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Perceptual causality in children.

Three experiments considered the development of perceptual causality in children from 3 to 9 years of age (N = 176 in total). Adults tend to see cause and effect even in schematic, two-dimensional motion events: Thus, if square A moves toward B, which moves upon contact, they report that A launches B--physical causality. If B moves before contact, adults report that B tries to escape from A--social or psychological causality. A brief pause between movements eliminates such impressions. Even infants in the first year of life are sensitive to causal structure in both contact and no-contact events, but previous research with talking-age children found poor verbal reports. The present experiments used a picture-based forced-choice task to reduce linguistic demands. Observers saw eight different animations involving squares A and B. Events varied in whether or not these agents made contact; whether or not there was a delay at the closest point; and whether they moved rigidly or with a rhythmic, nonrigid "caterpillar" motion. Participants of all ages assigned events with contact to the physical domain and events without contact to the psychological domain. In addition, participants of all ages chose causality more often for events without delay than with delay, but these events became more distinct over the preschool range. The manipulation of agent motion had only minor and inconsistent effects across studies, even though children of all ages considered only the nonrigid motion to be animal-like. These results agree with the view that perceptual causality is available early in development.

Child↗

How to satisfy both clinical and information technology goals in designing a successful picture archiving and communication system.

Designing and operating a PACS system requires an integrated focus to maintain peak performance of the system from an information technology (IT) perspective and to ensure that all clinical and financial requirements are met. An IT-based picture archiving and communication system (PACS) manager is in the best position to satisfy these sometime conflicting audiences. This report will describe how an institution moving towards PACS can unite radiologists, hospital administrators, and information systems (IS)/IT specialists into one cohesive team to ensure the highest levels of success with their future PACS. There are several keys to success: (1) Designing and selecting PACS requires a dedicated team, with representatives from radiology, as well as IS/IT and administration. (2) Each group needs to thoroughly outline their specific needs, so that the final PACS solution is relevant from all perspectives. This needs assessment needs to be made before issuing a request for proposal (RFP) and interviewing vendors. (3) The team needs to be small to be effective. Each group should have one or at most two representatives that collect input from, and report to, a group of his or her peers. (4) Plans need to be made to determine how to integrate current and future hospital information systems (HIS), in order to ensure a smooth pathway to the electronic medical record. (5) All team members should agree on the overall objectives for PACS and participate in its design and installation. (6) Each team member is charged with motivating, and helping to educate, his or her peers. (7) Training should be tailored to the needs of each audience. Explain how each staff member benefits from the PACS. Training should be ongoing to accommodate the addition of new system features and new users. This report will describe the importance of recognizing PACS as being an IT system with a clinical focus. The importance of designing goals of the PACS system from various perspectives, including clinical, technical, and financial, will be addressed. More importantly, this presentation will highlight the benefits a medical institution will receive if the various groups can work together, while at the same time outlining some pitfalls they can expect to encounter if the groups take an adversarial approach.

Consultants↗

Support of clinician image-related workflow by a user-edited, web-based patient list manager.

Clinician efficiency can be enhanced by worklists that compile useful data for rapid access at the time of need. The authors report development of a web-based, user-edited "Patient List Manager" for the Clinical Image Management System (CIMS). The CIMS List Manager interfaces with the CIMS Archive to provide the user with available studies. It has tools that let the user build personal lists from the available studies. Listed studies are moved from the archive to the cache for rapid access at the time of need. Users can build/edit the list through a browser (without viewing pictures) or from within the image viewer. In this way, the List Manager distributes list building into knowledgeable hands. This is particularly valuable at the current time when health system patient registries are not mature enough to reliably support building build anticipatory patient lists.

Humans↗

Mechanisms of lithium transport in amorphous polyethylene oxide.

We report calculations using a previously reported model of lithium perchlorate in polyethylene oxide in order to understand the mechanism of lithium transport in these systems. Using an algorithm suggested by Voter, we find results for the diffusion rate which are quite close to experimental values. By analysis of the individual events in which large lithium motions occur during short times, we find that no single type of rearrangement of the lithium environment characterizes these events. We estimate the free energies of the lithium ion as a function of position during these events by calculation of potentials of mean force and thus derive an approximate map of the free energy as a function of lithium position during these events. The results are consistent with a Marcus-like picture in which the system slowly climbs a free energy barrier dominated by rearrangement of the polymer around the lithium ions, after which the lithium moves very quickly to a new position. Reducing the torsion forces in the model causes the diffusion rates to increase.

Journal Article↗

An allosteric model of the molecular interactions of excitation-contraction coupling in skeletal muscle.

A contact interaction is proposed to exist between the voltage sensor of the transverse tubular membrane of skeletal muscle and the calcium release channel of the sarcoplasmic reticulum. This interaction is given a quantitative formulation inspired in the Monod, Wyman, and Changeux model of allosteric transitions in hemoglobin (Monod, J., J. Wyman, and J.-P. Changeux. 1965. Journal of Molecular Biology. 12:88-118), and analogous to one proposed by Marks and Jones for voltage-dependent Ca channels (Marks, T. N., and S. W. Jones. 1992. Journal of General Physiology. 99:367-390). The allosteric protein is the calcium release channel, a homotetramer, with two accessible states, closed and open. The kinetics and equilibrium of this transition are modulated by voltage sensors (dihydropyridine receptors) pictured as four units per release channel, each undergoing independent voltage-driven transitions between two states (resting and activating). For each voltage sensor that moves to the activating state, the tendency of the channel to open increases by an equal (large) factor. The equilibrium and kinetic equations of the model are solved and shown to reproduce well a number of experimentally measured relationships including: charge movement (Q) vs. voltage, open probability of the release channel (Po) vs. voltage, the transfer function relationship Po vs. Q, and the kinetics of charge movement, release activation, and deactivation. The main consequence of the assumption of allosteric coupling is that primary effects on the release channel are transmitted backward to the voltage sensor and give secondary effects. Thus, the model reproduces well the effects of perchlorate, described in the two previous articles, under the assumption that the primary effect is to increase the intrinsic tendency of the release channel to open, with no direct effects on the voltage sensor. This modification of the open-closed equilibrium of the release channel causes a shift in the equilibrium dependency of charge movement with voltage. The paradoxical slowing of charge movement by perchlorate also results from reciprocal effects of the channel on the allosterically coupled voltage sensors. The observations of the previous articles plus the simulations in this article constitute functional evidence of allosteric transmission.

Allosteric Regulation↗

Cost, volume and profitability analysis.

If you want to increase your income by seeing more patients, it's important to figure out the financial impact such a move could have on your practice. Learn how to run a cost, volume, and profitability analysis to determine how business decisions can change your financial picture.

Costs and Cost Analysis↗

[Investigations on hips and extremities by ultrasonics (author's transl)].

Using a Picker Echoview System 80 L, an Ultrasound Compound scanning instrument from Picker Roentgen GmbH, Espelkamp, Germany, some investigations on bones and joints were performed. In comparison with needle probe diameter measuring of muscles it could be shown that ultrasound tomography gives identical results without pain. Figuring of hip and knee joints outlines was possible. Alterations of muscles and tendon tissue were to be seen. Special meridians on the hip joint, along with the ultrasound probe had to be moved, were defined by anatomical marking points. So it became possible to reproduce some angles which usually had to be measured at X-ray pictures.

Achilles Tendon↗

Determinants of visual attention in real-wound scenes.

The present study examined the saliency of size, movement, and human content variables in visual selective attention. Ss named stimuli present in motion pictures of real world scenes or in animated cartoon controls during a 15-sec. exposure period. Regardless of the type of presentation that they saw, Ss tended to name large and/or moving stimuli more often than small and/or nonmoving stimuli. Also, small human stimuli were named more frequently than small nonhuman stimuli, while there were no differences between the frequencies with which large human and nonhuman stimuli were named. The order in which Ss named stimuli was not related to either the size, movement, or human content variables. Results are discussed in terms of the generalizability of the results of previous studies to conditions simulating the real world.

Attention↗

The many phases of anaphase.

Anaphase is the stage of the cell cycle in which duplicated chromosomes separate and move towards opposite poles of the cell. Although its chromosome movements have always been viewed as majestic, until recently anaphase lacked obvious landmarks of regulation. The picture has changed with numerous recent studies that have highlighted the raison d'être of anaphase. It is now known to be associated with a series of regulatory pathways that promote a switch from high to low cyclin-dependent kinase activity--an essential feature for proper mitotic exit. The balance between protein phosphorylation and protein dephosphorylation drives and coordinates diverse processes such as chromosome movement, spindle dynamics and cleavage furrow formation. This well-ordered sequence of events is central to successful mitosis.

Anaphase↗

Transmission of gamma-ray-induced unstable chromosomal aberrations through successive mitotic divisions in human lymphocytes in vitro.

Transmission of unstable chromosomal aberrations through successive mitotic divisions M1-M4 was analysed in 3 Gy gamma-ray-irradiated G0 human lymphocytes in vitro, harvested at 50, 72 and 96 h. Bromodeoxyuridine (BrdU) incorporation and subsequently the fluorescence plus Giemsa (FPG) method allowed the cell cycle status of each cell scored to be ascertained. Higher dicentric frequencies were observed in cells within the same post-irradiation division derived from extended culture times, indicating either a delay in cell cycle progression of aberrant cells or different lymphocyte sub-populations. The yield of complete dicentrics decreased by a factor of two in passing from M1 to M2 and showed further reductions of 26 and 44%, respectively, in moving from M2 to M3 and from M3 to M4. In the case of conventionally stained metaphases, wherein the cell cycle status does not enter the picture, the dicentric frequencies showed a reduction in yield of 39.6% at 72 h and 52.1% at 96 h compared with 50 h, because the cells analysed comprise a mixture of metaphases in different cell cycles. In the FPG stained first division metaphases, 92-100% of dicentrics analysed at 50, 72 and 96 h and in the conventionally stained metaphases, 90-94, 72-84 and 54-80% of dicentrics analysed at 50, 72 and 96 h respectively were complete dicentrics (with fragments). In the M1, M2, M3 and M4 metaphases analysed, 92-100, 50-89, 20-70 and 10-50% of dicentrics, respectively, were complete dicentrics and 55-75, 53-68, 43-57 and 36-50% excess acentrics, respectively, were seen in cells with complete dicentrics. Interindividual variation was observed in cell cycle kinetics, radiation-induced chromosomal aberrations and micronucleus frequencies. A salient feature of the delayed effects was the induction of giant cells and the mirror dicentrics observed in them. The reduction in dicentric frequencies due to either cell cycle delay or cell death in successive generations is aided by the multiplicity of aberrations. Bridge-breakage-fusion (BBF) events mediated by dicentric chromosomes may also be instrumental in the perpetuation of chromosomal instability.

Adult↗

Cardiac anatomy viewed systematically with two dimensional echocardiography.

The details of three-dimensional cardiac anatomy are complex, and structure recognition is difficult in tomograms produced with recently developed two-dimensional ultrasonic sector scanners. This article presents a method we have found useful for systematic inclusion of most cardiac structures during such echocardiographic examinations. Orthogonal planes, aligned parallel and perpendicular to the long or major left ventricular axis, are obtained from each of three transducer positions on the body surface. Moving this X-Y image plane through the heart perpendicular to the plane (z axis) allows the viewer to integrate the images into a mental picture of the whole structure. The illustrations are oriented as they are displayed by ultrasonic sector scanners so they aid rapid recognition of cardiac structures.

Echocardiography↗

Non-linear, visual-rich supplemental material designed for an introductory course in veterinary anesthesia.

A possible reason for superficial learning in an introductory anesthesia course was considered to be a lack of visual reinforcement at the time of examination preparation. Students had limited access to live animal laboratories and clinical cases during the course, reducing their ability to depend on experiential learning. In an attempt to improve student learning, simple presentation software was used to develop a supplemental CD. The design involved multiple PowerPoint presentations that incorporated text, pictures, videos, and self-assessments. Non-linear exploration of the topics covered was made possible by extensive use of hyperlinks within and between presentations, moving the student to definitions, background material, videos, advanced details, and previously covered information. Comments received from students on a prototype were positive overall, and improvements were made related to their feedback. Other supplemental materials and lecture presentations can easily incorporate the techniques described here.

Anesthesiology↗

Induction of corneal graft rejection by passive cell transfer.

An experimental model is presented demonstrating that penetrating corneal grafts in the rabbit may be rejected by passive transfer into the anterior chamber of specifically sensitized lymphoid cells. Destruction of histo-incompatible corneal endothelium is always marked by the formation of focal pock-like areas of damage in this system, rather than by the typical moving line of rejecting endothelium usually seen in spontaneous graft rejection. Where the transferred lymphoid cells are compatible with the tissues of the graft recipient, the picture is one of a severely affected graft on a field of uninvolved recipient corneal endothelium. Where the lymphoid cells are compatible with the graft and not with the tissues of the recipient, one sees a clear corneal graft surviving on a field of endothelial destruction on the recipient bed. The specificity of these reactions is illustrated in terms of the histocompatibility relationships between corneal donor, graft recipient, and the donor of the sensitized lymphoid cells.

Animals↗

Issues and advances in pain control in children.

Increased interest in the topic of pain has resulted in pharmacologic advances that provide new possibilities for pain relief in children. It has also resulted in new nonpharmacologic therapies that are now being used more frequently with children. It is hoped that these advances will continue so that health care providers will have a larger repertoire of pain control methods effective with children, and so that the traumatic aspects of hospitalization and health care can be reduced greatly. The pain experienced by children has heretofore been on the backroads of scientific and scholarly development. As a result, we actually know very little about pediatric pain, its measurement, and its treatment. The literature and research cited previously are strikingly limited for providing a base of knowledge to guide clinical practice. We avoided a "cookbook" approach to the discussion on pain control, because there are many of those available. Instead, we presented a summary of the research that is currently available in the attempt to help nurses better recognize the limitations in what we know with certainty about this important topic. We hope that this knowledge will spur readers to examine their own beliefs and knowledge, question former assumptions about pediatric pain, and promote a more inquiring approach to assessment and management of children's pain. Pain is a multidisciplinary problem. Although health care providers from the various disciplines each approach the pain problem from different angles, each approach has its place in the overall picture of solving the problems of pediatric pain control. Nurses have been and will continue to be a vital part of clinical and scientific advancements to move pediatric pain out of the realm of mystery and into the realm of the known.

Analgesics↗

Abnormal line bisection judgements in children with Tourette's syndrome.

Tourette's syndrome (TS) has been associated with loss of normal basal ganglia asymmetry, as well as loss of normal functional asymmetry, including the leftward bias on traditional visuospatial tasks such as line bisection and turning bias tests. The aim of the present study was to examine the lateralisation of visuospatial attention in TS. We examined the effect of an irrelevant moving-dot background on line bisection judgements. Nine children with a DSM IV diagnosis of TS participated, in addition to 9 healthy controls, individually matched for age, sex and IQ. Horizontal lines of varying length were presented on a computer screen with either a blank background, or a moving, random-dot field. The dots moved either leftward or rightward across the screen at 40 or 80 mm/s, and participants were instructed to ignore these distracting stimuli when judging the lines. TS children were found to be abnormally right-biased in line bisection in a similar fashion to unmedicated ADHD children who, in a previous study, showed a similar small, yet significant, right-bias in line bisection. Matched controls showed a small, nonsignificant left bias, consistent with past research. Unlike previous findings with hemineglect patients, the irrelevant moving background had no effect on bisection performance for TS children or healthy controls. The present findings suggest a deficit in visuospatial attention consistent with the emerging picture of a lateralised dysfunction of frontostriatal circuitry in TS.

Adolescent↗

Effects of organization and working memory on age differences in memory for scene information.

We examined the effects of organization and working memory on young and older adults' scene memory. Subjects discriminated transformed pictures from unchanged study items in organized or unorganized scenes. Memory was tested independently for two types of scene transformations: (a) relocations (two objects rearranged and one moved) and (b) substitutions (one object replaced by another). Organization had similar effects on young and older adults, improving memory for relocations but not substitutions. Working memory significantly predicted scene memory, except for relocations in organized scenes, and partially mediated the observed age effects. The results are discussed in relation to the resource and environmental support views of cognitive aging.

Adult↗

Nonequilibrium gating and voltage dependence of the ClC-0 Cl- channel.

The gating of ClC-0, the voltage-dependent Cl- channel from Torpedo electric organ, is strongly influenced by Cl- ions in the external solution. Raising external Cl- over the range 1-600 mM favors the fast-gating open state and disfavors the slow-gating inactivated state. Analysis of purified single ClC-0 channels reconstituted into planar lipid bilayers was used to identify the role of Cl- ions in the channel's fast voltage-dependent gating process. External, but not internal, Cl- had a major effect on the channel's opening rate constant. The closing rate was more sensitive to internal Cl- than to external Cl-. Both opening and closing rates varied with voltage. A model was derived that postulates (a) that in the channel's closed state, Cl- is accessible to a site located at the outer end of the conduction pore, where it binds in a voltage-independent fashion, (b) that this closed conformation can open, whether liganded by Cl- or not, in a weakly voltage-dependent fashion, (c) that the Cl(-)-liganded closed channel undergoes a conformational change to a different closed state, such that concomitant with this change, Cl- ion moves inward, conferring voltage-dependence to this step, and (d) that this new Cl(-)-liganded closed state opens with a very high rate. According to this picture, Cl- movement within the pre-open channel is the major source of voltage dependence, and charge movement intrinsic to the channel protein contributes very little to voltage-dependent gating of ClC-0. Moreover, since the Cl- activation site is probably located in the ion conduction pathway, the fast gating of ClC-0 is necessarily coupled to ion conduction, a nonequilibrium process.

Animals↗

Modelling regulatory pathways in E. coli from time series expression profiles.

MOTIVATION: Cells continuously reprogram their gene expression network as they move through the cell cycle or sense changes in their environment. In order to understand the regulation of cells, time series expression profiles provide a more complete picture than single time point expression profiles. Few analysis techniques, however, are well suited to modelling such time series data. RESULTS: We describe an approach that naturally handles time series data with the capabilities of modelling causality, feedback loops, and environmental or hidden variables using a Dynamic Bayesian network. We also present a novel way of combining prior biological knowledge and current observations to improve the quality of analysis and to model interactions between sets of genes rather than individual genes. Our approach is evaluated on time series expression data measured in response to physiological changes that affect tryptophan metabolism in E. coli. Results indicate that this approach is capable of finding correlations between sets of related genes.

Adaptation, Physiological↗