Application of self-quenched JH consensus primers for real-time quantitative PCR of IGH gene to minimal residual disease evaluation in multiple myeloma.

Monitoring multiple myeloma patients for relapse requires sensitive methods to measure minimal residual disease and to establish a more precise prognosis. The present study aimed to standardize a real-time quantitative polymerase chain reaction (PCR) test for the IgH gene with a JH consensus self-quenched fluorescence reverse primer and a VDJH or DJH allele-specific sense primer (self-quenched PCR). This method was compared with allele-specific real-time quantitative PCR test for the IgH gene using a TaqMan probe and a JH consensus primer (TaqMan PCR). We studied nine multiple myeloma patients from the Spanish group treated with the MM2000 therapeutic protocol. Self-quenched PCR demonstrated sensitivity of >or=10(-4) or 16 genomes in most cases, efficiency was 1.71 to 2.14, and intra-assay and interassay reproducibilities were 1.18 and 0.75%, respectively. Sensitivity, efficiency, and residual disease detection were similar with both PCR methods. TaqMan PCR failed in one case because of a mutation in the JH primer binding site, and self-quenched PCR worked well in this case. In conclusion, self-quenched PCR is a sensitive and reproducible method for quantifying residual disease in multiple myeloma patients; it yields similar results to TaqMan PCR and may be more effective than the latter when somatic mutations are present in the JH intronic primer binding site.

A realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

Objective: To determine what, how, for whom, why, and in what circumstances educational interventions to improve the delivery of nutrition care by doctors and other healthcare professionals work?

Design: Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched Medline, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar, and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms, and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations.

Results: Over half of the 46 studies from which we extracted data originated from the US. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in both developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included: feeling competent; feeling confident and comfortable; having greater self-efficacy; being less inhibited by barriers in healthcare systems; and feeling that nutrition care was accepted and recognised.

Conclusion: These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients’ health by helping health students and professionals to appreciate the importance of delivering nutrition care and feel competent to deliver it.

Field investigation of contactless displacement measurement using computer vision systems for civil engineering applications

Much of the bridge stock on major transport links in North America and Europe was constructed in the 1950s and 1960s and has since deteriorated or is carrying loads far in excess of the original design loads. Structural Health Monitoring Systems (SHM) can provide valuable information on the bridge capacity but the application of such systems is currently limited by access and bridge type. This paper investigates the use of computer vision systems for SHM. A series of field tests have been carried out to test the accuracy of displacement measurements using contactless methods. A video image of each test was processed using a modified version of the optical flow tracking method to track displacement. These results have been validated with an established measurement method using linear variable differential transformers (LVDTs). The results obtained from the algorithm provided an accurate comparison with the validation measurements. The calculated displacements agree within 2% of the verified LVDT measurements, a number of post processing methods were then applied to attempt to reduce this error.

Laboratory investigation of contactless displacement measurement using computer vision systems

Much of the bridge stock on major transport links in North America and Europe was constructed in the 1950’s and 1960’s and has since deteriorated or is carrying loads far in excess of the original design loads. Structural Health Monitoring Systems (SHM) can provide valuable information on the bridge capacity but the application of such systems is currently limited by access and system cost. This paper investigates the development of a low cost portable SHM system using commercially available cameras and computer vision techniques. A series of laboratory tests have been carried out to test the accuracy of displacement measurements using contactless methods. The results from each of the tests have been validated with established measurement methods, such as linear variable differential transformers (LVDTs). A video image of each test was processed using two different digital image correlation programs. The results obtained from the digital image correlation methods provided an accurate comparison with the validation measurements. The calculated displacements agree within 4% of the verified measurements LVDT measurements in most cases confirming the suitability full camera based SHM systems