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PubMed2005

Age, sex and regional brain volumes predict perceptual-motor skill acquisition.

Neural mechanisms of skill acquisition across the lifespan are largely unknown. Neuroimaging in younger adults and research on neurodegenerative disorders suggests that perceptual-motor learning relies on the striatum, cerebellum, and prefrontal cortex. Our objective in this study was to explore whether individual differences in regional brain volumes modify the effects of age and sex on the acquisition of a perceptual-motor skill in healthy adults. The participants (N = 85, age 22-80) performed five 5-trial blocks of a mirror-drawing task on three separate days (for a total of 25 trials). Index of performance was time to completion and number of errors committed. All participants improved with practice, but younger adults performed better than their older counterparts, and women performed better than men. Four brain regions--lateral prefrontal cortex (LPFC), hippocampus (HC), cerebellar hemispheres (Cb) and the caudate nucleus (Cd)--were selected on the basis of the relevant literature and measured on MRI scans. All regional volumes were negatively associated with age, although the magnitude of association differed from LPFC (the strongest) to Cd (the weakest). Larger lateral PFC was associated with better performance on the mirror drawing task, and this link was stronger in the older participants and was strengthened at the later stages of learning. Larger caudate was related to better performance, especially at later learning, among men, but among women the link was evident only during early learning. Thus, mirror-drawing represents a task that, despite its visual-spatial nature, favors women, and may exhibit sexually dimorphic brain substrates.

Adult↗

PubMed1983

The diary as a transitional object in female adolescent development.

The concept of the diary as a transitional object adds a new perspective to the theory and treatment of adolescents. The findings of this pilot study suggest that the diary mirrors, soothes , helps inhibit frightening impulses, and helps integrate inner and outer realities. These functional aspects of the diary become internalized into the evolving psychic structure just as the analogous functions of the therapist in the context of a positive transference are internalized. The use of the adolescent diary in psychotherapy enhances and enriches the meaning of the treatment alliance and promotes the progress of the "second separation-individuation." The therapist's sensitive and creative understanding of the diary- diarist relationship can lead to improved treatment strategies for adolescent patients. Further empirical research on the phenomenon of adolescent diary writing may deepen our clinical and theoretical understanding of this challenging population.

Adolescent↗

PubMed2002

Teaching communication skills: a skills-based approach.

OBJECTIVES: The purpose of this project was to design structured training activities to emphasize key points about patient-physician communication. Effective communication has been shown to enhance patient satisfaction, compliance with treatment, and medical decisions and outcomes. Basic communication skills and behavioral-change interview skills are taught. DESCRIPTION: Communication is a core "building block" of a four-semester, two-year Essentials of Clinical Medicine Course (ECM), which is in its second year of existence. Four interactive lab sessions have been designed, each with structured learning exercises. At the beginning of each session, students work in groups of 30 completing activities based on videos developed by the Bayer Institute for HealthCare Communication.(1) Subsequently, two groups of three students each work with a behavioral or physician facilitator. A formal training and administration manual for all activities has been developed and an evaluation system developed and implemented. Session 1, "Initial Interview Skills," teaches opening, mirroring, and encouraging non-interrogation activities. Session 2, "Empathic Responses," includes activities entitled "Cue Detection," "Accurate Empathy," and "Getting the Story Straight." In Session 3, "Obtaining an HPI," students view an exemplary medical interview, then role-play computerized cases(2) and practice the HPI data collection based on clinical facts taken from the computerized cases. During the Session 4, "Putting It All Together," students interview a standardized patient (SP) for five to seven minutes and receive and give feedback from peers, SPs, and facilitators. Subsequent to the communication lab, students conduct six physician-supervised patient interviews practicing their medical interviewing skills and write-ups. Two subsequent small-group sessions include "group" interviews of SPs in which students assess readiness for behavioral change (e.g., quitting smoking, losing weight) and also learn to conduct more "difficult' health-promotion conversations (e.g., sexual behavior, alcohol use). Evaluation methods include the use of a professional behavior evaluation form completed by communication facilitators and small-group leaders. This assessment form consists of ratings on: reliability and responsibility, relationships with others, self-improvement and adaptability, upholding professional standards, and communication skills dimensions. A formal interview-behavior checklist is used during the training and in the feedback sessions. Finally, SP OSCEs of communication and behavioral-change interviewing occur at the end of the first year of training. DISCUSSION: The communication labs have been well received by students. Students have reported increased understanding of their upcoming roles as physicians, have stated they have gained insights about the importance of connecting with patients in order to give them proper medical treatment, and have requested additional training in communication. Students have reported increased confidence in their interviewing skills prior to interactions with "actual" patients, and clinical preceptors have reported increased levels of preparedness among students who have participated in the structured learning experience. Future plans include adding communication training with problem patients, and about end-of-life and other challenging issues.

Communication↗

PubMed2025

Out-of-the-box bioinformatics capabilities of large language models (LLMs).

Large Language Models (LLMs), AI agents and co-scientists promise to accelerate scientific discovery across fields ranging from chemistry to biology. Bioinformatics- the analysis of DNA, RNA and protein sequences plays a crucial role in biological research and is especially amenable to AI-driven automation given its computational nature. Here, we assess the bioinformatics capabilities of three popular general-purpose LLMs on a set of tasks covering basic analytical questions that include code writing and multi-step reasoning in the domain. Utilizing questions from Rosalind, a bioinformatics educational platform, we compare the performance of the LLMs vs. humans on 104 questions undertaken by 110 to 68,760 individuals globally. GPT-3.5 provided correct answers for 59/104 (58%) questions, while Llama-3-70B and GPT-4o answered 49/104 (47%) correctly. GPT-3.5 was the best performing in most categories, followed by Llama-3-70B and then GPT-4o. 71% of the questions were correctly answered by at least one LLM. The best performing categories included DNA analysis, while the worst performing were sequence alignment/comparative genomics and genome assembly. Overall, LLMs performance mirrored that of humans with lower performance in tasks in which humans had low performance and vice versa. However, LLMs also failed in some instances where most humans were correct and, in a few cases, LLMs excelled where most humans failed. To the best of our knowledge, this presents the first assessment of general purpose LLMs on basic bioinformatics tasks in distinct areas relative to the performance of hundreds to thousands of humans. LLMs provide correct answers to several questions that require use of biological knowledge, reasoning, statistical analysis and computer code.

Journal Article↗

PubMed2005

The kidneys in the Bible: what happened?

The kidneys, always used in the plural (kelayot), are mentioned more than 30 times in the Bible. In the Pentateuch, the kidneys are cited 11 times in the detailed instructions given for the sacrificial offering of animals at the altar. Whereas those instructions were for purification ceremonies at the Temple, sacrificial offerings were made subsequently in seeking divine intervention for the relief of medical problems. In the books of the Bible that follow the Pentateuch, mostly in Jeremiah and Psalms, the human kidneys are cited figuratively as the site of temperament, emotions, prudence, vigor, and wisdom. In five instances, they are mentioned as the organs examined by God to judge an individual. They are cited either before or after but always in conjunction with the heart as mirrors of the psyche of the person examined. There is also reference to the kidneys as the site of divine punishment for misdemeanors, committed or perceived, particularly in the book of Job, whose suffering and ailments are legendary. In the first vernacular versions of the Bible in English, the translators elected to use the term "reins" instead of kidneys in differentiating the metaphoric uses of human kidneys from that of their mention as anatomic organs of sacrificial animals burned at the altar. This initial effort at linguistic purity or gentility has progressed further in recent versions of the Bible, in which the reins are now replaced by the soul or the mind. The erosion may have begun in the centuries that followed the writing of the Bible, when recognition of the kidneys as excretory organs deprived them of the ancient aura of mysterious organs hidden deep in the body but accessible to the look of God. At approximately the same time, Greek analytical philosophy argued that the brain, which is never mentioned in the Bible, was the most divine and sacred part of the body. This argument gained ground in the past century, when the functions of the brain were elucidated, and ultimately established in the 1960s, when salvaging the kidneys for transplantation necessitated a change in the definition of death as irreversible brain function. It is ironic that advances in understanding kidney function and in nephrology that made kidney transplantation feasible may have contributed, albeit indirectly, to the gradual elimination of the metaphoric mention of human kidneys in the Bible.

Animals↗

PubMed1999

Ethical and methodologic benefits of using a reflexive journal in hermeneutic-phenomenologic research.

PURPOSE: To illustrate the importance of considering the researcher's written reflections on the qualitative research process as a valuable source of data and as a means of enhancing ethical and methodologic rigour. ORGANIZING CONSTRUCT: Excerpts from the researcher's reflexive journal are presented as evidence of an audit trail. Ethical and methodologic concerns arising during the research process are outlined and the value of reflecting on these issues is addressed. METHODS: A hermeneutic-phenomenologic study, conducted in Scotland, included in-depth interviews with six problem drinkers to explore the lived experience of their suffering. The researcher was considered to be a primary data-collection tool, whose reflections on the research process added to the contextual richness of the study. For an interpretative approach to data analysis, the researcher found metaphors to convey the participants' stories to a new audience. This intuitive, creative process was analysed and reported in the reflexive journal. CONCLUSIONS: The researcher's self-awareness, fostered by the use of a reflexive journal, is mirrored by the participants' ability to reflect on the final interpretation of their stories and on the therapeutic benefits of the research process. The researcher's reflexive journal reveals previously hidden contextual information which enhances the prime ethical and methodologic aim of the study--to understand the lived experience of suffering by problem drinkers.

Adaptation, Psychological↗

PubMed2000

Illness narratives: time, hope and HIV.

Life threatening illness, such as HIV/AIDS, also threaten people's sense of identity and taken-for-granted assumptions about the temporal framing of their lives. In response, people often experience transformations in values, spirituality and life priorities. Drawing on a combined quantitative and qualitative study of people living with HIV/AIDS in Australia, three different narratives that people use to make sense of their illness experience are identified: linear restitution narratives, linear chaotic narratives and polyphonic narratives. Linear illness narratives colonise the future, assuming that the future can be controlled through human action. They emphasise a faith in medical science, tend to be secular and self-centred and assume the end of life to be in the distant future. Hope is focused on concrete outcomes such as improved health or material possessions. Linear narratives can be either restitutive or chaotic. Restitutive linear narratives anticipate a life that will mirror the narrative. Chaotic linear narratives anticipate a life that will fail to meet the linear ideal resulting in despair and depression. In contrast, polyphonic illness narratives are oriented toward the present, emphasising the unpredictability of the future. These narratives tend to include spiritual experiences, a communally oriented value system, and to recount increased self-understanding and the gaining of new insights as a consequence of their illness. Hope in polyphonic narratives is more abstract and focused on a celebration of mystery, surprise and creativity.

HIV Infections↗

PubMed2005

Listening to Oedipus: two poems by sons about fathers.

Using the writings of Thomas Ogden, Donald Spence, Jessica Benjamin, Roy Schafer, Evelyn Schwaber, and others, the author discusses the "kinship" between poets and psychoanalysts. The author also attempts to demonstrate how reading and listening to poetry can greatly enhance analytic listening, as well as illuminate how language that is contained within a guiding structure, such as a poem or an analysis, can "surprise" us into new awareness and meaning. Two poems are chosen, in which the speakers describe their relationships with their fathers in order to evoke oedipal associations. A brief discussion follows of how contemporary analysts are using intersubjective and relational lenses in order to expand on and revise traditional oedipal metaphor and theory and capture new levels of meaning. Each poem is then analyzed to underline how the sounds and selection, as well as sense of language, reveal the speaker's inner world and process. Poetry provides a mirror for the increasing richness, scope, and dialectical play that can be found in contemporary psychoanalysis.

Famous Persons↗

PubMed1990

Spatial representation of words in the brain implied by studies of a unilateral neglect patient.

Reading and writing require access to stored knowledge about the spelling of words. Presumably, we recognize chair but not chare or chiar as a word of English, and similarly would write 'chair' but not 'chare' or 'chiar', because we access orthographic representations that specify the identity and the order of the graphemes (abstract letter representations) that comprise the spelling of words. Thus, a fundamental problem concerns the content and structure of the hypothesized orthographic representations, and how information about grapheme order is represented and processed. We present evidence from a brain-damaged patient (N.G.) with unilateral neglect that this information is coded spatially. Unilateral neglect is a disorder clinically characterized by the inability to perceive or respond to stimuli presented to the side contralateral to the site of lesion, despite the absence of significant sensory or motor deficits. The patient made reading and spelling errors only on the right half of words, regardless of length. Furthermore, she produced the same pattern of errors in reading and spelling, irrespective of the topographic arrangement of stimuli in reading (horizontal, vertical or mirror-reversed words) and of the type of response in spelling (written, oral or backward oral spelling). This pattern of performance suggests that order information in orthographic representations is coded spatially in a word-centred coordinate system; that is, in a spatially defined coordinate frame whose centre corresponds to the midpoint of a canonical, orientation-invariant representation of the word and not the midpoint of the word stimulus.

Aged↗

PubMed1977

[The problem of juvenile alcoholism. An analysis of the literature (author's transl)].

In contrast to drug addiction juvenile alcoholism now also common in West Germany, has hardly been investigated. This is meant to be an analysis of the literature, based mainly paper on German and American writings which the author tries to link to his own experience. The older papers from around the turn of the century are particularly evaluated. Essentially the following may be said: Transition between the use, misuse and dependence on alcohol is fluid, particularly in juvenile alcoholism. In our type of Society drinking in adolescence is part of an anticipatory socialization process and so a normal transitional phenomenon. More attention has lately been paid to influences arising in the primary group (family and peers). Girls tent to accept the traditions of the family more readily and follow in alcohol consumption more their mothers than their fathers. The epidemiologic papers published in German on drug addiction of juveniles can hardly be compared with each other, even if they take account of alcohol consumption. Individual control investigations on comparable populations during the last few years show an increase of excessive alcohol intake particularly among the young. In West Germany there are no reliable statistics on alcoholism in adults, even less in juveniles. The methodic difficulties in assessing prevalence of juvenile alcoholism are specific, but they mirror the general difficulties of definition in research into alcoholism. Clinical experience suggests that alcoholism runs a different course in juveniles--and in women--from that seen in adult men. Literature on juvenile alcoholism is sparse compared with that on drug addiction. The question of a correlation between primary alcoholism and drug-addiction - the role of alcohol as initiator to drugs - cannot be defined in general, only in individual terms. In drug addicts alcohol had and has the function of an addition to/or replecement for drugs. The alcohol problem started under the cover of drug addiction but without the preceding wave of drugs it would not have reached the present level...

Adolescent↗

PubMed2003

Changes in corticospinal motor excitability induced by non-motor linguistic tasks.

The excitability of the corticospinal motor pathways to transcranial magnetic stimulation (TMS) can be differentially modulated by a variety of motor tasks. However, there is emerging evidence that linguistic tasks may alter excitability of the corticospinal motor pathways also. In this study we evaluated the effect of several movement-free, low-level linguistic processes involved in reading and writing on the excitability of the bilateral corticospinal motor pathways in a group of right-handed subjects. The study included two series of tasks, visual searching/matching and imaginal writing/drawing. The tasks were designed to roughly correspond with elemental aspects of the reading and writing, grapheme recognition and grapheme generation, respectively. Each task series included separate blocks with different task targets: letters, digits, semantically easy-to-code (i.e. geometric) shapes, and semantically hard-to-code shapes, as well as control blocks with no task. During task performance, TMS was delivered randomly over the hand area of either the left or right motor cortex and the modulation of the excitability of the corticospinal motor pathways was measured bilaterally through changes of the size of the motor-evoked potential (MEP) induced in the relaxed right and left first dorsal interosseous (FDI) muscles. We found that the size of the MEP in hand muscles increased during visual searching/matching tasks, particularly when targets were letters or geometric shapes, and the increase was significant for the dominant hand (left hemisphere) only. No such consistent effects were seen across subjects during imaginal tasks. This study provides evidence that even the performance of certain low-level linguistic tasks can modulate the excitability of the corticospinal motor pathways, particularly those originating from the left (dominant) hemisphere, despite the absence of overt motor activity. Moreover, in the light of the recently increased awareness of the role of "mirror neurons" in perception, the results suggest that activation of motor circuits used in generation of the written output may be an essential part of the perception of the written material as well. Understanding the patterns of task-dependent changes in excitability of the corticospinal motor pathways will provide insights into the organisation of central nervous system functional networks involved in linguistic processes, and may also be useful for future development of novel approaches to rehabilitation therapy of linguistic and motor functions.

Adult↗