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Changes to the Criminal Code provisions for mentally disordered offenders and their implications for Canadian psychiatry.

Bill C-30, implemented in February 1992, made a number of significant changes to the Criminal Code provisions concerning the assessment, treatment and disposition of mentally disordered persons charged with a crime, including persons considered to be unfit to stand trial or pleading insanity. The changes deal mainly with procedural law and the civil rights of persons being assessed or held in custody, and put limits on where, how long and for what purpose persons may be detained. The new law abolishes the automatic, indeterminate detention of persons found unfit to stand trial or not criminally responsible on account of mental disorder. The changes may mean that the forensic psychiatric route is now a more "attractive option" for defendants. The new law may create administrative problems for clinicians by leading to increased requests for psychiatric assessments while at the same time constraining the assessment process.

Canada↗

RNA editing in an untranslated region of the Ginkgo chloroplast genome.

mRNAs in plant cell organelles can be subject to RNA editing, an RNA processing step altering the identity of single nucleotide residues. In higher plant chloroplasts, editing proceeds by C-to-U conversions at highly specific sites. All known plastid RNA editing sites are located in protein-coding regions and, typically, change the coding properties of the mRNA. To gain more insight into the evolution of editing, we have determined the molecular structure and RNA editing pattern of the psbE operon of the primitive seed plant Ginkgo biloba. We report here the identification of altogether four sites of C-to-U editing, two of which are unique to Ginkgo and have not been found in other species. Surprisingly, one of the sites is located in an intercistronic spacer, thus being the first chloroplast editing site detected outside a protein-coding region. This indicates that the plastid editing machinery can operate also in untranslated regions and without having apparent functional consequences.

Base Sequence↗

Mutagenesis induced by bacterial UmuDC proteins and their plasmid homologues.

The popular image of a world full of pollutants mutating DNA is only partly true since there are relatively few agents which can subtly and directly change base coding; for example, some alkylating agents alter guanine so that it pairs like adenine. Many more mutagens are less subtle and simply destroy coding altogether rather than changing it. Such mutagens include ultraviolet light, X-rays, DNA cross-linkers and other agents which make DNA breaks or large adducts. In Escherichia coli, mutagenesis by these agents occurs during a DNA repair process which increases cell survival but with an inherent possibility of changing the original sequence. Such mutagenic DNA repair is, in part, encoded by the E. coli umuDC operon. This article reviews the structure, function, regulation and evolution of the umuDC operon and similar genes found both in other species and on naturally occurring plasmids.

Amino Acid Sequence↗

Effects of the prospective payment system on medical record coding.

This article reports upon a study carried out in Alabama to verify if coding functions had actually changed due to PPS as commonly perceived. The study also sought to identify the specific changes in coding procedures and in personnel requirements in that state.

Abstracting and Indexing↗

Issues in neural plasticity as related to cochlear implants in children.

There is compelling evidence across species for a changing place code during development. This change in frequency organization may provide a mechanism for all elements within the central auditory pathways to receive the necessary stimulation to promote normal growth and development. We must take these normal developmental processes into consideration when deciding on the appropriate stimulation, training, and success procedures in cochlear implants in children.

Animals↗

Free-text fields change the meaning of coded data.

Researchers have advocated the supplementation of coded fields with free-text fields in electronic medical records (EMRs) to provide clinicians with flexibility during data entry. They cite advantages of more complete data capture and improved clinician acceptance and use of the EMR. However, free text may have the disadvantage of changing the meaning of coded data, which causes lower data accuracy for applications that cannot read free text. We studied the free-text entries that clinicians made during the recording of medication data. We found that these entries changed the meaning of coded data and lowered data accuracy for the medical decision-support system (MDSS) in our EMR. We conclude that supplemental free-text entries made by clinicians frequently alter the meaning of coded data.

Abstracting and Indexing↗

Safety and accessibility effects of code modifications and traffic calming of an arterial road.

The European Road E12 through the community center of Storuman, Sweden was reconstructed in 1999 and 2000. Pedestrian walkways, traffic islands, chicanes of a type referred to as "Danish buns", a roundabout and a two-directional cycle track along the E12 were installed. The purpose of the reconstruction was to improve safety for pedestrians and bicyclists, primarily for children, the elderly and the disabled, and to reduce the barrier effect of the E12 thoroughfare. In May 2000, the code governing the conduct of drivers at marked crosswalks in Sweden became stricter to improve safety and mobility for pedestrians. The combined effect of reconstructions and change of code was analyzed. Traffic behavior was studied at the intersection where the roundabout was constructed. Yield behavior towards pedestrians changed significantly. The difference was even greater with respect to yielding to child bicyclists - from 6% before to 84% after - even though the code change only related to pedestrians. Crash data analysis suggests a minor increase in fall injuries after reconstructions and change of code. Measures of speed, behavioral studies, questionnaires, face-to-face interviews and crash data analysis suggest that safety has increased not only along the E12 but also along adjacent roads. The final conclusion is that a bypass is not needed in a case like Storuman. Traffic calming of the main arterial through the town seems sufficient.

Accidents, Traffic↗

Short-term effects of countermeasures for improved safety and mobility at marked pedestrian crosswalks in Borås, Sweden.

The Swedish code concerning car drivers' responsibility to give way to pedestrians was strengthened in 2000. The primary aim of this study is to evaluate the short-term effects of the change in code. Another goal is to look at the effects of the reconstruction of four sites in Borås, Sweden. One site had changes made prior to the change of code, two test sites had countermeasures implemented during the study, and one comparison site was left unchanged. All the sites were chosen because schools were situated nearby. The focus of the evaluation was on children and elderly as pedestrians and cyclists. The goal of traffic calming of a 90 percentile driving speed below 30 km/h was not fulfilled at any of the test sites. A conclusion is that the height of a speed cushion is important. After the speed cushions were lowered from 70 mm to 55 mm, the 90 percentile speed increased from 34 km/h to 41 km/h. Sites with no speed cushions had much higher speeds. The design of an intersection influences road users' behavior. At the site where one crosswalk was removed, pedestrians that were using the remaining marked crosswalk were given way to less frequently than at the other sites. At intersections where most pedestrians used marked crosswalks, the children benefited the most in mobility. At the intersection where pedestrians used marked crosswalks to a lower extent after reconstruction, children and the elderly had the smallest increase in frequency of being given way to. After reconstruction to a court-yard street, the pedestrians were given way to a lower extent compared with the other sites, though the vehicle speeds were the lowest observed at this study. At the sites were no physical changes were made, the change of code improved driver yield behavior, but no more towards children than other age groups.

Accident Prevention↗

[Cloning and sequencing of human papillomavirus 16 L1 gene from cervical carcinoma tissues of Chinese women].

OBJECTIVE: Human papillomavirus type 16 (HPV16) is highly related with the development of cervical carcinoma. HPV16 late gene L1 encodes its main capsid protein. This study is to analyze the whole sequence of L1 gene of HPV16 of the Chinese isolates. METHODS: Three samples of HPV16 L1 gene were amplified from cervical carcinoma tissues of Chinese patients by PCR and then cloned and sequenced. RESULTS: There were four sites in nucleic acid sequences of all three HPV16 L1 fragments were different from the originally reported sequence of HPV16 and the differed sequences had changed the triplet codes, therefore, subsequently changed the amino acids it coded. CONCLUSION: The results showed that some mutation had taken place in the nucleotide sequence of L1 gene of HPV16 obtained from the cervical carcinoma tissues of Chinese women.

Capsid Proteins↗

Changes in mitochondrial genetic codes as phylogenetic characters: two examples from the flatworms.

Shared molecular genetic characteristics other than DNA and protein sequences can provide excellent sources of phylogenetic information, particularly if they are complex and rare and are consequently unlikely to have arisen by chance convergence. We have used two such characters, arising from changes in mitochondrial genetic code, to define a clade within the Platyhelminthes (flatworms), the Rhabditophora. We have sampled 10 distinct classes within the Rhabditophora and find that all have the codon AAA coding for the amino acid Asn rather than the usual Lys and AUA for Ile rather than the usual Met. We find no evidence to support claims that the codon UAA codes for Tyr in the Platyhelminthes rather than the standard stop codon. The Rhabditophora are a very diverse group comprising the majority of the free-living turbellarian taxa and the parasitic Neodermata. In contrast, three other classes of turbellarian flatworm, the Acoela, Nemertodermatida, and Catenulida, have the standard invertebrate assignments for these codons and so are convincingly excluded from the rhabditophoran clade. We have developed a rapid computerized method for analyzing genetic codes and demonstrate the wide phylogenetic distribution of the standard invertebrate code as well as confirming already known metazoan deviations from it (ascidian, vertebrate, echinoderm/hemichordate).

Amino Acid Sequence↗

Strategy choices by young Braille readers.

The hypotheses that in Braille learning coding strategies change with reading level, and coding differs between normal and retarded readers were tested with oddity judgments by blind children. Experiment 1 showed that strategy choices varied with reading level only in association with mental age. By contrast, shape neglect and preference for phonological strategies were shown by retarded readers rather than by matched normal readers. Experiment 2 showed that under instructions to use given coding strategies the retarded were as accurate as normal readers. Accuracy for all forms of coding increased with reading level, but coding word shape was significantly less accurate than other forms of coding, and even correct coding of shape was no faster than semantic or phonological coding. It is concluded that coding the shape of Braille words is unlikely to be a major factor in producing faster Braille reading, and retarded Braille readers differ from normal readers in their spontaneous choice of strategy rather than in the ability to use the relevant codes.

Blindness↗

A change in the genetic code in Mycoplasma capricolum.

Mycoplasma capricolum was previously found to use UGA instead of UGG as its codon for tryptophan and to contain 75% A + T in its DNA. The codon change could have been due to mutational pressure to replace C + G by A + T, resulting in the replacement of UGA stop codons by UAA, change of the anticodon in tryptophan tRNA from CCA to UCA, and replacement of UGG tryptophan codons by UGA. None of these changes should have been deleterious.

Anticodon↗

An overview of the major changes in the 2002 APA Ethics Code.

This article summarizes the major changes that were made to the 2002 Ethical Principles and Code of Conduct of the American Psychological Association. The 2002 Ethics Code retains the general format of the 1992 Ethics Code and does not radically alter the obligations of psychologists. One goal of the Ethics Committee Task Force was to reduce the potential of the Ethics Code to be used to unnecessarily punish psychologists. In addition, the revised Ethics Code expresses greater sensitivity to the needs of cultural and linguistic minorities and students. Shortcomings of the 2002 Ethics Code are discussed.

Behavioral Research↗

Evolutionary nucleotide replacements in DNA.

With the increasing availability of analytical information on mRNA molecules, it is now possible to compare homologous nucleotide sequences from different organisms and to draw conclusions about their evolution. Such comparisons have shown that silent changes in codons occur more frequently than nucleotide replacements that produce changes in amino acid sequences (code-altering changes). Furthermore, there is an important difference between amino acid sequence comparisons and nucleotide sequence comparisons. The former show only differences in amino acid residues, but the latter show several types of differences when corresponding codons are compared. Single-base replacements may be degenerate (silent) or expressed as amino acid replacements. Two-base codon changes may be degenerate, single-base changes, or be visible as such. Three-base codon changes may be degenerate (involving serine), simulate either single-base or two-base changes or be visible as such. All nine types of change are found in comparisons of genes from the viruses phi X174 and G4. The relative numbers of these nine types as based on all possible interchanges between all 61 amino acid codons were listed by Holmquist et al. and are shown in Table 1. We discuss these results in the light of the significance of nucleotide changes in molecular evolution.

Base Sequence↗

New coding and billing opportunities for 2005--Part I.

Part I of this series will highlight several changes in coding and billing for 2005. Medicare has established new preventive medicine services and screening tests for beneficiaries, but they have certain qualifications and documentation rules that must be followed. New codes have been established for using the Internet or similar electronic communications in response to a patient's request. There are additional revisions for pediatricians, orthopedists, endoscopists and surgeons performing transplants and bariatric surgery. All new CPT codes must be activated and deleted codes must be discontinued effective January 1, 2005. From that date forward, the patient's date of service must reflect current diagnosis (ICD-9) and procedure/services (CPT and HCPCS) codes. The Health Insurance Portability and Accountability Act (HIPAA) mandated a January 1, 2005, date compliance for all new and deleted diagnosis (ICD-9-CM) and physician service codes (CPT and HCPCS). Physicians no longer are allowed the 90-day grace period to update their coding systems to reflect the changes. The new 2005 CPT book contains many revisions within the codes themselves along with revisions found in the specific "guidelines" at the beginning of many sections. The CPT codes for 2005 contain 26 deleted codes and 130 new codes, thus providing a challenge to update all coding systems by the January 1, 2005, compliance date for CPT codes.

Current Procedural Terminology↗

To code, or not to code?

In summary, it is also important to remember the hidden rules: 1) Just because there is a code in the manual, it doesn't mean it can be billed to insurance, or that once billed, it will be reimbursed. 2) Just because a code was paid once, doesn't mean it will ever be paid again--or that you get to keep the money! 3) The healthcare provider is responsible for knowing all the rules, but then it is impossible to know all the rules! And not knowing all the rules can lead to fines, penalties or worse! New codes are added annually (quarterly for OPPS), definitions of existing codes are changed, and it is the responsibility of healthcare providers to keep abreast of all coding updates and changes. In addition, the federal regulations are constantly updated and changed, making compliant billing a moving target. All healthcare entities should focus on complete documentation, the adherence to authoritative coding guidance and the provision of detailed explanations and specialty education to the payor, as necessary.

Centers for Medicare and Medicaid Services, U.S.↗

Altered nucleotide sequences of a translocated c-myc gene in Burkitt lymphoma.

The nucleotide sequence of a translocated c-myc gene in a Burkitt lymphoma reveals multiple base changes in the coding region. Twenty-five base changes, generating 16 codon alterations, were found in the first coding exon; no changes occur in the second coding exon. These changes are probably the result of somatic mutations that occurred during and after translocation, and may contribute to oncogenesis by allowing synthesis of an altered c-myc gene product.

Amino Acid Sequence↗

Effects of adaptation on neural coding by primary sensory interneurons in the cricket cercal system.

Methods of stochastic systems analysis were applied to examine the effect of adaptation on frequency encoding by two functionally identical primary interneurons of the cricket cercal system. Stimulus reconstructions were obtained from a linear filtering transformation of spike trains elicited in response to bursts of broadband white noise air current stimuli (5-400 Hz). Each linear reconstruction was compared with the actual stimulus in the frequency domain to obtain a measure of waveform coding accuracy as a function of frequency. The term adaptation in this paper refers to the decrease in firing rate of a cell after the onset or increase in power of a white noise stimulus. The increase in firing rate after stimulus offset or decrease in stimulus power is assumed to be a complementary aspect of the same phenomenon. As the spike rate decreased during the course of adaptation, the total amount of information carried about the velocity waveform of the stimulus also decreased. The quality of coding of frequencies between 70 and 400 Hz decreased dramatically. The quality of coding of frequencies between 5 and 70 Hz decreased only slightly or even increased in some cases. The disproportionate loss of information about the higher frequencies could be attributed in part to the more rapid loss of spikes correlated with high-frequency stimulus components than of spikes correlated with low-frequency components. An increase in the responsiveness of a cell to frequencies > 70 Hz was correlated with a decrease in the ability of that cell to encode frequencies in the 5-70 Hz range. This nonlinear property could explain the improvement seen in some cases in the coding accuracy of frequencies between 5 and 70 Hz during the course of adaptation. Waveform coding properties also were characterized for fully adapted neurons at several stimulus intensities. The changes in coding observed through the course of adaptation were similar in nature to those found across stimulus powers. These changes could be accounted for largely by a change in neural sensitivity. The effect of adaptation on the coding of stimulus power was examined by measuring the response curves to steps in stimulus power before and after exposure to an adapting stimulus. Adaptation caused a loss of information about the mean stimulus power but did not cause any improvement in the coding of changes in stimulus power. The unadapted response of the cells did not show any saturation even at the highest powers used in these experiments.

Acoustic Stimulation↗