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Defining an international research agenda for quality of life in men with prostate cancer.

BACKGROUND: While the traditional goal in the management of patients with prostate cancer has been to maximize survival, the recent advent of the medical outcomes movement has underscored the importance of patient-centered issues, such as health-related quality of life (HRQOL). METHODS: In this paper we present a comprehensive approach to the study of HRQOL in men with prostate cancer. We begin by defining HRQOL in general, discussing its measurement, and placing it in the context of prostate cancer. We then describe the primary goals of HRQOL research and present examples of validated instruments. We finish by proposing a quality of life research agenda for the next two decades. RESULTS: Contemporary perspectives on HRQOL are based on the World Health Organization's definition of health as not merely the absence of disease, but as a state of physical, emotional, and social well-being. HRQOL measurement must adhere to the strict methodological principles of survey psychometrics and is best accomplished with any of several validated instruments. Once collected, HRQOL information is useful for prostate cancer patients facing difficult treatment decisions. CONCLUSIONS: A solid foundation for HRQOL research has been built in early- and late-stage prostate cancer. It includes the development of new instruments and the establishment of descriptive data. This groundwork will allow investigators to address more complex research issues, such as interpreting interactions among HRQOL domains, presenting HRQOL data to future patients, optimally timing HRQOL data collection, uncovering innate and alterable factors that influence HRQOL, and exploring the intercultural nuances of HRQOL assessment.

Health↗

Whatever happened to qualitative description?

The general view of descriptive research as a lower level form of inquiry has influenced some researchers conducting qualitative research to claim methods they are really not using and not to claim the method they are using: namely, qualitative description. Qualitative descriptive studies have as their goal a comprehensive summary of events in the everyday terms of those events. Researchers conducting qualitative descriptive studies stay close to their data and to the surface of words and events. Qualitative descriptive designs typically are an eclectic but reasonable combination of sampling, and data collection, analysis, and re-presentation techniques. Qualitative descriptive study is the method of choice when straight descriptions of phenomena are desired.

Data Collection↗

Lanthanide complexes of a picolinate ligand derived from 1,4,7-triazacyclononane with potential application in magnetic resonance imaging and time-resolved luminescence imaging.

The new potentially octadentate ligand, 1-(carboxymethyl)-4,7-bis[(6-carboxypyridin-2-yl)methyl]-1,4,7-triazacyclononane (H(3)bpatcn), in which two picolinate arms and one acetate arm are connected to the 1,4,7-triazacyclonane core, has been prepared. Potentiometric studies show an increased stability of the Gd(III) complex of H(3)bpatcn (logK(GdL)=15.8(2)) with respect to the Gd(III) complex of the analogous ligand 1,4,7-triazacyclononane-N,N',N''-triacetic acid (H(3)nota) (logK(GdL)=13.7), associated with an increased selectivity of H(3)bpatcn for gadolinium over calcium. The H(3)bpatcn ligand sensitises the terbium ion very efficiently, leading to a long-lived and highly luminescent terbium complex (quantum yield=43 %), in spite of the presence of a coordinated water molecule. (1)H proton NMR studies indicate that the metal ion is rigidly encapsulated by the three arms of the octadentate ligand H(3)bpatcn and that the macrocycle framework remains bound (through the five nitrogen and the three oxygen atoms) even at high temperature. A new theoretical method for interpreting the water proton relaxivity is presented. It is based on recent progresses in the description of the electronic spin relaxation and on an auxiliary probe solute. It replaces the Solomon, Bloembergen and Morgan (SBM) framework, which is questionable at low field, while avoiding resorting to simulations and/or sophisticated theories with additional unknown zero-field splitting (ZFS) parameters. The inclusion of two picolinate groups on a triazacyclononane framework affords the mono-aquo gadolinium complex [Gd(bpatcn)(H(2)O)] with favourable electron-relaxation properties (tau(eff)(S0)=125 ps). The optimisation of the electronic relaxation by ligand design is especially important to achieve high relaxivity in the new generation macromolecular complexes with long rotational correlation times.

Crystallography, X-Ray↗

The visceral nervous system and its environments.

Starting from the observation of the relationships of the biological system with its environments and of the genetically determined neuronal properties of plasticity and rhythmicity, it is possible to propose a new hypothesis about the functional role and organization of the visceral nervous system based on the physical model of the Dissipative Structure by I. Prigogine. The similarily between the visceral nervous system function and this model is supported by the following observations: (1) The visceral nervous system is a complex system, composed of many interacting units, which works away from thermodynamic equilibrium; (2) the functional organization of the nervous system is strongly dependent on internal and external environmental stimuli; (3) it is characterized by the presence of rhythms and periodic behaviors and (4) the internal order of the system is maintained in the continuous interplay between function, structure and fluctuations. On the basis of the present hypothesis, a few general principles can be formulated: (1) the higher brain centers, the fluid matrix and the external world, are the visceral nervous system natural environments; (2) with which it is plastically interfaced as a thermodynamic dissipative structure; (3) its main functional role is to regulate, distribute and maintain ordered exchanges of matter, energy and information between these environments. The present is a general interpretation of the operations of the visceral nervous system as a whole. In the frame of this interpretation the hypotheses so far formulated, including the homeostatic theory, can be viewed as the description of discrete and complementary aspects of the visceral nervous system functions.

Autonomic Nervous System↗

On the expression of psychosis in different cultures: schizophrenia in an Indian and in a Nigerian community.

This sub-study of the WHO Determinants of Outcome of Severe Mental Disorders research project was aimed at characterizing the behavioral and expressive qualities of schizophrenia in two highly diverse cultures. Early research has indicated that the core elements involving affect, perceptual and cognitive dysfunction in schizophrenia are highly similar in form in most cultures of the world. Much of the cross-cultural literature emphasizes, however, strong differences in the ways in which schizophrenia is actually expressed and manifested in different settings. The basic methodology for psychiatric description and diagnosis in the WHO program was the Present State Examination. In five of the field centers a method for investigating the expressive quality and the social behavior of patients in their own communities through the eyes of significant others was applied. This method was then subjected to psychometric tests of cross-cultural applicability and found to be valid for comparing behavior across settings. The expressive patterns of the Indian and Nigerian patients were studied from two perspectives. Indian schizophrenics were described by family members as manifesting a more affective and "self-centered" orientation; the Nigerian patients presented with a highly suspicious, bizarre, anxious quality to the basic behavioral pattern. The main features of pathology were in general accord with the descriptions of indigenous psychiatrists. The special qualities of the psychosis in the two cultures were interpreted against the background of traditional psychopathological and anthropologic theories concerning the psychodynamics and the influence of differing social conflictual themes in the two cultures. Analysis of psychopathology in this manner was found to enhance understanding of underlying mechanisms and the role of cultural conflicts in its expression.

Adolescent↗

Imaging of the oropharynx and oral cavity. Part I: Normal anatomy.

This article reviews the anatomy of the oropharynx and oral cavity, as seen on CT and MR imaging studies. Emphasis is placed on the description and illustration of the structures which are of importance to detect tissue alterations and interprete them adequately. Common pitfalls in the image interpretation of this region are indicated.

Humans↗

[CT staging of malignant lymphoma. How to avoid misinterpretations].

Therapeutic strategy and prognosis of malignant lymphoma are influenced by staging. Therefore, evaluation of pattern of lymphatic involvement is highly relevant. There are numerous pitfalls possible in detection and description when malignant lymphomas are visualized by computed tomography (CT). Normal anatomic structures may be interpreted as pathologic lymph nodes by inexperienced radiologists. Assessment and detection of lymphomas require precise knowledge of normal anatomic structures as well as roentgenological criteria and adequate methods of imaging. This report provides an overview of the relevant pitfalls and often overlooked areas in staging of malignant lymphomas.

Diagnosis, Differential↗

Electrophoresis of human red blood cells and platelets. Evidence for depletion of dextran.

A theoretical description of polymer depletion layers near smooth and hairy surfaces is developed and used for interpretation of experiments. Electrophoretic mobility measurements of human red blood cells and platelets in aqueous electrolyte solutions were performed in the presence of dextran (MW = 70 kD) to study the interaction of dextran with the cell surface. The electrophoretic mobility in the presence of dextran was considerably larger than expected from the viscosity. This behavior was interpreted as evidence for the existence of a polymer depletion layer. Depending on ionic strength, depletion layer thicknesses ranging from 2.9 to 4.4 nm were found. The dextran concentration at the outer border of the glycocalyx was only 10% of the bulk value. One cannot exclude the possibility that this small amount reflected adsorption. In the case of platelets, the degree of the mobility reduction depended on ionic strength. Depletion of dextran from the platelet surface apparently became smaller with decreasing ionic strength. This indicated a more complex pattern of interaction of dextran with the platelet surface than with the RBC surface. Both adsorption and polymer penetration into the glycocalyx were discussed quantitatively. It was concluded that ionic strength-dependent penetration of dextran into the hairy layer is more likely than ionic strength dependent adsorption changes. As in the case of red cells, some adsorption of dextran might be present.

Adsorption↗

Correlation of the five test methods to assess chemical toxicity and relation to physical properties.

Biological tests using Orizias latipes (LC50 and oxygen uptake test), Moina macrocopa (LC50), and Dugesia japonica (head regeneration test and LC50) were carried out in order to clarify the mutual relationship of these test methods. The oxygen uptake rate of O. latipes was not effective to assess chemical toxicity. Adding the results of the growth inhibition test of Tetrahymena pyriformis (Yoshioka, Y., Ose, Y., and Sato, T. (1985). Sci. Total Environ. 43, 149-157), the correlation coefficients between each two test methods were calculated. The test results except EC50 and LC50 of D. japonica showed a good relation to each other. We determined the solubility and the n-octanol/water partition coefficient (P) of some chemicals used in the test. Log P interpreted the toxicity in mol/liter unit but not in mg/liter. Solubility was not a useful descripter neither in mol/liter nor in mg/liter unit.

Animals↗

[Non verbal communication abilities in severe traumatic brain injury].

OBJECTIVE: Discursive abilities of severe brain injured patient are always impaired: loss of flexibility, lack of cohesion and coherence, often more elliptic. We know few about nonverbal competencies during discourse. The objective is to verify nonverbal abilities of these patients by pragmatic analysis. METHODS: Four men were examined more than 7 years after severe traumatic brain injury. Nonverbal Prutting and Kirchner Pragmatic Protocol (1987) were done allowing to a qualitative and quantitative measurement of paralinguistic behaviour: prosody and quality of speech, facial expression, posture, gaze, gesture. Two conditions were recorded: dual (descriptive discourse) and group (conversational discourse). Associated impairments such as cognitive and dysexecutive functioning were also investigated. RESULTS/DISCUSSION: Impoverishment (loss of ability) or impaired inadequacity was observed in all patients. Paralinguistic competences of conversational discourse was worse than descriptive one. Facial expression, gaze functioning, referential gesture were more often impaired. Maladjustment could be interpretated in reference with dysexecutive syndrome. CONCLUSION: In spite of the lack of information about the range of normal pragmatic behaviour, it seems that brain injured patients have shown poor nonverbal abilities during discourse. Rehabilitation training of communication skills would integrate this fact in order to improve interactivity and social relationship.

Adult↗

Chain configuration and flexibility gradient in phospholipid membranes. Comparison between spin-label electron spin resonance and deuteron nuclear magnetic resonance, and identification of new conformations.

The electron spin resonance spectra of 1-myristoyl-2-[n-(4,4-dimethyloxazolidine-N-oxyl)myristoyl]-sn- glycero-3-phosphocholine spin-label positional isomers (n = 6, 10, and 13) have been studied in oriented, fully hydrated bilayers of dimyristoylphosphatidylcholine, as a function of temperature and magnetic field orientation. The spectra have been simulated using a line-shape model which incorporates chain rotational isomerism, as well as restricted anisotropic motion of the lipid molecules as a whole, and which is valid in all motional regimes of conventional spin-label electron spin resonance (ESR) spectroscopy. At least one component of the lipid motion is found to lie in the slow-motion regime for all label positions, even in the fluid liquid crystalline phase, well above the phase transition. In the gel phase, the chain isomerism lies in the slow-motional regime, and the overall motions are at the rigid-limit. In the fluid phase, the chain isomerism is in the fast-motional regime, and the chain axis motions are in the slow regime. This indicates that the commonly used motional-narrowing theory is not appropriate for the interpretation of spin-label spectra in biological membranes. The simulation parameters yield a consistent description for the chain order and dynamics for all label positions. The correlation times and order parameters for the overall motion are the same at all positions down the chain, whereas the chain conformation and trans-gauche isomerism rate display a characteristic flexibility gradient, with increasing motion towards the terminal methyl end of the chain. Significantly, it is found that all six distinct tetrahedral orientations of the hyperfine tensor at the labeled segment are required for a consistent description of the chain isomerism. For the C-6 segment only the 0 degree (trans) and two 60 degrees (gauche) orientations are significantly populated, for the C-10 position two further 60 degrees orientations are populated, and for the C-13 position all orientations have non-vanishing populations. Detailed comparisons have been made with the results of 2H nuclear magnetic resonance (NMR) measurements on dimyristoylphosphatidylcholine labeled at the same position in the sn-2 chain, and using an identical motional model. The parameters of overall reorientation, both order parameter and correlation times, have very similar values as determined by ESR and NMR. The major difference between the results from the two methods lies in the conformational populations at the labeled chain segment and the trans-gauche isomerization rate in the gel phase. The conformational order is much lower for the spin-labeled chain segments than for the corresponding deuterium-labeled segments, and the isomer interconversion rates in the gel phase(although displaying a mobility gradient in both cases) are found to be much slower in the former case. In addition the spin-label measurements provide information on the macro order (chain tilt), which is only available from oriented samples. These results are consistent between the different spin label positions and are in agreement with the findings from x-ray diffraction.

Dimyristoylphosphatidylcholine↗

The biological toolbox: a computer program for simulating basic biological and pathological processes.

The program described here has been written to enable pathologists and biologists with almost no computer experience to design complex models of cell interactions. The program although simulating in only two dimensions allows the user to define the individual rules governing cell behaviour using a language called Cell Description Language, then simulates the multiple interactions between the cells to produce a dynamic visual interpretation representing tissue growth and differentiation. The program has been developed using the World Wide Web, thereby giving access to anyone with an Internet connection. The Web technology allows others to use our powerful computers to perform the complex calculations that are necessary and effectively eliminates the problems of modifying and compiling the program to run on more than one hardware platform. The changes that take place during the simulation are presented as a video using the MPEG video format; they may then be viewed on many different types of computers. The toolbox provides a novel approach to computer-based biological simulations and an excellent resource for teaching.

Biology↗

Cd and Zn concentrations in small mammals and willow leaves on disposal facilities for dredged material.

Disposal sites for dredged material are often polluted with heavy metals. The uptake of Cd and Zn by small mammals and willow trees was assessed on three sites with a different pollution degree. Detailed soil sampling showed a huge variation in soil characteristics within the sites, typical for disposal sites for dredged material. This variation made risk assessment and interpretation of soil chemical analyses complicated. Small mammals were thought to give a more integral description of the contaminant level because they cover a large area. Cd concentrations in small mammals were elevated compared with background levels whereas Zn concentrations were rather low. There were no significant differences between sites in Cd or Zn levels in animals. Leaf analysis showed a clear response to the pollution degree of the sites. The calculations using the BIOMAG model indicated that the Cd of the soil caused low risk for predators. However, the elevated Cd and Zn concentrations in the willow leaves on the polluted sites and the high Cd concentrations in the small mammals on all sites indicated that ecosystem development should be carefully considered.

Animals↗

Effectiveness of ignition interlock devices in reducing drunk driving recidivism.

OBJECTIVE: To determine if ignition interlock devices reduce driving while intoxicated (DWI) recidivism. SEARCH STRATEGIES: Cochrane Collaboration search strategies were used. SELECTION CRITERIA: Studies for selection examined the effectiveness of interlock programs in a defined population. Studies were required to have a clear description of the program and outcomes evaluated, to have a comparison group and to provide interpretable data. DATA COLLECTION AND ANALYSIS: A total of 31 studies were found. Ten studies met the selection criteria. Three of these studies were eliminated from further analysis because they did not contain original data. A fourth study was eliminated due to methodologic weaknesses, leaving six studies for final review and analysis. Pooled analyses were not done because studies did not follow similar methods over comparable time periods. MAIN RESULTS: Five of the six studies found interlocks were effective in reducing DWI recidivism while the interlock was installed in the car. In the five studies demonstrating a significant effect, participants in the interlock programs were 15%-69% less likely than controls to be re-arrested for DWI. The only reported randomized, controlled trial demonstrated a 65% reduction in re-arrests for DWI in the interlock group, compared with the control group. CONCLUSIONS: Alcohol ignition interlock programs appear to be effective in reducing DWI recidivism during the time period when the interlock is installed in the car. Future studies should attempt to control for exposure (i.e., number of miles driven) and determine if certain sub-groups are most benefited by interlock programs.

Alcohol Drinking↗

A dynamic analysis of the rotation mechanism for conformational change in F(1)-ATPase.

Molecular dynamics trajectories for the bovine mitochondrial F(1)-ATPase are used to demonstrate the motions and interactions that take place during the elementary (120 degrees rotation) step of the gamma subunit. The results show how rotation of the gamma subunit induces the observed structural changes in the catalytic beta subunits. Both steric and electrostatic interactions contribute. An "ionic track" of Arg and Lys residues on the protruding portion of the gamma subunit plays a role in guiding the motions of the beta subunits. Experimental data for mutants of the DELSEED motif and the hinge region are interpreted on the basis of the molecular dynamics results. The trajectory provides a unified dynamic description of the coupled subunit motions involved in the 120 degrees rotation cycles of F(1)-ATPase.

Crystallography, X-Ray↗

The systemic paradigm and its relevance to the modelling of biological functions.

If we are to make advances in the design of information systems for the processing of functional genomic data, we must carefully examine the concepts of gene and function. Therefore, we must consider the biological models that are used to acquire these data from an epistemological point of view. This article introduces three elements of this view: (i) we reviewed the major concepts and the axioms of the systemic paradigm; (ii) we considered their relevance for the modelling of the biological functions within the framework of an intracellular signalling process; (iii) we present an operational input founded on this methodological viewpoint to illustrate the coherence of a theoretical framework and the use of its formalism for the description and the representation of biological activities. This formalism will guide the modelling and the interpretation of molecular interactions in terms of organisational operations producing and transforming the genetic information; thus, providing a better understanding of the complex relationship between the generation, the circulation and the computation of information when biological systems are set up.

Animals↗

Molecular architecture of Escherichia coli F1 adenosinetriphosphatase.

The structure of the E. coli F1 ATPase (ECF1) has been studied by a novel combination of two specimen preparation and image analysis techniques. The molecular outline of the ECF1 was determined by three-dimensional reconstruction of images of negatively stained two-dimensional crystals of ECF1. Internal features were revealed by analysis of single particles of ECF1, preserved in their native state in a thin layer of amorphous ice, and examined by cryoelectron microscopy. Various projections of the unstained ECF1 were interpreted consistently with the three-dimensional structure in negative stain, yielding a more informative description of the enzyme than otherwise possible. Results show that the ECF1 is a roughly spherical complex approximately 90-100 A in diameter. Six elongated protein densities (the alpha and beta subunits, each approximately 90 A X approximately 30 A in size) comprise its hexagonally modulated periphery. At the center of the ECF1 is an aqueous cavity which extends nearly or entirely through the length of the complex. A compact protein density, located at one end of the hexagonal barrel and closely associated with one of the peripheral subunits, partially obstructs the central cavity.

Crystallography↗

Looking for natural patterns in analytical data. 2. Tracing local density with OPTICS.

The main principles and the algorithm of a density-based clustering approach, OPTICS, are described, and its unique properties, such as the ability to reveal clusters of arbitrary shapes and different densities, are illustrated on simulated and real spectral and chromatographic data sets. A "reachability plot" visualizing density fluctuations of data in multivariate space and a "color map" relating the original and/or descriptive features with data clustering allow a deeper insight into the data structure and its interpretation in chemical terms.

Journal Article↗