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PubMed2025

Cardiovascular Complications Are Increased in Inflammatory Bowel Disease: A Path Toward Achievement of a Personalized Risk Estimation.

Background/Objectives: The global burden of inflammatory bowel diseases (IBDs) continues to rise, with up to 50% of patients experiencing extraintestinal manifestations. Cardiovascular diseases (CVDs) are of particular concern, ranking as the second leading cause of mortality in this population. Despite a comparatively lower prevalence of traditional cardiovascular (CV) risk factors, the persistent inflammatory milieu and immune dysregulation inherent to IBD may contribute to heightened CVD risk. In this study, following a review of the current literature, an ongoing prospective trial designed to clarify CV risk profiles in IBD patients is detailed. Methods: A cohort of patients with IBD is being enrolled for comprehensive baseline evaluation of CV risk factors, lifestyle metrics, and disease characteristics. The incidence of major adverse cardiovascular events (MACEs) will be tracked and contrasted with a gender- and age-matched non-IBD cohort over a 2-year follow-up period. In cases of MACE occurrence, a multi-omics analysis-including genomic, proteomic, transcriptomic, and microbiome profiling-will be performed, along with a parallel evaluation in matched IBD controls without MACE. An artificial intelligence (AI) framework will support the analysis of this complex dataset. Results: To date, over 150 patients with IBD have been enrolled, and detailed phenotypic data and biological samples have been collected. Conclusions: We aim to introduce an IBD-specific correction factor for existing CV risk scores upon study completion. This is particularly relevant for individuals under 40 years of age, who are often inadequately assessed by current risk stratification models.

Crohn’s disease↗
PubMed2002

The ICIDH-2 as a framework for the assessment of functioning and disability in rheumatoid arthritis.

OBJECTIVE: To investigate by a cross sectional study in patients with rheumatoid arthritis (RA) the relationship between measures of impairment, activity limitation, and participation of the model of functioning and disability (ICIDH-2). METHODS: Inclusion data of patients with RA (n=803) from the Swiss Clinical Quality Management Group were used. Impairments were measured by the Short Form-36 (SF-36) bodily pain scale, rheumatoid arthritis disease activity index (RADAI), disease activity score (DAS28), and radiographic scoring (x ray). Activity limitation was measured with the Health Assessment Questionnaire (HAQ) and the SF-36 physical functioning scale. Participation was measured with the SF-36 role and social functioning scales. Spearman (partial) correlations were used for analysis. RESULTS: Impairment and activity limitation dimensions of the ICIDH-2 model are related; correlations with the HAQ were: SF-36 bodily pain (r(s)=-0.61), RADAI (r(s)=0.58), DAS28 (r(s)=0.49), and x ray (r(s)=0.35). Similar correlations were found for SF-36 physical functioning. Activity limitation and participation restriction dimensions are also related: the HAQ correlates well with SF-36 role-physical (r(s)=-0.53) and SF-36 social functioning (r(s)=-0.43); SF-36 physical functioning correlates similarly. For impairment and participation restriction dimensions only SF-36 bodily pain is substantially correlated (r(s)=0.47 and 0.48) with SF-36 role-physical, after correcting for the influence of the activity limitation dimension (HAQ and SF-36 physical functioning). CONCLUSIONS: In this cross sectional study of patients with RA, impairments are associated with activity limitations, and activity limitations are associated with participation restrictions. Pain is the only impairment directly associated with participation restrictions. Based on the results of this study, it is strongly recommended that the ICIDH-2 framework is used in clinical trials and observational studies including the assessment of disease consequences in RA.

Activities of Daily Living↗
PubMed2003

Translation and restandardization of an instrument: the Early Infant Temperament Questionnaire.

AIMS OF THE STUDY: To test the psychometric properties of a Danish translation of the Early Infant Temperament Questionnaire (EITQ) and to establish standards for scoring the questionnaire. RATIONALE: The general aim was to create a translation that remained close to the original version, was meaningful for the Danish participants, and had acceptable psychometric properties. BACKGROUND: Patterns of temperament can be discerned early in life and tend to persist over time and across situations. For the past 50 years, temperament has been studied by theorists, clinicians and nurse clinicians to predict behaviour, discover interventions that prevent serious behaviour disturbances, and help parents understand the implications of their child's temperament. Thomas and Chess's conceptualization of temperament in nine categories was the framework for the development of the English-language EITQ. Research methods. The translation followed a stepwise process of translation, back translation and consensus. A convenience sample of 204 Danish mothers with 1-4-month old infants completed the translated questionnaire and a demographic questionnaire in 1999. RESULTS: Alpha coefficients for the nine subscales ranged from 0.59 to 0.82. All alpha coefficients were comparable to or higher than those reported on the original United States standardization study. There were statistically significant differences between reported United States mean scores and those in the Danish sample. DISCUSSION: The psychometric properties of the Danish translation are equal to or better than those reported for the United States study. Differences in mean scores or most subscales point to the need to create Danish profiles for scoring. CONCLUSIONS: The Danish version of the EITQ has acceptable reliability and is ready for use in Denmark.

Denmark↗
PubMed2002

Differential metabolization of the impact of life events on subjects hospitalized for depressive and anxiety disorders: case-control study.

BACKGROUND: The study of the relationship between life events and mental illness has progressed considerably over the last 30 years. Practically all mental disorders have been explored using a variety of methods of variable value. The results are in favor of the existence of a temporal link between life events and illness. The part played by life events is the most pronounced in triggering depressive disorders and attempted suicide. Many aspects of this relationship have been explored, but the ability to metabolize the event impact over time has never been studied. This paper reports the results of a longitudinal study. Its objective is to make a comparative study of the ability to metabolize event impacts in depressive in-patients and controls. METHODS: The investigation was designed as a longitudinal, clinical, case-control study constructed on in-patients with depressive and anxiety disorders (n=25) and healthy controls from the community (n=28). The absence or presence of mental pathology was assessed using the SCAN, events and event-impacts were reported by subjects from a list of events constructed from the LEDS framework. RESULTS: The results show that the ability to metabolize the event-impact is positively linked to the mental health status of subjects, and that the first self-assessment of the event-impact has a good predictive capacity on the progression of this score a few months later and then 15-18 months later both in in-patients and in controls.

Adult↗
PubMed1999

The treatment of chronic cancer pain in a cancer hospital in The Netherlands.

In a prospective study of 313 Dutch cancer patients with chronic pain, the practice of pain treatment was evaluated by means of Donabedian's structure-process-outcome framework. The practice of pain treatment was assessed by: (1) structural resources, describing the setting in which pain treatment is provided; (2) process components, which describe the clinical practice; and (3) outcome measures, which refer to patients' pain intensity, patient satisfaction, or composite pain management index scores. Results showed that 31.4-59.8% of the cancer pain patients received less than optimal pain treatment. Although pain education and refresher courses for health care providers are scarce, structural resources were not the major cause of the suboptimal level of pain treatment. Rather, the major cause was the process components. Only 36.4% of the patients received strong opioids; 23.1% received analgesics "as needed." Patients' pain knowledge was far from optimal (54.8 on a 0-100 scale), and written pain information was given to only 15.8% of the patients. After discharge, only 36.8% of the district nurses were informed about patients' pain. These results emphasize that continuing efforts to improve the practice of pain treatment are needed.

Chronic Disease↗
PubMed2005

Identification of patients with noncancer diseases for palliative care services.

OBJECTIVE: To identify criteria for measuring the eligibility of patients with end-stage noncancer diseases for palliative care services in Australian residential aged care facilities. METHODS: No validated set if guidelines were available so five instruments were used: an adaptation of the American National Hospice Association Guidelines; a recent adaptation of the Karnofsky Performance Scale; the Modified Barthel Index; the Abbey Pain Score for assessment of people who are nonverbal and a Verbal Descriptor Scale, also for pain measurement. In addition, nutritional status and the presence of other problematic symptoms and their severity were also sought. RESULTS: The adapted American National Hospice Association Guidelines provided an initial indicative framework and the other instruments were useful in providing confirmatory data for service eligibility and delivery.

Australia↗
PubMed1998

Factors associated with very early weaning among primiparas intending to breastfeed.

OBJECTIVES: The major objective of this study was to identify predictor variables that accurately differentiated breastfeeding women who weaned during the first 4 weeks, those who weaned between 5 and 26 weeks, and those who weaned after 26 weeks. Predictors were demographic variables, Theory of Planned Behavior (TPB) variables, breastfeeding knowledge, and difficulties experienced during the first month. METHODS: Primiparas who delivered healthy infants in an urban midwestern hospital provided initial data prior to discharge. Follow-up occurred at 1, 3, 6, 9, and 12 months. Following appropriate bivariate analyses, polychotomous logistic regression was used to determine predictors of weaning group. Linear multiple regression was used to predict intended duration. RESULTS: Most of the 84 women who weaned very early had intended to breastfeed considerably longer. According to the multivariate analysis, women who weaned earlier were younger, had completed fewer years of education, had a more positive bottle-feeding attitude and a less positive breastfeeding attitude, intended to breastfeed less time, had lower knowledge scores, had higher perceived insufficient milk scores, and planned to work outside the home. Variables postulated by the TPB to be direct predictors of intention explained 36% of the variance in intended duration. CONCLUSIONS: Women at risk for early weaning can be identified with reasonable accuracy using a TPB-based conceptual framework expanded to include breastfeeding specific variables. Casefinding using empirically derived screening methods and careful postpartum follow-up, along with professional intervention, should be used to avert unintended early weaning.

Adolescent↗
PubMed1994

Do clinicians tell each other enough? An analysis of referral communications in two specialties.

Referral letters and replies are an important vehicle for conveying information about patients and for creating and sustaining professional relationships. Studies of communication between hospital specialists and GPs, however, suggest that improvements could be made to the content of letters. In this study, which is part of a larger study of referral expectations, a sample of 39 letters to and from the ENT and Rheumatology departments at Sunderland Royal Infirmary was analysed to find out what objectives were being achieved through the correspondence between consultants and GPs. An analytical framework of letter content was derived from a review of 25 letters to and from each specialty and from a separate study of doctors' opinions of letter content conducted by two of the authors. Doctors recruited to the present study were involved in devising a weighted scoring system for letter content. Analysis showed that the letters accomplish the basic objective of transferring clinical and administrative information. They were less likely to contain items of a socio-psychological type. There was very little difference in the standardized letter scores between the two specialties. While the level of detail recorded in this sample may be adequate for straightforward referrals, there are indications that clinicians' letters are frequently not addressing nonclinical matters that can be a complicating factor in a proportion (perhaps a fifth) of referrals. This may be a possible topic for audit in multidisciplinary groups.

Communication↗
PubMed2006

ArchPRED: a template based loop structure prediction server.

ArchPRED server (http://www.fiserlab.org/servers/archpred) implements a novel fragment-search based method for predicting loop conformations. The inputs to the server are the atomic coordinates of the query protein and the position of the loop. The algorithm selects candidate loop fragments from a regularly updated loop library (Search Space) by matching the length, the types of bracing secondary structures of the query and by satisfying the geometrical restraints imposed by the stem residues. Subsequently, candidate loops are inserted in the query protein framework where their side chains are rebuilt and their fit is assessed by the root mean square deviation (r.m.s.d.) of stem regions and by the number of rigid body clashes with the environment. In the final step remaining candidate loops are ranked by a Z-score that combines information on sequence similarity and fit of predicted and observed [/psi] main chain dihedral angle propensities. The final loop conformation is built in the protein structure and annealed in the environment using conjugate gradient minimization. The prediction method was benchmarked on artificially prepared search datasets where all trivial sequence similarities on the SCOP superfamily level were removed. Under these conditions it was possible to predict loops of length 4, 8 and 12 with coverage of 98, 78 and 28% with at least of 0.22, 1.38 and 2.47 A of r.m.s.d. accuracy, respectively. In a head to head comparison on loops extracted from freshly deposited new protein folds the current method outperformed in a approximately 5:1 ratio an earlier developed database search method.

Algorithms↗
PubMed2026

Long-read based detection of large copy number variants with potential functional significance using the ContextSV structural variant caller.

Long-read sequencing enables improved detection of structural variants (SVs) in the human genome due to its substantially increased read lengths. However, currently widely used long-read SV callers primarily rely on alignment-based evidence, limiting their ability to detect large and complex SVs and potentially missing disease-relevant events. To address these limitations, we developed ContextSV, a framework that integrates alignment evidence with copy number predictions derived from sequencing coverage and single-nucleotide variant allele frequencies to improve SV detection, particularly for large copy number variants (CNVs). We additionally developed ContextScore, a machine learning-based classification model to assign SV confidence scores based on genomic context features and integrated it within ContextSV. Through benchmarking analyses on both simulated and real datasets, we demonstrate that ContextSV improves detection of large CNVs and inversions that may be missed by existing long-read SV callers. We further illustrate its utility by identifying and experimentally validating multiple large SVs in the KOLF2.1J reference stem cell line that were not detected by other methods. Collectively, our results demonstrate that ContextSV serves as a valuable complement to existing long-read SV detection approaches by improving sensitivity for large and clinically relevant SVs.

Humans↗
PubMed2002

Examining health problems and intensity of need for care in family-focused community and public health nursing.

The purpose of this study was to advance evidence-based family-focused community and public health nursing (C/PHN) practice by examining 2 important indicators of health need, family health problem labels, and intensity of need for care, and their relationship to each other. The Omaha System (OS; Martin & Scheet, 1992) was the framework used to classify the most common family health problems. Intensity of need for care was determined using the Community Health Intensity Rating Scale (CHIRS; Hays, Sather, & Peters, 1998). Secondary analysis of C/PHN clinical data was done using a descriptive correlational design (n = 205). An investigator scored the CHIRS and assigned OS family problems based on clinical record data. The mean number of family health problems per person was 4.40 (+/- 2.06). The mean CHIRS total score was 33.9 (+/- 6.34). The total number of OS problems was significantly correlated with CHIRS total scores (r = .586, p < .001). Family problem labels and intensity of need for care both provide essential information for health need determination in C/PHN practice.

Adult↗
PubMedDate not supplied

Development and reliability of the ankle instability instrument.

CONTEXT: Functional ankle instability has been defined in a variety of ways. Factors that are frequently used in this definition include a history of a severe ankle sprain, a history of multiple ankle sprains, and a recurrent feeling of instability or "giving way." With all the variations in defining functional ankle instability, it becomes increasingly important to develop a more consistent framework for assessing this instability. OBJECTIVE: To develop a new ankle instability assessment tool, the Ankle Instability Instrument, and evaluate the reliability of this instrument. DESIGN: Test-retest reliability was evaluated using intraclass correlation coefficients (2,1) for each item, each factor, and the total score between test days 1 and 2. Cronbach alpha was calculated to estimate internal consistency of the 12 items. SETTING: Classrooms, offices, athletic fields, and private residences. PATIENTS OR OTHER PARTICIPANTS: College students (29 males, 72 females, age = 20.7 +/- 2.7 years), including 73 (72%) with and 28 (28%) without a history of ankle injury. MAIN OUTCOME MEASURE(S): Subjects were asked to complete the Ankle Instability Instrument on 2 occasions approximately 1 week apart. RESULTS: An exploratory factor analysis of the Instrument produced 3 factors and reduced it from 21 to 12 items. The factors accounted for 32.3%, 10.7%, and 7.0% of the variance, respectively. Together, these factors accounted for 50.0% of the variance in the responses to the Instrument. Test-retest reliability ranged from .70 (SEM = 0.28) to .98 (SEM = 0.06) for the individual items and .95 (SEM = 1.85) for the Instrument overall. The Cronbach alpha coefficient was .92 for factor 1 (severity of initial ankle sprain), .87 for factor 2 (history of ankle instability), .81 for factor 3 (instability during activities of daily life), and .89 for the Instrument overall. CONCLUSIONS: The creation of the Ankle Instability Instrument is a first step in recognizing a more objective way of identifying patients suffering from functional ankle instability. The high reliability we found shows that self-reporting of ankle symptoms is a feasible, appropriate way to obtain information on the presence of instability symptoms. Additionally, through this preliminary study, we found 3 factors that represent unique and important components of functional ankle instability. Clinicians and researchers can, therefore, use these 12 items, either alone or in combination with other information, to determine if functional ankle instability is present.

Journal Article↗
PubMed1990

Socialization into nursing: a developmental approach.

This paper explores the process of socialization into the profession of nursing through developmental models and examines the differences in the degree of professional socialization among nursing students at three academic levels. The conceptual framework around which this study was organized was Richard Hall's concept of professional socialization. The descriptive, comparative cross-sectional study utilized Hall's professional inventory as modified by Snizek to ascertain degree and differences of professional socialization in the three groups. The total mean score indicated a moderate degree of professional socialization for the sample as a whole. The findings also indicated that the sophomore nursing students had a statistically significantly higher degree of professional socialization than either the senior or masters nursing students. Implications and recommendations for nursing education, practice, and future research are discussed.

Cross-Sectional Studies↗
PubMed2003

A first-generation map of the turkey genome.

A primary linkage map of the domestic turkey (Meleagris gallopavo) was developed by segregation analysis of genetic markers within a backcross family. This reference family includes 84 offspring from one F1 sire mated to two dams. Genomic DNA was digested using one of five restriction enzymes, and restriction fragment length polymorphisms were detected on Southern blots using probes prepared from 135 random clones isolated from a whole-embryo cDNA library. DNA sequence was subsequently determined for 114 of these cDNA clones. Sequence comparisons were done using BLAST searches of the GenBank database, and redundant sequences were eliminated. High similarity was found between 23% of the turkey sequences and mRNA sequences reported for the chicken. The current map, based on expressed genes, includes 138 loci, encompassing 113 loci arranged into 22 linkage groups and an additional 25 loci that remain unlinked. The average distance between linked markers is 6 cM and the longest linkage group (17 loci) measures 131 cM. The total map distance contained within linkage groups is 651 cM. The present map provides an important framework for future genome mapping in the turkey.

Animals↗
PubMed2004

Quantitative trait linkage analysis by generalized estimating equations: unification of variance components and Haseman-Elston regression.

Two of the major approaches for linkage analysis with quantitative traits in humans include variance components and Haseman-Elston regression. Previously, these were viewed as quite separate methods. We describe a general model, fit by use of generalized estimating equations (GEE), for which the variance components and Haseman-Elston methods (including many of the extensions to the original Haseman-Elston method) are special cases, corresponding to different choices for a working covariance matrix. We also show that the regression-based test of Sham et al. ([2002] Am. J. Hum. Genet. 71:238-253) is equivalent to a robust score statistic derived from our GEE approach. These results have several important implications. First, this work provides new insight regarding the connection between these methods. Second, asymptotic approximations for power and sample size allow clear comparisons regarding the relative efficiency of the different methods. Third, our general framework suggests important extensions to the Haseman-Elston approach which make more complete use of the data in extended pedigrees and allow a natural incorporation of environmental and other covariates.

Algorithms↗
PubMed2026

Longitudinal analysis of circulating tumor DNA and CA19-9 dynamics in predicting disease relapse and monitoring treatment response in stage I-III pancreatic ductal adenocarcinoma: An interim analysis of a prospective observational study.

INTRODUCTION: Postoperative recurrence is the leading cause of mortality in resected pancreatic ductal adenocarcinoma (PDAC), yet reliable tools for early relapse detection and treatment response assessment remain lacking. METHODS: In a prospective cohort of 136 patients with resected stage I-III PDAC receiving adjuvant chemotherapy, we evaluated circulating tumor DNA (ctDNA) and CA19-9 as longitudinal biomarkers across multiple postoperative time windows. RESULTS: ctDNA consistently outperformed CA19-9 as an independent prognostic factor; ctDNA positivity at on-treatment and surveillance assessments achieved a positive predictive value of 91.7%, while persistent negativity identified the lowest-risk patients. Integrating CA19-9 with ctDNA resolved the ctDNA-alone gap in distinguishing treatment clearance from conversion, improving discrimination of responders from non-responders (HR 3.72; P&#x202f;=&#x202f;.008). A time-weighted dynamic ctDNA risk score (MinerVa-dynamic) further stratified ctDNA-negative patients into clinically distinct prognostic subgroups, achieving an area under the curve of 0.87 and 0.82 for one- and two-year disease-free survival prediction, respectively. CONCLUSIONS: These findings support a dual-biomarker longitudinal monitoring framework as a practical, individualized approach to postoperative surveillance and early therapeutic decision-making in PDAC.

CA19-9↗
PubMed2006

Stereo and motion information are not independently processed by the visual system.

Many visual tasks are carried out by using multiple sources of sensory information to estimate environmental properties. In this paper, we present a model for how the visual system combines disparity and velocity information. We propose that, in a first stage of processing, the best possible estimate of the affine structure is obtained by computing a composite score from the disparity and velocity signals. In a second stage, a maximum likelihood Euclidean interpretation is assigned to the recovered affine structure. In two experiments, we show that human performance is consistent with the predictions of our model. The present results are also discussed in the framework of another theoretical approach of the depth cue combination process termed Modified Weak Fusion.

Cues↗
PubMed1998

Emotional intelligence: in search of an elusive construct.

The view that emotional intelligence should be included within the traditional cognitive abilities framework was explored in 3 studies (total N = 530) by investigating the relations among measures of emotional intelligence, traditional human cognitive abilities, and personality. The studies suggest that the status of the emotional intelligence construct is limited by measurement properties of its tests. Measures based on consensual scoring exhibited low reliability. Self-report measures had salient loadings on well-established personality factors, indicating a lack of divergent validity. These data provide controvertible evidence for the existence of a separate Emotion Perception factor that (perhaps) represents the ability to monitor another individual's emotions. This factor is narrower than that postulated within current models of emotional intelligence.

Adolescent↗