Psychiatric comorbidity and causal disease models

In psychiatry, comorbidity is the rule rather than the exception. Up to 45% of all patients are classified as having more than one psychiatric disorder. These high rates of comorbidity have led to a debate concerning the interpretation of this phenomenon. Some authors emphasize the problematic character of the high rates of comorbidity because they indicate absent zones of rarities. Others consider comorbid conditions to be a validator for a particular reclassification of diseases. In this paper we will show that those at first sight contrasting interpretations of comorbidity are based on similar assumptions about disease models. The underlying ideas are that firstly high rates of comorbidity are the result of the absence of causally defined diseases in psychiatry, and second that causal disease models are preferable to non-causal disease models. We will argue that there are good reasons to seek after causal understanding of psychiatric disorders, but that causal disease models will not rule out high rates of comorbidity — neither in psychiatry, nor in medicine in general. By bringing to the fore these underlying assumptions, we hope to clear the ground for a different understanding of comorbidity, and of models for psychiatric diseases.     

股骨干骨折钢板内固定术后再折原因分析

目的：分析股骨干骨折钢板内固定术后再次骨折的原因。方法：分析151例股骨干骨折钢板内固定患者术后再次骨折的原因。结果和结论：原因主要包括：①钢板固定于股骨干前方或前外侧方;②骨折端骨痂生长过少或无;③钢板选择过短;④螺丝钉选择过短;⑤过早负重或功能锻炼;⑥钢板类型选择错误;⑦钢板与螺丝钉不配套。     

Neurology in the electronic information age

This review discusses the state of neurology and the Internet at the turn of the millennium. First, some basic definitions about the Internet and its component protocols are presented. Next, ways neurologists and patients can use the Internet are enumerated. Internet resources or applications are available or are being created that can aid in the successful fulfillment of a neurologist's core professional activities: clinical care, teaching, research, and practice issues. Currently, the most useful categories of Internet resources for neurologists are electronic communication and access to knowledge bases. They fulfill needs that are not met by traditional, non-electronic media. There are many other types of Internet applications that supplement traditional medical methodologies. Finally, some problems and prospects concerning medical uses of the Internet are discussed: technological infrastructure including usability, security, meaning, validity/quality, value, outcomes, and responsibility. These issues must be successfully addressed if Internet computing is to become truly useful 'just in time' at the point of medical care. Solutions are actively under development today. The prospects are bright for neurology, and medicine in general, on the Internet. The Internet will become an essential medical device in the near future.     

An Introduction to Search Engines

Scientific Inquiry provides a forum to facilitate the ongoing process of questioning and evaluating practice, presents informed practice based on available data, and innovates new practices through research and experimental learning.     

类型化的Web服务组合形式化模型

Web服务组合的正确性包括动态行为的匹配性和数据类型的一致性.本文定义了一个扩充的Pi-演算类型系统,同时利用该系统对BPEL4WS Web服务组合规范建立了一个类型化的形式化模型,通过该模型能够对Web服务组合的正确性进行验证.最后通过一个案例,给出了对Web服务组合动态行为的匹配性和数据类型的一致性的验证方法.     

An exploration of four web-based open and flexible learning modules in post-registration nurse education

This paper presents an exploratory evaluation of four newly developed web-based modules for post-registration nurses. The topics for the modules were: dermatology; diabetes; mentorship; and prescribing. STUDY OBJECTIVE: To explore the students' perceptions of the web-based modules before and after completing the modules. DESIGN: A pre-post test design using questionnaires and group interviews. PARTICIPANTS: 39 students enrolled on the modules, pre-module data were collected on 74% (n = 29) and post-module data on 71% (n = 28). None of students had previous web-based education experience. 79% (n = 31) completed and 66% (n = 26) passed the modules. Students level of IT skills prior to commencing the modules were important in explaining module completion and outcome. The modules were rated highly in terms of achieving learning outcomes with moderate ratings for level of support and utility of learning materials. The content analysis of the interviews highlighted the importance of preparing students ensuring they have the IT and independent learning skills necessary to participate in web-based learning programmes, together with a number of issues relating to the accessibility of the learning materials. The perceived benefits of this mode of learning were that they offered flexible and resource rich learning. The downside was that the learning can be isolating. CONCLUSIONS: This form of learning may not be suited to all groups of nurses or all educational topics. Further research is required to establish the educational benefits of different approaches to e-learning.     

MSeqDR mvTool: A mitochondrial DNA Web and API resource for comprehensive variant annotation,universal nomenclature collation,and reference genome conversion

Accurate mitochondrial DNA (mtDNA) variant annotation is essential for the clinical diagnosis of diverse human diseases. Substantial challenges to this process include the inconsistency in mtDNA nomenclatures, the existence of multiple reference genomes, and a lack of reference population frequency data. Clinicians need a simple bioinformatics tool that is user‐friendly, and bioinformaticians need a powerful informatics resource for programmatic usage. Here, we report the development and functionality of the MSeqDR mtDNA Variant Tool set (mvTool), a one‐stop mtDNA variant annotation and analysis Web service. mvTool is built upon the MSeqDR infrastructure ( https://mseqdr.org ), with contributions of expert curated data from MITOMAP ( https://www.mitomap.org ) and HmtDB ( https://www.hmtdb.uniba.it/hmdb ). mvTool supports all mtDNA nomenclatures, converts variants to standard rCRS‐ and HGVS‐based nomenclatures, and annotates novel mtDNA variants. Besides generic annotations from dbNSFP and Variant Effect Predictor (VEP), mvTool provides allele frequencies in more than 47,000 germline mitogenomes, and disease and pathogenicity classifications from MSeqDR, Mitomap, HmtDB and ClinVar (Landrum et al., 2013). mvTools also provides mtDNA somatic variants annotations. “mvTool API” is implemented for programmatic access using inputs in VCF, HGVS, or classical mtDNA variant nomenclatures. The results are reported as hyperlinked html tables, JSON, Excel, and VCF formats. MSeqDR mvTool is freely accessible at https://mseqdr.org/mvtool.php .     

Versión en español del software gratuito OxMaR para minimización y aleatorización de estudios clínicos

Randomized clinical trials provide the highest level of scientific evidence. The method used for randomization should make the group to which each case will be assigned unpredictable and facilitate the concealment of the randomization sequence. Centralized methods, generally implemented with computer support, are considered the safest to avoid biases. The OxMaR system, acronym for Oxford Minimization and Randomization, was published as free and open source software in 2014. It works online in a web environment and allows simple randomization and adaptive assignment through minimization. We present a Spanish version developed in collaboration with the author of the original English version. The system has been modified to work on low cost shared web servers and also to allow the concealment of the randomization sequence.     

Causal attribution in individuals with subclinical and clinical autism spectrum disorder: An fMRI study

This neuroimaging study compares brain activation during causal attribution to three different attribution loci (i.e., self, another person, and situation) across a typical population without (N = 20) or with subclinical autism spectrum symptoms (N = 18) and a clinical population with autism spectrum disorder (ASD; N = 11). While they underwent fMRI, all participants read short sentences describing positive and negative behaviors and thoughts of another person directed toward the participant (i.e., “you”). Participants were then asked to attribute these behaviors to themselves, the other person, or the situation. Behavioral measures revealed self-serving attributions (i.e., attributing positive events to the self, while attributing negative events externally from the self) in all three participant groups. Neural measures revealed a great deal of shared activation across the three attribution loci and across the three participant groups in the temporo-parietal junction, the posterior superior sulcus, and the precuneus. Comparison between groups revealed more widespread activation in both subclinical and clinical ASD participants, which may be indicative of the extraneural resources these participants invest to compensate their impairments.