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PubMedDate not supplied

[Individual development and lessons of evolutionism].

The present crisis of evolutionism was predictable initially, since the preformational model of development expressed in the idea of discrete heredity contradicts the systemic properties of ontogenesis. Correspondingly, the principle of selection of inherited factors cannot explain evolution. The synthetic theory based on this principle contains insoluble contradictions in its key notions. According to the alternative epigenetic theory based on the integrity of living organization, heredity is a product of selection and expresses teleonomic direction of development to a stable final state. Unification of the genetic concept of evolution with recognition of the integrity of development is principally impossible. The cause of dominance of genetic views on evolution consists in the correspondence of the mechanistic tradition of the 18-19th centuries, rather than in their logistic substantiation. For the same reason, the biology as a whole is characterized by identification of specific linear dependences with the laws of evolution. Following this path in search for "new evolutionary synthesis" invites a priori its failure. Evolutionary interpretation of genetic generalizations is only possible on the basis of their description in terms of development.

Biological Evolution↗
PubMed1995

Receptor encoding of moving tactile stimuli in humans. II. The mean response of individual low-threshold mechanoreceptors to motion across the receptive field.

The mean firing rate evoked in 70 cutaneous, low-threshold mechanoreceptors in the human median, radial, and inferior alveolar nerves by stimulus motion across the skin was quantitatively studied. Moving stimuli, controlled for velocity, direction, and length of skin traversed, were provided by a servo-controlled motor that carried a brush across the receptive field. Each unit was studied with stimuli delivered at multiple velocities from 0.5 to 32 cm/sec in at least two opposing directions. A power function provided an excellent description of the MFR-versus-velocity relationship. The exponent n was interpreted to reflect the receptor's sensitivity to changes in stimulus velocity, and the multiplicative constant c, the predicted response to stimuli moving at 1.0 cm/sec. The fast adapting mechanoreceptors exhibited higher sensitivity to stimulus velocity than the slowly adapting mechanoreceptors. The mean velocity at which the fast adapting units were predicted to first respond to movement was also higher. Estimates of n, c, or both differed significantly for stimuli delivered in opposing directions for more than 70% of the mechanoreceptors. No direction of motion consistently led to power function parameters with higher values so as to suggest a "preferred" regional direction of motion for the entire population. Neither the directional difference in n nor c could be attributed to directional differences in the forces applied across the receptive fields. These findings suggest that information about velocity and direction is represented in the mean firing rate responses evoked in the population of mechanoreceptors activated by a moving tactile stimulus.

Adult↗
PubMed2003

Complexity of factors modulating airway narrowing in vivo: relevance to assessment of airway hyperresponsiveness.

In vivo, the airway response to constrictor stimuli is the net result of a complex array of factors, some facilitating and some opposing airway narrowing, which makes the interpretation of bronchial challenges far from being straightforward. This review begins with a short description of the complex mechanisms of airway smooth muscle activation and force generation as the starting events for airway narrowing. It then focuses on gain factors modulating airway smooth muscle shortening and on the geometric factors determining the magnitude of reduction in airway caliber in vivo. Finally, in light of the evidence that mechanical modulation of airway smooth muscle tone and airway narrowing is at least as important as the inflammatory contractile mediators in the pathogenesis of airway hyper-responsiveness, the implications for the interpretation of bronchial challenges in clinical settings are discussed.

Animals↗
PubMed1998

Segmentation and interpretation of MR brain images: an improved active shape model.

This paper reports a novel method for fully automated segmentation that is based on description of shape and its variation using point distribution models (PDM's). An improvement of the active shape procedure introduced by Cootes and Taylor to find new examples of previously learned shapes using PDM's is presented. The new method for segmentation and interpretation of deep neuroanatomic structures such as thalamus, putamen, ventricular system, etc. incorporates a priori knowledge about shapes of the neuroanatomic structures to provide their robust segmentation and labeling in magnetic resonance (MR) brain images. The method was trained in eight MR brain images and tested in 19 brain images by comparison to observer-defined independent standards. Neuroanatomic structures in all testing images were successfully identified. Computer-identified and observer-defined neuroanatomic structures agreed well. The average labeling error was 7%+/-3%. Border positioning errors were quite small, with the average border positioning error of 0.8+/-0.1 pixels in 256 x 256 MR images. The presented method was specifically developed for segmentation of neuroanatomic structures in MR brain images. However, it is generally applicable to virtually any task involving deformable shape analysis.

Algorithms↗
PubMed2005

Graphical interpretation of observability in terms of feedback circuits.

It is known that the observability of a system depends crucially on the choice of the observable. Locally, such a feature results directly from the couplings between the dynamical variables (globally, it will also depend on symmetry). Using a feedback circuit description, it is shown how the location of the nonlinearity can affect the observability of a system. A graphical interpretation is introduced to determine--without any computation--whether a variable provides full observability of the system or not. Up to a certain degree of accuracy, this graphical interpretation allows us to rank the variables from the best to the worst. In addition to that, it is shown that provided that the system is observable, it can be rewritten under the form of a jerk system. The Rössler system and nine simple Sprott systems, having two fixed points, are investigated here.

Journal Article↗
PubMed2002

Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds.

BACKGROUND AND PURPOSE: The interpretation of patient scores on clinical tests of physical mobility is limited by a lack of data describing the range of performance among people without disabilities. The purpose of this study was to provide data for 4 common clinical tests in a sample of community-dwelling older adults. SUBJECTS: Ninety-six community-dwelling elderly people (61-89 years of age) with independent functioning performed 4 clinical tests. METHODS: Data were collected on the Six-Minute Walk Test (6MW), Berg Balance Scale (BBS), and Timed Up & Go Test (TUG) and during comfortable- and fast-speed walking (CGS and FGS). Intraclass correlation coefficients (ICCs) were used to determine the test-retest reliability for the 6MW, TUG, CGS, and FGS measurements. Data were analyzed by gender and age (60-69, 70-79, and 80-89 years) cohorts, similar to previous studies. Means, standard deviations, and 95% confidence intervals for each measurement were calculated for each cohort. RESULTS: The 6MW, TUG, CGS, and FGS measurements showed high test-retest reliability (ICC [2,1]=.95-.97). Mean test scores showed a trend of age-related declines for the 6MW, BBS, TUG, CGS, and FGS for both male and female subjects. DISCUSSION AND CONCLUSION: Preliminary descriptive data suggest that physical therapists should use age-related data when interpreting patient data obtained for the 6MW, BBS, TUG, CGS and FGS. Further data on these clinical tests with larger sample sizes are needed to serve as a reference for patient comparisons.

Activities of Daily Living↗
PubMed1985

Neurologic examination in stroke rehabilitation: adequacy of its description in clinical textbooks.

Medical textbooks were reviewed to establish how well they presented those aspects of examination of the nervous system which are important in stroke rehabilitation. In addition, information was sought concerning such factors as the presence of instructions for the examiner and patient, grading and interpretation of results, and the importance of observer variation which can influence results of periodic neurologic examination of stroke patients. Study results demonstrated that the description of the neurologic examination which should be used in stroke rehabilitation was often incomplete and poorly defined. Material provided little interpretation for the physical signs which might be found. Factors which might influence results of periodic examination of the nervous system in stroke patients received little attention. There is an urgent need to develop a standardized form of clinical examination to meet the needs of practitioners who assess neurologic status in stroke rehabilitation.

Books↗
PubMed2003

Maximum information approach to scale description for affective measures based on the Rasch model.

Using the Rasch model for ordered categories, this paper provides a method for qualitative interpretations of data from an affective measure such as an attitude scale or survey instrument. The Bock procedure is first used to partition the total item information to each response category. The location of each response category is determined by maximizing the information associated with this category. The response categories that cluster around a given point on the latent trait are then used to provide a qualitative description of this point. The description is explicit in terms of the behaviors or activities that are likely to be displayed by a respondent at this point. An illustration is provided using an alumni survey used at a large university in the southeast.

Attitude↗
PubMed1989

Analysis of surveillance data: a rationale for statistical tests with comments on confidence intervals and statistical models.

In the examination of differences between subgroups in surveillance data, whether through simple counting or through sophisticated statistical modelling, the comparison is not between simple random samples from two or more populations. The rationale for statistical tests rests on an appeal to a model of random permutation of demographic and disease factors for the observed population during the surveillance period. The testing evaluates chance as a possible explanation for the observed results. In the analysis of internal structure in a surveillance data set, statistical tests produce a conceptually simple result that lends itself to concise presentation and flexible interpretation. Tests limit emphasis on probabilistic manipulation and on parameter estimates. They cannot stand alone, and thus encourage descriptive presentation of observations. In contrast, statistical models and confidence intervals emphasize parameters rather than distributions and compete with the data for limited space.

Data Interpretation, Statistical↗
PubMed2002

Working with interpreters: an interactive Web-based learning module.

OBJECTIVE: Medical students are presented with unique challenges when they care for patients with limited English proficiency. Students must learn a complex set of skills needed to care for patients across cultural and language barriers and to understand the impact of their own attitudes and beliefs about caring for these patients. We developed and piloted a multimedia interactive Web-based module aimed at teaching students effective strategies for working with interpreters and diverse patient populations, and at raising their awareness of important legal, ethical, and cultural issues. DESCRIPTION: First the learner completes a 37-multiple-choice-question (MCQ) pre-test that assesses attitudes, factual knowledge, and ability to analyze written clinical scenarios relevant to the module's content. Learners are then shown a series of professionally produced video vignettes, which reflect diverse patient populations, interpreters, and effectiveness of interpretation strategies (e.g., a Russian-speaking woman with chest pain whose daughter interprets, a medical student interpreting for a Chinese-speaking man using herbal medication, a Haitian woman told of an abnormal mammogram through a trained simultaneous interpreter). In each case, learners submit short answers to on-screen questions analyzing the effectiveness of the interpretation strategies demonstrated. Immediate feedback is given comparing student responses with those of experts. At any time during the module, the learners may view video commentary by legal, ethics, and cultural experts, or access a glossary and Web site links. Students conclude the module by again taking the MCQ test. A final screen compares their pre- and post-MCQ test responses and shows best answers, allowing them to assess their learning. The learners also complete a survey, providing personal cultural information and feedback on the module. DISCUSSION: All 160 first-year medical students completed the module and evaluated its effectiveness this year. On average, students improved by 20% on the MCQ post-test and 86% of the students were satisfied with the learning experience and acquired new knowledge. As a result of their participation in the module, students examined their own cultural and linguistic backgrounds and made the following comments: "I am interested in exploring the way my own culture and cultural biases could impact my working with patients from other cultures"; "This module has opened my eyes to the fears and concerns of immigrants who do not speak English." Therefore, this pilot of the module effectively imparted guidelines for, and raised awareness of, medical interpreting. The most common critique of the module was that as a result of technical difficulties, it was time-consuming. A more rigorous evaluation is planned for the next academic year. We are also working to enrich and enhance the module for more experienced clinicians (GME and CME). As a complementary educational tool, the Internet has the advantages of allowing students to work at their own paces, view engaging video clips, and participate in interactive learning with immediate feedback and self-assessment.

Communication Barriers↗
PubMed1999

An anatomically based protocol for the description of foot segment kinematics during gait.

OBJECTIVE: To design a technique for the in vivo description of ankle and other foot joint rotations to be applied in routine functional evaluation using non-invasive stereophotogrammetry. DESIGN: Position and orientation of tibia/fibula, calcaneus, mid-foot, 1st metatarsal and hallux segments were tracked during the stance phase of walking in nine asymptomatic subjects. Rigid clusters of reflective markers were used for foot segment pose estimation. Anatomical landmark calibration was applied for the reconstruction of anatomical landmarks. BACKGROUND: Previous studies have analysed only a limited number of joints or have proposed invasive techniques. METHODS: Anatomical landmark trajectories were reconstructed in the laboratory frame using data from the anatomical calibration procedure. Anatomical co-ordinate frames were defined using the obtained landmark trajectories. Joint co-ordinate systems were used to calculate corresponding joint rotations in all three anatomical planes. RESULTS: The patterns of the joint rotations were highly repeatable within subjects. Consistent patterns between subjects were also exhibited at most of the joints. CONCLUSION: The method proposed enables a detailed description of ankle and other foot joint rotations on an anatomical base. Joint rotations can therefore be expressed in the well-established terminology necessary for their clinical interpretation. RELEVANCE: Functional evaluation of patients affected by foot diseases has recently called for more detailed and non-invasive protocols for the description of foot joint rotations during gait. The proposed method can help clinicians to distinguish between normal and pathological pattern of foot joint rotations, and to quantitatively assess the restoration of normal function after treatment.

Adult↗
PubMed2002

Methenamine hippurate for preventing urinary tract infections.

BACKGROUND: Methenamine salts are often used for the prevention of urinary tract infection (UTI). OBJECTIVES: To assess the effectiveness of methenamine hippurate in preventing UTI. SEARCH STRATEGY: Published and unpublished randomised controlled trials were identified from the Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, Current Contents, reference lists of review articles and retrieved trials. The manufacturers' of methenamine salts were contacted for unpublished studies and contact was made with known investigators in the area. SELECTION CRITERIA: Randomised and quasi-randomised trials of methenamine hippurate used for the prevention of UTIs in all population groups were eligible for inclusion. A comparison with a control (no treatment) group was a prerequisite to selection. DATA COLLECTION AND ANALYSIS: Two reviewers (BL and TB) performed independent assessment and data extraction using a standardised format. Discrepancies, methodological and interpretative issues were discussed with JS or JC. An exploration of heterogeneity as well as a detailed description of results grouped by population was conducted. MAIN RESULTS: Eleven studies met the inclusion criteria. All trials were included in a descriptive analysis. Seven trials were included in meta-analyses. Four trials (199 patients) studied symptomatic bacteriuria and six trials (341 patients) studied bacteriuria as an outcome measure. Overall, trial quality was poor. The direction of six of the pooled trials was towards a favourable treatment effect from methenamine hippurate. Interpretation of the pooled estimates was not done in view of underlying heterogeneity. The study by Pettersson 1989 explained some, but not all, of the underlying heterogeneity. This study differed from all others by including patients with known upper renal tract abnormalities. Adverse reactions were mentioned by 10 studies. The rate of adverse events was low. REVIEWER'S CONCLUSIONS: There is not enough evidence to conclusively support the use of methenamine hippurate for urinary prophylaxis. An exploration of heterogeneity raises the (hypothesis generating) possibility that methenamine hippurate may have some efficacy in patients without but not in patients with known upper renal tract abnormality (with asymptomatic bacteriuria as the outcome measure). Due to the small sample size and methodological problems within the studies involved, interpretation of these data should be done cautiously. The rate of adverse events reported by the trials was low, which suggests that current usage is unlikely to be causing significant harm.

Anti-Infective Agents, Urinary↗
PubMedDate not supplied

Patterns of enhancement on breast MR images: interpretation and imaging pitfalls.

The role of dynamic contrast material-enhanced magnetic resonance (MR) imaging of the breast as an adjunct to the conventional techniques of mammography and ultrasonography has been established in numerous research studies. MR imaging improves the detection and characterization of primary and recurrent breast cancers and allows evaluation of the response to therapy. The breast imaging lexicon published by the American College of Radiology allows a standardized and consistent description of the morphologic and kinetic characteristics of breast lesions; however, there are many challenges in the interpretation of breast enhancement patterns and kinetics, and many imaging and interpretation pitfalls must be considered. New breast MR imaging techniques that are based on the use of molecular markers of malignancy may help improve lesion characterization. The margin characteristics of a lesion and the intensity of its enhancement at MR imaging 2 minutes or less after contrast material injection are currently considered the most important features for breast lesion diagnosis.

Breast Neoplasms↗
PubMedDate not supplied

How to submit a specimen for cutaneous pathology analysis. Using the '5 D's' to get the most from biopsies.

Evaluation of cutaneous biopsy specimens is greatly assisted by appropriate clinical information from the submitting physician. Without such data, it is difficult if not impossible to accurately interpret some histologic findings. As such, the more dermatopathologists know about the patient from whom a biopsy specimen is being obtained the more accurate their interpretation of the histologic findings may be. We have listed 5 categories of information all beginning with the letter D, which should be available to dermatopathologists as they evaluate a cutaneous biopsy specimen-description, demographics, duration, diameter, and diagnosis. Inclusion of this information with skin biopsy specimens will assist in their accurate and timely interpretation.

Humans↗
PubMed2005

Analysis of interval-censored longitudinal data with application to onco-haematology.

The analysis of repeated measurements on a biomarker, either alone or jointly with the analysis of time to the event of interest, is an area of active research. Nevertheless, we are not yet able to deal in complete generality with these complex data, which frequently consist of error-prone, sparse and intermittent values. In many cancer studies, they arise in the framework of clinical trials and thus their relationship with prognosis is a primary focus. In such a setting, the Cox model is regarded as the standard technique for analysis. The aim of this work is to illustrate an alternative approach to the analysis of studies in which the biomarker values are complicated by interval censoring and an event occurs when the biomarker itself passes a certain threshold. We propose a linear mixed model with a Gaussian stochastic process that allows for interval-censored data and can be used both to track the biomarker trajectory and to estimate the probability of event occurrence. It is developed within the classic approach to longitudinal data analysis that was previously adapted for left-censored data, only. We apply this method to a study on the minimal residual disease (MRD) in childhood leukaemia. MRD is an interval-censored measurement of residual leukaemic cells that was scheduled at 9 time-points during treatment. The aim is to investigate the relationship between MRD and the disease process. Relapse, the event of interest, may conveniently be represented as MRD over a pre-defined threshold. Our focus is on modelling the probability of relapse conditional on MRD observed prior to it. Results show that the approach is promising as it allows proper description of the data, while maintaining flexibility of modelling, feasibility of computations and interpretability of results.

Biomarkers↗
PubMed1990

Relativism and stations of epistemic doubt.

This sequence of studies examined the role that relativistic thinking plays in the cognitive and social-emotional lives of adolescents. Study 1 introduces an assessment strategy and associated descriptive model employed in evaluating how 70 concrete and formal operational adolescents differently interpret and resolve problems involving competing knowledge claims. A second study explored the relations between the epistemic orientations evidenced by 61 of these subjects and their current level of identity development. Study 3 compared the epistemic assumptions of a group of 29 psychiatrically hospitalized adolescents with those of a matched group of normal controls. Results from these studies indicate that relativistic approaches to problems of belief entitlement are: a) routinely characteristic of most normal adolescents; b) available to formal operational, but not concrete operational individuals; c) associated with more mature ego-identity statuses; and d) typically absent in groups of psychiatrically hospitalized youth.

Adolescent↗
PubMed1996

National Association of Medical Examiner's Pediatric Toxicology (PedTox) Registry.

In 1985, the National Association of Medical Examiners (St. Louis, MO) established a Pediatric Toxicology (PedTox) Registry to collect case reports of drugs and substances detected in children. For many drugs and substances detected in children, to date, the medical and toxicology literature contain little useful information regarding toxic and lethal concentrations, and the PedTox Registry was established to provide additional information to those who must interpret observed concentrations of drugs and substances in children. This article includes a description of the development of the PedTox Registry, its management, and a brief summary of data that have been published, including information for acetaminophen, benzene, carboxyhemoglobin, codeine, desipramine, dextromethorphan, ethanol, phenobarbital, phenylpropanolamine, and pseudoephedrine.

Adolescent↗