Critical appraisal by reading for medical students--a case study from Pakistan

Doctors read literature to keep abreast of medical advances. A recommendation from the 1993 World Summit for Medical Education is that medical schools should teach medical students to critically appraise scientific reports. The Department of Community Health Sciences of Aga Khan University Medical College teaches basic research methods to medical students. This is now supplemented with "Critical Reading". Critical reading was first taught to 67 third year students between October, 1993 and May, 1994. A "validity check-list for critical readers" was introduced in a two week orientation consisting of three one-hour classroom sessions and four one-hour small group sessions. Thereafter, small groups met monthly to critique clinical epidemiological reports relevant to current organ system teaching. The students reading attitudes and critical appraisal skills were assessed through continuous assessment and a written final examination with questionnaire. All but three students passed the final examination (mean score (74%, standard deviation 12%). Sixty-four of 67 (96%) completed questionnaires. All (73% strongly) agreed that critical reading skills were essential, but only 30% strongly agreed that they had, indeed, mastered the skills. Ninety-seven percent (56% strongly) disagreed that year three was too early to start critical reading. Clinical teaching staff expressed interest in learning these skills. Students benefited from and enjoyed this first critical reading course. It strengthened ties between clinical and community health sciences teaching staff. The critical reading skills of the clinical teaching staff is being addressed in seminars to strengthen institutional research capacity.     

Protein topology of presenilin 1

Mutations in a gene encoding a multitransmembrane protein, termed presenilin 1 (PS1), are causative in the majority of early-onset cases of AD. To determine the topology of PS1, we utilized two strategies: first, we tested whether putative transmembranes are sufficient to export a protease-sensitive substrate across a lipid bilayer; and second, we examined the binding of antibodies to specific PS1 epitopes in cultured cells selectively permeabilized with the pore-forming toxin, streptolysin-O. We document that the "loop," N-terminal, and C-terminal domains of PS1 are oriented toward the cytoplasm.     

Fast transmission CT for determining attenuation maps using a collimated line source, rotatable air-copper-lead attenuators and fan-beam collimation

We describe a technique using a line source and a rotatable air-copper-lead assembly to acquire gamma transmission computed tomographic (TCT) data for determining attenuation maps to compensate SPECT emission scans. The technique minimizes problems associated with discriminating 99mTc transmission and 201Tl emission photons and requires only a modest increase in total study time. A 99mTc line source and a stacked foil ("multislat") collimator are placed near the focal line of a fan-beam collimator (114 cm focal length) mounted on one detector of a triple-camera SPECT system. We acquired TCT data of plastic rod and anthropomorphic thorax phantoms to investigate the capability of the line source and rotatable air-copper-lead attenuators to determine attenuation maps. The data were acquired with and without 5.4 MBq (145 microCi) of 201Tl placed in the myocardial chamber of the thorax phantom. Phantoms also were scanned using a curved transmission slab source mounted to a parallel-hole collimator. Fan-beam TCT images have improved resolution compared with parallel-beam TCT images. Two patient scans also were performed to evaluate the clinical usefulness of fan-beam TCT. The rotatable air-copper-lead attenuator method eliminates contamination of emission data by transmission photons and reduces spill-over of emission data into the transmission energy window for some cases. Results show the feasibility of using fast, sequential or interlaced transmission scans of a line source within a rotatable air-copper-lead attenuator assembly to obtain accurate attenuation maps for SPECT attenuation compensation.     

Comparative analysis of experimental performance and stability of sensorless induction motor drives

This paper compares the experimental performance of three flux and speed observers for speed-sensorless induction motor drives and discusses the cause of their differences. The small signal analysis using the linearized model is carried out to analyze stability. Three methods are generally accepted to be representative candidates for high sensorless performance, namely: 1) rotor-flux model reference adaptive system (MRAS); 2) torque-current MRAS; and 3) adaptive nonlinear flux observer. Many other sensorless methods improved these methods. The paper discusses baseline conditions for the experiments and the stability analysis, which include matched load inertia, specified speed estimator dynamics, and sensorless operation within a speed control loop. For the comparison tests in the paper, the speed estimation dynamics of the methods are the same; this is important for parameter sensitivity. The paper concentrates on the low-speed performance, and all results shown are under sensorless speed control.     

Preparation and assessment of frozen-hydrated sections of mammalian tissue for electron microscopy and X-ray microprobe analysis

A system is described for preparing and examining frozen-hydrated sections of mammalian tissue, using commercially available equipment. An essential part of the system is a liquid nitrogen cooled vacuum transfer system. Minor modifications were required to interface the various manufacturers' equipment, and also to facilitate handling of specimens in the cryoultramicrotome. A variety of criteria indicates that our sections are truly frozen-hydrated, but negligible image contrast in the sections is a serious problem both for morphological work and X-ray microanalysis.     

A Strategy for Managing Office Automation Projects

Experience indicates that a change in technology must be accompanied by user education. It is not the technology alone, but the way in which the technology is planned, designed, and implemented that determines the success of change. Employees must not only understand the applications of office technologies but also deal with the organizational impact of change. Successful development of office automation systems must involve users, management, and systems professionals in the planning, design, and implementation of change.     

Bacteria in a water‐damaged building: associations of actinomycetes and non‐tuberculous mycobacteria with respiratory health in occupants

We examined microbial correlates of health outcomes in building occupants with a sarcoidosis cluster and excess asthma. We offered employees a questionnaire and pulmonary function testing and collected floor dust and liquid/sludge from drain tubing traps of heat pumps that were analyzed for various microbial agents. Forty‐nine percent of participants reported any symptom reflecting possible granulomatous disease (shortness of breath on exertion, flu‐like achiness, or fever and chills) weekly in the last 4 weeks. In multivariate regressions, thermophilic actinomycetes (median = 529 CFU/m²) in dust were associated with FEV₁/FVC [coefficient = ?2.8 per interquartile range change, P = 0.02], percent predicted FEF_25–75% (coefficient = ?12.9, P = 0.01), and any granulomatous disease‐like symptom [odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.45?6.73]. Mycobacteria (median = 658 CFU/m²) were positively associated with asthma symptoms (OR = 1.5, 95% CI = 0.97?2.43). Composite score (median = 11.5) of total bacteria from heat pumps was negatively associated with asthma (0.8, 0.71?1.00) and positively associated with FEV₁/FVC (coefficient = 0.44, P = 0.095). Endotoxin (median score = 12.0) was negatively associated with two or more granulomatous disease‐like symptoms (OR = 0.8, 95% CI = 0.67?0.98) and asthma (0.8, 0.67?0.96). Fungi or (1→3)‐β‐D‐glucan in dust or heat pump traps was not associated with any health outcomes. Thermophilic actinomycetes and non‐tuberculous mycobacteria may have played a role in the occupants' respiratory outcomes in this water‐damaged building.     

Mining knowledge from text repositories using information extraction: A review

There are two approaches to mining text form online repositories. First, when the knowledge to be discovered is expressed directly in the documents to be mined, Information Extraction (IE) alone can serve as an effective tool for such text mining. Second, when the documents contain concrete data in unstructured form rather than abstract knowledge, Information Extraction (IE) can be used to first transform the unstructured data in the document corpus into a structured database, and then use some state-of-the-art data mining algorithms/tools to identify abstract patterns in this extracted data. This paper presents the review of several methods related to these two approaches.