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Psychiatrists' versus patients' concepts of unpleasant emotions.

A semantic differential technique was used to elicit concepts of anxiety, depression and irritability from twenty patients suffering from neurosis and ten experienced psychiatrists. It was found that psychiatrists hold concepts of these unpleasant affects that are much more differentiated than those held by patients. In particular, the psychiatrists' concepts of anxiety and depression showed a correlation of zero, whereas the patients' concepts of these affects overlapped to a considerable degree. Patients were unable to discriminate between anxiety and depression on the basis of 11 somatic symptoms, but were able to use these symptoms to distinguish anxiety and depression from irritability. The psychiatrists were in close accord with the patients over the somatic symptoms that distinguished anxiety from irritability.

Affective Symptoms

The concept of induction and elicitation as an immunotherapeutic approach.

The concept of "induction and elicitation," propounded by Stuart Mudd, circumvents the dangers of infecting the immunologically impaired individual without abrogating the effectiveness of the antigenic stimulus provided by an initial infection with living organisms. Mudd's concept utilizes the ubiquitous and naturally established delayed type hypersensitivity to Staphylococcus aureus as the primary induction step for the more effective use of bacterial fractions, such as staphylococcal phage lysate, a potent immunizing agent, commercially licensed and available, in the subsequent elicitation of a nonspecific, cell-mediated immune response. The results of an exploratory study in which induction and elicitation were applied as an immunotherapeutic modality, in combination with surgery, in a metastasizing animal tumor model (the F344 rat) are presented.

Animals

Trait salience in the spontaneous self-concept.

A discrimination theory of selective perception was used to predict that a given trait would be spontaneously salient in a person's self-concept to the exten that this trait was distinctive for the person within her or his social groups. Sixth-grade students' general and physical spontaneous self-concepts were elicited in their classroom settings. The distinctiveness within the classroom of each student's characteristics on each of a variety of dimensions was determined, and it was found that in a majority of cases the dimension was significantly more salient in the spontaneous self-concepts of those students whose characteristic on thedimension was more distinctive. Also reported are incidental findings which include a description of the contents of spontaneous self-comcepts as well as determinants of their length and of the spontaneous mention of one's sex as part of one's self-concept.

Body Image

Development of an age specific EORTC questionnaire to assess the health-related quality of life (HRQOL) of children with cancer aged 8-14 years - a mixed-methods content elicitation phase I & II EORTC QLG study.

BACKGROUND: Experiencing cancer can be physically and psychosocially challenging in the short- and long-term. Integrating Patient-Reported Outcome Measurements (PROMs) to capture these challenges can support patient-centered care and may reduce morbidity and mortality. However, age-appropriate tools remain scarce for children and adolescents. We report on the development phases I/II of the EORTC QLQ-CHI questionnaire tailored for children 8-14 years. METHODS: Following the EORTC QLG module development guidelines, qualitative semi-structured interviews were conducted in children aged 8-14 years undergoing active cancer treatment, parents and healthcare professionals (HCPs). Participants rated the relevance of issues identified in a previous systematic review (Phase Ia) and provided preferences on response format and recall period (Phase Ib). During expert round tables, key issues were converted into items (Phase II). RESULTS: Interviews were completed with 47 children, 45 parents, and 22 HCPs from six countries. Among all children (mean age=10.8&#x202f;&#xb1;&#x202f;1.9 years; 57.4% female), 55.3% had haematological cancers. Of the initially identified issues, 57 were identified as key issues by comparing children's, parents' and HCPs feedback. Children preferred four response options (70.0%) and a shorter recall period (43.3%). Through expert round tables (Phase II), items were assigned to a more symptom-oriented core scale and an additional scale for psychosocial concerns. The provisional questionnaire consists of 50 items. CONCLUSION: This study represents the first step in developing the EORTC QLQ-CHI (8-14 years). Next steps include pilot testing, validation (Phase III and IV), co-development of a corresponding measure for children <&#x202f;8 years and an observer-rating version.

Humans

Complement-dependent anaphylactic reactions.

The concept of elicitation of reactions of anaphylactic type by non-tissue-fixing antibody, through activation of complement and release of anaphylatoxins by antigen-antibody complexes in vivo, is not clearly defined by published evidence. Experimental data are presented to demonstrate that guinea pig immunoglobulin G2 (noncytotropic) complexed with antigen in vitro elicits dermal reactions in guinea pigs, and that pretreatment of animals with complement-inactivating cobra venom factor diminishes such reactions. The various pathways through which immediate hypersensitive reactions may occur are discussed.

Anaphylaxis

Expert opinion elicitation for assisting deep learning based Lyme disease classifier with patient data.

BACKGROUND: Diagnosing erythema migrans (EM) skin lesion, the most common early symptom of Lyme disease, using deep learning techniques can be effective to prevent long-term complications. Existing works on deep learning based EM recognition only utilizes lesion image due to the lack of a dataset of Lyme disease related images with associated patient data. Doctors rely on patient information about the background of the skin lesion to confirm their diagnosis. To assist deep learning model with a probability score calculated from patient data, this study elicited opinions from fifteen expert doctors. To the best of our knowledge, this is the first expert elicitation work to calculate Lyme disease probability from patient data. METHODS: For the elicitation process, a questionnaire with questions and possible answers related to EM was prepared. Doctors provided relative weights to different answers to the questions. We converted doctors' evaluations to probability scores using Gaussian mixture based density estimation. We exploited formal concept analysis and decision tree for elicited model validation and explanation. We also proposed an algorithm for combining independent probability estimates from multiple modalities, such as merging the EM probability score from a deep learning image classifier with the elicited score from patient data. RESULTS: We successfully elicited opinions from fifteen expert doctors to create a model for obtaining EM probability scores from patient data. CONCLUSIONS: The elicited probability score and the proposed algorithm can be utilized to make image based deep learning Lyme disease pre-scanners robust. The proposed elicitation and validation process is easy for doctors to follow and can help address related medical diagnosis problems where it is challenging to collect patient data.

Humans

Null space in the Hodgkin-Huxley Equations. A critical test.

Voltage perturbation methods based upon topological concepts are used to elicit responses from the Hodgkin-Huxley (HH) nonlinear differential equations. These responses present a critical check upon the validity of the HH model for electrical activity across squid axon membrane. It is shown that when a constant current is applied such that a stable equilibrium and rhythmic firing are present, the following predictions are inherent in the HH system of equations: (a) Small instantaneous voltage perturbations to the axon given at points along its firing spike result in phase resetting curves (when new phase versus old phase is plotted) with an average slope of 1. (b) A larger voltage perturbation (from certain points along the firing spike) results in the permanent cessation of periodic firing, with membrane voltage rapidly approaching the equilibrium value. (c) A still larger perturbation yields phase resetting curves with an average slope equal to 0. These predictions, coupled with Tasaki's experimental demonstration that squid axons in excellent condition do give repetitive firing under constant current, provide a critical test of the validity of the HH model.

Animals

Immunotherapy and human tumor immunology.

Present knowledge about the immune response to tumors in man is briefly reviewed, and the effects of cancer on immune-system functions are noted. The concepts that human tumors elicit cell-mediated immune responses to tumor antigens are re-examined and modified; for example, cell-mediated immunity may be detectable only at certain stages of tumor growth. Introduction of more sensitive methods for detecting antibodies is providing additional evidence for humoral immune responses to tumor-associated antigens. The present proliminary approaches to immunotherapy, particularly the use of adjuvants such as BCG and Corynebacterium parvum, are assessed, and initial pharmacoimmunologic findings with these agents are reported. The field of tumor immunology is in a dynamic state of development, with input from many areas of immunology and oncology. Carefully controlled clinical trials of these therapeutic regimens will be required to establish the value and indications for the use of such procedures.

BCG Vaccine

Structures of respiratory syncytial virus G bound to broadly reactive antibodies provide insights into vaccine design.

Respiratory syncytial virus (RSV) is a leading cause of severe lower respiratory tract disease in infants and older adults. The attachment glycoprotein (RSV G) binds to the chemokine receptor CX3CR1 to promote viral entry and modulate host immunity. Antibodies against RSV G are a known correlate of protection. Previously, several broadly reactive, high-affinity anti-RSV G human monoclonal antibodies were isolated from RSV-exposed individuals and were shown to be protective in vitro and in vivo. Here, we determined the structures of three of these antibodies in complex with RSV G and defined distinct conformational epitopes comprised of highly conserved RSV G residues. Binding competition and structural studies demonstrated that this highly conserved region displays two non-overlapping antigenic sites. Analyses of anti-RSV G antibody sequences reveal that antigenic site flexibility may promote the elicitation of diverse antibody germlines. Together, these findings provide a foundation for next-generation RSV prophylactics, and they expand concepts in vaccine design for the elicitation of germline lineage-diverse, broadly reactive, high-affinity antibodies.

Humans

Responses of cancer patients in the MEM test: not just a function of charge on basic proteins.

It has been reported that lymphocytes from cancer patients give positive responses to PPD, myelin basic protein, tumour basic protein, and certain histone fractions in the MEM test. The underlying mechanisms of the MEM test are poorly understood, but it is widely assumed that it detects immunological sensitization to specific antigenic determinants. The cross-reactivity experienced is interpreted as indicating shared antigenicity. Since all the stimulatory proteins are strongly basic we investigated an alternative explanation that responsiveness is a function of electrical charge by comparing the known stimulatory proteins in the MEM test with two others of similar basicity: lysozyme and cytochrome-C. We obtained highly significant stimulation with PPD, tryptophane peptide of myelin, and tumour basic protein using Mantoux + cancer patients, but found no response to other basic proteins. We failed to confirm the reported activity of histone F2a. Our results indicate that basicity alone is insufficient to elicit response, and strengthens the concept that the MEM test is measuring sensitization to the determinants shared by myelin and tumour basic protein.

Animals

Evaluating attitude change in community dental service programs in Minnesota, U.S.A.

Attitude changes of students participating in two community service programs at the University of Minnesota were evaluated using the semantic differential technique. Program I, a single day clinical experience at a state institution for the mentally retarded, involved 170 students; Program II, a 1-week clinical program in dental auxiliary utilization, involved 30 students. For each program, semantic differentials were designed to elicit scaled evauative responses toward concepts such as mental retardation and dentistry which were important to program objectives. Scales were administered in a pretest, post-test design. Statistically significant differences were noted for seven of eight target concepts, and appropriate attitude changes were inferred from these differences. Design of community programs and evaluation of desired attitude change using the semantic differential were discussed.

Attitude

The significance of early changes of positive and negative dP/dt following contrast ventriculography.

The contrast agents used for cardiac angiography have pharmacologic effects on the myocardium and on peripheral and coronary circulations. These effects are a stress to the left ventricle. We have studied the sequential changes in heart rate, LVEDP, positive and negative dP/dt in 34 patients following left ventriculography. These patients were divided into three groups: nine normal patients, 14 patients with valvular or coronary artery disease and abnormal left ventricular function at rest, and 11 patients with significant coronary artery stenosis but normal left ventricular function at rest. Changes in dP/dt most clearly defined the normal and abnormal response. In the normal group the mean positive dP/dt rose abruptly at 30 sec after the ventriculogram, whereas the abnormal group showed a mean decrease. The extent of change varied, however, for patients within each group. Negative dP/dt decreased in both groups but more so in the abnormal group. As did the other groups, patients with coronary artery disease but with normal ventricular function showed individual variation in response. Their mean changes in positive and negative dP/dt were intermediate. Positive dP/dt decreased at 30 sec (similar to, but less than, the group with abnormal ventricular function) and negative dP/dt also diminished at 30 sec with a mean value between the normal and abnormal groups. The results of this study support the concept that left ventricular dysfunction may be elicited by the stress of contrast injection. More importantly, such dysfunction seen both with abnormal and normal left ventricles at rest, may be reflected by the relatively simple measurement of positive dP/dt after ventriculography.

Blood Circulation

Use of situational cues by preschool children.

Pictures often are used in language intervention programs to elicit selected linguistic constructions or to teach concepts to children below the age of 5 years. However,, preschool children frequently are egocentric in their perceptions and in their language, and are unable to view a situation from a perspective other than their own. This study presented children who were in Piaget's preoperational period of development with pictures accompanied by a one-word descriptive phrase and asked the children to explain what was meant by the utterance. It was found that the younger child generally was more egocentric in his interpretations, and his responses reflected less attention to the situational cues present in the picture. The results are discussed in light of common clinical practices of using pictorial stimuli for children with language problems.

Age Factors

The orienting response and stimulus significance: some comments.

Bernstein (1969, 1979) has argued that Skolov's (1963) model is not sufficient to account for the data concerning orienting response (OR) elicitation to stimulus change. He has argued that following the registration of stimulus mismatch, an additional stage of stimulus evaluation occurs and that only stimuli which represent change and are judged as 'significant' elicit ORs. The present paper takes issue with this assertion. It is argued that the data on which the 'significance hypothesis' was originally based are not replicable and that the argument, as it was formulated originally, is tautological. It is also argued that individual differences in OR responsiveness are more parsimoniously explained in terms of individual response stereotypy and that differential responsiveness to different sorts of stimulus change poses problems for the significance hypothesis. Evidence is also reviewed which suggests that the relationship between stimulus change and stimulus significance is additive rather than multiplicative as suggested by Bernstein, i.e., stimulus change and stimulus significance are each sufficient for OR elicitation. Finally, it is concluded that the concept of 'significance', introduced operationally, may be of value in terms of examining the role of the OR in information processing.

Auditory Perception

Nocturnal variations in lower-leg subcutaneous blood flow in paraplegic men.

1. Lower-leg subcutaneous adipose tissue blood flow rates were measured over 12-20 h under ambulatory conditions by means of the 133Xe-washout technique in nine paraplegic men, all with complete spinal cord lesions at or below the Th 6 level, and in nine age-matched healthy men. Portable CdTe(Cl) detectors and data-storage units were used. 2. The central and local sympathetic vasoconstrictive activity at the lower leg was measured under laboratory conditions by means of the 133Xe-washout technique and a stationary NaI(Tl) detector system. 3. The paraplegic men were found to have intact central and local sympathetic vasoconstrictive activity in their lower legs. Moreover, they all had a nocturnal hyperaemic blood flow phase of the same magnitude and duration as the control subjects. 4. The possibility that the somaesthetic nerves play a role in the hyperaemic response could be excluded, as all the paraplegic men suffered from complete lower-leg somaesthetic denervation. 5. A significant correlation was found between the time of going to bed and the nightly hyperaemic response in the right and left lower legs (P less than 0.01). 6. It is concluded that the present data are in accordance with the concept of a central nervous or humoral elicitation of nocturnal hyperaemia, although local metabolic and other factors might participate as well. Paraplegic men have an intact regulation of the postural and nocturnal changes in peripheral blood flow whether of central sympathetic or humoral origin.

Adipose Tissue

Pharmacological effects of alpha-methyldopa, alpha-methylnorepinephrine, and octopamine on rat arteriolar, arterial, and terminal vascular smooth.

Experiments on rat mesenteric arterioles, metarterioles, and aortae demonstrate that although alpha-methylnorepinephrine is much less potent in inducing contraction than epinephrine on all three blood vessel types, it is either equivalent or only one and a half to two times less potent than the natural postganglionic neurotransmitter, norepinephrine, on these blood vessels. Furthermore, alpha-methylnorepinephrine is equivalent to norepinephrine in its ability to induce maximal contractile responses on rat arterioles, metarterioles, and aortae. Systemic administration of alpha-methyldopa to rats for 15 days shifted the log dose-response curves for all three catecholamines, but not vasopressin or potassium chloride, to the right of all three blood vessel types; the maximal contractile responses to these amines were, however, not affected by chronic treatment with alpha-methyldopa. In addition, acute, intra-arterial administration of 500 mg/kg of alpha-methyldopa was found not only to induce mesenteric arteriolar vasodilatation gradually but also to depress arteriolar reponsiveness to catecholamines. In view of these direct findings, it is difficult to accept the hypothesis that alpha-methyldopa induces hypotension via formation of a "false" postganglionic neurotransmitter substance, namely, alpha-methylnorepinephrine. The present findings suggest that alpha-methyldopa may exert some of its anti-hypertensive action, at least in the rat, by (1) depressing arteriolar responsiveness to circulating and released catecholamines and (2) some unknown direct action on peripheral vascular muscle. In addition, the present study indicates that octopamine is (1) between 60 and 15,000 times less potent than norepinephrine on rat arterioles and metarterioles and (2) incapable of eliciting more than a 40% occlusion of these terminal vessels. It is suggested that such data support the concept that octopamine, in contrast to alpha-methylnorepinephrine, could serve as a false adrenergic neurotransmitter agent and thus account for part or all of the hypotensive action of monoamine oxidase inhibitors like pargyline. The use of complete dose-response curves, several different adrenergic compounds (i.e., epinephrine, norepinephrine, alpha-methylnorepinephrine, octopamine, phenylephrine, and dopamine), and different rat blood vessels supports the concept that adrenergic molecules containing a catecholamine nucleus and a beta-hydroxyl group elicit the most potent constrictor responses from peripheral blood vessels. In addition, the data suggest that the structure-activity relationships for catecholamines and their analogs on terminal vascular smooth muscle are probably different from those for arterial smooth muscle.

Administration, Topical