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Using UMLS metathesaurus concepts to describe medical images: dermatology vocabulary.

Web servers at the National Library of Medicine (NLM) displayed images of ten skin lesions to practicing dermatologists and provided an online form for capturing text they used to describe the pictures. The terms were submitted to the UMLS Metathesaurus (Meta). Concepts retrieved, their semantic types, definitions and synonyms, were returned to each subject in a second web-based form. Subjects rated the concepts against their own descriptive terms. They submitted 825 terms, 346 of which were unique and 300 mapped to UMLS concepts. The dermatologists rated 295 concepts as 'Exact Match' and they accomplished both tasks in about 30 min.

Abstracting and Indexing↗

Ecological classification and assessment concepts in soil protection.

Evaluation of ecological soil quality requires the integration of physical, chemical, and biological variables. From a biological point of view, the maintenance of biodiversity and the assurance of life support functions are the main goals of protection to secure sustainable land use. To reach these goals, biological concepts for the classification and assessment of soils were developed in various countries, most of them based on similar concepts in limnology and aquatic ecotoxicology, which are already routinely applied. In this article, an overview of existing concepts, as well as a detailed description of the two most promising ones (BISQ from The Netherlands and BBSK from Germany), is given, followed by a discussion of the properties essential to an ideal biological concept for soil protection. Finally, recommendations for further research and a basic outline of a monitoring program ready for immediate use are provided.

Animals↗

Of circles and spirals: bridging the gap between the leading circle and spiral wave concepts of cardiac reentry.

The "leading circle model" was the first detailed attempt at understanding the mechanisms of functional reentry, and remains a widely-used notion in cardiac electrophysiology. The "spiral wave" concept was developed more recently as a result of modern theoretical analysis and is the basis for consideration of reentry mechanisms in present biophysical theory. The goal of this paper is to present these models in a way that is comprehensible to both the biophysical and electrophysiology communities, with the idea of helping clinical and experimental electrophysiologists to understand better the spiral wave concept and of helping biophysicists to understand why the leading circle concept is so attractive and widely used by electrophysiologists. To this end, the main properties of the leading circle and spiral wave models of reentry are presented. Their basic assumptions and determinants are discussed and the predictions of the two concepts with respect to pharmacological responses of arrhythmias are reviewed. A major difference between them lies in the predicted responses to Na(+)-channel blockade, for which the spiral wave paradigm appears more closely to correspond to the results of clinical and experimental observations. The basis of this difference is explored in the context of the fundamental properties of the models.

Action Potentials↗

Chromosome 21 mosaic human preimplantation embryos predominantly arise from diploid conceptions.

OBJECTIVE: High rates of chromosomal mosaicism in human IVF embryos question the accuracy of preimplantation genetic diagnosis, and, with the majority of embryo transfers still resulting in no pregnancy, chromosomal mosaicism is likely to be a contributing factor to human IVF failure. The aim of this study was to investigate the origin and nature of chromosome 21 (Ch21) cell division errors in human IVF embryos. DESIGN: Perform single cell Ch21 allelic profiling on human IVF embryos. SETTING: Academic research environment. PATIENT(S): Women of advanced maternal age (> 35 yrs) (n = 65) undergoing infertility treatment; and amniocytes/chorionic cells from trisomy 21 pregnancies (n = 28). INTERVENTION(S): Cells were analyzed by single cell allelic profiling, MAIN OUTCOME MEASURE(S): The origin and nature of cell division errors. RESULT(S): The vast majority of Ch21 mosaic embryos (approximately 80%) originated from diploid conceptions. In contrast, all fetal trisomy 21 originated from aneuploid conceptions. Increasing maternal age was significantly associated with aneuploid conceptions, meiotic cell division error, and adverse pregnancy outcome (P < .05). The mean daily FSH dose that produced embryos with normal Ch21 cell division was significantly lower than the mean daily FSH dose that produced embryos with mitotic Ch21 cell division errors (P < .01) and embryos with meiotic cell division errors (P < .05). CONCLUSION(S): Chromosomal mosaicism of Ch21 in human IVF embryos predominantly originate from diploid conceptions. Further understanding of chromosomal mosaicism with respect to IVF parameters, such as daily FSH dose, may eventually lead to improvements in IVF outcomes.

Adult↗

Information literacy-what it is about? Literature review of the concept and the context.

OBJECTIVES: The use of IT in health care has merged advanced knowledge and skills for health care professionals. Former studies indicate that basic skills in computer use are no more than comprehensive competencies to manage electronically stored information in health care. The purpose of this paper is to review the literature focusing on the concept information literacy in the field of health, nursing and medical informatics. The target is to find out how information literacy is defined, in what kind of context it is presented and who are the focus of interest. METHODS: An automated literature search was performed on-line to Medline and by using the EndNote Bibliographic Software. All together the number of papers analyzed was 97 or 78% of the total literature search result. RESULTS: The survey indicates that the concept information literacy does not exist as such in the literature, but it can be found as a synonym to 'computer literacy' or even more obscure concepts such as 'informatics awareness' or 'computer experience'. The definitions of these concepts varied considerably. A variety of descriptions of educational programs were also found, none were based on the IMIA recommendations. CONCLUSIONS: In international cooperation such as that of IMIA WG1, a wide range of efforts still needs to be carried out to compile educational programmes in health informatics to enhance knowledge and skills in computer use among health care professionals.

Computer Literacy↗

Estimation of radiation-induced cancer from three-dimensional dose distributions: Concept of organ equivalent dose.

PURPOSE: Estimates of secondary cancer risk after radiotherapy are becoming more important for comparative treatment planning. Modern treatment planning systems provide accurate three-dimensional dose distributions for each individual patient. These data open up new possibilities for more precise estimates of secondary cancer incidence rates in the irradiated organs. We report a new method to estimate organ-specific radiation-induced cancer incidence rates. The concept of an organ equivalent dose (OED) for radiation-induced cancer assumes that any two dose distributions in an organ are equivalent if they cause the same radiation-induced cancer incidence. METHODS AND MATERIALS: The two operational parameters of the OED concept are the organ-specific cancer incidence rate at low doses, which is taken from the data of the atomic bomb survivors, and cell sterilization at higher doses. The effect of cell sterilization in various organs was estimated by analyzing the secondary cancer incidence data of patients with Hodgkin's disease who were treated with radiotherapy in between 1962 and 1993. The radiotherapy plans used at the time the patients had been treated were reconstructed on a fully segmented whole body CT scan. The dose distributions were calculated in individual organs for which cancer incidence data were available. The model parameter that described cell sterilization was obtained by analyzing the dose and cancer incidence rates for the individual organs. RESULTS: We found organ-specific cell radiosensitivities that varied from 0.017 for the mouth and pharynx up to 1.592 for the bladder. Using the two model parameters (organ-specific cancer incidence rate and the parameter characterizing cell sterilization), the OED concept can be applied to any three-dimensional dose distribution to analyze cancer incidence. CONCLUSION: We believe that the concept of OED presented in this investigation represents a first step in assessing the potential risk of secondary cancer induction after the clinical application of radiotherapy.

Dose-Response Relationship, Radiation↗

What are theories for? Concept use throughout the continuum of dinosaur expertise.

Although it is now well established that object concepts are situated within broader systems of theoretical knowledge, it is less clear how theories influence the use of object concepts at various points throughout the continuum of expertise. Two studies were conducted to investigate the impact of specific theories (concerning dinosaurs) and overarching framework theories (of biology) on children's and adults' performance on categorization tasks involving familiar and less familiar concepts. Although expertise increased the quantity of deep feature knowledge possessed by children and increased their understanding of biologically adaptive relations among features, few aspects of children's performance generalized beyond highly familiar dinosaurs. Children's specific theories related to dinosaurs were empirically constrained and relatively dissociated from other types of biological knowledge. The interaction of specific concept knowledge with broader framework theories of biology throughout the continuum of expertise is considered.

Animals↗

Implementation of a course on wellness concepts into a chiropractic college curriculum.

OBJECTIVE: The purpose of this study is to implement and evaluate a course on "wellness concepts" for chiropractic students, emphasizing national goals and evidence-based practices for health promotion and prevention. METHODS: Teaching methods included traditional lecture discussions and experiential activities, including objectives described in Healthy People 2010. Evaluation included pre- and posttests of students' familiarity with and intention to use key concepts, resources, and practices; item analysis of multiple choice exams; and a qualitative survey. RESULTS: Increases in students' self-reported familiarity were statistically significant for all but 2 of the 23 key topics assessed. At baseline, students already expressed intention to use most wellness-related practices listed, and showed significant increases for approximately half the practices listed at the posttest. Item analysis found students less able to correctly answer questions requiring analytic thinking than simple memorization. Students were most satisfied with the experiential portions of the course. CONCLUSION: Although the course was successful at introducing students to national resources and initiatives related to wellness, health promotion, and prevention, these concepts may be more meaningful if integrated into a teaching clinic that encouraged practical application of course concepts.

Attitude to Health↗

Are intramural suction-squeezing effects generated by the variations in radial wall stress during each heart beat the motor of atherosclerosis? A new concept.

In the early sixties, the existence of predilection sites for atherosclerotic lesions inside the arterial circulation led to the concept that low wall shear stress (WSS) was responsible, together with systemic factors like high blood pressure, hypercholesterolemia, or diabetes, for the genesis and progression of atherosclerosis. It was found later that oscillating WSS and high WSS gradients could also be incriminated. Yet, this concept, which is broadly accepted today, fails to explains several facts, for instance that some arteries (e.g. epicardial coronary arteries) are more prone to become atherosclerotic than other ones exposed to the same systemic factors (e.g. hepatic and brain arteries). In this paper, we present a quite different concept. It is based on the fact that the increase in intravascular pressure and flow that occur in the arteries during systole generates, at the predilection sites of atherosclerotic lesions (bends, bifurcations, and branchings), an increase of radial wall stress in the outer layers of the arterial wall so that this stress becomes momentarily tensile. These cyclic stress increases have a suction effect that is likely to facilitate the diffusion of atherogenic cells and substances inside the wall. Furthermore, since arteries are not primarily structured to resist inversions of radial stress, they may also create damages (e.g. disruptions of cell membranes and elastic lamellae) followed by inflammations and micro-haemorrhages in the wall. This new concept may provide a complementary (or possibly alternative) explanation of atherosclerosis.

Animals↗

Adolescent resilience: an evolutionary concept analysis.

Resilience is a concept that has enormous utility in nursing, although there is a need for concept clarity as it relates to adolescence. The purpose of this article is to describe the concept and apply the Evolutionary Model of Concept Analysis to resilience in adolescents. A literature search and an analysis of 22 articles specific to the adolescent population were completed. The literature review revealed adolescent resilience to be a composite of attributes that include the characteristics of the adolescent, sources of social support, and available resources. Implications for nursing and a proposed model of adolescent resilience are presented.

Adaptation, Psychological↗

Stress and welfare: two complementary concepts that are intrinsically related to the animal's point of view.

The closely associated concepts of welfare and stress may be considered as opposites since welfare cannot be achieved under stress and vice versa. Stress was first considered as an unspecific response to any challenge taxing the organism's resources where the HPA axis plays a central role [Selye H. A syndrome produced by diverse nocuous agents. Nature 1936:32]. Along the same lines, welfare was considered as the state of an individual on a continuum between poor and good depending on the efforts required to adapt to the environment [Broom DM. Animal welfare: concepts and measurement. J Anim Sci 1991;69:4167-75]. However, these views cannot explain opposite results such as up- vs. down-regulation of the HPA axis and hypo- vs. hyper-behavioural reactivity under chronic stress. Later, it was shown that aversive situations trigger stress responses only if the individual perceives them as aversive. Mason [Mason JW. A re-evaluation of the concept of 'non-specificity' in stress theory. J Psychiatr Res 1971;8:323-33] suggested that the unspecificity of stress responses originates from a common emotion that produces them. Welfare has also been defined in terms of emotional states by Dawkins [Dawkins MS. Animal suffering, the science of animal welfare. London: Chapman and Hall Ltd.; 1980] and Duncan [Duncan IJH. Welfare is to do with what animals feel. J Agric Environ Ethics 1993;6:8-14]. Hence, both concepts are linked to mental states. Recent advances in psychology suggest that the very nature of an emotion results from a series of evaluations of the triggering situation that the individual makes based on criteria including novelty, predictability, controllability, and others [Scherer KR. Appraisal considered as a process of multi-level sequential checking. In: Scherer KR, Schorr A, Johnstone T, editors. Appraisal processes in emotion: theory, methods, research. New York: Oxford University Press; 2001. p. 92-120]. It is therefore suggested that the discrepancies found in the literature in terms of responses of the HPA axis or modification of behaviour under aversive conditions may stem from differences in the way a situation is evaluated. It is argued that stress comes from the animal's evaluation of the outcome of a situation, and that welfare is the state resulting from that evaluation.

Animal Welfare↗

Supplementing previously treated anestrous dairy cows with progesterone does not increase first-service conception rate.

The objective of this study was to investigate the effect of supplementing previously treated anovulatory anestrous (AA) dairy cows with progesterone delivered intra-vaginally for 7 days, commencing 4 or 5 days after insemination, on first-service conception rate. A clinical trial, involving 990 AA dairy cows in 14 dairy herds, was conducted during the 2002/2003 breeding season. On Day -8, all cows were treated with a progesterone-containing intravaginal device (Cue-Mate). The devices were removed on Day -2; on Day -1, all cows were given 1mg of estradiol benzoate im. Cows in the control group (n = 499) received no further treatments. Cows in the treatment group (n = 491) that had been inseminated on Day 0 or 1 had a new device inserted (on Day 4 or 5), with removal of the device after 7 days. First-service conception rates for the control and treatment groups were not different (35.0% versus 36.7% respectively; P = 0.41). Furthermore, there was no difference in conception rates between cows that had devices inserted on Day 4 or 5 (31.3% versus 37.2% respectively; P = 0.45). In conclusion, supplementation of previously treated AA dairy cows with an intravaginal progesterone-releasing device for 7 days (commencing 4 or 5 days after insemination) did not significantly improve first-service conception rate.

Administration, Intravaginal↗

Revisiting matrix games: the concept of neighborhood invader strategies.

We extend the concept of neighborhood invader strategy (NIS) to finite-dimensional matrix games and compare this concept to the evolutionarily stable strategy (ESS) concept. We show that these two concepts are not equivalent in general. Just as ESS's may not be unique, NIS's may also not be unique. However, if there is an ESS and a NIS then these strategies must be the same. We show that an ESNIS (an ESS and NIS) for any matrix game is unique and that a mixed ESS with full support is a NIS. Thus a mixed ESS with full support is not invadable by any pure or mixed strategy and it can invade any pure or mixed strategy. An ESS which is an ESNIS, therefore, has better chance of being established evolutionarily through dynamic selection.

Animals↗

Post-conception mating in wild long-tailed macaques (Macaca fascicularis): characterization, endocrine correlates and functional significance.

In many anthropoid primates, mating activity is not restricted to the ovarian cycle but also occurs during pregnancy. Although it has been suggested that the main function of this post-conception mating is to confuse paternity, studies showing whether or not male primates can distinguish between the fertile phase of the conception cycle (FPCC) and the period of peak post-conception mating (peak PCM) are almost non-existent. Here, we examine whether the pattern of female sexual traits (specific sexual behaviors, sexual swelling) and female attractiveness to males differ between FPCC and peak PCM in 6 wild female long-tailed macaques. We also use fecal hormone analysis to investigate whether female traits during peak PCM are related to changes in female sex hormones. All females exhibited a distinct period of heightened mating activity around days 45-60 of gestation. During peak PCM, swelling size and frequency of female solicitations (but not reaching back) were significantly correlated with changes in the estrogen to progestogen ratio. Swelling size, frequency of female sexual behaviors and copulations and proportion of male-initiated copulations and ejaculations were not significantly different between FPCC and peak PCM. Although males spent significantly less time consorting females during peak PCM, all (particularly low-ranking and non-resident males) invested heavily in terms of reproductive costs associated with mate-guarding and mating during pregnancy. We conclude that post-conception mating in wild long-tailed macaques is not merely a by-product of endocrine changes and devoid of adaptive function. Our results more strongly support the hypothesis that it may form part of a female reproductive strategy to confuse paternity, which appears to apply particularly to low-ranking and extra-group males.

Animals↗

Macular translocation: unifying concepts, terminology, and classification.

PURPOSE: To describe some unifying concepts, terminology, and classification of macular translocation so as to facilitate communication within the scientific community. METHODS: A panel of ophthalmologists with expertise in macular translocation reviewed available data and developed some unifying concepts, terminology, and classification of macular translocation. RESULTS: Macular translocation may be defined as any surgery that has a primary goal of relocating the central neurosensory retina or fovea intraoperatively or postoperatively specifically for the management of macular disease. It may be classified according to the size of the retinotomy and, where applicable, the technique of chorioscleral shortening used. The direction of macular translocation is denoted by the movement of the neurosensory macula relative to the underlying tissues. Effective macular translocation may be defined as successful intraoperative or postoperative relocation of the fovea overlying a subfoveal lesion to an area outside the border of the lesion. The concepts of minimum desired translocation and median postoperative foveal displacement can give some useful idea of the likelihood of effective macular translocation before surgery. CONCLUSIONS: Use of a common standardized terminology for macular translocation will facilitate communication within the scientific community and enhance further research in this area. However, the definitions, terms, classification, and concepts concerning macular translocation are likely to continue to evolve as macular translocation undergoes further modifications and refinements.

Humans↗

Important concepts for treating ocular surface and tear disorders.

PURPOSE: To outline important concepts for treating ocular surface and tear disorders. METHOD: A review was conducted of recently published findings. RESULTS: Five concepts were delineated: ocular surface health is ensured by a close relationship between ocular surface epithelia and the preocular tear film; a stable tear film is inherently maintained by external adnexae; the intact protective mechanism is controlled by effective neuroanatomic integration; corneal epithelial stem cells are located at the corneoscleral limbus; and ocular surface epithelial cell function is supported by stromal fibroblasts and matrix. CONCLUSIONS: These concepts stress that ocular surface epithelia and the preocular tear film function as a unit and, furthermore, that several corneal and external diseases can be categorized as ocular surface and tear disorders. These concepts also help one formulate unified diagnostic and therapeutic strategies for management of these diseases.

Animals↗

Isoeffect lines using TDF and CRE concepts.

In most of the radiotherapy centres the treatment planning is based on isodose lines. Isoeffect lines are also being drawn based on the concepts of TDFs and CREs. It was aimed in this work to find out whether the isoeffect lines based on the concepts of TDFs, CREs and the physical isodose lines are identical in all the treatment situations. Isoeffect lines for a few treatment schedules involving treatment of carcinoma of the bladder, treatment of cancer of the uterine cervix by combined intracavitary and external beam therapies and intracavitary therapy alone have been obtained and compared in the present study. The effect of treatment mode on the isoeffect lines is also studied. It is found that the isodose curves and the isoeffect lines using the TDF and CRE concepts are not identical in all situations. Therefore, the ultimate treatment plans based on theses isoeffect lines will not be exactly the same. The dependence of the isoeffect lines with the variation of the exponents of time and number of fractions used in the empirical relationship for NSD have also been investigated. Clinical trials have been initiated in the case of cancer of the bladder and cervix uterus based on the isodose curves and the isoeffect lines using CRE and TDF concepts.

Cobalt Radioisotopes↗

Knowledge of concept meanings in Alzheimer's disease.

The present study focuses on semantic deficits in Alzheimer's disease (AD). We distinguish three different levels of semantic knowledge: (1) lexical, (2) semantic-conceptual, (3) conscious understanding. We devised methods that tap levels (2) and (3). Our aim was to determine how much guidance AD patients need to consciously access a given semantic-conceptual field and how well they can understand the meanings of concepts and semantic relations. Four different tasks were used to tap different kinds of concepts, the relationships between concepts and their attributes, and the hierarchical structure among different concepts. The retrieval demands of the tasks were eased by presenting guiding questions. The results revealed that AD patients have deficient voluntary access to semantic-conceptual representations. The deficits persist even in passive recognition and forced-choice tasks. We conclude that AD patients have a generalized access deficit, although some aspects of the results are suggestive of storage deficit.

Aged↗