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PubMed2005

Histological reclassification of lupus nephritis.

PURPOSE OF REVIEW: This review examines the progress in clinico-pathologic studies following the publication of the International Society of Nephrology (ISN)/Renal Pathology Society (RPS) 2003 classification of lupus nephritis. Major features in this classification system include non-ambiguous diagnostic criteria based on quantitative assessment of histological abnormalities and further classification of Class IV lesions with regard to the predominance of segmental or global lesions. RECENT FINDINGS: The new classification has been applied in two recent retrospective studies. Key findings included improved diagnostic concordance compared with the World Health Organization classification for lupus nephritis, but no observable difference in renal outcome between Classes IV-S and IV-G during short-term follow up. The data also suggested that fibrinoid necrosis and interstitial inflammation may be more prominent in the IV-S group. While the new classification stipulates the description of individual lesions indicating activity or chronicity, it has not devised new composite histological scores. In this regard, recent studies on novel histological indices of lupus renal biopsies based on digital imaging and computerized data analysis have demonstrated a better correlation with clinical parameters. SUMMARY: The ISN/RPS 2003 classification facilitates accurate communication between pathologists and clinicians. It also provides a clear framework for standardization, upon which the clinical and pathogenetic significance of individual lesions and histological subtypes require further elucidation.

Humans↗

PubMed1981

Transcultural aspects of depressive symptomatology.

The following is a presentation of the first results of a cross-cultural study of depressive symptomatology, within the framework of a larger research project which is still in progress. Southern Italian and northern Swedish depressed patients completed a self-rating scale for depression and were rated by the doctors using a subscale of the Comprehensive Psychological Rating Scale. In the doctors' ratings Italian patients scored higher for variables referring to motor retardation and hypochondriasis, and Swedish patients for variables referring to inability to feel and agitation. These findings were in line with expectations. In contrast, in the self-ratings Swedish patients scored higher for the variables weight loss, tachycardia and agitation and Italian patients for hopelessness and loss of interest and dissatisfaction. This discrepancy between results in self-ratings and doctors' ratings might reflect cultural differences either in the way patients in the two countries are able to express verbally their symptoms or in the way doctors from the two countries give weight to different symptoms. Taking the results of the two ratings together as a general measure of the severity of the depressive disorder, patients in the two places appeared to be quite alike. Since the two centers are engaged in comprehensive investigations of depressed patients, the last-mentioned finding suggests that the populations in the two centers are comparable as concerns severity.

Adult↗

PubMed1996

Genetic and physical mapping of the Chediak-Higashi syndrome on chromosome 1q42-43.

The Chediak-Higashi syndrome (CHS) is a severe autosomal recessive condition, features of which are partial oculocutaneous albinism, increased susceptibility to infections, deficient natural killer cell activity, and the presence of large intracytoplasmic granulations in various cell types. Similar genetic disorders have been described in other species, including the beige mouse. On the basis of the hypothesis that the murine chromosome 13 region containing the beige locus was homologous to human chromosome 1, we have mapped the CHS locus to a 5-cM interval in chromosome segment 1q42.1-q42.2. The highest LOD score was obtained with the marker D1S235 (Zmax = 5.38; theta = 0). Haplo-type analysis enabled us to establish D1S2680 and D1S163, respectively, as the telomeric and the centromeric flanking markers. Multipoint linkage analysis confirms the localization of the CHS locus in this interval. Three YAC clones were found to cover the entire region in a conting established by YAC end-sequence characterization and sequence-tagged site mapping. The YAC contig contains all genetic markers that are nonrecombinant for the disease in the nine CHS families studied. This mapping confirms the previous hypothesis that the same gene defect causes CHS in human and beige pheno-type in mice and provides a genetic framework for the identification of candidate genes.

Animals↗

PubMed2026

Machine learning-based clinical tool for identifying factors associated with symptomatic knee osteoarthritis: the Nagahama study.

BACKGROUND: A clinical tool that evaluates factors associated with symptomatic knee osteoarthritis (OA) based on modifiable factors is lacking. This study aimed to develop a machine learning-based clinical assessment tool using modifiable factors to identify factors associated with symptomatic knee OA and to determine its accuracy. METHODS: This study included 429 participants (81.8% women; age, 69.0 ± 5.3 years) from the Nagahama Study who were ≥60 years old and had radiographically confirmed knee OA. A Knee Society Knee Scoring System 2011 symptom score of <23 points defined symptomatic knee OA. Participants were randomly assigned to training (70%) and test (30%) datasets. A machine learning model was developed using Extreme Gradient Boosting with 27 variables, and the SHapley Additive exPlanation (SHAP) values were used to assess feature importance. The top 8 features were translated into a 100-point clinical scoring tool weighted by their SHAP contributions. The cutoff value indicating symptomatic knee OA in the clinical assessment tool was determined using receiver operating characteristic analysis, and model performance was evaluated in both datasets. RESULTS: The clinical assessment tool consisted of low back pain, OA severity, depressive tendencies, knee flexion/extension range of motion, knee extension and hip abduction strength, and lower limb muscle quality. The model showed moderate discriminative performance (AUC 0.771 and 0.773 in the training and test datasets, respectively), with a cutoff point of 47. CONCLUSION: The proposed clinical assessment tool may provide a structured framework for assessing modifiable factors associated with symptomatic knee OA, reflecting their contribution to current symptom status.

Humans↗

PubMed2003

A practical and user-friendly toxicity classification system with microbiotests for natural waters and wastewaters.

Various types of toxicity classification systems have been elaborated by scientists in different countries, with the aim of attributing a hazard score to polluted environments or toxic wastewaters or of ranking them in accordance with increasing levels of toxicity. All these systems are based on batteries of standard acute toxicity tests (several of them including chronic assays as well) and are therefore dependent on the culturing and maintenance of live stocks of test organisms. Most systems require performance of the bioassays on dilution series of the original samples, for subsequent calculation of L(E)C50 or threshold toxicity values. Given the complexity and costs of these toxicity measurements, they can only be applied in well-equipped and highly specialized laboratories, and none of the classification methods so far has found general acceptance at the international level. The development of microbiotests that are independent of continuous culturing of live organisms has stimulated international collaboration. Coordinated at Ghent University, Belgium, collaboration by research groups from 10 countries in central and eastern Europe resulted in an alternative toxicity classification system that was easier to apply and substantially more cost effective than any of the earlier methods. This new system was developed and applied in the framework of a cooperation agreement between the Flemish community in Belgium and central and eastern Europe. The toxicity classification system is based on a battery of (culture-independent) microbiotests and is particularly suited for routine monitoring. It indeed only requires testing on undiluted samples of natural waters or wastewaters discharged into the aquatic environment, except for wastewaters that demonstrate more than 50% effect. The scoring system ranks the waters or wastewaters in 5 classes of increasing hazard/toxicity, with calculation of a weight factor for the concerned hazard/toxicity class. The new classification system was applied during 2000 by the participating laboratories on samples of river water, groundwaters, drinking waters, mine waters, sediment pore waters, industrial effluents, soil leachates, and waste dump leachates and was found to be easy to apply and reliable.

Animals↗

PubMed1979

A computer program for testing average partial association in three-way contingency tables (PARCAT).

PARCAT is a computer program which implements alternative tests for average partial association in three-way contingency tables within the framework of the product multiple hypergeometric probability model. Primary attention is directed at the relationship between two of the variables, controlling for the effects of a covariable. This approach is essentially a multivariate extension of the Cochran/Mantel-Haenszel test to sets of (s x r) tables. A set of scores such as uniform, ridits, or probits can be assigned to categories which are ordinally scaled. In particular, if ridit scores with midranks assigned for ties are utilized, this procedure is equivalent to a partial Kruskal-Wallis test when one variable is ordinally scaled, and is equivalent to a partial Spearman rank correlation test when both variables are ordinally scaled.

Age Factors↗

PubMed2005

Domain-specific identity, epistemic regulation, and intellectual ability as predictors of belief-biased reasoning: a dual-process perspective.

To explore the hypothesis that domain-specific identity development predicts reasoning biases, adolescents and young adults completed measures of domain-general and domain-specific identity, epistemic regulation, and intellectual ability and evaluated arguments that either supported or threatened their occupational goals. Biases were defined as the use of sophisticated reasoning to reject goal-threatening arguments and the use of cursory reasoning to accept goal-supportive arguments. Across two measures of bias, hierarchical regression analyses showed that domain-specific vocational identity and epistemic regulation best predicted reasoning biases. Neither age nor intellectual ability predicted significant variance in biases after vocational identity and epistemic regulation scores were entered into the regression equations. The results support the thesis that biases in specific domains can be explained both by domain-specific personality attributes and by domain-general metacognitive dispositions to monitor reasoning and decontextualize problem structure from superficial contents. A dual-process framework is proposed to explain the relationships among identity, epistemic regulation, age, intellectual ability, and reasoning biases.

Adolescent↗

PubMedDate not supplied

Stages of acquisition and cessation for adolescent smoking: an empirical integration.

Adolescent cigarette smoking acquisition and cessation were integrated into a single nine-stages-of-change continuum using the transtheoretical model of change framework. Findings in a high school student sample (n > 700) showed that a few of the never smokers were planning to try smoking, and half of the current smokers were contemplating quitting. More than half of former smokers were long-term quitters. The high pros of smoking scores assessing coping benefits of cigarettes were related to smoking acquisition and the high con (disadvantages) scores to long-term abstinence. Never smokers were most tempted to try smoking when they anticipated that smoking would help reduce negative and increase positive mood. Current and former smokers were tempted due to peer cigarette offers and negative mood. These temptations were significantly reduced among ex-smokers.

Adolescent↗

PubMed1999

Prognostic factors and treatment-related changes associated with return to work in the multimodal treatment of chronic back pain.

The goals of the current study were to determine those preprogram (= prognostic) variables and treatment-related changes that predict return to work in the multimodal management of chronic back pain. The outcome measures for 143 patients at 6-month follow-up were analyzed. The program had a duration of 4 weeks, was based largely on the functional restoration approach (Mayer and Gatchel, 1998), and occurred within a workers' compensation framework. Some 87% of the patients successfully returned to work. Three sets of predictor variables were considered: demographic/socioeconomic data, physical measures, and psychological measures. Three prognostic variables proved to be significant negative predictors of return to work: time off work, previous spinal surgery, and a clinically elevated (preprogram) score on the MMPI-2 scale Lassitude-Malaise (Hy3). A repeated-measures MANOVA showed an incomplete return to work to be associated with only limited improvement in self-reported disability and pain report. However, patients who failed to return to work did not differ with regard to improvement in objective physical functioning or psychological distress. It is therefore hypothesized that a change in the perceived disability status is the key element necessary to return patients with chronic back pain to work, although ongoing reinforcement schemes operative in the home/work environment may lead to a relapse in the posttreatment phase.

Adult↗

PubMed2026

gMISpy: integration of complex regulatory networks and genome scale metabolic models.

MOTIVATION: Genome-scale metabolic models lack explicit regulatory mechanisms, limiting their predictive accuracy for genetic interventions. Current methods for computing genetic Minimal Cut Sets either ignore regulatory networks entirely or use simplified acyclic representations that cannot capture regulatory feedback loops, ubiquitous features critical in cellular modeling. RESULTS: We developed gMISpy, a Python package that that enables efficient computation of genetic Minimal Intervention Sets (gMISs) in integrated genome-scale metabolic and regulatory networks. gMISpy incorporates cyclic regulatory logic into our previous computational framework using layered Boolean networks and BoNesis framework, resulting in a more accurate modeling of how regulatory interactions affect metabolic genes. Benchmarking across four different regulatory networks with Human-GEM showed consistent improvements in prediction accuracy, with Matthews correlation coefficient gains ranging from 2.50% to 14.42%. Validation against cancer data from DepMap and Project Score confirmed that cyclic integration reduces false positives and better captures biological vulnerabilities compared to acyclic approaches. AVAILABILITY AND IMPLEMENTATION: https://github.com/PlanesLab/cyclic-gMISpy.

Software↗

PubMed2005

The predictive power of the CluSTr database.

SUMMARY: The CluSTr database employs a fully automatic single-linkage hierarchical clustering method based on a similarity matrix. In order to compute the matrix, first all-against-all pair-wise comparisons between protein sequences are computed using the Smith-Waterman algorithm. The statistical significance of the similarity scores is then assessed using a Monte Carlo analysis, yielding Z-values, which are used to populate the matrix. This paper describes automated annotation experiments that quantify the predictive power and hence the biological relevance of the CluSTr data. The experiments utilized the UniProt data-mining framework to derive annotation predictions using combinations of InterPro and CluSTr. We show that this combination of data sources greatly increases the precision of predictions made by the data-mining framework, compared with the use of InterPro data alone. We conclude that the CluSTr approach to clustering proteins makes a valuable contribution to traditional protein classifications. AVAILABILITY: http://www.ebi.ac.uk/clustr/.

Algorithms↗

PubMed2005

Dysphagia management in a 3-year dental hygiene education programme in Japan.

This paper reports the development and evaluation of a dysphagia management course taught to the third year dental hygiene students during 2004-2005 as one framework of the new curriculum. The course consisted of lectures by specialists in each field, basic practice and clinical practice at a facility for the elderly. Evaluation of the course showed that improvements were found in students' understanding in certain subjects when compared with that during 2003-2004. Scores on the post-test were statistically significantly higher than those on the pre-test, showing that basic knowledge of the students had been improved. Introductory and follow-up lectures by dental hygiene instructors and appropriate basic practice enhanced the learning process of the students. In the clinical practice, the concept of 'dental hygiene process of care' was incorporated. The dental hygiene process facilitated the students in planning and implementing dental hygiene care that meets the needs of the individual clients. This active learning experience enhanced the students' understanding of dysphagia management. Although further improvements are necessary, this dysphagia management course should help dental hygienists in playing a greater role in the field of oral care and dysphagia rehabilitation.

Curriculum↗

PubMed2003

A bicycle safety education program for parents of young children.

This study examined parental perceptions of the benefits and barriers to bicycle helmet use and their level of knowledge about bicycle safety issues. A school-based bicycle safety education program was taught to first- and second-grade students in a rural/suburban school district by a graduate nursing student. Pender's Health Promotion Model was the theoretical framework used to guide this research study. A parent Bicycle Helmet Questionnaire (BHQ) developed by the author was the tool used to gather data. The study determined that parents of children in schools that received the educational intervention prior to completing the questionnaire had significantly higher knowledge level scores and that the majority of parents were in favor of bicycle helmet legislation for children. The implications from this research study include the importance of bicycle safety education interventions for students and parents and the need to implement bicycle helmet legislation.

Attitude to Health↗

PubMed1992

Assessing geropsychiatric patients.

Although other disciplines involved in the care of geriatric patients with psychiatric or neurobehavioral problems have established assessment procedures, this is not the case for nursing. Some approaches to assessing geropsychiatric patients from a nursing perspective have been proposed (Baldwin, 1987; Burnside, 1981; Ninos, 1985), but they have been limited in scope (Abraham, 1990b). However, with nursing assuming an increasingly central role in the multidisciplinary care of geropsychiatric patients and their families, a comprehensive and accepted method of multidimensional geropsychiatric nursing assessment is necessary. This method enables nurses to provide the best possible nursing care to patients and families while contributing effectively to multidisciplinary assessment and intervention. To this end, Abraham and associates (Abraham, 1990a; Thompson-Heisterman, 1992) developed the Psychogeriatric Nursing Assessment Protocol (PNAP). Previous articles have described the rationale and content of the PNAP (Abraham, 1990a; Thompson-Heisterman, 1992). This article will draw on the authors' clinical experience in using the PNAP and will offer practical clinical strategies for assessment within the PNAP framework. The PNAP is presented in the Figure, and readers are referred to previous articles for detailed descriptions of the various aspects of the PNAP. A rating form has been developed for use with the PNAP that permits quantification of clinical observations and the determination of selected clinical scores.

Caregivers↗

PubMed2002

[The fetal ECG--ST analysis in the diagnosis of fetal hypoxia].

OBJECTIVE: Clinical tests of a new apparatus STAN S21 evaluating the foetal ECG--ST section in the diagnosis of foetal hypoxia. DESIGN: Retrospective analysis. SETTING: Gynaecological and Obstetric Clinic, First Medical Faculty Charles University and General Faculty Hospital, Prague. METHOD: Within the framework of clinical tests 27 analyses were made on a apparatus STAN S21 manufactured by Swedish firm Neoventa. Contrary to hitherto implemented and published studies, in all monitored deliveries the CTG curve was evaluated as well as FpO2 and STAN. After each delivery in the neonate the Apgar score and acid-base equilibrium from the umbilical artery was evaluated. ST analysis was included mainly in case of abnormal CTG records, risk and pathological deliveries. Evaluation was divided into two groups: in one delivery was terminated by the vaginal route, in the second one by Caesarean section. For evaluation of the CTG curve the FIGO terminology was selected (intermediary-suspect) and (abnormal-pathological). For evaluation of the FpO2 pathology 30% saturation for 10 minutes was used. In STAN analysis important phenomena were evaluated by computer (increase of T wave, increase of T/QRS complex and biphasic character of ST). RESULTS: In reduced values of the Apgar score (during the 5th minute < 8 points) and the acid-base balance from umbilical artery (pH < 7.2, BE > -8) pathological CTG records and FpO2 were present in 25%. STAN had in these instances pathological records in 50%). CONCLUSION: ST analysis is another very effective link in the diagnosis of interpartial foetal hypoxia. Initial experience indicates, that STAN will have probably a higher diagnostic specificity than CTG and FpO2.

Apgar Score↗

PubMed1992

A quantitatively scored cancer-risk assessment tool: its development and use.

Achievement of NIH and ACS goals for reduction in cancer mortality will require increased efforts directed at risk reduction and early detection in the general population. Primary care providers will play a major role. This paper describes the development and use of a quantitative cancer-risk appraisal tool designed to promote cancer prevention and screening and provide a framework for advancing education on these critical issues at all levels of medical training, to assist physicians in risk identification and patient counseling. The risk assessment questionnaire is close-ended and easily completed by the patient within 10 to 15 minutes. The IBM-compatible format permits easy quantitation by laser scanning and computer analysis. This program quantitates risks arising from interacting independent factors and estimates the effects of primary prevention interventions. Program output includes age- and sex-specific ACS screening guidelines and discussion of intensified screening measures in high-risk subjects.

Breast Neoplasms↗

PubMed1996

Treatment outcomes in cervical dystonia: a clinimetric study.

We reviewed 21 studies (8 blinded and 13 open) on the treatment of botulinum toxin type A for cervical dystonia, directed to the health aspects used to evaluate the patients' response to treatment (Medline search 1985-1993, English language literature). The prerequisite for comparing the treatment results was that studies had to evaluate similar aspects of disease. The ICIDH model, outlined by the World Health Organization in 1980, orders the different health outcomes into distinct classes of disease consequences. Our aim was to order the health outcomes according to the model and, thus, to study the comparability of treatment outcomes. Three differences could be identified between the objective and the subjective instruments. (a) The aspects measured by the subjective instruments varied substantially; of the 22 different subjective instruments identified in 18 studies, 8 measured impairments, 5 disability, and 9 could not be classified according to the ICIDH model. The objective instruments measured impairments. (b) All objective instruments were multiitem, whereas only 2 of 22 subjective instruments could be identified as multiitem. (c) The subjective instruments were generally poorly documented with regard to the number of items, score range, or grading. We conclude that the treatment outcomes can only be compared on the objective level of assessment and with regard to the patients with painful dystonia. The subjective instruments, particularly those focusing on disease-specific disability, deserve further research. The ICIDH model offers a useful framework for selection, improvement, and development of outcome instruments. Because the model clearly demarcates the different consequences of disease, adoption will enhance the comparability of outcomes in cervical dystonia intervention trials.

Botulinum Toxins, Type A↗

PubMed2005

Evaluation score and interpretation index for the ecological quality of running waters in Central and Northern Hellas.

The present study aims at creating an evaluation system for the quality of running waters, based on the analysis of benthic macroinvertebrate records from Hellenic rivers (473 samples from 8 river basins). The proposed evaluation system (Hellenic Evaluation Score and its Interpretation Index) may be used for waters sampled with the cost effective semi-quantitative sampling method of "3 min kick-sweep" and requires benthic macroinvertebrates to be identified to the taxonomic level of family. Though resulting from a modification of the Spanish score BMWP, it differs from it in the following characteristics: a) it includes the relative abundance of benthic macroinvertebrates and b) it takes into consideration the habitat diversity of the studied site, classifying it as "poor" or "rich", based on some parameters of the System B of the Water Framework Directive (2000/60/EU). Its interpretation is also based on a five-scaled classification system, consistent with the provisions of the same Directive.

Animals↗