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Cherubism: clinicopathologic features.

A case of cherubism in 6-year-old boy is reported. He presented with bilateral symmetrical enlargement of the jaw in addition to medially dislocated premature teeth, narrow V-shaped palatal vault, and mild upward turning of the eyes. Radiographs showed multiloculated osteolysis in both the mandible and maxilla. Histology revealed a non-neoplastic fibrous lesion, rich in multinucleated giant cells, consistent with giant-cell reparative granuloma. Since the original description of cherubism, various histologic interpretations have been proposed, particularly that of fibrous dysplasia. However, it should be emphasized that cherubism is a disease histologically indistinguishable from giant-cell reparative granuloma.

Cherubism↗

Novel approach to evolutionary neural network based descriptor selection and QSAR model development.

Capability of evolutionary neural network (ENN) based QSAR approach to direct the descriptor selection process towards stable descriptor subset (DS) composition characterized by acceptable generalization, as well as the influence of description stability on QSAR model interpretation have been examined. In order to analyze the DS stability and QSAR model generalization properties multiple random dataset partitions into training and test set were made. Acceptability criteria proposed by Golbraikh et al. [J. Comput.-Aided Mol. Des., 17 (2003) 241] have been chosen for selection of highly predictive QSAR models from a set of all models produced by ENN for each dataset splitting. All QSAR models that pass Golbraikh's filter generated by ENN for each dataset partition were collected. Two final DS forming principles were compared. Standard principle is based on selection of descriptors characterized by highest frequencies among all descriptors that appear in the pool [J. Chem. Inf. Comput. Sci., 43 (2003) 949]. Search across the model pool for DS that are stable against multiple dataset subsampling i.e. universal DS solutions is the basis of novel approach. Based on described principles benzodiazepine QSAR has been proposed and evaluated against results reported by others in terms of final DS composition and model predictive performance.

Benzodiazepines↗

An algorithm for complete enumeration of the mechanisms of supraventricular tachycardias that use multiple atrioventricular, AV nodal, and/or Mahaim pathways.

The EINTHOVEN system is a model-based expert system that interprets the cardiac rhythm from the electrocardiogram. It simulates the expected behavior of realistic semi-quantitative cardiac models constructed by heuristic rules to generate interpretations that include both text descriptions and event-by-event causal explanations in the form of ladder diagrams. The simulation has been limited by an inability to predict all possible behaviors of hearts with more than one reentrant circuit. We now describe an algorithm that overcomes this limitation. Its output has been validated by an independent possibility-tree analysis. Timing and storage measurements are presented for models with up to three slow atrioventricular nodal pathways, four atrioventricular pathways, and a single atriofascicular (Mahaim) pathway. This is the first report in the literature of an algorithm that enumerates all possible mechanisms for reentrant supraventricular tachycardias that use atrioventricular, atrioventricular nodal, and/or atriofascicular pathways in humans.

Algorithms↗

Validation of a new protocol for computer-assisted evaluation of kinematics of double-bundle ACL reconstruction.

BACKGROUND: Computer-assisted surgery is useful to increase the precision of anterior cruciate ligament (ACL) surgical procedure, but could be even more important in evaluating the global performance of reconstructed ACL. This paper describes a new protocol for an accurate and extensive computer-assisted evaluation of single- and double-bundle reconstructions of ACL. METHODS: The protocol consists of the acquisition of the leg axes, ACL and graft insertions by a navigation system, and tracking of the knee motion during the classical kinematic test of knee stability. These data are elaborated by computer software in order to compute graft biomechanical behaviour and the knee kinematics and estimate the performance of the intervention. FINDINGS: The proposed protocol was validated on three cadaver knees. It resulted minimally invasive, effective to describe graft kinematic performance and able to provide a 3D reliable description of the reconstructed knee. INTERPRETATION: The protocol is an extension of the present evaluation of computer-assisted packages and includes additional kinematic tests and computations. The scientist-reader can find important details on tested computations to implement a similar computer-assisted procedure for new applications in knee surgery, while the surgeon can find in this procedure a means to improve the evaluation of ACL reconstruction and identify the residual laxity.

Anterior Cruciate Ligament↗

Chemical agents and enzymes used for the extraction of gut lymphocytes influence flow cytometric detection of T cell surface markers.

Chemical agents (DTT, EDTA) and enzymes (collagenase, DNAse) are often used for the generation of a single cell suspension from tissue samples. In this study, flow cytometry was used to examine the effect of chemical agents and enzymes on the expression of cell membrane markers of T lymphocytes from tonsils and peripheral blood. Expression of CD4, CD8, CD25, CD38, L-selectin, CD44, alphaEbeta7 and alpha4beta7 were studied. Incubation of lymphocytes with DTT and EDTA resulted in a decrease of CD38, alphaEbeta7 and alpha4beta7 expression. Incubation with collagenase A and DNAse resulted in a decrease of CD25, L-selectin, alphaEbeta7 and alpha4beta7. The results of this study indicate that a careful interpretation is necessary for phenotypic descriptions of lymphocyte populations obtained by enzymatic isolation techniques.

Adolescent↗

In-vivo three-dimensional ultrasound reconstructions of embryos and early fetuses.

BACKGROUND: Three-dimensional (3D) imaging of the living human embryo has become possible in the monitoring of embryological development, as described by classic human embryology. We aimed to create 3D images of organs in embryos on early pregnancy. METHODS: We used a specially developed 7.5 MHz annular array 3D transvaginal probe to examine embryos. We included 34 women at 7-10 weeks' gestation. We measured the crown-rump length (CRL) of the embryos and fetuses and transferred the 3D ultrasound data to an external computer for further processing to calculate volume. FINDINGS: The CRLs ranged from 9.3 mm to 39.0 mm. The quality of the images of the embryos and fetuses made it possible to outline in detail the outer contours and the contours of the brain cavities, and the calculated volumes corresponded well to the descriptions from classic human embryology. INTERPRETATION: Our 3D imaging system allowed visualisation of structures of less than 10 mm. Therefore, development and abnormal development of fetuses can be monitored.

Embryonic and Fetal Development↗

Selected techniques for data mining in medicine.

Widespread use of medical information systems and explosive growth of medical databases require traditional manual data analysis to be coupled with methods for efficient computer-assisted analysis. This paper presents selected data mining techniques that can be applied in medicine, and in particular some machine learning techniques including the mechanisms that make them better suited for the analysis of medical databases (derivation of symbolic rules, use of background knowledge, sensitivity and specificity of induced descriptions). The importance of the interpretability of results of data analysis is discussed and illustrated on selected medical applications.

Adult↗

Set/reset: use and disuse of concepts in impression formation.

In three experiments, impressions of an ambiguously described stimulus person were assimilated toward the implications of primed concepts when performance of the priming task was interrupted, but were contrasted with these implications when performance of the priming task was allowed to continue to completion. In addition, when the primed concepts were evaluatively consistent (Experiment 1), assimilation and contrast were observed on both prime-related and prime-unrelated dimensions. When the primed concepts were evaluatively inconsistent (Experiment 2), however, these shifts in impression were observed only on dimensions directly related to the primed concepts. When no concepts descriptively relevant to the stimulus information were primed (Experiment 3), the assimilation and contrast were relative to the favorableness of a primed general evaluative person concept. Taken together, these results suggest that a concept may be accessible to an individual and may be relevant to target information, yet not be used to encode that information; that assimilation and contrast may occur for reasons other than the discrepancy between the target and the contextual stimuli on the dimension of judgment; and that individuals may use the evaluative implications of their person representation as a cue in deciding which of several equally applicable, equally accessible descriptive concepts to use in interpreting information about a person.

Adult↗

Nursing experience in Iran.

The aim of this study was to describe Iranian registered nurses' experience of nursing, and to discuss some of the sociocultural viewpoints that are relevant for such experience. Data were collected by asking 75 registered nurses (RNs) to write statements about their nursing experience. Written descriptions were analyzed by an interpretative phenomenological method. Four different themes emerged: (i) task-oriented nursing experience; (ii) caring-oriented nursing experience; (iii) altruism-oriented nursing experience; and (iv) difficulties experienced. Some participants explained nursing experience by describing a series of daily routine tasks. Others described experience by emphasizing how nursing was a caring profession, and some described their nursing experience from an altruistic viewpoint. Furthermore, the participants described nursing experience based on the relevant problems that they faced in everyday professional life. They expressed difficulties relating to work settings and also problems that were related to the sociocultural view of nursing in society. The nurses in general were dissatisfied with their work and this made them seriously consider leaving the nursing profession. The findings have implications for nursing management and education. These suggestions might enable changes that could effectively improve the status of nursing in Iran. An holistic approach is necessary to integrate these implications into a nursing system, both in practice and in education, for improving conditions that will facilitate a higher development of nursing in Iran.

Adult↗

Empowerment of dying patients: the strategies and barriers to patient autonomy.

The growing debate about the ability of the nurse to empower patients has featured frequently in the nursing journals over recent years. This paper seeks to address the issue around the need to empower dying patients by an examination of nurses' written reflections on critical incidents in their practice. Geertz's 'thick description' has been used to interpret the data. The issues of power and professionalism are central to the discussion. The results are tentative given the sample size but point towards a redefinition of the empathetic approach and the adoption of a 'facilitative' approach to the sharing of power. The paper recommends careful examination of the role of the nurse and the communication process to identify further barriers to patient empowerment.

Communication Barriers↗

TreeWiz: interactive exploration of huge trees.

MOTIVATION: The rapidly increasing amount and disparity of biological data requires interpretation at many levels of description. Human judgement and intuition are important because not all data can be automatically and comprehensively analyzed. Visualization of trees and substructures corresponding to certain features are often used to analyze phylogenies or taxonomies. Unfortunately, most existing tools do not cope with the size of current datasets, the required functionality, or both. RESULTS: We introduce a program for visualization of huge trees and also for the interactive exploration of their content. We have developed a range of new schemes which are tailored for biological problems. Users can get an overview, zoom in, filter out data and retrieve details from standard databases such as SWISS-PROT. Furthermore, it is possible to analyze the relationship between chosen leaf sets that are specified by common features on a second level of representation. On a PC (with approximately equal to 512 MB RAM), trees of up to several tens of thousands of leaves can be loaded and both rapidly and interactively explored. We demonstrate the use of this program for the analysis of the SYSTERS data set (which contains hierarchically clustered protein sequences) to which PFAM domains were added as features.

Classification↗

Monitoring the growth of children: conclusions from a long-term study.

BACKGROUND: The National Study of Health and Growth (NSHG) was set up in 1972 to monitor the growth of primary school children. Areas were selected in England and Scotland by stratified random sampling. Schools within these areas were visited annually until 1982, biennially thereafter, resulting in a mixed longitudinal design. The reasons for the original design and the study as it has operated are reviewed, with advantages and disadvantages compared to the monitoring system now to be implemented by the Department of Health. METHODS: Description of the statistical and interpretive problems of monitoring rates of growth and a comparison of the response rates achieved in the two types of monitoring. RESULTS: Although the design of the NSHG was selected in order to monitor rates of growth this presents statistical problems. The usable information is contained in trends in attained height rather than in rates of growth. This study has achieved an average response rate of over 95%; less than 78% can be expected from the proposed survey of households. CONCLUSIONS: The small loss of efficiency of the mixed longitudinal design compared with repeated cross-sectional studies is more than compensated for by its high response rate and the comparability of data over time, neither of which can be guaranteed by the proposed survey.

Body Height↗

A genetics course for advanced clinical nursing practice.

PURPOSE: To describe a genetics course for advanced clinical nursing practice. BACKGROUND: The Human Genome Project is yielding new discoveries in genetics. The sheer volume of new information threatens to overwhelm healthcare providers as they must find ways to interpret and use these discoveries. DESCRIPTION OF PROJECT: The course was developed in recognition of the fact that graduate nursing students in advanced practice programs need to understand and apply genetic information in the care of their patients. The course builds on core competencies identified by the National Coalition for Health Professional Education in Genetics and the International Society of Nurses in Genetics. OUTCOMES: Students demonstrate that they can access, evaluate, and synthesize current information on a genetic condition and develop a comprehensive plan of care for patients with the selected condition. INTERPRETATION/CONCLUSION: Students learn basic and applied genetic concepts and skills. They are able to utilize resources appropriately to identify patient care needs and develop strategies for meeting those needs. IMPLICATIONS FOR NURSING PRACTICE: The need to remain current in understanding emerging technologies and genetic information will continue to grow as scientific discoveries are made that affect greater numbers of the public. Nurses in advanced practice are in a position to support patients and their families as they deal with the significance of these discoveries for their current and future health.

Curriculum↗

Ultrasonography of the adolescent female pelvis.

Ultrasound of the adolescent female pelvis is the imaging method of choice for most medical problems presenting with symptoms and signs referable to this area. Recognizing the transition from child to mature female and its manifestations are crucial in directing the workup and interpreting the sonographic findings. A description of the normal anatomy and physiology of the pelvic organs is followed by a discussion of the clinical and imaging findings in primary and secondary amenorrhea, pelvic pain, and pelvic masses.

Journal Article↗

Anomalous optical absorption in the normal state of overdoped cuprates near the charge-ordering instability.

We argue that the hump observed in the optical conductivity at or below a few hundreds of cm(-1), in overdoped cuprates such as the electron-doped Nd(2-x)Ce(x)CuO(4-y) at x > or approximately equal to 0.15 and the hole-doped Bi2Sr2CuO6 and La2-xSrxCuO4, cannot be accounted for within a single-fluid description. We propose instead an interpretation based on the direct excitation of charge collective modes, which become nearly critical in the proximity to a charge-ordering instability. Their critical character entails a peculiar temperature dependence and a pseudoscaling form of the optical spectra, which agree with the experimental data.

Journal Article↗

Presynaptic currents in mouse motor endings.

1. We used external electrodes placed under precise visual control on motor endings of the mouse to record electrical activity promoted by nerve stimulation.2. Three types of wave form have been observed in relation to well-defined electrode emplacements: (i) at the transition between myelinated and non-myelinated parts of the axon, the wave form consists of two negative deflexions preceded by a small positivity (preterminal response), (ii) at the main part of the terminal branches, we obtained a two component positive wave form (terminal response) and (iii) electrode positions in a narrow area between the former and the latter yielded triphasic (positive-negative-positive) wave forms (intermediate responses).3. Since these responses could not be readily interpreted in terms of classical description of membrane currents associated with propagating action potentials, we used specific channel blocking agents to identify wave form components.4. Bath application of tetraethylammonium or aminopyridines, or, better, a combination of both, suppressed delayed positive deflexions of terminal and intermediate responses and the late negative component of preterminal responses. Local inophoretic drug application showed that K channels are present only at the terminal part of the endings. K(+) outflux promotes a local circuit whose sink is located at the preterminal part where it generates the late negative deflexion of the preterminal response.5. Local application of tetrodotoxin suppressed the first negative component of preterminal responses but failed to affect electrical activity at the terminal part of the endings. This indicates that Na channels, and, therefore, action potential generation, are restricted to the preterminal part.6. Suppression of K conductance revealed a slow inward current at the terminal part of the endings which could be identified as a Ca current. Ba(2+) and Sr(2+) could substitute for Ca(2+) as inward current carriers.7. Activation of spatially separated Na channels, on one side, and of K and Ca channels, on the other, generated ionic currents and separated local circuit currents which flow between preterminal and terminal parts (and vice versa). Thus, the signals recorded at each point of motor endings correspond to the sum of ionic and passive currents entering (or leaving) the membrane at that point.8. The present results represent a further example of heterogeneity of axonal membrane.

Action Potentials↗

Ray dynamics in a long-range acoustic propagation experiment.

A ray-based wave-field description is employed in the interpretation of broadband basin-scale acoustic propagation measurements obtained during the Acoustic Thermometry of Ocean Climate program's 1994 Acoustic Engineering Test. Acoustic observables of interest are wavefront time spread, probability density function (PDF) of intensity, vertical extension of acoustic energy in the reception finale, and the transition region between temporally resolved and unresolved wavefronts. Ray-based numerical simulation results that include both mesoscale and internal-wave-induced sound-speed perturbations are shown to be consistent with measurements of all the aforementioned observables, even though the underlying ray trajectories are predominantly chaotic, that is, exponentially sensitive to initial and environmental conditions. Much of the analysis exploits results that relate to the subject of ray chaos; these results follow from the Hamiltonian structure of the ray equations. Further, it is shown that the collection of the many eigenrays that form one of the resolved arrivals is nonlocal, both spatially and as a function of launch angle, which places severe restrictions on theories that are based on a perturbation expansion about a background ray.

Journal Article↗

Artificial neural network: improving the quality of breast biopsy recommendations.

PURPOSE: To evaluate the performance and inter- and intraobserver variability of an artificial neural network (ANN) for predicting breast biopsy outcome. MATERIALS AND METHODS: Five radiologists described 60 mammographically detected lesions with the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) nomenclature. A previously programmed ANN used the BI-RADS descriptors and patient histories to predict biopsy results. ANN predictive performance was compared with the clinical decision to perform biopsy. Inter- and intraobserver variability of radiologists' interpretations and ANN predictions were evaluated with Cohen kappa analysis. RESULTS: The ANN maintained 100% sensitivity (23 of 23 cancers) while improving the positive predictive value of biopsy results from 38% (23 of 60 lesions) to between 58% (23 of 40 lesions) and 66% (23 of 35 lesions; P < .001). Interobserver variability for interpretation of the lesions was significantly reduced by the ANN (P < .001); there was no statistically significant effect on nearly perfect intraobserver reproducibility. CONCLUSION: Use of an ANN with radiologists' descriptions of abnormal findings may improve interpretation of mammographic abnormalities.

Biopsy↗