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At least 91 records · Page 5Linked to original sources
PubMed1989

Explaining the pain of active labor: the importance of maternal confidence.

This study was designed to investigate the relationships between the perception of pain during active labor and nine predictor variables: age, parity, childbirth preparation, state anxiety, confidence in ability to handle labor, concern regarding the outcome of labor, fear of pain, cervical dilatation and frequency of uterine contractions. The sample included 134 low-risk women at term with a normal singleton pregnancy. Standard and stepwise regression was used to examine the ability of the selected variables to explain the variance in the sensory, affective, and evaluative components of pain as measured by the subscales of the Pain Rating Index of the McGill Pain Questionnaire. Although significant proportions of variance were explained for each component of pain, the study variables were most powerful in their ability to explain the variance in the affective component of active labor pain. The stepwise analysis suggested that of the nine variables, confidence in ability to handle labor was the most significant predictor of all components of pain during active labor.

Adolescent↗
PubMed2025

CaXML: Chemistry-informed machine learning explains mutual changes between protein conformations and calcium ions in calcium-binding proteins using structural and topological features.

Proteins' flexibility is a feature in communicating changes in cell signaling instigated by binding with secondary messengers, such as calcium ions, associated with the coordination of muscle contraction, neurotransmitter release, and gene expression. When binding with the disordered parts of a protein, calcium ions must balance their charge states with the shape of calcium-binding proteins and their versatile pool of partners depending on the circumstances they transmit. Accurately determining the ionic charges of those ions is essential for understanding their role in such processes. However, it is unclear whether the limited experimental data available can be effectively used to train models to accurately predict the charges of calcium-binding protein variants. Here, we developed a chemistry-informed, machine-learning algorithm that implements a game theoretic approach to explain the output of a machine-learning model without the prerequisite of an excessively large database for high-performance prediction of atomic charges. We used the ab initio electronic structure data representing calcium ions and the structures of the disordered segments of calcium-binding peptides with surrounding water molecules to train several explainable models. Network theory was used to extract the topological features of atomic interactions in the structurally complex data dictated by the coordination chemistry of a calcium ion, a potent indicator of its charge state in protein. Our design created a computational tool of CaXML, which provided a framework of explainable machine learning model to annotate ionic charges of calcium ions in calcium-binding proteins in response to the chemical changes in an environment. Our framework will provide new insights into protein design for engineering functionality based on the limited size of scientific data in a genome space.

Machine Learning↗
PubMed1990

Hereditary retinoblastoma: can balanced insertion entirely explain the differences of expressivity among families?

Although the retinoblastoma gene has been isolated and sequenced, the difference in penetrance and expressivity among families has not yet been fully explained. Balanced chromosomal insertion involving the 13q14 regions has been shown to account for some families with several unaffected carriers. Since there could be cases with karyotypically undetectable insertions, we tested whether this mechanism was general enough to explain the whole difference in expressivity among families. Using 166 pedigrees, reported in nine series available in the literature (including our own), we conclude that balanced insertion cannot entirely explain the familial data, even if we allow for a reduced viability of unbalanced gametes. Other mechanisms are proposed and discussed in this paper.

Chromosome Aberrations↗
PubMed1980

Bringing the models together: an empirical approach to combining variables used to explain health actions.

Considerable confusion has existed among researchers with regard to the selection of a particular model of health behavior for study, and many investigators have long felt that the actual number of truly distinct concepts relevant to explaining health-related actions is considerably lower than the large number of variables currently employed. This paper explores selected approaches and models which have been advanced to explain health actions, in terms of structural similarities and differences identified by a panel of judges who are the relevant experts in this field. Judges were asked to partition a set of 109 variables, representing 14 different models, into 12-14 groups on the basis of similarity. The structural similarities among the variable groups were evaluated using Smallest Space Analysis. Six interpretable factors emerged from the analyses: (1) accessibility to health care, (2) evaluation of health care, (3) perception of symptoms and threat of disease, (4) social network characteristics, (5) knowledge about disease, and (6) demographic characteristics. The results of the study provide a first step in developing a unified framework for explaining health actions.

Attitude to Health↗
PubMed1998

Explaining social class differences in depression and well-being.

Work characteristics, including skill discretion and decision authority, explain most of the socioeconomic status gradient in well-being and depression in middle-aged British civil servants from the Whitehall II Study, London. Social support explained about one-third of the gradient, life events and material difficulties less than one-third. Socioeconomic status was measured by employment grade. Work characteristics were based on the Karasek model, social support was measured by the Close Persons Questionnaire, depression by the General Health Questionnaire and well-being by the Affect Balance Scale. Despite a small contribution from social selective factors measured by upward mobility, the psychosocial work environment explained most of the cross-sectional socioeconomic status gradient in well-being and depression.

Adult↗
PubMed2005

Differences in peak bone mass in women of European and South Asian origin can be explained by differences in body size.

There are few data concerning the occurrence of peak bone mass in women of South Asian origin. The aim of this study was to determine the level of peak bone mass in South Asian women in the UK and to determine whether any observed differences could be explained by differences in body size. Two groups of South Asian women, those of (1) Pakistani Muslim and (2) Gujarati Hindu origin, together with a European group aged 18 to 36 years, were recruited from primary-care population age-sex registers in the Greater Manchester area. They were invited to attend for a detailed interview-assisted lifestyle questionnaire and assessment of height and weight. Bone mass density (BMD) at the hip and lumbar spine was measured by dual energy X-ray absorptiometry (DEXA) scan (Hologic QDR 4500). Volumetric bone density was measured at the distal radius using pQCT (Norland Stratec XCT 2000). Linear regression was used to determine whether any observed differences in the level of bone mass could be explained by differences in body size. A total of 119 European women with a mean age of 30.4 years, 98 Pakistani Muslim women with a mean age of 29.2 years and 20 Gujarati Hindu women with a mean age of 29.2 years had bone density measurements performed. The Europeans were taller and heavier than either South Asian group. Peak BMD was greater among the European than the Pakistani women at all three measuring sites, with the Gujarati women having intermediate values at the hip and lumbar spine. Observed differences disappeared, however, after adjusting for height and weight. There were no differences in volumetric density at the lumbar spine or distal radius between the groups. In summary, there are differences in the level of bone mass between European and South Asian women, though these can be explained by differences in bone size, height or weight.

Absorptiometry, Photon↗
PubMed2002

In search of effective scales for stream management: does agroecoregion, watershed, or their intersection best explain the variance in stream macroinvertebrate communities?

Our lack of understanding of relationships between stream biotic communities and surrounding landscape conditions makes it difficult to determine the spatial scale at which management practices are best assessed. We investigated these relationships in the Minnesota River Basin, which is divided into major watersheds and agroecoregions which are based on soil type, geologic parent material, landscape slope steepness, and climatic factors affecting crop productivity. We collected macroinvertebrate and stream habitat data from 68 tributaries among three major watersheds and two agroecoregions. We tested the effectiveness of the two landscape classification systems (i.e., watershed, agroecoregion) in explaining variance in habitat and macroinvertebrate metrics, and analyzed the relative influence on macroinvertebrates of local habitat versus regional characteristics. Macroinvertebrate community composition was most strongly influenced by local habitat; the variance in habitat conditions was best explained at the scale of intersection of major watershed and agroecoregion (i.e., stream habitat conditions were most homogeneous within the physical regions of intersection of these two landscape classification systems). Our results are consistent with findings of other authors that most variation in macroinvertebrate community data from large agricultural catchments is attributable to local physical conditions. Our results are the first to test the hypothesis and demonstrate that the scale of intersection best explains these variances. The results suggest that management practices adjusted for both watershed and ecoregion characteristics, with the goal of improving physical habitat characteristics of local streams, may lead to better basin-wide water quality conditions and stream biological integrity.

Agriculture↗
PubMed2006

Racial and ethnic differences in lung cancer incidence: how much is explained by differences in smoking patterns? (United States).

OBJECTIVES: Lung cancer rates vary considerably among U.S. racial/ethnic groups. We quantitatively analyzed the extent to which these differences can be attributed to differential patterns of smoking. METHODS: We utilized survey data from the U.S. Census to estimate smoking patterns in the following racial/ethnic groups: non-Hispanic whites, non-Hispanic blacks, Hispanics, Asian/Pacific Islanders and American Indians. We used several dose-response models of smoking and lung cancer to predict relative lung cancer rates in these groups based on reported smoking patterns, specifically, on smoking status (current, former, never), cigarettes per day, age started, and age quit (for former smokers). Predicted rates were compared to observed population rates for these groups. RESULTS: Black men had slightly lower predicted lung cancer rates than white men, but had 35-47% higher observed rates. Hispanic men had predicted rates about 25% lower than whites but observed rates 50% lower than whites; predicted rates for Hispanic women were 50% lower than whites compared to observed rates that were 60-70% lower. For Asian/Pacific Islanders, predicted and observed rates relative to whites were comparable. Predicted rates for American Indians were slightly higher than whites while observed rates were about 40% lower. CONCLUSION: Differences in smoking largely explain lower lung cancer rates in Asian/Pacific Islanders relative to whites and partially explain lower rates in Hispanics compared to whites. Increased rates in black men and decreased rates in American Indians are not explained by differences in smoking.

Ethnicity↗
PubMed2005

Can human error theory explain non-adherence?

OBJECTIVE: To apply human error theory to explain non-adherence and examine how well it fits. METHOD: Patients who were taking chronic medication were telephoned and asked whether they had been adhering to their medicine, and if not the reasons were explored and analysed according to a human error theory. RESULTS: Of 105 patients, 87 were contacted by telephone and they took part in the study. Forty-two recalled being non-adherent, 17 of them in the last 7 days; 11 of the 42 were intentionally non-adherent. The errors could be described by human error theory, and it explained unintentional non-adherence well, however, the application of 'rules' was difficult when considering mistakes. The consideration of error producing conditions and latent failures also revealed useful contributing factors. CONCLUSION: Human error theory offers a new and valuable way of understanding non-adherence, and could inform interventions. However, the theory needs further development to explain intentional non-adherence.

Drug Therapy↗
PubMed1995

Variation in rat urinary aeroallergen levels explained by differences in site, task and exposure group.

We describe how much of the variation in rat urinary aeroallergen (RUA) levels may be explained by differences in site and exposure group in research establishments and we identify task categories associated with high RUA levels. In this population 73% of the variability in RUA levels could be explained by exposure group, site and their interaction term. Exposure group alone explained the majority of the variation (69%). The task category associated with the highest RUA level was cleaning out, followed by indirect contact with rats and handling rats. The task categories associated with the lowest levels were slide production, post mortem and experiments. These results may help choose appropriate exposure measures for epidemiological studies in research establishments in the future and may help reduce the incidence of laboratory animal allergy.

Allergens↗
PubMedDate not supplied

Comorbid features in bulimics before and after therapy: are they explained by axis II diagnoses, secondary effects of bulimia, or both?

This study evaluated the extent to which personality disorder (PD) diagnoses drawn in active bulimics explained pretreatment and posttreatment comorbid features, once possible secondary effects of bulimia nervosa (BN) on the mental status were controlled. We used structured interviews to assign axis II diagnoses to 73 DSM-III-R bulimics, and then examined whether or not classification into borderline PD (BPD), other PD (OPD), or no PD (NPD) groups (a) predicted pretreatment and posttreatment differences in comorbid symptoms, and (b) explained the severity of comorbid symptoms independent of effects attributable to BN sequelae. Groups never differed on eating-symptom measures, with all showing satisfactory average improvements over 3 months. However, on pretreatment and posttreatment comorbid symptoms, BPD subjects displayed more depression, reliance on maladaptive defenses, and other pathological features than did other groups. More importantly, after controlling for the effects of possible sequelae of BN on comorbid symptoms at each point in time, a borderline/nonborderline distinction always explained significant residual proportions of variance in comorbid symptoms. These findings suggest that despite tendencies for BN to exacerbate concurrent symptoms, axis II diagnoses remain meaningful as indicators of comorbid features.

Adult↗
PubMed1991

A model for diagnosing and explaining multiple disorders.

The ability to diagnose multiple interacting disorders and explain them in a coherent causal framework has only partially been achieved in medical expert systems. This paper proposes a causal model for diagnosing and explaining multiple disorders whose key elements are: physician-directed hypotheses generation, object-oriented knowledge representation, and novel explanation heuristics. The heuristics modify and link the explanations to make the physician aware of diagnostic complexities. A computer program incorporating the model currently is in use for diagnosing peripheral nerve and muscle disorders. The program successfully diagnoses and explains interactions between diseases in terms of underlying pathophysiologic concepts. The model offers a new architecture for medical domains where reasoning from first principles is difficult but explanation of disease interactions is crucial for the system's operation.

Acid-Base Imbalance↗
PubMed1993

Witchcraft-explained childhood tragedies in Tlaxcala, and their medical sequelae.

This paper describes results of a study in Tlaxcala, Mexico, involving the sudden death of infants and children that culturally are explained as resulting from the attack of blood-sucking witches. The attacks of the supernaturals are relatively common occurrences and an elaborate ideology has evolved to explain them. Such an ideology serves to explain what constitutes a major trauma of loss and supernatural assault. Data on a total of 47 cases were collected prospectively. The illness experiences of the parents following these traumas were recorded and their nature and consequences analyzed. The results of the study provide a 'folk medical' epidemiology of sudden infant death, a well identified cultural-ecological stressor. Ideas from cultural, psychological and medical anthropology as well as general medicine and psychiatry are used in the interpretation of the results.

Adult↗
PubMed1991

Clinical and pathophysiological observations in migraine and tension-type headache explained by integration of vascular, supraspinal and myofascial inputs.

A vascular-supraspinal-myogenic (VSM) model for pain in migraine based on our previous clinical and pathophysiological observations is proposed. According to the model, perceived pain (headache) intensity is determined by the sum of nociception from cephalic arteries and pericranial myofascial tissues converging upon the same neurons and integrated with supraspinal effects (usually facilitating). Vascular input predominates over myofascial input in migraine, whereas significance of supraspinal facilitation is difficult to estimate. The importance of these 3 effects may vary between patients and in the same individual with time. The model is in accordance with recent experimental studies showing convergence of somatovisceral afferents upon n. caudalis neurons. Also, long term potentiation due to nociceptive activation and sensitization of neurons to input from wider areas and non-nociceptive stimuli are relevant to our model. In tension-type headache, nociception is primarily myofascial, but vascular input cannot be disregarded. Supraspinal facilitation probably plays a large, sometimes dominant role (the MSV model). The model explains much of the complexity of the clinical picture of these disorders as well as their tendency to overlap and to change into one another. Also, a number of pathophysiological observations such as why muscles are tender during migraine, why trigger-point injection may cure migraine attacks and why chronic tension-type headache is often associated with episodes of pulsating pain, can be explained. The model gives a rational explanation of empirically developed, internationally accepted, multimodal treatment strategies for migraine and tension-type headache. It may thus serve a useful purpose in explaining the disorder to patients. Finally, the model points to several avenues of future research in animals and man.

Animals↗
PubMed1992

The neurohormonal hypothesis: a theory to explain the mechanism of disease progression in heart failure.

Because physicians have traditionally considered heart failure to be a hemodynamic disorder, they have described the syndrome of heart failure using hemodynamic concepts and have designed treatment strategies to correct the hemodynamic derangements of the disease. However, although hemodynamic abnormalities may explain the symptoms of heart failure, they are not sufficient to explain the progression of heart failure and, ultimately, the death of the patient. Therapeutic interventions may improve the hemodynamic status of patients but adversely affect their long-term outcome. These findings have raised questions about the validity of the hemodynamic hypothesis and suggest that alternative mechanisms must play a primary role in advancing the disease process. Several lines of evidence suggest that neurohormonal mechanisms play a central role in the progression of heart failure. Activation of the sympathetic nervous system and renin-angiotensin system exerts a direct deleterious effect on the heart that is independent of the hemodynamic actions of these endogenous mechanisms. Therapeutic interventions that block the effects of these neurohormonal systems favorably alter the natural history of heart failure, and such benefits cannot be explained by the effect of these treatments on cardiac contractility and ejection fraction. Conversely, pharmacologic agents that adversely influence neurohormonal systems in heart failure may increase cardiovascular morbidity and mortality, even though they exert favorable hemodynamic effects. These observations support the formulation of a neurohormonal hypothesis of heart failure and provide the basis for the development of novel therapeutic strategies in the next decade.

Adrenergic beta-Antagonists↗
PubMed2005

How principles of domain formation in model membranes may explain ambiguities concerning lipid raft formation in cells.

Sphingolipid and cholesterol-rich liquid ordered lipid domains (lipid rafts) have been studied in both eukaryotic cells and model membranes. However, while the coexistence of ordered and disordered liquid phases can now be easily demonstrated in model membranes, the situation in cell membranes remains ambiguous. Unlike the usual situation in model membranes, under most conditions, cell membranes rich in sphingolipid and cholesterol may have a "granular" organization in which the size of ordered and/or disordered domains is extremely small and domains may be of borderline stability. This review attempts to explain the origin of the divergence between of our understanding of rafts in model membranes and in cells, and how the physical properties of model membranes can help explain many of the ambiguities concerning raft formation and properties in cells. How physical principles of ordered domain formation relate to limitations of detergent insolubility and cholesterol depletion methods used to infer the presence of rafts in cells is also discussed. Possible modifications of these techniques that may increase their reliability are considered. It will be necessary to study model membrane systems more closely approximating cell membranes in order gain a complete understanding of raft properties in cells. Very high concentrations of membrane cholesterol and proteins may explain key physical characteristics of domains in cellular membranes, and are the two of the most obvious factors requiring additional study.

Animals↗
PubMed2004

Changes in bone mineral density explain little of the reduction in vertebral or nonvertebral fracture risk with anti-resorptive therapy.

The structural basis for the reduction in vertebral and nonvertebral fracture risk in patients using anti-resorptive therapy is not well understood. As reduced bone mineral density (BMD) increases the risk for fracture and anti-resorptive agents increase BMD, it was commonly held that the increase in BMD explained the fracture risk reduction until several meta-analyses either failed to detect a significant association between vertebral fracture risk reduction and the incremental increase in BMD or reported that only a small proportion of the vertebral fracture risk reduction was explained by changes in BMD. Recently, it was reported that the risk of nonvertebral fractures decreased when an increase in BMD accompanied anti-resorptive treatment [J. Clin. Endrocrinol. Metab. 87 (2002) 1586]. However, a reanalysis of the data, using the same statistical methods after correcting for discrepancies in the reported BMD and person-year data, suggested that the magnitude of reductions in nonvertebral fracture risk was not associated with the magnitude of increases in BMD at the end of the first year or at completion of the studies. We infer that only a small proportion of risk reduction in vertebral and nonvertebral fractures observed with anti-resorptive drug therapy is explained by the increase in BMD. Further studies are needed to define the structural basis of the fracture risk reduction.

Bone Density↗
PubMed2004

Can the increase of bone mineral density following bisphosphonates treatments be explained by biomechanical considerations?

OBJECTIVE: We hypothesized that bone mineral density increase following bisphosphonates treatments may be explained by the influence of the drug on the mechanical bone remodeling parameters. BACKGROUND: Patients treated with bisphosphonates continuously increase their bone mineral density. This increase is explained in the first 12-18 months following the treatment by the filling of the transient remodeling deficit. Recently, results of a clinical study of alendronate treatment over 7 years still show a continuous increase of bone mineral density. These results raised several questions regarding our understanding of bisphosphonates mode of action. METHODS: Bone remodeling is influenced by different factors including mechanical forces. In the present study, we propose then to consider the effect of bisphosphonates also under biomechanical considerations. RESULTS: Identification of the model with the clinical data showed that daily treatment of 10 and 20 mg alendronate decreased the bone turnover rate by 2% and 11%, respectively, in comparison with the 5 mg alendronate treatment. Moreover, the alendronate treatments decreases the resorption threshold stimulus by 19% (25%, 28%) for the 5 mg (10 and 20 mg, respectively) compared to placebo. CONCLUSIONS: The increase of bone mineral density following bisphosphonates treatment may then be explained by biomechanical considerations. Based on this description, bisphosphonates treatment may indeed change the susceptibility of bone to its biomechanical environment decreasing the mechanical threshold where bone should undergo resorption.

Alendronate↗