Health research in the developing world: a gastroenterological view from Bangladesh

OBJECTIVES: To identify knowledge levels of academic surgeons about Food and Drug Administration (FDA) and Institutional Review Board (IRB) regulations for clinical research and to determine whether being a member in an IRB, conducting or participating in clinical trials, or being a member in surgical societies affected knowledge levels. DESIGN: Survey of surgical department faculty members in 20 universities. RESULTS: Sixty-five responses were received from 14 sites. Overall mean (+/- SEM) correct score was 6.7 +/- 0.2 of a possible 20 points. The best predictor of overall score was being a primary investigator of a clinical trial (P < .001), followed by being or having been a member of an IRB (P < or = .02). The total mean score of members of the Surgical Infection Society (8.2 +/- 0.5) was significantly higher (P < .001) than that of nonmembers (6.1 +/- 0.2), a phenomenon not observed with other surgical societies. In certain hypothetical clinical scenarios, all respondents were mistakenly willing to conduct clinical trials without obtaining appropriate approval from the FDA. Four (22%) of 18 IRB member respondents and 16 (25%) of the 65 respondents were willing to conduct human research without appropriate approval from patients, the IRB, or both. CONCLUSIONS: Knowledge deficits exist in the academic surgical community about the role and requirements of the FDA and local IRBs for conducting clinical research. Further study is required to determine the reasons for this deficit and to identify appropriate interventions.     

Cloning and disruption of the antigenic catalase gene of Aspergillus fumigatus

Aspergillus fumigatus possesses two catalases (described as fast and slow on the basis of their electrophoretic mobility). The slow catalase has been recognized as a diagnostic antigen for aspergillosis in immunocompetent patients. The antigenic catalase has been purified. The enzyme is a tetrameric protein composed of 90-kDa subunits. The corresponding cat1 gene was cloned, and sequencing data show that the cat1 gene codes for a 728-amino-acid polypeptide. A recombinant protein expressed in Pichia pastoris is enzymatically active and has biochemical and antigenic properties that are similar to those of the wild-type catalase. Molecular experiments reveal that CAT1 contains a signal peptide and a propeptide of 15 and 12 amino acid residues, respectively. cat1-disrupted mutants that were unable to produce the slow catalase were as sensitive to H2O2 and polymorphonuclear cells as the wild-type strain. In addition, there was no difference in pathogenicity between the cat1 mutant and its parental cat1+ strain in a murine model of aspergillosis.     

Driver detection and recognition of lineside signals and signs at different approach speeds

A study was carried out using simulation to investigate driver responses to lineside signals and signs at various approach speeds. The objectives of the study were: (1) to find out whether train speed would significantly affect signal/sign reading; (2) to examine at which point certain types of signs or signals could be detected or recognised, and (3) to determine a speed cut-off level above which certain types of signs or signals are no longer recognisable or detectable. Fifty-seven train drivers from 12 Train Operating Companies in the UK participated in the trials. Twenty different types of lineside signs and ten types of signals were tested under six different approach speeds ranging from 100 to 350 km/h (62–218 mph). Driver performance measures were ‘time remaining to the signal/sign’ at the point of detection or recognition, and reading error rate. The results showed a significant influence of train speed on driver responses to lineside signals/signs and demonstrated a non-linear relationship between driver responses to signals/signs and approach speed. This has been used to estimate a maximum approach speed limit within which a specific signal or sign can be correctly detected or recognised. The findings and implications of the study are discussed in the paper.     

A case-mix classification system for medical rehabilitation

Dissatisfaction with Medicare's current system of paying for rehabilitation care has led to proposals for a rehabilitation prospective payment system, but first a classification system for rehabilitation patients must be created. Data for 36,980 patients admitted to and discharged from 125 rehabilitation facilities between January 1, 1990, and April 19, 1991, were provided by the Uniform Data System for Medical Rehabilitation. Classification rules were formed using clinical judgment and a recursive partitioning algorithm. The Functional Independence Measure version of the Function Related Groups (FIM-FRGs) uses four predictor variables: diagnosis leading to disability, admission scores for motor and cognitive functional status subscales as measured by the Functional Independence Measure, and patient age. The system contains 53 FRGs and explains 31.3% of the variance in the natural logarithm length of stay for patients in a validation sample. The FIM-FRG classification system is conceptually simple and stable when tested on a validation sample. The classification system contains a manageable number of groups, and may represent a solution to the problem of classifying medical rehabilitation patients for payment, facility planning, and research on the outcomes, quality, and cost of rehabilitation.     

The impact of publicly funded basic research: an integrative extension of Martin and Salter

This paper provides an integrative literature review of the research on the impact of the public funding of basic research, extending previous work done at the Science Policy Research Unit (SPRU), University of Sussex, East Sussex, UK. "Impact" is measured in terms of publications, patents, new drugs, employment, and new start-up companies. The primary focus of this paper is on empirical studies of the impact of biomedical research. However, a few key theoretical papers and empirical papers with a broader industrial focus are also reviewed to provide a more complete perspective. Conclusions, including an alternative view that basic research need not be public supported, and future research opportunities in this area are also discussed.     

LEICA: a low energy ion composition analyzer for the study of solarand magnetospheric heavy ions

The SAMPEX (Solar, Anomalous, and Magnetospheric Particle Explorer) LEICA instrument is designed to measure ~0.5-5-MeV/nucleon solar and magnetospheric ions over the range from He-Ni. The instrument is a time-of-flight (TOF) mass spectrometer, which measures particle TOF over an ~0.5-m path and the residual energy deposited in an array of Si solid state detectors. Large-area microchannel plates are used, resulting in a large geometrical factor for the instrument (0.6 cm² sr), which is essential for accurate compositional measurements in small solar flares and in studies of precipitating magnetospheric heavy ions     

Influence of adsorption on the measurement of diffusion coefficients by Taylor dispersion

The effect of adsorption on the measurement of diffusion coefficients by the Taylor dispersion technique is investigated by modifying the governing equation to account for reversible, nonequilibrium adsorption. The resulting two-dimensional equations are solved by an explicit finite-difference technique. Experimental data for the acridine carbon dioxide system indicated that acridine adsorbs on the walls on the tubing and these data were investigated with this model. The influence of carious parameters including the number of sites and the rates of adsorption desorption was investigated by conducting a parametric sensitivity analysis on the model. It was found that adsorption of the solute on the wall of the tubing could produce an error as high as 35% on the measured diffusion coefficient compared to the actual diffusion coellicient. Examination of the influence of each of the parameters will enable Inure investigators to reduce the effect of adsorption in the measurement of diffusion coefficients by Taylor dispersion.     

Insight into the chemical reaction of CH2OH with NO: Formation of N-hydroxy formamide as an isocyanic acid precursor

This study has explored the potential energy surface on the chemical reaction of CH₂OH with NO by using ab initio calculation. We have found the new reaction pathway producing N-hydroxy formamide, which can further decompose to generate isocyanic acid as a reducing agent of hydrocarbons selective catalytic reduction.