Time to Listen More and Talk Less

Submitted as Invited Editorial response to Singh Ospina et. al. Eliciting the Patient’s Agenda – Secondary Analysis of Recorded Clinical Encounters. In 1984, Elliot Mishler published a book called the Discourse of Medicine in which he argued that patients and providers bring different stories to a clinical encounter—the former reflecting the world in which the patient manages their health and illness and the latter reflecting the biomedical definitions of disease and treatment. He showed that providers far too often interrupt the patient stories in favor of a more biomedical version of the person in front of them. It was the beginning of reflections on the need to bridge these two stories in order to foster better communication and patient-centered care

Tough Tables: Carefully Evaluating Entity Linking for Tabular Data

Table annotation is a key task to improve querying the Web and support the Knowledge Graph population from legacy sources (tables). Last year, the SemTab challenge was introduced to unify different efforts to evaluate table annotation algorithms by providing a common interface and several general-purpose datasets as a ground truth. The SemTab dataset is useful to have a general understanding of how these algorithms work, and the organizers of the challenge included some artificial noise to the data to make the annotation trickier. However, it is hard to analyze specific aspects in an automatic way. For example, the ambiguity of names at the entity-level can largely affect the quality of the annotation. In this paper, we propose a novel dataset to complement the datasets proposed by SemTab. The dataset consists of a set of high-quality manually-curated tables with non-obviously linkable cells, i.e., where values are ambiguous names, typos, and misspelled entity names not appearing in the current version of the SemTab dataset. These challenges are particularly relevant for the ingestion of structured legacy sources into existing knowledge graphs. Evaluations run on this dataset show that ambiguity is a key problem for entity linking algorithms and encourage a promising direction for future work in the field

Hostility, relationship quality, and health among African American couples

Objective: This study investigated the association between hostility and health and whether it is moderated by the quality of an individual\u27s primary romantic relationship. Method: Longitudinal data were provided by 184 African Americans, including 166 women. Participants averaged 38 years old and were married or in long-term marriagelike relationships. Hostility and relationship quality were measured at the first assessment. Hostility was based on participants\u27 responses to items tapping cynical attitudes about relationships. Relationship quality was based on trained observer ratings of videotaped couple interactions on behavioral scales reflecting warmth, support, and communication skills. At 2 assessments approximately 5 and 7 years later, participants provided health data. Health index scores were formed from responses to five scales of the SF-12 (Ware, Kosinski, & Keller, 1998) as well as to responses to questions about the number of chronic health conditions and the number of prescribed medications. Results: Stepwise regression analyses controlling for demographic variables and the earlier health score tested the main and interactive effects of hostility and relationship quality on longitudinal changes in health. Whereas no main effects were supported, the interaction of hostility and relationship quality was significant (p \u3c .05). The form of the interaction was such that high-hostile individuals had better health outcomes if they were in a high-quality relationship. Conclusion: Hostile persons in high-quality relationships may be at less risk for negative health outcomes because they do not regularly experience the physiologic reactivity and adverse psychosocial outcomes that they would otherwise experience as a result of recurring interpersonal conflict

Neighborhood Racial Discrimination and the Development of Major Depression

This study examined the impact of neighborhood racial discrimination on the development of major depressive disorder (MDD) in a sample of African American women. Participants were 499 women from Georgia and Iowa with no history of MDD who were followed for 9 to 11 years. Several neighborhood characteristics (community social disorder, community cohesion, and community racism) and individual characteristics (negative life events, financial strain, personal outlook, religious involvement, relationship quality, negative affectivity, and individual experiences of racism) were employed as predictors of whether or not the women met criteria for MDD during this period of time. In a multilevel logistic regression analysis, neighborhood-level discrimination as well as individual-level variables including the number of negative life events, financial strain, and negative affectivity were found to be significant predictors of developing MDD. Analyses of cross-level interactions indicated that the effects of neighborhood-level discrimination were moderated by the quality of individuals’ relationships, such that better relationships with others served to lessen the effect of neighborhood discrimination on depression. Implications of these findings for understanding the negative effects of racial discrimination are discussed

Predicting relationship stability among midlife African American couples

Objective: This study examined predictors of relationship stability over 5 years among heterosexual cohabiting and married African American couples raising an elementary-school-age child. The vulnerability–stress–adaptation model of relationships (Karney & Bradbury, 1995) guided the investigation. Contextual variables were conceptualized as important determinants of education and income, which in turn influence family structure, stress, and relationship quality and stability. Religiosity was tested as a resource variable that enhances relationship stability. Method: Couples (N = 207) were drawn from the Family and Community Health Study. Variables assessed at Wave 1 (education, income, religiosity, biological vs. stepfamily status, marital status, financial strain, and relationship quality) were used to predict relationship stability 5 years later. Results: Higher levels of education were associated with higher income, lower financial strain, and family structures that research has shown to be more stable (marriage rather than cohabitation and biological-family rather than stepfamily status; Bumpass & Lu, 2000). These variables, in turn, influenced relationship quality and stability. Religiosity, an important resource in the lives of African Americans, promoted relationship stability through its association with marriage, biological-family status, and women\u27s relationship quality. Conclusions: Enhancing the stability of African American couples\u27 relationships will require changes in societal conditions that limit opportunities for education and income and weaken relationship bonds. Programs to assist couples with blended families are needed, and incorporation of spirituality into culturally sensitive relationship interventions for African American couples may also prove beneficia

Effects of miRNA-15 and miRNA-16 expression replacement in chronic lymphocytic leukemia : implication for therapy

This work was supported by: Associazione Italiana Ricerca sul Cancro (AIRC) Grant 5 x mille n.9980, (to M.F., F.M. A. N., P.T. and M.N.) ; AIRC I.G. n. 14326 (to M.F.), n.10136 and 16722 (A.N.), n.15426 (to F.F.). AIRC and Fondazione CaRiCal co-financed Multi Unit Regional Grant 2014 n.16695 (to F.M.). Italian Ministry of Health 5x1000 funds (to S.Z. and F.F). A.G R. was supported by Associazione Italiana contro le Leucemie-Linfomi-Mielomi (AIL) Cosenza - Fondazione Amelia Scorza (FAS). S.M. C.M., M.C., L.E., S.B. were supported by AIRC.Peer reviewedPostprin

Effect of Nedocromil Sodium on Polymorphonuclear Leukocyte Plasma Membrane

The effect of nedocromil sodium on the plasma membrane fluidity of polymorphonuclear leukocytes (PMNs) was investigated by measuring steady-state fluorescence anisotropy of 1-[4-trimethylammonium-phenyl]-6-phenyl- 1,3,5-hexatriene (TMA-DPH) incorporated in the membrane. Our results show that nedocromil sodium 300 μM significantly decreased membrane fluidity of PMNs. The decrease in membrane fluidity of PMNs induced by fMLP was abolished in the presence of nedocromil sodium. These data suggest that nedocromil sodium interferes with the plasma membranes of PMNs and modulates their activities

Facilitators and barriers to post-discharge pain assessment and triage: a qualitative study of nurses\u27 and patients\u27 perspectives

BACKGROUND: After hospital discharge, patients can experience symptoms prompting them to seek acute medical attention. Early evaluation of patients\u27 post-discharge symptoms by healthcare providers may improve appropriate healthcare utilization and patient safety. Post-discharge follow-up phone calls, which are used for routine transitional care in U.S. hospitals, serve as an important channel for provider-patient communication about symptoms. This study aimed to assess the facilitators and barriers to evaluating and triaging pain symptoms in cardiovascular patients through follow-up phone calls after their discharge from a large healthcare system in Central Massachusetts. We also discuss strategies that may help address the identified barriers. METHODS: Guided by the Practical, Robust, Implementation and Sustainability Model (PRISM), we completed semi-structured interviews with 7 nurses and 16 patients in 2020. Selected nurses conducted (or supervised) post-discharge follow-up calls on behalf of 5 clinical teams (2 primary care; 3 cardiology). We used thematic analysis to identify themes from interviews and mapped them to the domains of the PRISM model. RESULTS: Participants described common facilitators and barriers related to the four domains of PRISM: Intervention (I), Recipients (R), Implementation and Sustainability Infrastructure (ISI), and External Environment (EE). Facilitators include: (1) patients being willing to receive provider follow-up (R); (2) nurses experienced in symptom assessment (R); (3) good care coordination within individual clinical teams (R); (4) electronic health record system and call templates to support follow-up calls (ISI); and (5) national and institutional policies to support post-discharge follow-up (EE). Barriers include: (1) limitations of conducting symptom assessment by provider-initiated follow-up calls (I); (2) difficulty connecting patients and providers in a timely manner (R); (3) suboptimal coordination for transitional care among primary care and cardiology providers (R); and (4) lack of emphasis on post-discharge follow-up call reimbursement among cardiology clinics (EE). Specific barriers for pain assessment include: (1) concerns with pain medication misuse (R); and (2) no standardized pain assessment and triage protocol (ISI). CONCLUSIONS: Strategies to empower patients, facilitate timely patient-provider communication, and support care coordination regarding pain evaluation and treatment may reduce the barriers and improve processes and outcomes of pain assessment and triage

CD10 is a marker for cycling cells with propensity to apoptosis in childhood ALL

CD10 constitutes a favourable prognostic marker for childhood acute lymphoblastic leukaemia. Since correlations between CD10, cell cycle and apoptotic abilities were demonstrated in various cell types, we investigated whether differences existed in the cycling/apoptotic abilities of CD10-positive and CD10-negative B acute lymphoblastic leukaemia cells. Twenty-eight cases of childhood acute lymphoblastic leukaemia (mean age of 6.8 years) were subdivided into two groups according to high (17 cases, 93.2±4.5%, MRFI 211±82 CD10-positive cells) or low (11 cases, 11.5±6.2%, MRFI 10±7 CD10-negative cells) expression of CD10. CD10-positive acute lymphoblastic leukaemia cells were cycling cells with elevated c-myc levels and propensity to apoptosis, whereas CD10-negative acute lymphoblastic leukaemia cells had lower cycling capacities and c-myc levels, and were resistant to apoptosis in vitro. A close correlation between all these properties was demonstrated by the observations that the few CD10-positive cells found in the CD10-negative acute lymphoblastic leukaemia group displayed elevated c-myc and cycling capacities and were apoptosis prone. Moreover, exposure of CD10-positive acute lymphoblastic leukaemia B cells to a peptide nucleic acid anti-gene specific for the second exon of c-myc caused inhibition of c-myc expression and reduced cell cycling and apoptotic abilities as well as decreased CD10 expression