Evaluating a federated medical search engine: tailoring the methodology and reporting the evaluation outcomes.

BACKGROUND: Federated medical search engines are health information systems that provide a single access point to different types of information. Their efficiency as clinical decision support tools has been demonstrated through numerous evaluations. Despite their rigor, very few of these studies report holistic evaluations of medical search engines and even fewer base their evaluations on existing evaluation frameworks. OBJECTIVES: To evaluate a federated medical search engine, MedSocket, for its potential net benefits in an established clinical setting. METHODS: This study applied the Human, Organization, and Technology (HOT-fit) evaluation framework in order to evaluate MedSocket. The hierarchical structure of the HOT-factors allowed for identification of a combination of efficiency metrics. Human fit was evaluated through user satisfaction and patterns of system use; technology fit was evaluated through the measurements of time-on-task and the accuracy of the found answers; and organization fit was evaluated from the perspective of system fit to the existing organizational structure. RESULTS: Evaluations produced mixed results and suggested several opportunities for system improvement. On average, participants were satisfied with MedSocket searches and confident in the accuracy of retrieved answers. However, MedSocket did not meet participants' expectations in terms of download speed, access to information, and relevance of the search results. These mixed results made it necessary to conclude that in the case of MedSocket, technology fit had a significant influence on the human and organization fit. Hence, improving technological capabilities of the system is critical before its net benefits can become noticeable. CONCLUSIONS: The HOT-fit evaluation framework was instrumental in tailoring the methodology for conducting a comprehensive evaluation of the search engine. Such multidimensional evaluation of the search engine resulted in recommendations for system improvement.

[Postcolostral immunoglobulin G (IgG) levels in newborn piglets using three different ELISA detection systems]. / Untersuchungen zur postkolostralen Immun-globulin-G-Versorgung neugeborener Saugferkel mittels unterschiedlicher ELISA-Nachweissysteme.

UNLABELLED: Objective of the study was to evaluate whether the Colostrum Quality Counter (CQC), a new test method for immunoglobulin G (IgG) levels in newborn piglets, is easy to handle and provides comparable results to established testing regimes. MATERIAL AND METHODS: Blood samples from 219 piglets from four different farms were tested for their IgG-concentrations using three different ELISA tests. Furthermore, double samples from 30 piglets were taken from both the anterior vena cava and from the tail to determine whether the collection site affects the results. The three tests used were the Colostrum Quality Counter (CQC; FarmulaONE, NL-Best), the internal IgG-ELISA from our laboratory (MUC) and a commercially-available IgG-ELISA (NAT; NatuTec, Frankfurt/Main, Germany). RESULTS: MUC and NAT showed a higher correlation to each other than to the CQC when referring to the individual results per single piglet. The results from the CQC were higher and the standard deviation was significantly greater. The sampling site had no significant effect on the IgG concentrations measured. CLINICAL RELEVANCE: The CQC is a straightforward and simple test, being very convenient for sampling a large number of piglets. CQC results were inhomogeneous with some unusually high IgG-concentrations. MUC and NAT provided comparable results to one another and the IgG-concentrations showed a good correlation.

Effect of carnitine on muscular glutamate uptake and intramuscular glutathione in malignant diseases.

Abnormally low intramuscular glutamate and glutathione (GSH) levels and/or a decreased muscular uptake of glutamate by the skeletal muscle tissue have previously been found in malignant diseases and simian immunodeficiency virus (SIV) infection and may contribute to the development of cachexia. We tested the hypothesis that an impaired mitochondrial energy metabolism may compromise the Na+-dependent glutamate transport. A randomized double-blind clinical trial was designed to study the effects of L-carnitine, i.e. an agent known to enhance mitochondrial integrity and function, on the glutamate transport and plasma glutamate level of cancer patients. The effect of carnitine on the intramuscular glutamate and GSH levels was examined in complementary experiments with tumour-bearing mice. In the mice, L-carnitine treatment ameliorated indeed the tumour-induced decrease in muscular glutamate and GSH levels and the increase in plasma glutamate levels. The carnitine-treated group in the randomized clinical study showed also a significant decrease in the plasma glutamate levels but only a moderate and statistically not significant increase in the relative glutamate uptake in the lower extremities. Further studies may be warranted to determine the effect of L-carnitine on the intramuscular GSH levels in cancer patients.

Monitoring the physiological status in bioprocesses on the cellular level.

The trend in bioprocess monitoring and control is towards strategies which are based on the physiological status of the organism in the bioprocess. This requires that the measured process variables should be biologically meaningful in order to apply them in physiologically based control strategies. The on-line monitoring equipment available today mostly derives information on the physiological status indirectly, from external variables outside the cells. The complementary approach reviewed here is to analyse the microbial cells directly, in order to obtain information on the internal variables inside the cells. This overview covers methods for analysis of whole cells (as a population or as a single cell), for groups of cellular components, and for specific compounds which serve as markers for a certain physiological status. Physico-chemical separation methods (chromatography, electrophoresis) and reactive analysis can be used to analyse elemental and macromolecular composition of cells. Spectroscopic methods (mass, dielectric, nuclear magnetic, infrared, and Raman) have only recently been applied to such complex multicomponent mixtures such as microbial cells. Spectroscopy and chemical separation methods produce large amounts of data, which can often be used in the best way by applying chemometrics. Some of the methods can yield information not just on the average of the microbial cell population, but also on the distribution of sub-populations. The suitability of the methods for on-line coupling to the bioprocess is discussed. Others not suitable for on-line coupling can be established in routine off-line analysis procedures. The information gained by the methods discussed can mainly be used to establish better knowledge of the basis for monitoring and control strategies. Some are also applicable in real-time monitoring and control.

Effect of maternal pyridoxine X HCl supplementation on the vitamin B-6 status of mother and infant and on pregnancy outcome.

The effect of maternal pyridoxine X HCl (PN-HCl) supplementation on the vitamin B-6 status of pregnant women and their infants at birth and on pregnancy outcome was investigated. Volunteer subjects were randomly assigned a daily vitamin B-6 supplement containing 0, 2.6, 5, 7.5, 10, 15 or 20 mg of PN-HCl in a double-blind study. The mean dietary vitamin B-6 intake of the group was 1.43 +/- 1.28 mg/day as estimated from 24-hour dietary recalls. Maternal plasma pyridoxal 5'-phosphate (PLP) levels were positively correlated with vitamin B-6 supplementation at 30 weeks gestation (r = 0.55, P less than 0.0005) and at delivery (r = 0.54, P less than 0.01). Cord plasma PLP levels reached a maximum when maternal PN-HCl supplementation was 7.5 mg and greater. Supplemental PN-HCl at the 7.5-mg level was required to prevent a decrease in maternal plasma PLP at delivery. Apgar scores at 1 minute after birth were higher (P less than 0.05) for infants whose mothers took 7.5 mg or more supplemental PN-HCl than for infants of mothers who took 5 mg or less. These findings indicate that a vitamin B-6 intake between 5.5 and 7.6 mg/day (diet plus supplement as pyridoxine equivalents) was required to maintain maternal plasma PLP levels at term at a level comparable to initial values.

Dance Therapy: Moving-With the Beat-Toward Health.

There is a world of dance beyond socializing and aerobics, the world of dance therapy in which therapists and patients unearth subconscious impulses through graceful, rhythmic movement.