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PubMed1982

[Social relationship and depression among the elderly (author's transl)].

The relevance of social relationships to the phenomena of depression among the aged was examined. The study was based on the reduced reinforcement hypothesis which predicts a low rate of social relationships (i.e. the loss of positive reinforcement) for those individuals who are prone to depression. This hypothesis was both tested and confirmed among the residents in homes for the aged in Berlin. The senior citizens who reported a low rate of social activities had higher depression scores than those reporting a higher rate of such social involvement. These results were confirmed for various indicators of social participation. A further variable influencing the rate of depression was identified as the self-rating of personal health. The results are discussed within both a behavioral and a cognitive framework.

Adjustment Disorders↗
PubMed2004

Brain metabolic alterations in medication-free patients with bipolar disorder.

BACKGROUND: Bipolar disorder (BD) has substantial morbidity and incompletely understood neurobiological underpinnings. OBJECTIVE: To investigate brain chemistry in medication-free individuals with BD. DESIGN: Two-dimensional proton echo-planar spectroscopic imaging (PEPSI) (32 x 32, 1-cm(3) voxel matrix) acquired axially through the cingulate gyrus was used to quantify regional brain chemistry. SETTING: The Center for Anxiety and Depression at the University of Washington in Seattle and the Bipolar Research Programs at McLean Hospital and the Massachusetts General Hospital in Boston. PARTICIPANTS: Thirty-two medication-free outpatients with a diagnosis of BD type I (BDI) or BD type II (BDII), predominantly in a depressed or mixed-mood state, were compared with 26 age- and sex-matched healthy controls. MAIN OUTCOME MEASURES: Tissue type (white and gray) and regional analyses were performed to evaluate distribution of lactate; glutamate, glutamine, and gamma-aminobutyric acid (Glx); creatine and phosphocreatine (Cre); choline-containing compounds (Cho); N-acetyl aspartate; and myo-inositol. Chemical relationships for diagnosis and mood state were evaluated. RESULTS: Patients with BD exhibited elevated gray matter lactate (P =.005) and Glx (P =.007) levels; other gray and white matter chemical measures were not significantly different between diagnostic groups. Isolated regional chemical alterations were found. An inverse correlation between 17-item Hamilton Depression Rating Scale scores and white matter Cre levels was observed for BD patients. CONCLUSIONS: Gray matter lactate and Glx elevations in medication-free BD patients suggest a shift in energy redox state from oxidative phosphorylation toward glycolysis. The possibility of mitochondrial alterations underlying these findings is discussed and may provide a theoretical framework for future targeted treatment interventions.

Adult↗
PubMed2026

Molecular Cloning, Recombinant Expression, and In Silico Structural Analysis of Cu/Zn-Superoxide Dismutase from Trachyspermum ammi.

Superoxide dismutase (SOD) is an essential antioxidant metalloenzyme that is critical for the cellular defense against oxidative damage, as it scavenges superoxide radicals and maintains the redox status. Cytosolic Cu/Zn-SOD is particularly important in the regulation of oxidative stress among different isoforms in higher plants. While Cu/Zn-SODs from several plant species have been characterized, molecular information is limited for Trachyspermum ammi, a medicinally important member of a family Apiaceae with antioxidant potential.In the present study, an integrated molecular and in silico approach has been taken to clone and analyze a Cu/Zn type SOD gene from T. ammi to get insight into its structural and evolutionary characteristics. PCR amplification yielded an open reading frame of 456 bp encoding a protein of 152 amino acids. Sequence analysis showed that plant Cu/Zn-SODs, especially those from Daucus carota, were highly similar to one another (about 90-95%).Multiple sequence alignment confirmed the presence of conserved catalytic motifs and metal-binding histidine residues, both of which are crucial for enzymatic function. Physicochemical analysis predicted the protein to be stable, hydrophilic and compatible with cytosolic localization. The analysis of secondary structure indicated a predominance of β-strands, consistent with the conserved β-barrel architecture of plant Cu/Zn-SODs.The three-dimensional structure was built by homology modeling using a closely related plant Cu/Zn-SOD template with high sequence identity. Structural validation demonstrated an acceptable stereochemical quality with 86.3% residues in the favored region of Ramachandran plot, satisfactory ERRAT and Verify3D scores, and a low RMSD value of 0.104 Å on structural superimposition. Phylogenetic analysis placed the enzyme in the Apiaceae lineage, suggesting evolutionary conservation among related plant species. In conclusion, this study presents the first molecular and structural characterization of Cu/Zn-SOD from T. ammi and confirms the existence of a conserved structural framework typical of plant Cu/Zn-SODs. These results provide a basis for further studies concerning recombinant expression, enzymatic validation and potential relevance in antioxidant and plant stress biology.

Cloning, Molecular↗
PubMedDate not supplied

An approach to automated particle picking from electron micrographs based on reduced representation templates.

Reduced representation templates are used in a real-space pattern matching framework to facilitate automatic particle picking from electron micrographs. The procedure consists of five parts. First, reduced templates are constructed either from models or directly from the data. Second, a real-space pattern matching algorithm is applied using the reduced representations as templates. Third, peaks are selected from the resulting score map using peak-shape characteristics. Fourth, the surviving peaks are tested for distance constraints. Fifth, a correlation-based outlier screening is applied. Test applications to a data set of keyhole limpet hemocyanin particles indicate that the method is robust and reliable.

Algorithms↗
PubMedDate not supplied

The importance of nurse caring behaviors as perceived by patients receiving care at an emergency department.

BACKGROUND: Increased workload at the emergency department (ED) and the shortage of nurses may leave some patients without proper care. The importance of patients' perceptions of caring is vital when organizing nursing practice under such circumstances. PURPOSE: The purpose of the study was to identify which nurse caring behaviors are perceived by patients in an ED as important indicators of caring. The nurse caring behaviors were categorized in terms of relative importance with respect to demographic variables and perceived illness. Watson's theory of caring was used as a theoretic framework for this quantitative and descriptive study. METHOD: A 61-item questionnaire designed on the basis of Cronin and Harrison's Caring Behaviors Assessment tool, which reflected the 10 carative factors of Watson's theory, was mailed to 300 ED patients. The response rate was 60.7%. RESULTS: Results showed that subjects scored the items "Know what they are doing", "Know when it is necessary to call the doctor", "Know how to give shots, IVs, etc.", and "Know how to handle equipment" as the most important nurse caring behaviors. The subscale "human needs assistance" was ranked highest. CONCLUSION: In line with several previous studies, subjects considered clinical competence to be the most important nurse caring behavior, which further emphasizes the notion of caring as a moral stance integral to all interactions with patients.

Clinical Competence↗
PubMedDate not supplied

Exercise referral: the public health panacea for physical activity promotion? A critical perspective of exercise referral schemes; their development and evaluation.

This review critically explores the development, impact and evaluation of exercise referral schemes (ERS) in the UK. A rapid expansion in the use of such ERSs has been recorded throughout leisure and primary care settings, but the evidence underpinning their implementation has been sparse and predominantly limited to randomized control trial (RCT) research design. Consequently, understanding of exercise referral as a 'real world' intervention has been limited. Considering the increasing importance being placed on evidence-based practice and clinical effectiveness, it is no longer sufficient for service providers of exercise referral to ignore the need to evaluate schemes. The guidelines on evaluation provided by the National Quality Assurance Framework for Exercise Referral are limited, hence practitioners are often unsure of the best measures to use when assessing effectiveness. Predominantly, exercise professionals focus on the collection of physiological data but tend to ignore relevant psychological and environmental parameters. Also, few UK studies have followed participants up in the long term, to see if physical activity behaviour is sustained over time. Here, evidence from two on-going, large-scale (n = 1600/annum) evaluation studies of exercise referral schemes, based in urban localities in the northwest of England, are described. A participatory action research framework for evaluation was utilized and incorporated multi-method research approaches for the assessment of both ERS participants and health professionals involved in intervention delivery. This framework is an appropriate methodology for the evaluation and development of complex interventions, and here incorporates case study, focus groups, interviews and survey questionnaires. Included was a 12-month tracking study of a cohort of exercise referral participants (n = 342), which measured leisure-time physical activity levels (Godin leisure time score), at baseline (entry to exercise referral) and at 3 monthly intervals thereafter. Adherence to the ERS was approximately 35-45%, with the older participants more likely to complete. Physiological changes during the ERS, although statistically significant, were not of a magnitude to convey any real health benefit to an individual's health status. Although small in scale, physiological changes were all in a positive direction (e.g. reduction in blood pressure) and, if maintained over time, could bring about population-level benefits in health. Participants referred from cardiac and practice nurses had higher levels of adherence than participants referred by general practitioners. Scheme B showed that the participants who adhered (n = 103) until the end of the ERS (12 weeks) were able to sustain a small increase in physical activity at the end of 12 months (increase of 21 min moderate activity/week compared with baseline). In conclusion, this research shows that the process of exercise referral benefits certain segments of the population, but not necessarily all.

Evaluation Studies as Topic↗
PubMed2002

A susceptibility gene for psoriatic arthritis maps to chromosome 16q: evidence for imprinting.

Several genetic loci have been reported for psoriasis, but none has been specifically linked to psoriatic arthritis (PsA), a condition that affects >10% of patients with psoriasis. A genetic component for PsA is suggested by segregation within families and high concordance among identical twins. We performed a linkage scan to map genes contributing to PsA. We identified 178 patients with PsA out of 906 patients who were included in our genetic study of psoriasis. Using a comprehensive genealogy database, we were able to connect 100 of these into 39 families. We genotyped the patients using a framework marker set of 1,000 microsatellite markers, with an average density of 3 cM, and performed multipoint, affected-only, allele-sharing linkage analysis using the Allegro program. On the basis of the initial results, we genotyped more markers for the most prominent loci. A linkage with a LOD score of 2.17 was observed on chromosome 16q. The linkage analysis, conditioned on paternal transmission to affected individuals, gave a LOD score of 4.19, whereas a LOD score of only 1.03 was observed when conditioned for maternal transmission. A suggestive locus on chromosome 16q has previously been implicated in psoriasis. Our data indicate that a gene at this locus may be involved in paternal transmission of PsA.

Alleles↗
PubMed2000

Comparing the success of different prediction software in sequence analysis: a review.

The abundance of computer software for different types of prediction in DNA and protein sequence analyses raises the problem of adequate ranking of prediction program quality. A single measure of success of predictor software, which adequately ranks the predictors, does not exist. A typical example of such an incomplete measure is the so-called correlation coefficient. This paper provides an overview and short analysis of several different measures of prediction quality. Frequently, some of these measures give results contradictory to each other even when they relate to the same prediction scores. This may lead to confusion. In order to overcome some of the problems, a few new measures are proposed including some variants of a 'generalised distance from the ideal predictor score'; these are based on topological properties, rather than on statistics. In order to provide a sort of a balanced ranking, the averaged score measure (ASM) is introduced. The ASM provides a possibility for the selection of the predictor that probably has the best overall performance. The method presented in the paper applies to the ranking problem of any prediction software whose results can be properly represented in a true positive-false positive framework, thus providing a natural set-up for linear biological sequence analysis.

Computational Biology↗
PubMed2003

Measuring chronic patients' feelings of being a burden to their caregivers: development and preliminary validation of a scale.

BACKGROUND: Burden on caregivers has been extensively studied, but the patient's own feelings of being a burden have rarely been examined. Such feelings may lead to distress and can complicate relations with the caregiver. This report describes the development and preliminary validation of a scale to measure patient-perceived burden. MATERIALS AND METHODS: A conceptual framework and scale items were derived from previous literature and from qualitative interviews with patients and health professionals. Following content validity and item clarity analyses, a 25-item scale was developed. This was then administered in a construct validation to 100 outpatients undergoing hemodialysis. RESULTS: Discriminant validity coefficients showed that burden scores were independent of age, education, and time on dialysis. Convergent analyses showed modest correlations with the number of comorbid conditions (r = 0.20, P < 0.04), functional status (r = 0.26, P < 0.01), physical function (r = 0.30, P < 0.01), and mental health (r = 0.39, P < 0.01). Alpha internal consistency was 0.92 and factor analyses revealed a single main factor. A 10-item abbreviation (alpha = 0.85) is therefore proposed. CONCLUSION: The self-perceived burden scale shows promise as a measure to identify patients in emotional distress due to feelings of being a burden on others, and as an outcome measure in intervention studies.

Age Factors↗
PubMed1976

Effect of stress on field dependence.

60 subjects were tested in the rod-and-frame test under flicker conditions (stress). As compared to scores in a control situation (no flicker), the rod-and-frame scores were large under stress and increased monotonically during the session. Futhermore, both intra- and interindividual variability of rod-and-frame performance changed under stress conditions in a consistent manner. The general results, which clearly point to a reliable influence of stress on field dependency, are discussed within the methodological framework of Witkin's theory of perception and personality.

Adult↗
PubMed2000

Creating notifications tailored for individual workers by using a database: a conceptual framework and its application.

Although prevention strategies to assure good mental health in the workplace have become important, worker notification in studies using psychometric tests has rarely been discussed. Until now it has been difficult to prepare a large number of notifications that are tailored well for individual workers. We have developed a system to create notifications that explain the results for individual workers in plain language using a relational database (RDB). First, scores for each test were divided into categories and the workers' data was classified. Then, explanations were written for each category. RDB software read component files into a database file, integrated all data, and printed out notifications. After the system was developed, we realized its high potential for use in occupational health care, as well as in many other fields. We also report an example of its application.

Databases, Factual↗
PubMed2026

Enterocutaneous Fistula-Associated Sepsis and Mortality: Development and Validation of a Multimodal Artificial Intelligence Prediction Model.

BACKGROUND: Predicting enterocutaneous fistula (ECF)-associated sepsis and mortality poses significant challenges in digital health care due to the disease's complexity and heterogeneous clinical manifestations. Current approaches that rely on single-modal data or traditional scoring systems often fail to capture the intricate immune-inflammatory dynamics and multisystem involvement in patients with ECF. OBJECTIVE: This study aims to develop an artificial intelligence (AI)-driven multimodal fusion model integrating clinical, imaging, and transcriptomic data for early prediction of ECF-associated sepsis and 28-day mortality, addressing the limitations of conventional single-dimensional models. METHODS: This study leveraged publicly available datasets (Medical Information Mart for Intensive Care III [MIMIC-III], electronic Intensive Care Unit [eICU], and The Cancer Genome Atlas) to construct a multimodal framework. Clinical parameters were processed using Extreme Gradient Boosting, abdominal imaging features were extracted via convolutional neural networks, and transcriptomic profiles were analyzed with variational autoencoders. A Transformer-based fusion network was employed for joint prediction and validated through cross-validation and external testing. Key features were identified using Shapley Additive Explanations and Local Interpretable Model-Agnostic Explanations interpretability algorithms, while immune regulatory mechanisms were explored via weighted gene co-expression network analysis. RESULTS: The multimodal model achieved an area under the curve (AUC) of 0.89 for predicting sepsis and 28-day mortality, outperforming unimodal models (clinical-only model, AUC 0.72, and imaging-only model, AUC 0.78). Critical predictors included Sequential Organ Failure Assessment score, lactate levels, intra-abdominal free fluid on imaging, and immunoregulatory genes (programmed death-ligand 1 [PD-L1] and indoleamine 2,3-dioxygenase 1 [IDO1]). Mechanistic analysis revealed distinct immune reprogramming in patients with sepsis, characterized by increased regulatory T cells and M2 macrophages, along with downregulated cluster of differentiation 8+ (CD8+) T cells. CONCLUSIONS: This multimodal AI model offers an innovative digital solution in medical informatics, enabling precise early risk stratification for ECF-associated sepsis. By integrating multisource data and providing interpretable insights into immune-inflammatory pathways, the model enhances health care quality for patients with ECF and paves the way for personalized intervention strategies.

Humans↗
PubMed1996

Conscious and unconscious retrieval in picture recognition: a framework for exploring gender differences.

The authors explored gender differences by examining 2 distinct memory processes involved in recognizing pictures that were scenes captured from videotapes. For Study 1, the authors used a process dissociation procedure (L.J. Anooshian & P.S. Seibert, 1995; L.L. Jacoby, 1991) to obtain separate estimates of the contributions of recollection (conscious retrieval) and sense of familiarity (unconscious retrieval) in recognizing scenes along previously viewed routes of travel. Women obtained higher familiarity scores than did men, whereas no gender difference emerged for conscious recollection. In Study 2, the authors tested both preschool children and adults and found results similar to those in Study 1 for a task with pictures captured from children's cartoons, regardless of age. The results from these studies illustrate the need for greater attention to diverse memory processes when investigating individual differences, including gender differences, in diverse task domains.

Adult↗
PubMedDate not supplied

Rehabilitation Activities Profile: the ICIDH as a framework for a problem-oriented assessment method in rehabilitation medicine.

The Rehabilitation Activities Profile (RAP) is an ICIDH-based assessment method that covers the domains of communication, mobility, personal care, occupation, and relationships. Disabilities and handicaps in these domains are assessed on four-point Likert scales for severity. Problems perceived by the patient associated with these disabilities or handicaps are also assessed on four-point Likert scales for severity. High scores on perceived problems represent a patient's priorities. Information is gathered through a semi-structured interview with the patient; proxies and observations can be used as additional sources of information. Assessment can be performed at two levels. The first level is a global one, serving as a screening device. If disabilities or handicaps are identified, the second level provides for an in-depth assessment of those specific disabilities and handicaps as well as the related perceived problems. The method is designed to assist screening, goal-setting, and outcome evaluation of individual patients.

Activities of Daily Living↗
PubMed2006

Diversity arrays technology (DArT) for high-throughput profiling of the hexaploid wheat genome.

Despite a substantial investment in the development of panels of single nucleotide polymorphism (SNP) markers, the simple sequence repeat (SSR) technology with a limited multiplexing capability remains a standard, even for applications requiring whole-genome information. Diversity arrays technology (DArT) types hundreds to thousands of genomic loci in parallel, as previously demonstrated in a number diploid plant species. Here we show that DArT performs similarly well for the hexaploid genome of bread wheat (Triticum aestivum L.). The methodology previously used to generate DArT fingerprints of barley also generated a large number of high-quality markers in wheat (99.8% allele-calling concordance and approximately 95% call rate). The genetic relationships among bread wheat cultivars revealed by DArT coincided with knowledge generated with other methods, and even closely related cultivars could be distinguished. To verify the Mendelian behaviour of DArT markers, we typed a set of 90 Cranbrook x Halberd doubled haploid lines for which a framework (FW) map comprising a total of 339 SSR, restriction fragment length polymorphism (RFLP) and amplified fragment length polymorphism (AFLP) markers was available. We added an equal number of DArT markers to this data set and also incorporated 71 sequence tagged microsatellite (STM) markers. A comparison of logarithm of the odds (LOD) scores, call rates and the degree of genome coverage indicated that the quality and information content of the DArT data set was comparable to that of the combined SSR/RFLP/AFLP data set of the FW map.

Chromosomes, Plant↗
PubMed2002

Autonomy development in adolescents with insulin dependent diabetes mellitus.

This descriptive study investigated autonomy development among young adolescents with insulin-dependent diabetes mellitus (IDDM); assessed relationships among behavioral, cognitive, and emotional autonomy; and determined the relationships between these types of autonomy and metabolic control. Developmental and family theory provided the framework for this study. This investigation suggested that the pattern of autonomy for adolescents with IDDM is congruent with that of adolescents without chronic illness. The three autonomy types are conceptually distinct and one aspect of emotional autonomy was related to poorer metabolic control. Daughters and adolescents in one-parent families scored higher on this component.

Adolescent↗
PubMed1990

Content areas for cardiac teaching: patients' perceptions of the importance of teaching content after myocardial infarction.

This descriptive study was undertaken to investigate patients' perceptions of the seven content areas commonly included in cardiac teaching in terms of how important and how realistic they were for being learned following the experience of an acute myocardial infarction (MI). Lazarus's stress-coping theory was used as a framework for the study. A sample of 30 MI subjects were interviewed before discharge and during early convalescence. Before discharge, subjects rated six out of the seven content areas as "important" for learning. Although the information was considered important, it was not rated as equally realistic to learn. During early convalescence, mean scores under 'important to learn' were slightly lower, but all seven content areas were rated as significantly more realistic to be learned (P less than 0.05). Little variation in patients' perceptions of the importance of teaching content was noted over time. However, there was major variation between their perceptions of how important and how realistic it was to learn the material before discharge. Both dimensions, how important and how realistic, are therefore crucial to consider in cardiac teaching.

Adult↗
PubMed2006

The role of disease management in pay-for-performance programs for improving the care of chronically ill patients.

To date, pay-for-performance programs targeting the care of persons with chronic conditions have primarily been directed at physicians and provide an alternative to health plan-sponsored chronic disease management (DM) programs. Both approaches require similar infrastructure, and each has its own advantages and disadvantages for program implementation. Pay-for-performance programs use incentives based on patient outcomes; however, an alternative system might incorporate measures of structure and process. Using a conceptual framework, the authors explore the variation in 50 diabetes DM programs using data from the 2002 National Business Coalition on Health's eValue8 Request for Information (RFI). The authors raise issues relevant to the assignment of accountability for patient outcomes to either health plans or physicians. They analyze the association between RFI scores measuring structures and processes, and HEDIS diabetes intermediate outcome measures. Finally, the strengths and weaknesses of using the RFI scores as an alternative metric for pay-for-performance programs are discussed.

Chronic Disease↗