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Naming oneself criminal: gender difference in offenders' identity negotiation.

This qualitative research examines gender differences in offenders'ability to negotiate a positive identity once the pejorative labels of criminal, prostitute, drug dealer, and incompetent parents have been imputed onto them. In-depth semi-structured focused interviews were conducted with a purposeful information-rich sample of eight male and eight female offenders. Content analysis reveals that males were much more adept than female offenders at juggling with conventional and street norms to justify and/or resist stigmatizing labels in order to construct a favorable identity. Appeal to such personal strengths as know-how, competence, loyalty, and a code of honor allowed male offenders to challenge the boundaries between conventional and delinquent worlds. Concomitantly such an appeal gave rise to a sense of efficacy perception and an optimistic explanatory style. In contrast, even though female offenders were able to justify the labels of drug dealer, prostitute, and thief by appeal to higher loyalties and reject that of insane, all their justifications collapsed when having to negotiate the identity of incompetent mother. Female offenders' negative internal attributions and deprivation of the normative center-motherhood resulted in apathy, anomie, and lack of confidence in their ability to do something worthwhile. Rehabilitation guidelines would build female offenders' personal strengths while redirecting those exhibited by male offenders into lawful enterprises.

Adult↗

Analyzing communication in medical consultations. Do behavioral measures correspond to patients' perceptions?

When analyzing relationships between physician-patient communication and medical outcomes, researchers typically rely on quantitative measures of behavior (e.g., frequencies or ratios) derived from observer-coding of transcripts, audiotapes, or videotapes. Interestingly, rarely have researchers assessed whether quantitative measures of communication (e.g., the physician's information giving) correspond to patients' perceptions of physicians' communication (e.g., informative). This investigation of 115 pediatric consultations examined this issue and yielded several notable findings. First, less satisfied parents received more directives and proportionally less patient-centered utterances from physicians than did more satisfied parents. Second, findings were mixed regarding the degree to which behavioral measures related to analogue measures of parents' perceptions. For example, the doctors' use of patient-centered statements was predictive of parents' perceptions of physicians' interpersonal sensitivity and partnership building, but the amount of information physicians provided parents was unrelated to judgments of the doctors' informativeness. Third, with some important exceptions, relationships between behavioral measures and parents' evaluations did not vary for parents differing in education and anxiety about the child's health. Finally, behavioral measures in the form of frequencies tended to be better predictors of parents' perceptions than were measures in the form of proportions. Implications are discussed.

Anxiety↗

Japanese single nucleotide polymorphism database for 267 possible drug-related genes.

To establish 'personalized medicines' that can provide the right drug at the appropriate dose for each individual patient on the basis of genetic background, we have been building the infrastructure for a Japanese single nucleotide polymorphism (SNP) database of the genes encoding various enzymes, transporters and receptors that are involved in the metabolism, transportation and action of drugs. We have so far screened a genomic region of 4,068.3 kb, and identified a total of 7,552 genetic variations, including 6,733 SNP and 819 genetic variations of other types among 267 genes in Japanese populations. Interestingly, among the 212 non-synonymous substitutions we found, six would be considered to be nonsense mutations. In this review, we focused on the molecular features of the non-synonymous substitutions and insertion/deletion polymorphisms within coding regions detected in drug-related gene loci. The database established in this study makes us confident of achieving one of our goals, which is establishment of personalized medicine.

Asian People↗

Comparison of RTP dose distributions in heterogeneous phantoms with the BEAM Monte Carlo simulation system.

Therapeutic treatment plan evaluation is often based on examining the radiotherapy treatment planning (RTP) system dose distributions in the target and surrounding normal structures. To study the effects of tissue inhomogeneities on photon dose distributions, we compared FOCUS RTP system dose distributions from the measurement-based Clarkson and model-based MultiGrid Superposition (MGS) algorithms with those from the BEAM Monte Carlo code system in a set of heterogeneous phantoms. The phantom inhomogeneities mimic relevant clinical treatment sites, which include lung slab, lung-bone slab, bone-lung slab, mediastinum, and tumor geometries. The benchmark comparisons were performed in lung densities of 0.20 and 0.31 g/cm3, and a bone density of 2.40 g/cm3 for 5x5 cm2 and 10x10 cm2, 6- and 15-MV photon beams. Benchmark comparison results show that the MGS model and BEAM doses match better than 3% or 3 mm, and the MGS model is more accurate than the Clarkson model in all phantoms. The MGS model, unlike the Clarkson model, predicts the build-down and build-up of dose near tissue interfaces and penumbra broadening in lung associated with high energy beams. The Clarkson model overestimates the dose in lung by a maximum of 10% compared to BEAM. Dose comparisons suggest turning-off the effective path length inhomogeneity correction in the Clarkson model for lung treatments.

Algorithms↗

An information system for epidemiology based on a computer-based medical record.

A new way is presented to build an information system addressed to problems in epidemiology. Based on our analysis of current and future requirements, a system is proposed which allows for collection, organization and distribution of data within a computer network. In this application, two broad communities of users-physicians and epidemiologists-can be identified, each with their own perspectives and goals. The different requirements of each community lead us to a client-service centered architecture which provides the functionality requirements of the two groups. The resulting physician workstation provides help for recording and querying medical information about patients and from a pharmacological database. All information is classified and coded in order to be retrieved for pharmaco-economic studies. The service center receives information from physician workstations and permits organizations that are in charge of statistical studies to work with "real" data recorded during patient encounters. This leads to a new approach in epidemiology. Studies can be carried out with a more efficient data acquisition. For modelling the information system, we use an object-oriented approach. We have observed that the object-oriented representation, particularly its concepts of generalization, aggregation and encapsulation, are very usable for our problem.

Computer Communication Networks↗

Information technology in diabetes care 'Diabeta': 23 years of development and use of a computer-based record for diabetes care.

In this article we have stressed that a diabetes care information system should be useful to, usable and actually used by carers at the point of patient contact. Information resulting from such encounters should, at no extra cost, furnish the needs of communication, audit, research and management. Diabeta is a clinical record system for supporting the management of patients with diabetes. It has grown 'organically' within an academic clinical unit over a period of 23 years. It is used for each and every encounter with the clinicians in our diabetes team and as such, contains an immense amount of objective clinical experience. This experience can be interrogated very easily by computer-naive clinicians using a remarkable interactive program ('Datascan') which contains statistical procedures 'embedded' in the APL computer code, eliminating the need to 'export' the data into a statistical package. The latest PC-based version is incredibly fast and this immense amount of clinical experience can be carried around on a notebook PC and be available for exploration at any time. This makes 'evidence-based medicine' available in a remarkably flexible way since it shares the accumulated objective experience of literally 'dozens' of clinicians over a period which now extends to 23 years. It adds a completely new dimension to the term 'clinical experience' and is unattainable with manual records. It would be naive to assume that such systems are easy to design, build or implement, or that the initial capital outlay required will be small although costs are falling continuously. Medicine is a highly complex activity, the essential basis of which is human interaction. Introduction of a technology into this interaction requires sensitivity to the wishes and requirements of individuals, and protection of their exchanges from third parties. The potential of computers in diabetes care is so great that these issues must be addressed through continuing research, development, evaluation and funding of new systems. This must be led by the medical profession not the computer industry.

Ambulatory Care↗

Single granule cells reliably discharge targets in the hippocampal CA3 network in vivo.

Processing of neuronal information depends on interactions between the anatomical connectivity and cellular properties of single cells. We examined how these computational building blocks work together in the intact rat hippocampus. Single spikes in dentate granule cells, controlled intracellularly, generally failed to discharge either interneurons or CA3 pyramidal cells. In contrast, trains of spikes effectively discharged both CA3 cell types. Increasing the discharge rate of the granule cell increased the discharge probability of its target neuron and decreased the delay between the onset of a granule cell train and evoked firing in postsynaptic targets. Thus, we conclude that the granule cell to CA3 synapses are 'conditional detonators,' dependent on granule cell firing pattern. In addition, we suggest that information in single granule cells is converted into a temporal delay code in target CA3 pyramidal cells and interneurons. These data demonstrate how a neural circuit of the CNS may process information.

Action Potentials↗

Ambulatory care databases for managed care organizations.

The uses, advantages, and limitations of ambulatory care databases are discussed, and processes for extracting and using the data are described. Claims databases allow health systems, including managed care organizations, to generate descriptive statistics on patients, providers, and diseases; to conduct comprehensive cost and resource-use analyses; and to build economic models of diseases. The use of health care databases has several advantages over clinical trials, including lower data collection costs, shorter times for analysis, larger numbers of patients, and less inconvenience to patients and providers. These databases allow the effectiveness of a treatment, instead of its efficacy, to be assessed and drug-switching patterns within disease categories to be detected. This information can be used for determining the cost and outcome implications of new treatments and formulary changes, as well as for monitoring disease management programs. Limitations of health care databases include the omission of services not covered by health plans, the risk of coding errors, the absence of indicators of disease severity, and the lack of data that would assist with clinical outcome analysis. Medical and pharmacy claims data do not contain all the information contained in patients' medical records. Despite their limitations, ambulatory care databases are useful for describing patient, provider, and disease characteristics. The databases are also useful for predicting and estimating the implications of a change in the formulary, measuring the effects of treatment guidelines, and monitoring disease management programs.

Ambulatory Care Information Systems↗

Knowledge discovery and data mining to assist natural language understanding.

As natural language processing systems become more frequent in clinical use, methods for interpreting the output of these programs become increasingly important. These methods require the effort of a domain expert, who must build specific queries and rules for interpreting the processor output. Knowledge discovery and data mining tools can be used instead of a domain expert to automatically generate these queries and rules. C5.0, a decision tree generator, was used to create a rule base for a natural language understanding system. A general-purpose natural language processor using this rule base was tested on a set of 200 chest radiograph reports. When a small set of reports, classified by physicians, was used as the training set, the generated rule base performed as well as lay persons, but worse than physicians. When a larger set of reports, using ICD9 coding to classify the set, was used for training the system, the rule base performed worse than the physicians and lay persons. It appears that a larger, more accurate training set is needed to increase performance of the method.

Artificial Intelligence↗

The crystal structure of Aq_328 from the hyperthermophilic bacteria Aquifex aeolicus shows an ancestral histone fold.

The structure of Aq_328, an uncharacterized protein from hyperthermophilic bacteria Aquifex aeolicus, has been determined to 1.9 A by using multi-wavelength anomalous diffraction (MAD) phasing. Although the amino acid sequence analysis shows that Aq_328 has no significant similarity to proteins with a known structure and function, the structure comparison by using the Dali server reveals that it: (1) assumes a histone-like fold, and (2) is similar to an ancestral nuclear histone protein (PDB code 1F1E) with z-score 8.1 and RMSD 3.6 A over 124 residues. A sedimentation equilibrium experiment indicates that Aq_328 is a monomer in solution, with an average sedimentation coefficient of 2.4 and an apparent molecular weight of about 20 kDa. The overall architecture of Aq_328 consists of two noncanonical histone domains in tandem repeat within a single chain, and is similar to eukaryotic heterodimer (H2A/H2B and H3/H4) and an archaeal histone heterodimer (HMfA/HMfB). The sequence comparisons between the two histone domains of Aq_328 and six eukaryotic/archaeal histones demonstrate that most of the conserved residues that underlie the Aq_328 architecture are used to build and stabilize the two cross-shaped antiparallel histone domains. The high percentage of salt bridges in the structure could be a factor in the protein's thermostability. The structural similarities to other histone-like proteins, molecular properties, and potential function of Aq_328 are discussed in this paper.

Bacteria↗

Synthesis and properties of bile acid phosphoramidites 5'-tethered to antisense oligodeoxynucleotides against HCV.

Recently, we synthesized antisense oligonucleotides (AS-ODNs) directed against the non-coding-region (NCR) and the adjacent core region of the hepatitis C virus (HCV) RNA. Backbone modifications like phosphorothioates, methyl- and benzylphosphonates were introduced three at each end of the sequence. For improvement of liver specific drug targeting and/or hepatocellular uptake efficient AS-ODNs were covalently conjugated to biomolecules such as cholesterol or bile acids. The use of base-labile alkylphosphonates afforded mild conditions for deprotection of bile acid conjugated AS-ODNs. Here, we describe a convenient synthesis of new cholic acid and taurocholic acid phosphoramidites. Derivatization to taurocholic acid was effected directly before phosphitylation reaction, which is the last step of the phosphoramidite synthesis. These building blocks were coupled to the 5'-position of AS-ODNs in the last step of solid-phase synthesis. After mild deprotection, purification and characterization the properties of these modified AS-ODNs like their lipophilicity or their ability to form stable duplices to DNA and RNA were investigated. Enhanced lipophilicity and formation of stable duplices and heteroduplices makes bile acid conjugated AS-ODNs interesting as antiviral antisense therapeutics against HCV.

Bile Acids and Salts↗

Spatial mutual nearest neighbors for spatial transcriptomics data.

MOTIVATION: Mutual nearest neighbors (MNN) is a widely used computational tool to perform batch correction for single-cell RNA-sequencing data. However, in applications such as spatial transcriptomics, it fails to take into account the 2D spatial information. RESULTS: Here, we present spatialMNN, an algorithm that integrates multiple spatial transcriptomic samples and identifies spatial domains. Our approach begins by building a k-nearest neighbors (kNN) graph based on the spatial coordinates, prunes noisy edges, and identifies niches to act as anchor points for each sample. Next, we construct a MNN graph across the samples to identify similar niches. Finally, the spatialMNN graph can be partitioned using existing algorithms, such as the Louvain algorithm to predict spatial domains across the tissue samples. We demonstrate the performance of spatialMNN using large datasets, including one with N = 31 10x Genomics Visium samples. We also evaluate the computing performance of spatialMNN to other popular spatial clustering methods. AVAILABILITY AND IMPLEMENTATION: Our software package is available on GitHub (https://github.com/Pixel-Dream/spatialMNN). The code is available on Zenodo (https://doi.org/10.5281/zenodo.15073963).

Algorithms↗

Biomimetic evolutionary analysis: testing the adaptive value of vertebrate tail stiffness in autonomous swimming robots.

For early vertebrates, a long-standing hypothesis is that vertebrae evolved as a locomotor adaptation, stiffening the body axis and enhancing swimming performance. While supported by biomechanical data, this hypothesis has not been tested using an evolutionary approach. We did so by extending biomimetic evolutionary analysis (BEA), which builds physical simulations of extinct systems, to include use of autonomous robots as proxies of early vertebrates competing in a forage navigation task. Modeled after free-swimming larvae of sea squirts (Chordata, Urochordata), three robotic tadpoles (;Tadros'), each with a propulsive tail bearing a biomimetic notochord of variable spring stiffness, k (N m(-1)), searched for, oriented to, and orbited in two dimensions around a light source. Within each of ten generations, we selected for increased swimming speed, U (m s(-1)) and decreased time to the light source, t (s), average distance from the source, R (m) and wobble maneuvering, W (rad s(-2)). In software simulation, we coded two quantitative trait loci (QTL) that determine k: bending modulus, E (Nm(-2)) and length, L (m). Both QTL were mutated during replication, independently assorted during meiosis and, as haploid gametes, entered into the gene pool in proportion to parental fitness. After random mating created three new diploid genotypes, we fabricated three new offspring tails. In the presence of both selection and chance events (mutation, genetic drift), the phenotypic means of this small population evolved. The classic hypothesis was supported in that k was positively correlated (r(2)=0.40) with navigational prowess, NP, the dimensionless ratio of U to the product of R, t and W. However, the plausible adaptive scenario, even in this simplified system, is more complex, since the remaining variance in NP was correlated with the residuals of R and U taken with respect to k, suggesting that changes in k alone are insufficient to explain the evolution of NP.

Animals↗

Introducing BF++: AC++ framework for cognitive bio-feedback systems design.

OBJECTIVE: This paper addressed the issue of building-up a framework for the realization of several cognitive bio-feedback (CBF) systems. It minimizes the programming effort and maximizes the efficiency and the cross-platform portability so that it can be used with many platforms (either software or hardware). METHODS: A generic CBF system was decomposed into six modules: acquisition, kernel, feedback rule, patient feedback, operator user interface and persistent storage. The way in which these modules interact was defined by immutable software interfaces in a way that allows to completely substitute a module without the need to modify the others. RESULTS: Three Brain Computer Interface engines were developed with less than 40 lines of C++ code each. They can also be used under virtually any platform that supports an ANSI C++ compiler. CONCLUSION: A framework for the implementation of a wide range of CBF systems was developed. Compared to the other approaches that are described in the literature, the proposed one is the most efficient, the most protable across different platforms, the most generic and the one that allows the realization of the cheapest final systems.

Cognition↗

Brain attack: the multifaceted potential for action.

BACKGROUND: Stroke is the number 3 killer in Singapore and a common contributor to morbidity statistics. This study was done to look at the profile of patients with acute stroke presenting to the Emergency Department, Singapore General Hospital, from 1 October to 31 November 1996. The data will help plan and guide future early interventional trials as well as look into possible areas of improvement in the multidisciplinary approach to stroke. METHOD: This is a retrospective study and patients records were traced using ICD-9 codes. A total of 309 patients were identified for the period of review; of this, the records of 240 patients were obtained (77.7%). RESULTS: The results revealed that local stroke patients are young (two-thirds are < 70 years) and live in high-rise accommodation (84.2%) with their families. The predominant risk factor was hypertension (80%) and weakness was the most common presentation (25%). Stroke patients are presenting at a later stage (only 16.7% presented within 6 hours of onset) and the average length of hospital stay was between 10 and 12 days. CONCLUSION: This study identified the multiple measures at various stages of the stroke chain, required to build up a concerted effort against Brain Attack.

Acute Disease↗

Is the communicative behavior of GPs during the consultation related to the diagnosis? A cross-sectional study in six European countries.

This study explores the relation between the diagnosis made by the general practitioner (GP) and his or her communicative behavior within a consultation, by means of the analysis of 2095 videotaped consultations of 168 GPs from six countries participating in the Eurocommunication study. The doctors' diagnoses were coded into ICPC chapters and merged into seven clinically relevant diagnostic clusters. The communicative behavior was gauged by means of the Roter interaction analysis system (RIAS). We found the most important differences for consultations about psychosocial problems as compared to all other diagnostic categories. In these consultations, doctors show more affective behavior, are more concerned about having a good relationship with their patients, ask more questions and give less information than in other consultations. The percentages of utterances in the other diagnostic categories were pretty similar. The communicative behavior of doctors reflects a global pattern in every consultation. This pattern is the most stable for affective behavior (social talk, agreement, rapport building and facilitation). Within instrumental behavior (the other categories), the directions and the information the doctor gives are adapted to the problems presented.

Adult↗

Factors influencing the retention and attrition of community health aides/practitioners in Alaska.

CONTEXT: The Community Health Aide Program (CHAP) is a unique program employing local, indigenous peoples as primary care nonphysician providers in extremely remote frontier, tribal Alaskan communities. With attrition rates up to 20%, recommendations for improving retention are necessary to maintain access to health services for Alaska Natives in these communities. PURPOSE: The purpose of this study was to identify factors contributing to retention in Alaska's CHAP program. METHODS: Key informant interviews were conducted with 41 community health aides/practitioners (CHA/Ps) in 15 villages statewide. Efforts were made to ensure the sample included a mix of villages with high retention of health aides and villages with lower retention. Geographic and ethnic diversity were also considered. Transcripts were coded using NUD*IST software, and data were analyzed for differences between high retention and low retention villages and between more experienced and less experienced CHA/Ps. FINDINGS: Five fundamental needs of health aides were identified as crucial for retention of personnel. These needs include strong co-worker support, access to basic training, a fully staffed clinic, good community support, and supportive families. CONCLUSIONS: For 35 years, the CHAP program has worked to diminish health disparities for Alaska Natives. Though unique challenges associated with the job have factored into low retention of CHA/Ps, improved retention is possible with easier access to basic training, increased support from colleagues and community, enhanced team-building skills, and better on-call schedules.

Adult↗

[Tables of coronary risk evaluation adapted to the Spanish population: the DORICA study].

BACKGROUND AND OBJECTIVE: Independent risk factors (smoking, hypertension, hypercholesterolemia and diabetes mellitus) are direct causes of coronary heart disease and are common in the population. Considering all independent factors together seems to be more appropriate to estimate the global risk of coronary heart disease. The objective of this paper was to estimate the global risk of coronary heart disease based on the Framingham function, adapted to the prevalence of risk factors in Spain. SUBJECTS AND METHOD: The prevalence of risk factors in the Spanish population was estimated based on pooled analysis of regional cross-sectional random population surveys. Prevalence estimates and incidence rate of coronary events were replaced in the Framingham equation accordingly. Risk probability for 10 years was estimated and risk tables were designed using a gradual color coding system according to an increasing risk. RESULTS: The estimated attributable fraction (AF) for hypertension in the Spanish population was 26.7% for men and 22.9% women; that for hypercholesterolemia was 15.7% and 12.7% for men and women, respectively. Smoking was identified in the third position of the ranking order for males (AF 13.13%) and fourth for the female group (AF 3.71%). The prevalence of obesity was 13.2% for men and 17.5% for women. AF for obesity among men was 4% and it was 5% for women. CONCLUSIONS: An adaptation of the Framingham equation according to the prevalence of independent risk factors and incidence of coronary events in the Spanish population is useful to build instruments to estimate the 10-year global risk of coronary heart disease while a specific function based on a well-designed cohort study in not available in Spain.

Adult↗