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At least 973 records · Page 54Linked to original sources
PubMed2004

Positive self-assessed general health in patients with medical problems. A qualitative study from general practice.

BACKGROUND: Patient and doctor do not always agree on the status of the patient's health. By underestimating the patient's strong sides, the doctor may be contributing to disempowerment and bypassing knowledge needed for adequate medical diagnosis and management. OBJECTIVE: To understand how our patients with medical problems assess their general health as good. DESIGN AND SETTING: Qualitative observational study based on audiotaped material from general practice consultations in authors' practices (Norway and Denmark). The patients were asked to rate their current state of health on a scale ranging from zero to 100, and then to explain their score. SUBJECTS: From 41 consecutive consultations we compiled a purposeful sample of 12 patients who reported positive self-assessed general health although medical problems were present. The 7 women and 5 men were aged between 43 and 96 years, and had been diagnosed with musculoskeletal disorders, heart disease, cancer, depression, headache or severe menopausal symptoms. MAIN OUTCOME MEASURES: Salutogenesis, represented by the authors' Health Resource/Risk Balance Model, and Antonovsky's Sense of Coherence (SOC) concept comprised the theoretical framework. Transcripts from audiotaped consultations were used for qualitative text condensation analysis, inspired by Giorgi's phenomenological method. Analysis was theory-driven, applying comprehensibility, manageability and meaningfulness as entries to elaborate patients' accounts of positive health. RESULTS: Patients' answers demonstrated how a feeling of logical reasoning related to symptom perception could provide comfort and sometimes lead to advantageous coping strategies. Personal and social resources were mentioned as essential means for tolerating and managing the burden of disease. Even fairly extensive endeavours could be experienced as worthwhile when sometimes providing relief, even only temporarily. CONCLUSIONS: Patients' accounts of general health can challenge the traditional medical views on assessment of health and disease.

Adult↗
PubMed2005

GATA: a graphic alignment tool for comparative sequence analysis.

BACKGROUND: Several problems exist with current methods used to align DNA sequences for comparative sequence analysis. Most dynamic programming algorithms assume that conserved sequence elements are collinear. This assumption appears valid when comparing orthologous protein coding sequences. Functional constraints on proteins provide strong selective pressure against sequence inversions, and minimize sequence duplications and feature shuffling. For non-coding sequences this collinearity assumption is often invalid. For example, enhancers contain clusters of transcription factor binding sites that change in number, orientation, and spacing during evolution yet the enhancer retains its activity. Dot plot analysis is often used to estimate non-coding sequence relatedness. Yet dot plots do not actually align sequences and thus cannot account well for base insertions or deletions. Moreover, they lack an adequate statistical framework for comparing sequence relatedness and are limited to pairwise comparisons. Lastly, dot plots and dynamic programming text outputs fail to provide an intuitive means for visualizing DNA alignments. RESULTS: To address some of these issues, we created a stand alone, platform independent, graphic alignment tool for comparative sequence analysis (GATA http://gata.sourceforge.net/). GATA uses the NCBI-BLASTN program and extensive post-processing to identify all small sub-alignments above a low cut-off score. These are graphed as two shaded boxes, one for each sequence, connected by a line using the coordinate system of their parent sequence. Shading and colour are used to indicate score and orientation. A variety of options exist for querying, modifying and retrieving conserved sequence elements. Extensive gene annotation can be added to both sequences using a standardized General Feature Format (GFF) file. CONCLUSIONS: GATA uses the NCBI-BLASTN program in conjunction with post-processing to exhaustively align two DNA sequences. It provides researchers with a fine-grained alignment and visualization tool aptly suited for non-coding, 0-200 kb, pairwise, sequence analysis. It functions independent of sequence feature ordering or orientation, and readily visualizes both large and small sequence inversions, duplications, and segment shuffling. Since the alignment is visual and does not contain gaps, gene annotation can be added to both sequences to create a thoroughly descriptive picture of DNA conservation that is well suited for comparative sequence analysis.

Algorithms↗
PubMed2026

scFANCL: Dual contrastive learning with false-negative correction at cell level for single-cell RNA-seq clustering.

BACKGROUND: Single-cell RNA sequencing (scRNA-seq) enables cellular characterization at single-cell resolution. However, its high dimensionality, sparsity, and noise make clustering challenging. Approaches utilizing contrastive learning and data augmentation have been introduced to improve representation quality for scRNA-seq clustering. In particular, dual contrastive frameworks combining instance- and cluster-level objectives can capture both cell-cell similarities and inter-cluster variations. However, existing dual contrastive frameworks focus primarily on discrete cluster boundaries, neglecting the biological continuity inherent in scRNA-seq data. METHODS: We propose scFANCL, a dual contrastive framework designed to capture biological continuity in scRNA data. Rather than treating all non-augmented samples as negatives, scFANCL applies a cosine-similarity-based threshold to exclude cells of the same type from the negative pool, preserving continuous transcriptional relationships among them while maintaining inter-cluster separation. RESULTS: Extensive experiments across seven publicly available scRNA-seq datasets demonstrated that scFANCL achieves competitive clustering performance compared with existing baseline methods, consistently yielding high ARI and NMI scores across datasets of varying size and complexity. Ablation studies further confirmed the contribution of the false negative filtering component, showing measurable improvements over variants without filtering. Downstream analyses further suggest that the learned embeddings may reflect biologically meaningful transcriptional transitions, including continuous differentiation trajectories within related cell types. The source code is available at https://github.com/mjuailab/scFANCL . CONCLUSIONS: scFANCL addresses a key limitation of conventional contrastive learning by applying a cosine-similarity-based threshold to exclude cells of the same type from the negative pool, thereby preserving biological continuity within cell types while maintaining inter-cluster separation. Evaluations across seven benchmark scRNA-seq datasets demonstrate competitive clustering performance, with learned embeddings capturing biologically meaningful transcriptional structure and characteristics of rare cell populations.

Clustering Algorithms↗
PubMed2005

Breast conservation after neoadjuvant chemotherapy.

BACKGROUND: The appropriate selection criteria for breast-conserving therapy (BCT) after neoadjuvant chemotherapy are poorly defined. The purpose of the current report was to develop a prognostic index to help refine selection criteria and to serve as a general framework for clinical decision-making for patients treated by this multimodality approach. METHODS: From a group of 340 patients treated with BCT after neoadjuvant chemotherapy, the authors previously determined 4 statistically significant predictors of ipsilateral breast tumor recurrence (IBTR) and locoregional recurrence (LRR): clinical N2 or N3 disease, residual pathologic tumor size > than 2 cm, a multifocal pattern of residual disease, and lymphovascular space invasion in the specimen. The M. D. Anderson Prognostic Index (MDAPI) was developed by assigning scores of 0 (favorable) or 1 (unfavorable) for each of these 4 variables and using the total to give an overall MDAPI score of 0-4. RESULTS: The MDAPI stratified the 340 patients into 3 subsets with statistically different levels of risk for IBTR and LRR after neoadjuvant chemotherapy and BCT. Actuarial 5-year IBTR-free survival rates were 97%, 88%, and 82% for patients in the low (MDAPI overall score 0 or 1, n=276), intermediate (MDAPI score 2, n=43), and high (MDAPI score 3 or 4, n=12) risk groups, respectively (P<0.001). Corresponding actuarial 5-year LRR-free survival rates were 94%, 83%, and 58%, respectively (P<0.001). CONCLUSIONS: Patients with an MDAPI score of 0 or 1, which made up 81% of the study population, had very low rates of IBTR and LRR. The MDAPI enabled the identification of a small group (4%) of patients who are at high risk for IBTR and LRR and who may benefit from alternative locoregional treatment strategies.

Adult↗
PubMed1978

Reliability and motor memory.

The generalizability framework was employed to estimate variance components and reliability of performance in a positioning task. The subjects (n =70) performed 16 trials at each of three target lengths of 25 cm, 45 cm, and 65 cm. The data were analyzed using a subjects x targets x trials repeated measures ANOVA. Two reliability coefficients were estimated. The first (R) provided an estimate of performance reliability generalized over targets and trials. The second (R') treated targets as a source of true-score variance and hence was generalized over trials alone. Both reliability coefficients were higher for algebraic error than for absolute error, and R1 provided higher reliability estimates than R for both dependent variables. Increasing the number of positioning trials from 2 to 16 at each target length did not appreciably alter either reliability coefficient. The overall low reliability of R appears to compound the dependent variables and statistical power problems associated with short-term motor-memory studies.

Journal Article↗
PubMed2005

Multigenerational health, development, and equality.

PURPOSE: Because of the significant aging of the global population, world regions are experiencing an increase in the number of generations within families. However, to date most practice methods in the health and human services are explicitly organized by age. This article discusses a multigenerational practice approach and the impact of an infusion strategy to integrate multigenerational practice into social work education. DESIGN AND METHODS: A required first-year MSW course was targeted for concentrated infusion of multigenerational content cutting across substantive areas. To compare students' perceptions and needs prior to and following the infusion of multigenerational content, students were surveyed, and mean scores were compared between the two time periods. RESULTS: Although the majority of social work practitioners work in multigenerational settings, most have received training that has been fragmented by age and relevant to only one stage of the life course. The vast majority of students endorsed multigenerational issues as important to social work in general and to their own professional careers. Following the infusion of multigenerational content, students' knowledge and skills in multigenerational practice increased significantly. IMPLICATIONS: A multigenerational practice framework honors the contributions, needs, and requirements of each generation as well as interdependence among generations. This approach prepares social work practitioners for practice, policy, and research that are more clearly relevant to the changing nature of the 21st century.

Health Status Indicators↗
PubMed2004

Regulog analysis: detection of conserved regulatory networks across bacteria: application to Staphylococcus aureus.

A transcriptional regulatory network encompasses sets of genes (regulons) whose expression states are directly altered in response to an activating signal, mediated by trans-acting regulatory proteins and cis-acting regulatory sequences. Enumeration of these network components is an essential step toward the creation of a framework for systems-based analysis of biological processes. Profile-based methods for the detection of cis-regulatory elements are often applied to predict regulon members, but they suffer from poor specificity. In this report we describe Regulogger, a novel computational method that uses comparative genomics to eliminate spurious members of predicted gene regulons. Regulogger produces regulogs, sets of coregulated genes for which the regulatory sequence has been conserved across multiple organisms. The quantitative method assigns a confidence score to each predicted regulog member on the basis of the degree of conservation of protein sequence and regulatory mechanisms. When applied to a reference collection of regulons from Escherichia coli, Regulogger increased the specificity of predictions up to 25-fold over methods that use cis-element detection in isolation. The enhanced specificity was observed across a wide range of biologically meaningful parameter combinations, indicating a robust and broad utility for the method. The power of computational pattern discovery methods coupled with Regulogger to unravel transcriptional networks was demonstrated in an analysis of the genome of Staphylococcus aureus. A total of 125 regulogs were found in this organism, including both well-defined functional groups and a subset with unknown functions.

Bacillus subtilis↗
PubMed1994

Grieving related to development: a preliminary comparison of three age cohorts of parents of children with intellectual disability.

It is argued that a child with intellectual disability represents an ongoing source of loss and grief for parents. A developmental framework was employed to compare three age cohorts of parents. Grief was operationalized within the affective, behavioural and cognitive domains. Measures of intrusive thoughts, avoidance behaviours, current emotional distress over reminders of time of diagnosis of disability, and intensity of wishing for what might have been were used, collectively, to reflect the parents' grief reactions. As hypothesized, the results indicate no significant age-related differences in the responses of 58 parent dyads but significant gender-related differences. Mothers scored higher than fathers on all measures. However, on the Wishing Scale, there were no significant differences between fathers and mothers. It is concluded that grieving, as defined, is an ongoing feature of rearing a child with intellectual disability and is more intense for mothers than fathers. Results are discussed within the implications for research and practice, with particular reference to the merit of programmes and services which empower parents and strengthen bonds of partnership between parents and professionals.

Adolescent↗
PubMed2021

Automated Extraction of Tumor Staging and Diagnosis Information From Surgical Pathology Reports.

PURPOSE: Typically stored as unstructured notes, surgical pathology reports contain data elements valuable to cancer research that require labor-intensive manual extraction. Although studies have described natural language processing (NLP) of surgical pathology reports to automate information extraction, efforts have focused on specific cancer subtypes rather than across multiple oncologic domains. To address this gap, we developed and evaluated an NLP method to extract tumor staging and diagnosis information across multiple cancer subtypes. METHODS: The NLP pipeline was implemented on an open-source framework called Leo. We used a total of 555,681 surgical pathology reports of 329,076 patients to develop the pipeline and evaluated our approach on subsets of reports from patients with breast, prostate, colorectal, and randomly selected cancer subtypes. RESULTS: Averaged across all four cancer subtypes, the NLP pipeline achieved an accuracy of 1.00 for International Classification of Diseases, Tenth Revision codes, 0.89 for T staging, 0.90 for N staging, and 0.97 for M staging. It achieved an F1 score of 1.00 for International Classification of Diseases, Tenth Revision codes, 0.88 for T staging, 0.90 for N staging, and 0.24 for M staging. CONCLUSION: The NLP pipeline was developed to extract tumor staging and diagnosis information across multiple cancer subtypes to support the research enterprise in our institution. Although it was not possible to demonstrate generalizability of our NLP pipeline to other institutions, other institutions may find value in adopting a similar NLP approach-and reusing code available at GitHub-to support the oncology research enterprise with elements extracted from surgical pathology reports.

Humans↗
PubMed2026

The Fragile Site Landscape of Induced Pluripotent Stem Cells: Hierarchy, Variability, Tissue Specificity, and Links to Culture-Acquired Rearrangements.

Induced pluripotent stem cells (iPSCs) are prone to genomic instability during prolonged culture, with recurrent chromosomal aberrations conferring selective advantages. Replication stress is a major driver of this instability, yet the repertoire of replication stress-sensitive loci in iPSCs remains largely unexplored. Here, we mapped aphidicolin-sensitive fragile sites (asFS) in three independent iPSC lines using classical cytogenetic break analysis combined with Monte Carlo simulation and MiDAS mapping directly on banded metaphase chromosomes. We identified 28 asFS, which segregated into a highly active Major cluster (8 sites, accounting for 59% of breaks among asFS) and a less active Minor cluster (20 sites). Five universal asFS (9p21, 6q25-26, 20p11-12, 10q22, Xq25) were present in all three lines, representing a fragility signature associated with the pluripotent state, with Xq25 shifting into the Major cluster after correction for X chromosome dosage. Minor asFS showed preferential co-localization with physical breakpoints or minimal overlapping regions of recurrent culture-acquired aberrations, including 20q11.21 (BCL2L1), 1q32 (MDM4), 8q24 (MYC), 17q21 (WNT3-WNT9B), and 18q21 (DCC/FRA18B). MiDAS mapping validated most asFS and revealed additional replication stress-sensitive loci in pericentromeric and subtelomeric regions that are difficult to score by conventional G-banding. Comparison with fragile site maps from other cell types revealed that the iPSC asFS repertoire is distinct in rank order and relative activity, characteristic of the pluripotent state. Collectively, our findings indicate that the asFS repertoire in iPSCs is hierarchically organized into a stable universal core and a variable peripheral component, and suggest that Minor asFS may contribute to, or be associated with, the genesis of culture-acquired rearrangements. This work provides a framework for understanding how replication stress and clonal selection shape the mutational landscape of pluripotent stem cells.

Induced Pluripotent Stem Cells↗
PubMed1994

[Psychosexual reactions in women after treatment of breast carcinoma].

Within the framework of a more extensive investigation of a group of women after treatment of a malignant breast tumour the authors paid also attention to their psychoesexual reactions. 119 probands were divided with regard to the type of their answers into three sub-groups: A - sthenic reaction (n = 35, i.e. 29.4% of the group), B - asthenic reaction (n = 55, 46.2%) and C - escape reply (n = 29, 24.4% of the group). The above sub-groups were compared, using the final score of four questionnaires (Heterosexual development of woman, Sexual activity of woman, Sexual function of woman and N5 questionnaire of neuroticism). The sub-group of women with the asthenic type of reaction was, as compared with the other two sub-groups, much more neurotic which in the authors' opinion indicates the need of professional psychotherapeutic care along with basic oncological treatment. As expected, in the examined group as a whole poor values were recorded in the questionnaires on sexual activity and sexual function. The values recorded in the three sub-groups with different psychosexual reaction, however, did not differ significantly.

Adaptation, Psychological↗
PubMedDate not supplied

Developing a sociological framework for dually diagnosed women.

This exploratory study was conducted with the purpose of enumerating both particular social stressors (e.g., the presence of trauma) and the incidence of a comorbid diagnosis (i.e., personality disorder[s] and substance abuse) on a sample of women in a residential therapeutic community. The women in the study were assessed within the first 3 weeks following admission into drug treatment, and then again 6 months after leaving the program. The initial assessment generally took 2 hours and consisted of the Structured Clinical Inventory for DSM-III-R-Patient edition (SCID-II), Addiction Severity Index (ASI), and the Millon Clinical Multiaxial Inventory-II (MCMI-II). Clinically significant scores on the MCMI-II antisocial and borderline personality scales were noted in this study. This study found women with histories of delinquent and/or criminal behavior before drug use were more likely to have used more types of drugs and have used multiple drugs together. These women also tended to have had a history of being abused, either emotionally, physically, or sexually. This group was also less successful on all outcome measures during 6-month follow-up. Moreover, the lifetime incidence of emotional, physical, and sexual abuse reported for this group at the baseline assessment was high--57.1% emotional abuse, 48.9% physical abuse, and 39.7% sexual abuse. These results are consistent with the research literature that indicates abuse plays a central role in the development and chronic effect of personality disorders and, in particular, posttraumatic stress disorder.

Adolescent↗
PubMed2003

Effects of stress management on PNI-based outcomes in persons with HIV disease.

A pretest-posttest, repeated-measures design was used to evaluate the effects of two stress management interventions on a battery of outcomes derived from a psychoneuroimmunological (PNI) framework. The effects of cognitive-behavioral relaxation training groups (CBSM) and social support groups (SSG) were compared with a WAIT-listed control group on the outcomes of psychosocial functioning, quality of life, neuroendocrine mediation, and somatic health. Participants were 148 individuals (119 men, 29 women), diagnosed with HIV disease; 112 (76%) completing the study groups. Using analysis of covariance, the CBSM group was found to have significantly higher postintervention emotional well-being and total quality-of-life scores than did either the SSG or WAIT groups. SSG participants had significantly lower social/family well-being scores immediately postintervention and lower social support scores after 6 months. The findings point to a pressing need for further, well-controlled research with these common intervention modalities.

Adaptation, Psychological↗
PubMed2005

Using social judgement theory to model nurses' use of clinical information in critical care education.

Understanding the learning needs of students is a vital step in planning the delivery of effective education. Evaluating the impact of such interventions is not always easy and many methods rely on self-reported behaviour or simple changes in knowledge--whose relationship to action is not always clear. Using conjoint analysis, within the theoretical framework of social judgement theory, this study illustrates a novel means of examining nurses' use of clinical information when diagnosing hypovolemic shock in a series of simulated cases presented via computer. The study examines changes in information usage before and after a traditional lecture. The results show that nurses' information use is not linear and the utility for decision judgement derived from clinical information is not distributed equally. The study also suggests that some clinical information (for example, the Glasgow Coma Score) is not well understood and incorporated into clinical judgement. The study has implications for those designing and evaluating educational interventions and those studying information use, clinical judgement and decision making.

Adult↗
PubMed2002

The evaluation of the introduction of a quality management system: a process-oriented case study in a large rehabilitation hospital.

OBJECTIVES: So far, there is limited proof concerning the effects of the introduction of quality management systems (QMS) on organisational level. This study concerns the introduction of a QMS in a large rehabilitation hospital. METHODS: Using an observational framework, a process-analysis is performed. The effects were analysed with repeated analyses using the Dutch version of the EFQM-model. RESULTS: The introduction of a QMS can be seen as a change process; the pre-change diagnosis proved to be essential. Although many change-related aspects are vital, training and communication, in particular, seemed to be underestimated. Outcomes are a positive correlation between participation in quality activities and work satisfaction and a repeatedly favourable EFQM-score (compared to national levels). CONCLUSIONS: Through a process-analysis, information could be generated to guide organisations in introducing a QMS. An outcome analysis revealed positive effects both in the EFQM-score and the staff's work satisfaction.

Communication↗
PubMed1996

Is the cognitive function of older patients affected by antihypertensive treatment? Results from 54 months of the Medical Research Council's trial of hypertension in older adults.

OBJECTIVE: To establish whether initiation of treatment with diuretic or beta blocker is associated over 54 months with change in cognitive function. DESIGN: A cognitive substudy, nested within a randomised, placebo controlled, single blind trial. SETTING: 226 general practices from the Medical Research Council's general practice research framework. SUBJECTS: A subset of 2584 subjects sequentially recruited from among the 4396 participants aged 65-74 in the trial of treatment of hypertension in older adults. The 4396 subjects were randomised to receive diuretic, beta blocker, or placebo. Subjects had mean systolic pressures of 160-209 mm Hg and mean diastolic pressures <115 mm Hg during an eight week run in. OUTCOME MEASURES: The rate of change in paired associate learning test (PALT) and trail making test part A (TMT) scores (administered at entry and at 1, 9, 21, and 54 months) over time. RESULTS: There was no difference in the mean learning test coefficients (rate of change of score over time) between the three treatments: diuretic -0.31 (95% confidence interval -0.23 to -0.39), beta blocker -0.33 (-0.25 to -0.41), placebo -0.30, (-0.24 to -0.36). There was also no difference in the mean trail making coefficients (rate of change in time taken to complete over time) between the three groups: diuretic -2.73 (95% confidence interval -3.57 to -1.88), beta blocker -2.08 (-3.29 to -0.87), placebo -3.01, (-3.69 to -2.32). A less conservative protocol analysis confirmed this negative finding. CONCLUSION: Treating moderate hypertension in older people is unlikely to influence, for better or for worse, subsequent cognitive function.

Adrenergic beta-Antagonists↗
PubMed2005

Location and intensity discrimination in the leech local bend response quantified using optic flow and principal components analysis.

In response to touches to their skin, medicinal leeches shorten their body on the side of the touch. We elicited local bends by delivering precisely controlled pressure stimuli at different locations, intensities, and durations to body-wall preparations. We video-taped the individual responses, quantifying the body-wall displacements over time using a motion-tracking algorithm based on making optic flow estimates between video frames. Using principal components analysis (PCA), we found that one to three principal components fit the behavioral data much better than did previous (cosine) measures. The amplitudes of the principal components (i.e., the principal component scores) nicely discriminated the responses to stimuli both at different locations and of different intensities. Leeches discriminated (i.e., produced distinguishable responses) between touch locations that are approximately a millimeter apart. Their ability to discriminate stimulus intensity depended on stimulus magnitude: discrimination was very acute for weak stimuli and less sensitive for stronger stimuli. In addition, increasing the stimulus duration improved the leech's ability to discriminate between stimulus intensities. Overall, the use of optic flow fields and PCA provide a powerful framework for characterizing the discrimination abilities of the leech local bend response.

Animals↗
PubMed1990

The relationship between human field motion and preferred visible wavelengths.

The purpose of this study was to investigate the relationship between human field motion and preferred visible wavelengths. The study was based on the principle of resonancy from Rogers' science of unitary human beings; 201 subjects were tested using a modified version of Ference's human field motion test (HFMT). Two matrices of color were projected to provide an environment for the measurement of preferred visible wavelengths. There was no statistically significant relationship (r = 0.0387, p = 0.293) between scores on the human field motion test and preferred visible wavelengths as measured in nanometers. The Rogerian concept of accelerated human field rhythms being coordinate with higher frequency environment patterns was not supported in this study. Questions concerning the validity of the HFMT were expressed and were based upon the ambiguity of the terminology of the instrument and the lack of understanding of the concepts used to describe human field motion. Recommendations include the use of other methods to study Rogers' framework, and the development of other instrumentation to measure human field motion.

Adolescent↗