Studying Lineage Decision-Making In Vitro: Emerging Concepts and Novel Tools

AbstractBackground and Objectives:Hospital-acquired legionnaires' disease can be prevented by disinfection of hospital water systems. This study assessed the long-term efficacy of copper-silver ionization as a disinfection method in controllingLegionellain hospital water systems and reducing the incidence of hospital-acquired legionnaires' disease. A standardized, evidence-based approach to assist hospitals with decision making concerning the possible purchase of a disinfection system is presented.Design:The first 16 hospitals to install copper-silver ionization systems forLegionelladisinfection were surveyed. Surveys conducted in 1995 and 2000 documented the experiences of the hospitals with maintenance of the system, contamination of water withLegionella, and occurrence of hospital-acquired legionnaires' disease. All were acute care hospitals with a mean of 435 beds.Results:All 16 hospitals reported cases of hospital-acquired legionnaires' disease prior to installing the copper-silver ionization system. Seventy-five percent had previously attempted other disinfection methods including superheat and flush, ultraviolet light, and hyperchlorination. By 2000, the ionization systems had been operational from 5 to 11 years. Prior to installation, 47% of the hospitals reported that more than 30% of distal water sites yieldedLegionella. In 1995, after installation, 50% of the hospitals reported 0% positivity, and 43% still reported 0% in 2000. Moreover, no cases of hospital-acquired legionnaires' disease have occurred in any hospital since 1995.Conclusions:This study represents the final step in a proposed 4-step evaluation process of disinfection systems that includes (1) demonstrated efficacy ofLegionellaeradication in vitro using laboratory assays, (2) anecdotal experiences in preventing legionnaires' disease in individual hospitals, (3) controlled studies in individual hospitals, and (4) validation in confirmatory reports from multiple hospitals during a prolonged time (5 to 11 years in this study). Copper-silver ionization is now the only disinfection modality to have fulfilled all four evaluation criteria.

Download Full-text

THE VALUE OF IN VITRO DIAGNOSTIC TESTING IN THE PROVISION OF MEDICAL CARE TO ELDERLY PATIENTS WITH CARDIOVASCULAR DISEASES

Russian Clinical Laboratory Diagnostics ◽

10.18821/0869-2084-2020-65-3-191-196 ◽

2020 ◽

Vol 65 (3) ◽

pp. 191-196

Author(s):

A. S. Pushkin ◽

O. V. Lyang ◽

T. A. Ahmedov ◽

S. A. Rukavishnikova

Keyword(s):

Decision Making ◽

Medical Care ◽

Laboratory Tests ◽

Clinical Decision Making ◽

Diagnostic Testing ◽

Clinical Decision ◽

Initial Examination ◽

Attending Physicians ◽

The Impact

In vitro diagnostics are used at all stages of patient care. The aim of this study was to assess the impact of laboratory examination on clinical decision-making in providing medical care to patients with a cardiovascular profile. We also took into account the level of financing for the laboratory industry in the Russian Federation. We divided our study on three sequential steps: literature review, survey of clinicians and test-survey of clinicians. The share of costs for the laboratory tests in 2017 amounted to about 8% of the total funding for Russian health care. About 80% (70; 90) of the visits of the attending physicians are associated with the appointment of laboratory tests. Among patients who were prescribed any laboratory test - in 62.1% (95% CI 16.9-24.9) cases, the results of these tests influenced clinical decision making related to the initiation, modification or termination of any treatment. All visits of clinicians were divided by purpose: tests were prescribed in almost 100% (90; 100) cases during the initial examination, in 40% (20; 60) cases during repeated visits, and in 40% (15; 40) cases when patients were examined before discharge. In more than half of cases (57,4%; n=31), doctors correctly assumed about the about the share of financing of the laboratory industry. The majority of respondents considered the amount of expenses adequate and recommended to maintain the current level in the future. According to attending physicians, new laboratory markers should demonstrate additional information about clinical relevance to improve patient outcomes. Thus, in current economic realities, future laboratory tests should be financially maximally available and at the same time be clinically highly effective auxiliary instruments. It creates new challenges in finding laboratory biomarkers and putting them into clinical practice.

Download Full-text

Improving Decision-Making in Drug Development Using In Vitro Toxicology Screening

International Journal of Pharmaceutical Medicine ◽

10.2165/00124363-200721050-00005 ◽

2007 ◽

Vol 21 (5) ◽

pp. 347-355 ◽

Cited By ~ 2

Author(s):

Willi Suter

Keyword(s):

Decision Making ◽

Drug Development ◽

In Vitro Toxicology ◽

Toxicology Screening

Download Full-text

The effect of a multifaceted empowerment strategy on decision making about the number of embryos transferred in in vitro fertilisation: randomised controlled trial

BMJ ◽

10.1136/bmj.c2501 ◽

2010 ◽

Vol 341 (sep30 2) ◽

pp. c2501-c2501 ◽

Cited By ~ 47

Author(s):

A. van Peperstraten ◽

W. Nelen ◽

R. Grol ◽

G. Zielhuis ◽

E. Adang ◽

...

Keyword(s):

Decision Making ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

In Vitro Fertilisation ◽

Randomised Controlled

Download Full-text

An ecofeminist perspective on new food technologies

Canadian Food Studies / La Revue canadienne des études sur l alimentation ◽

10.15353/cfs-rcea.v5i1.226 ◽

2018 ◽

Vol 5 (1) ◽

pp. 63-89 ◽

Cited By ~ 1

Author(s):

Angela Lee

Keyword(s):

Decision Making ◽

Research And Development ◽

Food System ◽

Genetically Engineered ◽

Animal Products ◽

Environmental Consequences ◽

In Vitro Meat ◽

Way Of Thinking ◽

Growing Population

New food technologies are touted by some to be an indispensable part of the toolkit when it comes to feeding a growing population, especially when factoring in the growing appetite for animal products. To this end, technologies like genetically engineered (GE) animals and in vitro meat are currently in various stages of research and development, with proponents claiming a myriad of justificatory benefits. However, it is important to consider not only the technical attributes and promissory possibilities of these technologies, but also the worldviews that are being imported in turn, as well as the unanticipated social and environmental consequences that could result. In addition to critiquing dominant paradigms, the inclusive, intersectional ecofeminist perspective presented here offers a different way of thinking about new food technologies, with the aim of exposing inherent biases, rejecting a view of institutions like science and law as being objective, and advancing methods and rationales for a more explicitly ethical form of decision-making. Alternative and marginalized perspectives are especially valuable in this context, because careful reflection on the range of concerns implicated by new food technologies is necessary in order to better evaluate whether or not they can contribute to the building of a more sustainable and just food system for all.

Download Full-text

Inflammation Predicts Decision-Making Characterized by Impulsivity, Present Focus, and an Inability to Delay Gratification

10.31219/osf.io/ptsd4 ◽

2018 ◽

Author(s):

TCU Hill Lab

Keyword(s):

Decision Making ◽

Immune System ◽

Theoretical Model ◽

Sexual Behaviour ◽

Risky Sexual Behaviour ◽

Inflammatory Activity ◽

The Relationship ◽

Present Focus

Here, we propose a novel theoretical model linking present-focused decision-making to the activities of the immune system. We tested our model by examining the relationship between inflammatory activity – in vivo and in vitro – and decision-making characterized by impulsivity, present focus, and an inability to delay gratification. Results support our model, revealing that inflammation predicts these outcomes even after controlling for factors that may contribute to a spurious linkage between them. Moreover, subsequent analyses revealed that our model was a better fit for the data than alternative models using present-focused decision-making and its health-harming behavioural sequelae (e.g., smoking, risky sexual behaviour) to predict inflammation, lending support for the proposed directionality of this relationship. Together, these results suggest that inflammation may contribute to decision-making patterns that can result in undesirable personal and societal outcomes.

Download Full-text

A sodium afterdepolarization in rat superior colliculus neurons and its contribution to population activity

Journal of Neurophysiology ◽

10.1152/jn.01138.2015 ◽

2016 ◽

Vol 116 (1) ◽

pp. 191-200 ◽

Cited By ~ 4

Author(s):

Nima Ghitani ◽

Peter O. Bayguinov ◽

Michele A. Basso ◽

Meyer B. Jackson

Keyword(s):

Decision Making ◽

Patch Clamp ◽

Superior Colliculus ◽

Sudden Onset ◽

Membrane Properties ◽

Persistent Activity ◽

Population Activity ◽

Lower Amplitude ◽

Superior Colliculus Neurons

The mammalian superior colliculus (SC) is a midbrain structure that integrates multimodal sensory inputs and computes commands to initiate rapid eye movements. SC neurons burst with the sudden onset of a visual stimulus, followed by persistent activity that may underlie shifts of attention and decision making. Experiments in vitro suggest that circuit reverberations play a role in the burst activity in the SC, but the origin of persistent activity is unclear. In the present study we characterized an afterdepolarization (ADP) that follows action potentials in slices of rat SC. Population responses seen with voltage-sensitive dye imaging consisted of rapid spikes followed immediately by a second distinct depolarization of lower amplitude and longer duration. Patch-clamp recordings showed qualitatively similar behavior: in nearly all neurons throughout the SC, rapid spikes were followed by an ADP. Ionic and pharmacological manipulations along with experiments with current and voltage steps indicated that the ADP of SC neurons arises from Na+ current that either persists or resurges following Na+ channel inactivation at the end of an action potential. Comparisons of pharmacological properties and frequency dependence revealed a clear parallel between patch-clamp recordings and voltage imaging experiments, indicating a common underlying membrane mechanism for the ADP in both single neurons and populations. The ADP can initiate repetitive spiking at intervals consistent with the frequency of persistent activity in the SC. These results indicate that SC neurons have intrinsic membrane properties that can contribute to electrical activity that underlies shifts of attention and decision making.

Download Full-text