The Role of Medical Language in Changing Public Perceptions of Illness

This study was designed to investigate the impact of medical terminology on perceptions of disease. Specifically, we look at the changing public perceptions of newly medicalized disorders with accompanying newly medicalized terms (e.g. impotence has become erectile dysfunction disorder). Does using “medicalese” to label a recently medicalized disorder lead to a change in the perception of that condition? Undergraduate students (n = 52) rated either the medical or lay label for recently medicalized disorders (such as erectile dysfunction disorder vs. impotence) and established medical conditions (such as a myocardial infarction vs. heart attack) for their perceived seriousness, disease representativeness and prevalence. Students considered the medical label of the recently medicalized disease to be more serious (mean = 4.95 (SE = .27) vs. mean = 3.77 (SE = .24) on a ten point scale), more representative of a disease (mean = 2.47 (SE = .09) vs. mean = 1.83 (SE = .09) on a four point scale), and have lower prevalence (mean = 68 (SE = 12.6) vs. mean = 122 (SE = 18.1) out of 1,000) than the same disease described using common language. A similar pattern was not seen in the established medical conditions, even when controlled for severity. This study demonstrates that the use of medical language in communication can induce bias in perception; a simple switch in terminology results in a disease being perceived as more serious, more likely to be a disease, and more likely to be a rare condition. These findings regarding the conceptualization of disease have implications for many areas, including medical communication with the public, advertising, and public policy.     

Simulation of Left Atrial Function Using a Multi-Scale Model of the Cardiovascular System

During a full cardiac cycle, the left atrium successively behaves as a reservoir, a conduit and a pump. This complex behavior makes it unrealistic to apply the time-varying elastance theory to characterize the left atrium, first, because this theory has known limitations, and second, because it is still uncertain whether the load independence hypothesis holds. In this study, we aim to bypass this uncertainty by relying on another kind of mathematical model of the cardiac chambers. In the present work, we describe both the left atrium and the left ventricle with a multi-scale model. The multi-scale property of this model comes from the fact that pressure inside a cardiac chamber is derived from a model of the sarcomere behavior. Macroscopic model parameters are identified from reference dog hemodynamic data. The multi-scale model of the cardiovascular system including the left atrium is then simulated to show that the physiological roles of the left atrium are correctly reproduced. This include a biphasic pressure wave and an eight-shaped pressure-volume loop. We also test the validity of our model in non basal conditions by reproducing a preload reduction experiment by inferior vena cava occlusion with the model. We compute the variation of eight indices before and after this experiment and obtain the same variation as experimentally observed for seven out of the eight indices. In summary, the multi-scale mathematical model presented in this work is able to correctly account for the three roles of the left atrium and also exhibits a realistic left atrial pressure-volume loop. Furthermore, the model has been previously presented and validated for the left ventricle. This makes it a proper alternative to the time-varying elastance theory if the focus is set on precisely representing the left atrial and left ventricular behaviors.     

Algorithmic Processing of Pressure Waveforms to Facilitate Estimation of Cardiac Elastance

ABSTRACT: INTRODUCTION: : Cardiac elastances are highly invasive to measure directly, but are clinically useful due to the amount of information embedded in them. Information about the cardiac elastance, which can be used to estimate it, can be found in the downstream pressure waveforms of aortic pressure (Pao) and the pulmonary artery (Ppa). However these pressure waveforms are typically noisy and biased, and require processing in order to locate the specific information required for the cardiac elastance estimation. This paper presents the method to algorithmically process the pressure waveforms. METHOD: S: A shear transform is developed in order to help locate information in the pressure waveforms. This transform turns difficult to locate corners into easy to locate maximum or minimum points as well as providing error correction. RESULTS: : The method located all points 87 out of 88 waveforms for Ppa to within the sampling frequency. For Pao, out of 616 total points, 605 were found within 1%, 5 within 5%, 4 within 10% and 2 within 20%. CONCLUSIONS: : The presented method provides a robust, accurate and dysfunction independent way to locate points on the aortic and pulmonary artery pressure waveforms, allowing the non-invasive estimation of the left and right cardiac elastance.     

A Single Mutation at Residue 25 Populates the Folding Intermediate of E. coli RNase H and Reveals a Highly Dynamic Partially Folded Ensemble

Understanding the nature of partially folded intermediates transiently populated during protein folding is important for understanding both protein folding and misfolding. These ephemeral species, however, often elude direct experimental characterization. The well-characterized protein ribonuclease H (RNase H) from Escherichia coli populates an on-pathway intermediate identified in both bulk studies and single-molecule mechanical unfolding experiments. Here, we set out to trap the transient intermediate of RNase H at equilibrium by selectively destabilizing the region of the protein known to be unfolded in this species. Surprisingly, a single change at Ile25 (I25A) resulted in the equilibrium population of the intermediate under near-native conditions. The intermediate was undetectable in a series of heteronuclear single quantum coherences, revealing the dynamic nature of this partially unfolded form on the timescale of NMR detection. This result is in contrast to studies in which the structures of trapped intermediates are solved by NMR, indicating that they are well packed and native-like. The dynamic nature of the RNase H intermediate may be important for its role as an on-pathway, productive species that promotes efficient folding.     

Genomic Analysis of Companion Rabbit Staphylococcus aureus

In addition to being an important human pathogen, Staphylococcus aureus is able to cause a variety of infections in numerous other host species. While the S. aureus strains causing infection in several of these hosts have been well characterised, this is not the case for companion rabbits (Oryctolagus cuniculus), where little data are available on S. aureus strains from this host. To address this deficiency we have performed antimicrobial susceptibility testing and genome sequencing on a collection of S. aureus isolates from companion rabbits. The findings show a diverse S. aureus population is able to cause infection in this host, and while antimicrobial resistance was uncommon, the isolates possess a range of known and putative virulence factors consistent with a diverse clinical presentation in companion rabbits including severe abscesses. We additionally show that companion rabbit isolates carry polymorphisms within dltB as described as underlying host-adaption of S. aureus to farmed rabbits. The availability of S. aureus genome sequences from companion rabbits provides an important aid to understanding the pathogenesis of disease in this host and in the clinical management and surveillance of these infections.     

Rapid Cohort Generation and Analysis of Disease Spectrum of Large Animal Model of Cone Dystrophy

Large animal models are an important resource for the understanding of human disease and for evaluating the applicability of new therapies to human patients. For many diseases, such as cone dystrophy, research effort is hampered by the lack of such models. Lentiviral transgenesis is a methodology broadly applicable to animals from many different species. When conjugated to the expression of a dominant mutant protein, this technology offers an attractive approach to generate new large animal models in a heterogeneous background. We adopted this strategy to mimic the phenotype diversity encounter in humans and generate a cohort of pigs for cone dystrophy by expressing a dominant mutant allele of the guanylate cyclase 2D (GUCY2D) gene. Sixty percent of the piglets were transgenic, with mutant GUCY2D mRNA detected in the retina of all animals tested. Functional impairment of vision was observed among the transgenic pigs at 3 months of age, with a follow-up at 1 year indicating a subsequent slower progression of phenotype. Abnormal retina morphology, notably among the cone photoreceptor cell population, was observed exclusively amongst the transgenic animals. Of particular note, these transgenic animals were characterized by a range in the severity of the phenotype, reflecting the human clinical situation. We demonstrate that a transgenic approach using lentiviral vectors offers a powerful tool for large animal model development. Not only is the efficiency of transgenesis higher than conventional transgenic methodology but this technique also produces a heterogeneous cohort of transgenic animals that mimics the genetic variation encountered in human patients.     

H-2 control of expression of an idiotype shared by normal B cells and a B-cell lymphoma

The spleens of normal B10,H-2 ^a H-44^b p/Wts (2 ^a 4 ^b ) mice; contain cells which, in response to mitogen stimulation, secrete hemolytic antibody specific for a determinant present on both sheep and bromelain-treated mouse erythrocytes. These cells were found to be Ly-1 positive. Approximately 50% of these cells bear surface immunoglobulin (sIg) with the same idiotype as the sIg of a 2^a4^b-derived B-cell lymphoma, CH12. Backcross analysis revealed H-2 control of the frequency of the idiotype-positive B cell. The regulatory gene did not correlate with the Igh-1 allotype, and analysis of 22 inbred mouse strains mapped the gene to the I-E subregion. Surprisingly, only strains homozygous for E ^k expressed the idiotype, and expression was a recessive trait. Possible mechanisms for this control of idiotype expression and its relation to lymphomagenesis are discussed.Abbreviations used in this paper 2 ^a4^b B10.H-2 ^aH-4^bp/Wts - Br-MRBC bromelain-treated mouse erythrocytes - C complement - LPS lipopolysaccharide W - pfc plaque-forming cells - sIg surface immunoglobulin - SRBC sheep erythrocytes - Ts T suppressor.