a second computational diagnostic workflow was trained, solely based on the best performing single tube of the training cohort. This workflow obtained 97% sensitivity and 95% specificity in the prospective validation cohort. Both workflows outperformed the conventional, expert analyzed flow cytometry scores for diagnosis with respect to accuracy, objectivity and time investment (less than 2 min per patient)

Patient socioeconomic determinants for the choice of the cheapest molecule within a cluster: evidence from Belgian prescription data

Reference pricing is a common cost-sharing mechanism, with the financial penalty for the use of costly drugs shifted from the third-party payer to the patient. Unintended distributional consequences might arise, if the weakest socioeconomic groups face a relatively higher financial burden. This study analyzed for a sample of Belgian individual prescription data for 4 clusters of commonly used drugs (proton pump inhibitors, statins and two groups of antihypertensives [drugs acting on renin-angiotensin system and dihydropyridine derivatives]) whether the probability to receive the least expensive molecule within a cluster was linked to the socioeconomic status of the patient. Logistic regression models included individual demographic, working, chronic illness and financial status and small area education data for 906,543 prescriptions from 1,280 prescribing general practitioners and specialists. For the 4 clusters, results show that patients with lower socioeconomic status consistently use slightly more the least expensive drugs than other patients. Larger effects are observed for patients residing in a nursing home for the elderly, patients entitled to increased reimbursement of co-payments, unemployed, patients treated in a primary care center financed per capita (and not fee-for-service) and patients having a chronic illness. Also, patients residing in neighborhoods with low education status use more less expensive drugs. The findings of the study suggest that although equity considerations were not explicitly taken into account in the design of the reference price system, there is no real equity problem, as the costly drugs with supplement are not prescribed more often in patients from lower socioeconomic classes

Analysis of optimal phenotypic space using elementary modes as applied to Corynebacterium glutamicum

BACKGROUND: Quantification of the metabolic network of an organism offers insights into possible ways of developing mutant strain for better productivity of an extracellular metabolite. The first step in this quantification is the enumeration of stoichiometries of all reactions occurring in a metabolic network. The structural details of the network in combination with experimentally observed accumulation rates of external metabolites can yield flux distribution at steady state. One such methodology for quantification is the use of elementary modes, which are minimal set of enzymes connecting external metabolites. Here, we have used a linear objective function subject to elementary modes as constraint to determine the fluxes in the metabolic network of Corynebacterium glutamicum. The feasible phenotypic space was evaluated at various combinations of oxygen and ammonia uptake rates. RESULTS: Quantification of the fluxes of the elementary modes in the metabolism of C. glutamicum was formulated as linear programming. The analysis demonstrated that the solution was dependent on the criteria of objective function when less than four accumulation rates of the external metabolites were considered. The analysis yielded feasible ranges of fluxes of elementary modes that satisfy the experimental accumulation rates. In C. glutamicum, the elementary modes relating to biomass synthesis through glycolysis and TCA cycle were predominantly operational in the initial growth phase. At a later time, the elementary modes contributing to lysine synthesis became active. The oxygen and ammonia uptake rates were shown to be bounded in the phenotypic space due to the stoichiometric constraint of the elementary modes. CONCLUSION: We have demonstrated the use of elementary modes and the linear programming to quantify a metabolic network. We have used the methodology to quantify the network of C. glutamicum, which evaluates the set of operational elementary modes at different phases of fermentation. The methodology was also used to determine the feasible solution space for a given set of substrate uptake rates under specific optimization criteria. Such an approach can be used to determine the optimality of the accumulation rates of any metabolite in a given network

Health behaviors and risk factors in those who use complementary and alternative medicine

<p>Abstract</p> <p>Background</p> <p>Surveys have generally found that individuals more likely to use complementary and alternative medicine are female, live in the western United States, are likely to have a health complaint, and have a higher socioeconomic status than do nonusers. What is not known is the extent to which those who use complementary and alternative medicine also engage in positive health behaviors, such as smoking cessation or increased physical activity and/or exhibit fewer health risk factors such as obesity. This has been identified as a key research question in a recent Institute of Medicine report. In the present study we sought to determine whether the use of complementary and alternative medicine is associated with health behaviors or risk factors known to impact on health status.</p> <p>Methods</p> <p>The current study is a cross-sectional regression analysis using data from the 2002 National Health Interview Survey. Data were collected in-person from 31,044 adults throughout the 50 states and the District of Columbia.</p> <p>Results</p> <p>After controlling for a range of other factors, we found that engaging in leisure-time physical activity, having consumed alcohol in one's life but not being a current heavy drinker, and being a former smoker are independently associated with the use of CAM. Obese individuals are slightly less likely to use CAM than individuals with a healthy body-mass index. No significant associations were observed between receipt of an influenza vaccine and CAM use.</p> <p>Conclusion</p> <p>Those engaging in positive health behaviors and exhibiting fewer health risk factors are more likely to use CAM than those who forgo positive health behaviors or exhibit more health risk factors. The fact that users of CAM tend to pursue generally healthy lifestyles suggests that they may be open to additional recommendations toward optimizing their health.</p

Ornamental plants: annual reports and research reviews, 2002

Ohio State University Extension Nursery, Landscape, and Turf Team directory: 2003 / Jack Kerrigan -- Floriculture Industry Roundtable of Ohio: 2003 / Charles Behnke -- Ohio State University Extension 2002 Buckeye Yard and Garden Line evaluation survey / Amy K. Stone and James A. Chatfield -- Weather, environmental, and cultural problems of ornamental plants in Ohio: 2002 / Pamela J. Bennett -- Infectious disease problems of ornamental plants in Ohio: 2002 / James A. Chatfield, Nancy A. Taylor, Erik A. Draper, and Joseph F. Boggs -- A biological calendar for predicting pest activity: six years of plant and insect phenology in Secrest Arboretum / Daniel A. Herms -- Biological suppression of foliar diseases of ornamental plants with composted manures, biosolids, and Trichoderma hamatum 382 / Harry A. J. Hoitink, Carol A. Musselman, Terry L. Moore, Leona E. Horst, Charles R. Krause, Randy A. Zondag, and Hannah Mathers -- Growth and water use by four leguminous tree species in containers on a gravel surface or embedded in mulch / Michael Knee, Daniel K. Struve, Michael H. Bridgewater, and Joseph W. Phillips -- The effects of sprayer configuration on efficacy for the control of scab on crabapple / Charles R. Krause, Richard C. Derksen, Leona E. Horst, Randall Zondag, Ross D. Brazee, Michael G. Klein, and Michael E. Reding -- Update on honeylocust knot / Pierluigi Bonello, Maria Bellizzi, and Harry A. J. Hoitink -- Control of phytophthora and other major diseases of Ericaceous plants / Harry A. J. Hoitink, Steven T. Nameth, and James C. Locke -- Is your landscape mulch going up in smoke? / Larry G. Steward, T. Davis Sydnor, and Bert Bishop -- IR-4 ornamental trials conducted by USDA-ARS in Ohio: 2002 / Betsy A. Anderson, Michael E. Reding, Michael G. Klein, and Charles R. Krause -- Research on black vine weevil and white grubs in ornamental nurseries-in Ohio by USDA-ARS / Michael E. Reding, Michael G. Klein, Ross D. Brazee, and Charles R. Krause -- Herbaceous ornamental field trial results in Clark County, Ohio – 2002 / Pamela J. Bennett -- Results of annual trial gardens at the Cincinnati Zoo and Botanical Garden for 2002 / Dave Dyke -- Ohio State University Learning Garden annual cultivar trials / Monica M. Kmetz-Gonzalez and Claudio C. Pasian -- A collection of crabapple knowledge from Secrest Arboretum: 1993-2002 / Erik A. Draper, James A. Chatfield, and Kenneth D. Cochran -- Key results of the 2001 Ohio Green Industry Survey / Gary Y. Gao, John J. Smith, James A. Chatfield, Joseph F. Boggs, Erik A. Draper, and Hannah Mathers -- The USDA/Agricultural Research Service research weather network in Lake County, Ohio - 2002 update / R. D. Brazee, R. C. Derksen, C. R. Krause, K. A. Williams, D. Lohnes, M. G. Klein, M. Reding, R. Lyons, W. Hendricks, R. Zondag, R. D. Fox, and D. Herms -- The OSU Chadwick Arboretum Learning Gardens / Dr. Steven Still and Annette Duetz -- Choosing soil testing labs / Gary Y, Gao, Maurice E. Watson, Joseph F. Boggs, and James A. Chatfield -- Top horticultural references for a green industry professional's library / Gary Y. Gao and Pamela J. Bennett -- The maples of Secrest Arboretum / Gary W. Graham, James A. Chatfield, and Kenneth D. Cochran -- Deck the halls with boughs from Ollie! / Kenneth D. Cochran and James A. Chatfiel

ART: A machine learning Automated Recommendation Tool for synthetic biology

Biology has changed radically in the last two decades, transitioning from a descriptive science into a design science. Synthetic biology allows us to bioengineer cells to synthesize novel valuable molecules such as renewable biofuels or anticancer drugs. However, traditional synthetic biology approaches involve ad-hoc engineering practices, which lead to long development times. Here, we present the Automated Recommendation Tool (ART), a tool that leverages machine learning and probabilistic modeling techniques to guide synthetic biology in a systematic fashion, without the need for a full mechanistic understanding of the biological system. Using sampling-based optimization, ART provides a set of recommended strains to be built in the next engineering cycle, alongside probabilistic predictions of their production levels. We demonstrate the capabilities of ART on simulated data sets, as well as experimental data from real metabolic engineering projects producing renewable biofuels, hoppy flavored beer without hops, and fatty acids. Finally, we discuss the limitations of this approach, and the practical consequences of the underlying assumptions failing