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Data mining and knowledge discovery in predictive toxicology.

This article describes the knowledge discovery process in predictive toxicology. This process consists of five major steps (i) feature calculation, (ii) feature selection, (iii) model induction, (iv) model validation and (v) interpretation of predictions and models. Data mining is a part of the knowledge discovery process and consists of the application of data analysis and discovery algorithms, which can be useful in all of the above steps. A brief review of suitable algorithms and their advantages and disadvantages is given for each knowledge discovery step, followed by a more detailed description of a problem-specific implementation of the lazar prediction system.

Algorithms↗

Stress transmission through a model system of cohesionless elastic grains

Understanding the mechanical properties of granular materials is important for applications in civil and chemical engineering, geophysical sciences and the food industry, as well as for the control or prevention of avalanches and landslides. Unlike continuous media, granular materials lack cohesion, and cannot resist tensile stresses. Current descriptions of the mechanical properties of collections of cohesionless grains have relied either on elasto-plastic models classically used in civil engineering, or on a recent model involving hyperbolic equations. The former models suggest that collections of elastic grains submitted to a compressive load will behave elastically. Here we present the results of an experiment on a two-dimensional model system--made of discrete square cells submitted to a point load--in which the region in which the stress is confined is photoelastically visualized as a parabola. These results, which can be interpreted within a statistical framework, demonstrate that the collective response of the pile contradicts the standard elastic predictions and supports a diffusive description of stress transmission. We expect that these findings will be applicable to problems in soil mechanics, such as the behaviour of cohesionless soils or sand piles.

Journal Article↗

Descriptions of suffering in connection with life values. Healthy individuals' reflections in interviews.

Nine semistructured interviews with attendant questions were conducted with the purpose of elucidating how healthy individuals describe suffering and life values in their reflections upon active euthanasia. In order to find the intended meaning in utterances, the interviews were interpreted step by step. The point of departure was the following question: What expressions of suffering and what expressions of life values can be found in the text? A connection was found between the interviewees' descriptions of suffering and life values in their reflections upon active euthanasia. The interviewees who considered close relations to be a value of life expressed suffering as dependence, compassion, violation, abandonment and feelings of guilt, while those to whom health was a value of life expressed suffering as torment, dependence, physical pain, feebleness, hopelessness and dying. Those who saw autonomy as a value of life expressed suffering as dependence and violation and those to whom doing good was a value of life expressed suffering as compassion. When organizing health care and deciding about the response to suffering, it seems important to strive for a response built upon the individual patient's description of suffering and life values.

Adult↗

Relational themes in the inpatient community meeting.

The authors present a model of psychiatric inpatient community meetings run as large group interpretive psychotherapy. They developed this model in part from Gill's notion that patients attach plausible meanings to therapist behavior based on the patient's characteristic and stereotypical ways of experiencing relationships. The model provides a framework for the description of 11 clinically derived "unconscious relational configurations" that can frequently be detected as organizing "relational themes" of community meetings. The authors present two clinical vignettes in which staff detect these themes and interpret them together with the defenses against them. They then discuss the prominent negative affective valence that characterizes the "unconscious relational configurations."

Ego↗

Operation for ascending aortic aneurysm and aortic regurgitation--pathological influence on survival.

The author briefly reviews the early operations of treatment of aortic aneurysm and aortic regurgitation leading to his description, in 1968, of the first composite graft replacement of the ascending aorta and aortic valve, with anastomosis of the coronary arteries into the graft. The original operation is described with reference to modifications suggested by a number of authors throughout the last 20 years. Methods of achieving coronary artery continuity by Carrel patch and pull-through by saphenous vein interposition and by synthetic graft techniques are discussed. While any of these methods may be needed in individual cases the preference of the author remains for simplicity. The arguments for and against excision of the aneurysmal sac are considered in relation to the control of haemorrhage. The early and medium term results of operation are good but in comparing results world-wide a lack of uniform diagnostic criteria is apparent. The full clinical Marfan syndrome presents little difficulty but the status of "annuloaortic ectasia", Erdheim's medionecrosis, "cystic medial necrosis" and many other pathological descriptions are not defined: "forme fruste" of Marfan's disease has been used for any of the above. Interpretation of surgical results remains difficult and often impossible in the absence of clear definitions. Recent work on elastic tissue and on the chemistry of collagen together with the hope of identification of the genetic background now offers real hope of clearer understanding.

Aorta↗

Managing research data with self-documenting files.

Processing biomedical research data is frequently complex due to the evolutionary nature of experiments and the requisite modification of analysis software. For the past several years we have been evolving a set of software tools designed to improve our ability to respond to evolving experimental designs. These tools allow the investigator to easily manipulate the research data and specify desired data transformations at run time. Coupling of analysis software to research data files is dependent on data files that are commented in a manner similar to that used in programming languages. The resulting annotated data files are self-documenting, and their use facilitates visual interpretation of displayed data as well as automatic processing of subsets of data. Here we present a formal description of a self-documenting file and describe several software tools that facilitate processing of biomedical research data.

Electronic Data Processing↗

Swelling of Golgi vesicles in mammary secretory cells and its relation to the yield and quantitative composition of milk.

A quantitative description is given of some cellular secretory mechanisms in the mammary epithelium, that can be used in the interpretation of changes in milk yield and composition. The volume of the aqueous phase is considered to depend on a flux of vesicles derived from the Golgi apparatus and on the degree of vesicle swelling prior to exocytosis. Milk proteins secreted by the Golgi route are diluted during vesicle swelling and secreted fat globules are diluted to their final, milk, concentration in the alveolar lumen. Swelling of Golgi vesicles is considered to occur through an osmotic flow of water induced by the intravesicular synthesis of lactose and by the net transport of ions coupled to lactose synthesis. A hypothetical model is given of ion transport mechanisms across the Golgi vesicle membrane to illustrate how the coupling of lactose synthesis to salt transport might occur.

Animals↗

Patient experiences of diagnostic uncertainty in musculoskeletal care: a systematic review of qualitative studies.

BACKGROUND: Diagnosis plays a central role in musculoskeletal care. However, establishing a clear diagnosis is often challenging, and diagnostic uncertainty is common. OBJECTIVES: To explore patient experiences of diagnostic uncertainty in musculoskeletal care. METHODS: Five databases (CINAHL, Embase, MEDLINE, AMED, Web of Science) were searched from inception to October 2025. Qualitative studies involving semi-structured interviews with adults receiving care for MSK conditions were included. Methodological quality was appraised using the Joanna Briggs Institute Qualitative Checklist. Data were synthesised using thematic synthesis, and confidence in findings was assessed using the Grading of Recommendations Assessment, Development, and Evaluation Confidence in the Evidence from Reviews of Qualitative Research approach (GRADE-CERQual). RESULTS: Twenty-six studies involving 462 participants were included. Critical appraisal identified 23 studies with varying methodological limitations; all studies were included in the synthesis. Nine descriptive themes were synthesised into three analytical themes: (1) patient expectations and perceived meanings of a diagnosis and interpretations of diagnostic uncertainty; (2) the multi-dimensional experience of diagnostic uncertainty; and (3) the role of contextual factors, particularly communication and the therapeutic relationship, in shaping experiences of diagnostic uncertainty. Using GRADE-CERQual, confidence in these themes was rated as low, moderate and very low, respectively. CONCLUSION: Diagnostic uncertainty is a subjective and multi-dimensional experience shaped in part by patients' expectations and the meanings attributed to diagnosis. Its impact spans predominantly cognitive and affective domains and may influence clinical presentation. Patient-centred communication and strong therapeutic relationships may support patients in navigating diagnostic uncertainty in musculoskeletal care.

Adult↗

The nature of penumbral depolarizations following focal cerebral ischemia in the rat.

It has been previously suggested that the transient ischemic depolarizations (IDs), thought involved in the gradual expansion of ischemic injury in the first hours following middle cerebral artery occlusion (MCAo), are akin to spreading depression (SD). However, previous studies indicate that the characteristics of these events are heterogeneous (unlike those of SDs). We therefore sought to determine whether different types of IDs exist or not. Using four cortical microelectrodes, we compared the spatial and the temporal characteristics of IDs that occur following intraluminal MCAo in halothane-anesthetized rats to those of electrically induced SDs. An average 4.6+/-3.2 series of events, sequentially affecting the four electrodes, were recorded in 5 h following the induction of ischemia. The distribution of ID duration disclosed two types: short IDs (<7 min, 53% of all events) and long IDs (>7 min; 9% of all events). Most long IDs occurred within the first 30 min and as the initial electrophysiological event. Later on and often restricted to a single or reduced number of recording sites, intermittent IDs were of reduced amplitude or even replaced entirely by suppressed electrocorticographic activity (38% of all events). While the amplitude, duration and spreading characteristics were similar between short IDs and SDs provoked in the cortex of non-ischemic rats, those of long IDs were markedly different. Our results indicate that two types of IDs exist and confirm that most IDs (short ones) are similar in nature to SDs. Long IDs may represent a penumbral anoxic depolarization (AD), reversed by an improvement of perfusion, in the early stages of ischemia. Furthermore, we show that intermittent blockade of depolarization waves occurs and that its incidence increases with time. This blockade may reflect adaptive mechanisms which take place to prevent further depolarizations, the nature of which remains to be determined. The present description of electrophysiological abnormalities might have implications for anti-depolarization therapy in focal cerebral ischemia and to interpret the results of non-invasive techniques which enable the imaging of depolarized areas following stroke.

Animals↗

Transthoracic needle biopsy.

Transthoracic needle biopsy (TNB) has emerged as the semi-invasive technique of choice for the diagnosis of localized intrathoracic lesions. Using CT, fluoroscopic, or sonographic guidance, TNB is highly accurate and safe when combined with expert pathologic interpretation of the aspirated specimen. This article details the preprocedural evaluation of the patient referred for TNB and discusses the technical aspects of performing the biopsy and processing and interpreting the material obtained. The reported results and complications of TNB are reviewed and followed by a brief description of the cost effectiveness of the technique and a comparison with alternative semi-invasive diagnostic techniques including bronchoscopic and video-assisted thoracoscopic biopsy.

Biopsy, Needle↗

Provision of information about drug side-effects to patients.

To make informed decisions about taking medicinal drugs, people need accurate information about side-effects. A European Union guideline now recommends use of qualitative descriptions for five bands of risk, ranging from very rare (affecting <0.01% of the population), to very common (>10%). We did four studies of more than 750 people, whom we asked to estimate the probability of having a side-effect on the basis of qualitative and quantitative descriptions. Our results showed that qualitative descriptions led to gross overestimation of risk. Until further work is done on how patients taking the drugs interpret these terms, the terms should not be used in drug information leaflets.

Adult↗

Virtual reality and anthropology.

Since the discovery of the Tyrolean Iceman in 1991 advanced imaging and post processing techniques were successfully applied in anthropology. Specific techniques include spiral computed tomography and 3-dimensional reconstructions including stereolithographic and fused deposition modeling of volume data sets. The Iceman's skull was the first to be reproduced using stereolithography, before this method was successfully applied in preoperative planning. With the advent of high-end graphics workstations and biomedical image processing software packages, 3-dimensional reconstructions were established as a routine tool for analyzing volume data sets. These techniques opened totally new insights in the field of physical anthropology. Computed tomography became the ideal research tool to access the internal structures of various precious fossils without damaging or even touching them. Many of the most precious specimens from the species Autralopithecus (1.8-3.5 Myears), Homo heidelbergensis (200-600 kyears) or Homo neanderthalensis (40-100 kyears) were scanned during the last 5 years. Often the fossils are filled with a stone matrix or other materials. During the postprocessing routines highly advanced algorithms were used to remove virtually these incrustations. Thus it was possible to visualize the morphological structures that lie beneath the matrix. Some specimen were partially destroyed, so the missing parts were reconstructed on computer screen in order to get estimations of the brain volume and endocranial morphology, both major fields of interest in physical anthropology. Moreover the computerized form of the data allows new descriptions of morphologic structures by the means of 'geometric morphometrics'. Some of the results may change aspects and interpretations in human evolution. The introduction of new imaging and post processing techniques created a new field of research: Virtual Anthropology.

Algorithms↗

Power vector analysis of the optical outcome of refractive surgery.

PURPOSE: To demonstrate the power vector method of representing and analyzing spherocylindrical refractive errors. SETTING: School of Optometry, Indiana University, Bloomington, Indiana, USA. METHODS: Manifest and keratometric refractive errors were expressed as power vectors suitable for plotting as points in a 3-dimensional dioptric space. The 3 Cartesian coordinates (x, y, z) of each power vector correspond to the powers of 3 lenses that, in combination, fulfill a refractive prescription: a spherical lens of power M, a Jackson crossed cylinder of power J0 with axes at 90 degrees and 180 degrees, and a Jackson crossed cylinder of power J45 with axes at 45 degrees and 135 degrees. The Pythagorean length of the power vector, B, is a measure of overall blurring strength of a spherocylindrical lens or refractive error. Changes in refractive error due to surgery were computed by the ordinary rules of vector subtraction. RESULTS: Frequency distributions of blur strength (B) clearly demonstrate the effectiveness of refractive surgery in reducing the overall blurring effect of uncorrected refractive error. CONCLUSIONS: Power vector analysis also revealed a reduction in the astigmatic component of these refractive errors. Paired comparisons revealed that the change in manifest astigmatism due to surgery was well correlated with the change in keratometric astigmatism. Power vectors aid the visualization of complex changes in refractive error by tracing a trajectory in a uniform dioptric space. The Cartesian components of a power vector are mutually independent, which simplifies mathematical and statistical analysis of refractive errors. Power vectors also provide a natural link to a more comprehensive optical description of ocular refractive imperfections in terms of wavefront aberration functions and their description by Zernike polynomials.

Astigmatism↗

Verification of coronary angiogenesis by quantitative morphology.

The angiogenic response may be reliably evaluated only by the methods of quantitative morphology. These methods may appear deceivingly simple but they contain several possible pitfalls. This review presents major principles of proper methodology for determination of tissue vascularization using quantitative morphology. Description of appropriate preparation of the tissue is followed by a survey of methods available for visualization of the vascular structures, by the description of principles for proper sampling and measurements and, finally, by a section on how to present and interpret the results.

Animals↗

Following the rules: consistency in sign.

The majority of hearing-impaired students in the United States are exposed to at least one, if not several, forms of simultaneously signed and spoken English input (e.g., Seeing Essential English, Signing Exact English, Signed/Manual English, or combinations of these systems). It was the purpose of this study to investigate teachers' and interpreters' consistency with regard to following the rules of three of these systems. Subjects were asked to interpret a carefully designed set of stimuli; their performance was videotaped for later bimodal transcription and analysis. Careful descriptive analysis of the form and content of the data revealed that some professionals who purported to use a particular system frequently do not follow accurately the rules of that system, but many can encode in sign the meaning of what they are saying. Signing Exact English (SEE-II) users were able to follow the rules of that system at a significantly higher percentage of time than users of either of the other two systems (p less than .03 and p less than .001). They also were able to encode the meaning in sign of what they were saying an average of 86% of the time--significantly higher than users of Signed/Manual English (p less than .02). However, the average percentage of ability to follow the precise rules of a system was below 57% for even the adults who used SEE-II. It is possible that the acquisition of English is confounded for hearing-impaired children when professionals do not consistently sign the system they purport to use.

Adult↗

Altered sexual patterns after treatment for prostate cancer.

PURPOSE: The purpose of this study was to identify and describe the impact of prostate cancer and its treatment on men's sexuality and intimate relationships from the perspective of the men's lived experiences. DESCRIPTION OF THE STUDY: Ten men diagnosed with prostate cancer were interviewed. Verbal transcripts were analyzed using an interpretive phenomenological approach based on Heidegger's philosophy. RESULTS: "Altered sexual patterns" was identified as the major theme, which in turn was influenced by five minor themes: choice of consequences; age affecting sexual life; hope of improvement; acceptance of altered sexual life; and image of manliness. Choice of consequences showed that survival is paramount, as interviewees often felt that they were choosing between death or sexual dysfunction. Age affecting sexual life identified sexual dysfunction as caused by natural effects of aging. Hope of improvement showed that several men hoped for improvement in sexual function, although it had been years since their treatment. Acceptance of altered sexual life illustrated that the men often felt the need to accept their altered sex life, with their wives playing an important role in this acceptance. Finally, the theme image of manliness showed the men's attempts to acknowledge and cope with the changes in their self-image. CLINICAL IMPLICATIONS: It is important that healthcare professionals adopt a comprehensive approach in communicating information about prostate cancer treatment choices and potential side effects that includes the patient and his partner. Communication and counselling about treatment options, potential side effects, and potential strategies to manage side effects should be offered both at the time of diagnosis and at post-treatment follow-up.

Age Factors↗

Electron transfer between biological molecules by thermally activated tunneling.

A theory of electron transfer between two fixed sites by tunneling is developed. Vibronic coupling in the individual molecules produces an activation energy to transfer at high temperatures, and temperature-independent tunneling (when energetically allowed) at low temperature. The model is compared with known results on electron transfer in Chromatium and in Rhodopseudomonas spheroides. It quantitatively interprets these results, with parameters whose scale is verified by comparison with optical absorption spectra. According to this description, the separation between linking sites for electron transfer is 8-10 A in Chromatium, far smaller than earlier estimates.

Journal Article↗

Anatomy of the sympathetic pathways in the cavernous sinus.

We studied sympathetic fibres in the cavernous sinus in 40 unfixed specimens obtained from human cadavers. Sympathetic fibres in the cavernous sinus are understood to be grouped in a plexiform configuration surrounding the internal carotid artery and have a diffuse distribution among the sympathetic nerves. Our study, however, suggests that a more systematic arrangement of sympathetic pathways exists in the cavernous sinus. A detailed anatomical description of intracavernous sympathetic fibres contributes to academic anatomical knowledge and may have practical applications for 1. diagnostic interpretation of pathologic conditions involving the cavernous sinus, 2. recognition and orientation of anatomical structures during intracavernous surgical procedures, and 3. a deeper understanding of the sympathetic nerve supply to cerebral vasculature.

Carotid Artery, Internal↗