Sample records for specific findings include

  1. Multimedia-based decision support system for hazards recognition and abatement

    DOEpatents

    Czachowski, John B.; Zoldak, John T.

    1998-01-01

    A system for monitoring a site includes a portable data collection module used in the field to collect site specific data, and a processor module located at a central location. The data collection module displays choices of categories of findings, and then specific findings within each category. A selected specific finding is then displayed in report form with a citation to the specific code or statutory requirement, as well as a recommended course of action and an abatement date.

  2. The sensitivity and specificity of the neurological examination in polyneuropathy patients with clinical and electrophysiological correlations.

    PubMed

    Abraham, Alon; Alabdali, Majed; Alsulaiman, Abdulla; Albulaihe, Hana; Breiner, Ari; Katzberg, Hans D; Aljaafari, Danah; Lovblom, Leif E; Bril, Vera

    2017-01-01

    Polyneuropathy is one of the most prevalent neurologic disorders. Although several studies explored the role of the neurological examination in polyneuropathy, they were mostly restricted to specific subgroups of patients and have not correlated examination findings with symptoms and electrophysiological results. To explore the sensitivity and specificity of different neurological examination components in patients with diverse etiologies for polyneuropathy, find the most sensitive combination of examination components for polyneuropathy detection, and correlate examination findings with symptoms and electrophysiological results. Patients with polyneuropathy attending the neuromuscular clinic from 01/2013 to 09/2015 were evaluated. Inclusion criteria included symptomatic polyneuropathy, which was confirmed by electrophysiological studies. 47 subjects with no symptoms or electrophysiological findings suggestive for polyneuropathy, served as controls. The total cohort included 312 polyneuropathy patients, with a mean age of 60±14 years. Abnormal examination was found in 95%, most commonly sensory findings (86%). The most common abnormal examination components were impaired ankle reflexes (74%), vibration (73%), and pinprick (72%) sensation. Combining ankle reflex examination with vibration or pinprick perception had the highest sensitivity, of 88%. The specificities of individual examination component were generally high, excluding ankle reflexes (62%), and vibration perception (77%). Abnormal examination findings were correlated with symptomatic weakness and worse electrophysiological parameters. The neurological examination is a valid, sensitive and specific tool for diagnosing polyneuropathy, and findings correlate with polyneuropathy severity. Ankle reflex examination combined with either vibration or pinprick sensory testing is the most sensitive combination for diagnosing polyneuropathy, and should be considered minimal essential components of the physical examination in patients with suspected polyneuropathy.

  3. Correlation between morphological MRI findings and specific diagnostic categories in fetal alcohol spectrum disorders.

    PubMed

    Boronat, S; Sánchez-Montañez, A; Gómez-Barros, N; Jacas, C; Martínez-Ribot, L; Vázquez, E; Del Campo, M

    2017-01-01

    Fetal alcohol spectrum disorders (FASD) include physical and neurodevelopmental abnormalities related to prenatal alcohol exposure. Some neuroimaging findings have been clearly related to FASD, including corpus callosum and cerebellar anomalies. However, detailed studies correlating with specific FASD categories, that is, the fetal alcohol syndrome (FAS), partial FAS (pFAS) and alcohol related neurodevelopmental disorders (ARND), are lacking. We prospectively performed clinical assessment and brain MR imaging to 72 patients with suspected FASD, and diagnosis was confirmed in 62. The most frequent findings were hypoplasia of the corpus callosum and/or of the cerebellar vermis. Additional findings were vascular anomalies, gliosis, prominent perivascular spaces, occipito-cervical junction and cervical vertebral anomalies, pituitary hypoplasia, arachnoid cysts, and cavum septum pellucidum. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. The sensitivity and specificity of the neurological examination in polyneuropathy patients with clinical and electrophysiological correlations

    PubMed Central

    Alabdali, Majed; Alsulaiman, Abdulla; Albulaihe, Hana; Breiner, Ari; Katzberg, Hans D.; Aljaafari, Danah; Lovblom, Leif E.; Bril, Vera

    2017-01-01

    Introduction Polyneuropathy is one of the most prevalent neurologic disorders. Although several studies explored the role of the neurological examination in polyneuropathy, they were mostly restricted to specific subgroups of patients and have not correlated examination findings with symptoms and electrophysiological results. Objectives To explore the sensitivity and specificity of different neurological examination components in patients with diverse etiologies for polyneuropathy, find the most sensitive combination of examination components for polyneuropathy detection, and correlate examination findings with symptoms and electrophysiological results. Methods Patients with polyneuropathy attending the neuromuscular clinic from 01/2013 to 09/2015 were evaluated. Inclusion criteria included symptomatic polyneuropathy, which was confirmed by electrophysiological studies. 47 subjects with no symptoms or electrophysiological findings suggestive for polyneuropathy, served as controls. Results The total cohort included 312 polyneuropathy patients, with a mean age of 60±14 years. Abnormal examination was found in 95%, most commonly sensory findings (86%). The most common abnormal examination components were impaired ankle reflexes (74%), vibration (73%), and pinprick (72%) sensation. Combining ankle reflex examination with vibration or pinprick perception had the highest sensitivity, of 88%. The specificities of individual examination component were generally high, excluding ankle reflexes (62%), and vibration perception (77%). Abnormal examination findings were correlated with symptomatic weakness and worse electrophysiological parameters. Conclusion The neurological examination is a valid, sensitive and specific tool for diagnosing polyneuropathy, and findings correlate with polyneuropathy severity. Ankle reflex examination combined with either vibration or pinprick sensory testing is the most sensitive combination for diagnosing polyneuropathy, and should be considered minimal essential components of the physical examination in patients with suspected polyneuropathy. PMID:28249029

  5. Male and Female Stimulant Use Among Rural Kentuckians: The Contribution of Spirituality and Religiosity

    PubMed Central

    Staton-Tindall, Michele; Oser, Carrie B.; Duvall, Jamieson L.; Havens, Jennifer R.; Webster, J. Matthew; Leukefeld, Carl; Booth, Brenda M.

    2017-01-01

    This study describes gender-specific patterns of drug use among active rural stimulant users and examines religiosity and spirituality as factors that may be related to stimulant use among males and females. The study includes a sample of 225 active rural stimulant users from Kentucky who were recruited using respondent driven sampling and completed face-to-face interviews. Findings suggest gender specific patterns among active rural stimulant users, with females reporting more amphetamine use. In addition, bivariate findings indicate that there is an inverse relationship between spirituality, religiosity, and stimulant use (specifically methamphetamine and amphetamine use), particularly for males. However, when further examining this relationship in multivariate models controlling for age and race, few significant findings were noted for spirituality and religiosity in predicting gender-specific stimulant use patterns. These findings suggest that treatment interventions that incorporate spirituality and religiosity should not only be gender specific, but should also target clients differentially. Findings on the degree of reported spirituality and religiosity also suggest that religious and/or faithbased organizations could be utilized for drug use interventions for rural stimulant users. PMID:29104311

  6. Biceps-Related Physical Findings Are Useful to Prevent Misdiagnosis of Cervical Spondylotic Amyotrophy as a Rotator Cuff Tear.

    PubMed

    Iwata, Eiichiro; Shigematsu, Hideki; Inoue, Kazuya; Egawa, Takuya; Tanaka, Masato; Okuda, Akinori; Morimoto, Yasuhiko; Masuda, Keisuke; Yamamoto, Yusuke; Sakamoto, Yoshihiro; Koizumi, Munehisa; Tanaka, Yasuhito

    2018-02-01

    Case-control study. The aim of the present study was to identify physical findings useful for differentiating between cervical spondylotic amyotrophy (CSA) and rotator cuff tears to prevent the misdiagnosis of CSA as a rotator cuff tear. CSA and rotator cuff tears are often confused among patients presenting with difficulty in shoulder elevation. Twenty-five patients with CSA and 27 with rotator cuff tears were enrolled. We included five physical findings specific to CSA that were observed in both CSA and rotator cuff tear patients. The findings were as follows: (1) weakness of the deltoid muscle, (2) weakness of the biceps muscle, (3) atrophy of the deltoid muscle, (4) atrophy of the biceps muscle, and (5) swallow-tail sign (assessment of the posterior fibers of the deltoid). Among 25 CSA patients, 10 (40.0%) were misdiagnosed with a rotator cuff tear on initial diagnosis. The sensitivity and specificity of each physical finding were as follows: (1) deltoid weakness (sensitivity, 92.0%; specificity, 55.6%), (2) biceps weakness (sensitivity, 80.0%; specificity, 100%), (3) deltoid atrophy (sensitivity, 96.0%; specificity, 77.8%), (4) biceps atrophy (sensitivity, 88.8%; specificity, 92.6%), and (5) swallow-tail sign (sensitivity, 56.0%; specificity, 74.1%). There were statistically significant differences in each physical finding. CSA is likely to be misdiagnosed as a rotator cuff tear; however, weakness and atrophy of the biceps are useful findings for differentiating between CSA and rotator cuff tears to prevent misdiagnosis.

  7. What Value Can Qualitative Research Add to Quantitative Research Design? An Example From an Adolescent Idiopathic Scoliosis Trial Feasibility Study.

    PubMed

    Toye, Francine; Williamson, Esther; Williams, Mark A; Fairbank, Jeremy; Lamb, Sarah E

    2016-08-09

    Using an example of qualitative research embedded in a non-surgical feasibility trial, we explore the benefits of including qualitative research in trial design and reflect on epistemological challenges. We interviewed 18 trial participants and used methods of Interpretive Phenomenological Analysis. Our findings demonstrate that qualitative research can make a valuable contribution by allowing trial stakeholders to see things from alternative perspectives. Specifically, it can help to make specific recommendations for improved trial design, generate questions which contextualize findings, and also explore disease experience beyond the trial. To make the most out of qualitative research embedded in quantitative design it would be useful to (a) agree specific qualitative study aims that underpin research design, (b) understand the impact of differences in epistemological truth claims, (c) provide clear thematic interpretations for trial researchers to utilize, and (d) include qualitative findings that explore experience beyond the trial setting within the impact plan. © The Author(s) 2016.

  8. The histopathologic features of autoimmune progesterone dermatitis.

    PubMed

    James, Travis; Ghaferi, Jessica; LaFond, Ann

    2017-01-01

    The histologic features of autoimmune progesterone dermatitis (APD) are generally non-specific and have been described only in brief case reports. We present a case of APD and review the literature with a focus on the histologic findings described. A review of the English literature on APD was performed using PubMed and MEDLINE. A total of 39 patients, including our patient are included in this review. The most consistent histologic finding reported was a perivascular inflammatory infiltrate, being seen in 72% of cases. A non-specific or interstitial inflammatory infiltrate was described in 31% of the cases, with 41% having an eosinophilic component and 21% having a neutrophilic component mixed with the predominant lymphocytic infiltrate. Interface dermatitis was the second most common finding with 36% showing a mild to exaggerated interface dermatitis. Although histopathologic changes are non-specific, perivascular dermatitis with eosinophils and interface changes are common in APD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. What Health Issues or Conditions Are Specific to Women Only?

    MedlinePlus

    ... Research Information Find a Study Resources and Publications Turner Syndrome Condition Information NICHD Research Information Find a Study ... disorders and conditions that affect only women include Turner syndrome , Rett syndrome , and ovarian and cervical cancers. Issues ...

  10. Mapping the mouse Allelome reveals tissue-specific regulation of allelic expression

    PubMed Central

    Andergassen, Daniel; Dotter, Christoph P; Wenzel, Daniel; Sigl, Verena; Bammer, Philipp C; Muckenhuber, Markus; Mayer, Daniela; Kulinski, Tomasz M; Theussl, Hans-Christian; Penninger, Josef M; Bock, Christoph; Barlow, Denise P; Pauler, Florian M; Hudson, Quanah J

    2017-01-01

    To determine the dynamics of allelic-specific expression during mouse development, we analyzed RNA-seq data from 23 F1 tissues from different developmental stages, including 19 female tissues allowing X chromosome inactivation (XCI) escapers to also be detected. We demonstrate that allelic expression arising from genetic or epigenetic differences is highly tissue-specific. We find that tissue-specific strain-biased gene expression may be regulated by tissue-specific enhancers or by post-transcriptional differences in stability between the alleles. We also find that escape from X-inactivation is tissue-specific, with leg muscle showing an unexpectedly high rate of XCI escapers. By surveying a range of tissues during development, and performing extensive validation, we are able to provide a high confidence list of mouse imprinted genes including 18 novel genes. This shows that cluster size varies dynamically during development and can be substantially larger than previously thought, with the Igf2r cluster extending over 10 Mb in placenta. DOI: http://dx.doi.org/10.7554/eLife.25125.001 PMID:28806168

  11. Diagnostic Value of Positive Findings of Toxoplasma gondii-Specific Immunoglobulin M Serum Antibody in Uveitis Patients to Confirm Ocular Toxoplasmosis.

    PubMed

    Park, Sung Who; Kim, So Hee; Kwon, Han Jo; Lee, Seung Min; Byon, Ik Soo; Lee, Ji Eun

    2018-03-07

    To assess the value of positive immunoglobulin (Ig) M serum antibody (Ab) findings in uveitis patients. We reviewed medical records of patients who had a positive serological test for Toxoplasma gondii-specific IgM Ab. Their clinical data, including history, demographic characteristics, laboratory findings, clinical findings, treatment outcomes, and recurrences, were reviewed retrospectively. Of 2919 uveitis patients who underwent a serological test for suspected ocular toxoplasmosis (OT), 18 presented with positive Ig M results. All 18 patients (100.0% specificity) were clinically diagnosed with OT. None had any retinochoroidal scar at the initial visit, indicating the OT was a recent and primary infection. However, 15 patients (83.3%) had no history suspected to account for the Toxoplasma transmission. The T. gondii IgM serum Ab is a specific biomarker for diagnosis of primary OT. Epidemiological studies are warranted to investigate the non-classic transmission routes of T. gondii in OT.

  12. Enhancing Individual Employability: The Perspective of Engineering Graduates

    ERIC Educational Resources Information Center

    Nilsson, Staffan

    2010-01-01

    Purpose: Employability includes the ability to find employment and remain employed. Employability includes both hard and soft skills, including formal and actual competence, interpersonal skills, and personal characteristics. This paper aims to focus on illuminating perceptions engineering graduates have regarding employability. More specifically,…

  13. The situation-specific theory of pain experience for Asian American cancer patients.

    PubMed

    Im, Eun-Ok

    2008-01-01

    Studies have indicated the need for theories that explain and target ethnic-specific cancer pain experiences, including those of Asian Americans. In this article, I present a situation-specific theory that explains the unique cancer pain experience of Asian Americans. Unlike other existing theories, this situation-specific theory was developed on the basis of evidence, including a systematic literature review and research findings, making it comprehensive and highly applicable to research and practice with Asian American patients with cancer. Thus, this theory would strengthen the interconnections among theory, evidence, and practice in pain management for Asian American cancer patients.

  14. Athletic pubalgia and the "sports hernia": MR imaging findings.

    PubMed

    Zoga, Adam C; Kavanagh, Eoin C; Omar, Imran M; Morrison, William B; Koulouris, George; Lopez, Hector; Chaabra, Avneesh; Domesek, John; Meyers, William C

    2008-06-01

    To retrospectively determine the sensitivity and specificity of magnetic resonance (MR) imaging findings in patients with clinical athletic pubalgia, with either surgical or physical examination findings as the reference standard. Institutional review board approval was granted for this HIPAA-compliant study, and informed consent was waived. MR imaging studies in 141 patients (134 male patients, seven female patients; mean age, 30.1 years; range, 17-71 years) who had been referred to a subspecialist because of groin pain were reviewed for findings including hernia, pubic bone marrow edema, secondary cleft sign, and rectus abdominis and adductor tendon injury. MR imaging findings were compared with surgical findings for 102 patients, physical examination findings for all 141 patients, and MR imaging findings in an asymptomatic control group of 25 men (mean age, 29.8 years; range, 18-39 years). Sensitivity and specificity of MR imaging for rectus abdominis and adductor tendon injury were determined by using a chi(2) analysis, and significance of the findings was analyzed with an unpaired Student t test. Disease patterns seen at MR imaging were compared with those reported in the surgical and sports medicine literature. One hundred thirty-eight (98%) of 141 patients had findings at MR imaging that could cause groin pain. Compared with surgery, MR imaging had a sensitivity and specificity, respectively, of 68% and 100% for rectus abdominis tendon injury and 86% and 89% for adductor tendon injury. Injury in each of these structures was significantly more common in the patient group than in the control group (P < .001). Only two patients had hernias at surgery. At MR imaging, injury or disease could be fit into distinct groups, including osteitis pubis, adductor compartment injury, rectus abdominis tendon injury, and injury or disease remote from the pubic symphysis. Patients with injury involving the rectus abdominis insertion were most likely to go on to surgical pelvic floor repair. MR imaging depicts patterns of findings in patients with athletic pubalgia, including rectus abdominis insertional injury, thigh adductor injury, and articular diseases at the pubic symphysis (osteitis pubis). (c) RSNA, 2008.

  15. Mechanisms of input and output synaptic specificity: finding partners, building synapses, and fine-tuning communication.

    PubMed

    Rawson, Randi L; Martin, E Anne; Williams, Megan E

    2017-08-01

    For most neurons to function properly, they need to develop synaptic specificity. This requires finding specific partner neurons, building the correct types of synapses, and fine-tuning these synapses in response to neural activity. Synaptic specificity is common at both a neuron's input and output synapses, whereby unique synapses are built depending on the partnering neuron. Neuroscientists have long appreciated the remarkable specificity of neural circuits but identifying molecular mechanisms mediating synaptic specificity has only recently accelerated. Here, we focus on recent progress in understanding input and output synaptic specificity in the mammalian brain. We review newly identified circuit examples for both and the latest research identifying molecular mediators including Kirrel3, FGFs, and DGLα. Lastly, we expect the pace of research on input and output specificity to continue to accelerate with the advent of new technologies in genomics, microscopy, and proteomics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Does Breastfeeding Protect Against Childhood Obesity? Moving Beyond Observational Evidence.

    PubMed

    Woo, Jessica G; Martin, Lisa J

    2015-06-01

    Human milk is the optimal feeding choice for infants, as it dynamically provides the nutrients, immunity support, and other bioactive factors needed for infants at specific stages during development. Observational studies and several meta-analyses have suggested that breastfeeding is protective against development of obesity in childhood and beyond. However, these findings are not without significant controversy. This review includes an overview of observational findings to date, then focuses on three specific pathways that connect human milk and infant physiology: maternal obesity, microbiome development in the infant, and the development of taste preference and diet quality. Each of these pathways involves complex interactions between mother and infant, includes both biologic and non-biologic factors, and may have both direct and indirect effects on obesity risk in the offspring. This type of integrated approach to examining breastfeeding and childhood obesity is necessary to advance research in this area beyond observational findings.

  17. Review of Quantitative Ultrasound: Envelope Statistics and Backscatter Coefficient Imaging and Contributions to Diagnostic Ultrasound.

    PubMed

    Oelze, Michael L; Mamou, Jonathan

    2016-02-01

    Conventional medical imaging technologies, including ultrasound, have continued to improve over the years. For example, in oncology, medical imaging is characterized by high sensitivity, i.e., the ability to detect anomalous tissue features, but the ability to classify these tissue features from images often lacks specificity. As a result, a large number of biopsies of tissues with suspicious image findings are performed each year with a vast majority of these biopsies resulting in a negative finding. To improve specificity of cancer imaging, quantitative imaging techniques can play an important role. Conventional ultrasound B-mode imaging is mainly qualitative in nature. However, quantitative ultrasound (QUS) imaging can provide specific numbers related to tissue features that can increase the specificity of image findings leading to improvements in diagnostic ultrasound. QUS imaging can encompass a wide variety of techniques including spectral-based parameterization, elastography, shear wave imaging, flow estimation, and envelope statistics. Currently, spectral-based parameterization and envelope statistics are not available on most conventional clinical ultrasound machines. However, in recent years, QUS techniques involving spectral-based parameterization and envelope statistics have demonstrated success in many applications, providing additional diagnostic capabilities. Spectral-based techniques include the estimation of the backscatter coefficient (BSC), estimation of attenuation, and estimation of scatterer properties such as the correlation length associated with an effective scatterer diameter (ESD) and the effective acoustic concentration (EAC) of scatterers. Envelope statistics include the estimation of the number density of scatterers and quantification of coherent to incoherent signals produced from the tissue. Challenges for clinical application include correctly accounting for attenuation effects and transmission losses and implementation of QUS on clinical devices. Successful clinical and preclinical applications demonstrating the ability of QUS to improve medical diagnostics include characterization of the myocardium during the cardiac cycle, cancer detection, classification of solid tumors and lymph nodes, detection and quantification of fatty liver disease, and monitoring and assessment of therapy.

  18. Review of quantitative ultrasound: envelope statistics and backscatter coefficient imaging and contributions to diagnostic ultrasound

    PubMed Central

    Oelze, Michael L.; Mamou, Jonathan

    2017-01-01

    Conventional medical imaging technologies, including ultrasound, have continued to improve over the years. For example, in oncology, medical imaging is characterized by high sensitivity, i.e., the ability to detect anomalous tissue features, but the ability to classify these tissue features from images often lacks specificity. As a result, a large number of biopsies of tissues with suspicious image findings are performed each year with a vast majority of these biopsies resulting in a negative finding. To improve specificity of cancer imaging, quantitative imaging techniques can play an important role. Conventional ultrasound B-mode imaging is mainly qualitative in nature. However, quantitative ultrasound (QUS) imaging can provide specific numbers related to tissue features that can increase the specificity of image findings leading to improvements in diagnostic ultrasound. QUS imaging techniques can encompass a wide variety of techniques including spectral-based parameterization, elastography, shear wave imaging, flow estimation and envelope statistics. Currently, spectral-based parameterization and envelope statistics are not available on most conventional clinical ultrasound machines. However, in recent years QUS techniques involving spectral-based parameterization and envelope statistics have demonstrated success in many applications, providing additional diagnostic capabilities. Spectral-based techniques include the estimation of the backscatter coefficient, estimation of attenuation, and estimation of scatterer properties such as the correlation length associated with an effective scatterer diameter and the effective acoustic concentration of scatterers. Envelope statistics include the estimation of the number density of scatterers and quantification of coherent to incoherent signals produced from the tissue. Challenges for clinical application include correctly accounting for attenuation effects and transmission losses and implementation of QUS on clinical devices. Successful clinical and pre-clinical applications demonstrating the ability of QUS to improve medical diagnostics include characterization of the myocardium during the cardiac cycle, cancer detection, classification of solid tumors and lymph nodes, detection and quantification of fatty liver disease, and monitoring and assessment of therapy. PMID:26761606

  19. ESTIMATES OF GLOBAL GREENHOUSE GAS EMISSIONS FROM INDUSTRIAL AND DOMESTIC WASTEWATER TREATMENT

    EPA Science Inventory

    The report summarizes the findings of field tests and provides emission factors for methane (CH4) and nitrous oxide (N2O) from wastewater treatment (WWT). It also includes country-specific activity data on industrial and domestic WWT which were used to develop country-specific em...

  20. Prostate cancer prediction using the random forest algorithm that takes into account transrectal ultrasound findings, age, and serum levels of prostate-specific antigen.

    PubMed

    Xiao, Li-Hong; Chen, Pei-Ran; Gou, Zhong-Ping; Li, Yong-Zhong; Li, Mei; Xiang, Liang-Cheng; Feng, Ping

    2017-01-01

    The aim of this study is to evaluate the ability of the random forest algorithm that combines data on transrectal ultrasound findings, age, and serum levels of prostate-specific antigen to predict prostate carcinoma. Clinico-demographic data were analyzed for 941 patients with prostate diseases treated at our hospital, including age, serum prostate-specific antigen levels, transrectal ultrasound findings, and pathology diagnosis based on ultrasound-guided needle biopsy of the prostate. These data were compared between patients with and without prostate cancer using the Chi-square test, and then entered into the random forest model to predict diagnosis. Patients with and without prostate cancer differed significantly in age and serum prostate-specific antigen levels (P < 0.001), as well as in all transrectal ultrasound characteristics (P < 0.05) except uneven echo (P = 0.609). The random forest model based on age, prostate-specific antigen and ultrasound predicted prostate cancer with an accuracy of 83.10%, sensitivity of 65.64%, and specificity of 93.83%. Positive predictive value was 86.72%, and negative predictive value was 81.64%. By integrating age, prostate-specific antigen levels and transrectal ultrasound findings, the random forest algorithm shows better diagnostic performance for prostate cancer than either diagnostic indicator on its own. This algorithm may help improve diagnosis of the disease by identifying patients at high risk for biopsy.

  1. Accuracy of MRI findings in chronic lateral ankle ligament injury: comparison with surgical findings.

    PubMed

    Park, H-J; Cha, S-D; Kim, S S; Rho, M-H; Kwag, H-J; Park, N-H; Lee, S-Y

    2012-04-01

    To evaluate the accuracy of magnetic resonance imaging (MRI) findings in chronic lateral ankle ligament injury in comparison with that of surgical findings. Forty-eight cases (25 men, 23 women, mean age 36 years) of clinically suspected chronic ankle ligament injury underwent MRI studies and surgery. Sagittal, coronal, and axial, T1-weighted, spin-echo, proton density and T2-weighted, fast spin-echo images with fat saturation were obtained in all patients. MRI examinations were read in consensus by two fellowship-trained academic musculoskeletal radiologists who evaluated the lateral ankle ligaments, including the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) without clinical information. The results of the MRI studies were then compared with the surgical findings. The MRI findings of ATFL injury showed a sensitivity of detection of complete tears of 75% and specificity of 86%. The sensitivity of detection of partial tears was 75% and the specificity was 78%. The sensitivity of detection of sprains was 44% and the specificity was 88%. Regarding the MRI findings of CFL injury, the sensitivity of detection of complete tears was 50% and the specificity was 98%. The sensitivity of detection of partial tear was 83% and the specificity was 93%. The sensitivity of detection of sprains was 100% and the specificity was 90%. Regarding the ATFL, the accuracies of detection were 88, 58, 77, and 85% for no injury, sprain, partial tear, and complete tear, respectively, and for the CFL the accuracies of detection were 90, 90, 92, and 96% for no injury, sprain, partial tear, and complete tear, respectively. The diagnosis of a complete tear of the ATFL on MRI is more sensitive than the diagnosis of a complete tear of the CFL. MRI findings of CFL injury are diagnostically specific but are not sensitive. However, only normal findings and complete tears were statistically significant between ATFL and CFL (p < 0.001). Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  2. Electrocardiogram findings in emergency department patients with syncope.

    PubMed

    Quinn, James; McDermott, Daniel

    2011-07-01

    To determine the sensitivity and specificity of the San Francisco Syncope Rule (SFSR) electrocardiogram (ECG) criteria for determining cardiac outcomes and to define the specific ECG findings that are the most important in patients with syncope. A consecutive cohort of emergency department (ED) patients with syncope or near syncope was considered. The treating emergency physicians assessed 50 predictor variables, including an ECG and rhythm assessment. For the ECG assessment, the physicians were asked to categorize the ECG as normal or abnormal based on any changes that were old or new. They also did a separate rhythm assessment and could use any of the ECGs or available monitoring strips, including prehospital strips, when making this assessment. All patients were followed up to determine a broad composite study outcome. The final ECG criterion for the SFSR was any nonsinus rhythm or new ECG changes. In this specific study, the initial assessments in the database were used to determine only cardiac-related outcomes (arrhythmia, myocardial infarction, structural, sudden death) based on set criteria, and the authors determined the sensitivity and specificity of the ECG criteria for cardiac outcomes only. All ECGs classified as "abnormal" by the study criteria were compared to the official cardiology reading to determine specific findings on the ECG. Univariate and multivariate analysis were used to determine important specific ECG and rhythm findings. A total of 684 consecutive patients were considered, with 218 having positive ECG criteria and 42 (6%) having important cardiac outcomes. ECG criteria predicted 36 of 42 patients with cardiac outcomes, with a sensitivity of 86% (95% confidence interval [CI] = 71% to 94%), a specificity of 70% (95% CI = 66% to 74%), and a negative predictive value of 99% (95% CI = 97% to 99%). Regarding specific ECG findings, any nonsinus rhythm from any source and any left bundle conduction problem (i.e., any left bundle branch block, left anterior fascicular block, left posterior fascicular block, or QRS widening) were 2.5 and 3.5 times more likely associated with significant cardiac outcomes. The ECG criteria from the SFSR are relatively simple, and if used correctly can help predict which patients are at risk of cardiac outcomes. Furthermore, any left bundle branch block conduction problems or any nonsinus rhythms found during the ED stay should be especially concerning for physicians caring for patients presenting with syncope. © 2011 by the Society for Academic Emergency Medicine.

  3. Autobiographical Memory Specificity in Child Sexual Abuse Victims

    PubMed Central

    Ogle, Christin M.; Block, Stephanie D.; Harris, LaTonya S.; Goodman, Gail S.; Pineda, Annarheen; Timmer, Susan; Urquiza, Anthony; Saywitz, Karen J.

    2013-01-01

    The present study examined the specificity of autobiographical memory in adolescents and adults with versus without child sexual abuse (CSA) histories. Eighty-five participants, approximately half of whom per age group had experienced CSA, were tested on the Autobiographical Memory Interview. Individual difference measures, including for trauma-related psychopathology, were also administered. Findings revealed developmental differences in the relation between autobiographical memory specificity and CSA. Even with depression statistically controlled, reduced memory specificity in CSA victims relative to controls was observed among adolescents but not among adults. A higher number of Posttraumatic Stress Disorder criteria met predicted more specific childhood memories in participants who reported CSA as their most traumatic life event. These findings contribute to the scientific understanding of childhood trauma and autobiographical memory functioning and underscore the importance of considering the role of age and degree of traumatization within the study of autobiographical memory. PMID:23627947

  4. Developmental Change and Time-Specific Variation in Global and Specific Aspects of Self-Concept in Adolescence and Association with Depressive Symptoms

    PubMed Central

    Kuzucu, Yasar; Bontempo, Daniel E.; Hofer, Scott M.; Stallings, Michael C.; Piccinin, Andrea M.

    2014-01-01

    Previous research has demonstrated that adolescents make differential self-evaluations in multiple domains that include physical appearance, academic competence, and peer acceptance. We report growth curve analyses over a seven year period from age 9 to age 16 on the six domains of the Harter Self-Perception Profile for Children. In general, we find little change in self-concept, on average, but do find substantial individual differences in level, rate of change, and time-specific variation in these self- evaluations. The results suggest that sex differences and adoptive status were related to only certain aspects of the participants’ self-concept. Depressive symptoms were found to have significant effects on individual differences in rate of change and on time-specific variation in general self-concept, as well as on some of the specific domains of self-concept. PMID:25143664

  5. Understanding the medical markers of elder abuse and neglect: physical examination findings.

    PubMed

    Gibbs, Lisa M

    2014-11-01

    A specific foundation of knowledge is important for evaluating potential abuse from physical findings in the older adult. The standard physical examination is a foundation for detecting many types of abuse. An understanding of traumatic injuries, including patterns of injury, is important for health care providers, and inclusion of elder abuse in the differential diagnosis of patient care is essential. One must possess the skills needed to piece the history, including functional capabilities, and physical findings together. Armed with this skill set, health care providers will develop the confidence needed to identify and intervene in cases of elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Modeling How, When, and What Is Learned in a Simple Fault-Finding Task

    ERIC Educational Resources Information Center

    Ritter, Frank E.; Bibby, Peter A.

    2008-01-01

    We have developed a process model that learns in multiple ways while finding faults in a simple control panel device. The model predicts human participants' learning through its own learning. The model's performance was systematically compared to human learning data, including the time course and specific sequence of learned behaviors. These…

  7. Determination of thermophysical characteristics of solid materials by electrical modelling of the solutions to the inverse problems in nonsteady heat conduction

    NASA Technical Reports Server (NTRS)

    Kozdoba, L. A.; Krivoshei, F. A.

    1985-01-01

    The solution of the inverse problem of nonsteady heat conduction is discussed, based on finding the coefficient of the heat conduction and the coefficient of specific volumetric heat capacity. These findings are included in the equation used for the electrical model of this phenomenon.

  8. State of the art: nursing knowledge and electroconvulsive therapy.

    PubMed

    Froimson, L; Creed, P; Mathew, L

    1995-09-01

    Nursing services attempting to develop standards for their own facilities will find limited literature specific to nursing and electroconvulsive therapy (ECT) in American publications. From 1966 to December 1994, there were only 19 publications in American nursing journals that provide a specific focus on nursing and ECT. Only one of these articles reported research findings. Twenty-seven citations in Convulsive Therapy included nurse contributors. While the APA Task Force on the Practice of ECT has addressed educational needs of nursing and technical elements of the procedure, there do not currently exist specific standards for nursing practice in ECT. Concerns salient to nursing that have generated articles by nurses include instruction of patients, support to patients and families, safety of patients, assessment of clinical status, informed consent, and nurses' and patients' attitudes about ECT. Nurses are encouraged to join their physician-colleagues in developing and disseminating the information needed for the field of nursing to contribute its own expertise to the care of patients receiving ECT.

  9. Association of vascular physical examination findings and arteriographic lesions in large vessel vasculitis.

    PubMed

    Grayson, Peter C; Tomasson, Gunnar; Cuthbertson, David; Carette, Simon; Hoffman, Gary S; Khalidi, Nader A; Langford, Carol A; McAlear, Carol A; Monach, Paul A; Seo, Philip; Warrington, Kenneth J; Ytterberg, Steven R; Merkel, Peter A

    2012-02-01

    To assess the utility of the vascular physical examination to detect arteriographic lesions in patients with established large vessel vasculitis (LVV), including Takayasu's arteritis (TAK) and giant cell arteritis (GCA). In total, 100 patients (TAK = 68, GCA = 32) underwent standardized physical examination and angiography of the carotid, subclavian, and axillary arteries. Sensitivity and specificity were calculated for the association between findings on physical examination focusing on the vascular system (absent pulse, bruit, and blood pressure difference) and arteriographic lesions defined as stenosis, occlusion, or aneurysm. We found 67% of patients had at least 1 abnormality on physical examination (74% TAK, 53% GCA). Arteriographic lesions were seen in 76% of patients (82% TAK, 63% GCA). Individual physical examination findings had poor sensitivity (range 14%-50%) and good-excellent specificity (range 71%-98%) to detect arteriographic lesions. Even when considering physical examination findings in combination, at least 30% of arteriographic lesions were missed. Specificity improved (range 88%-100%) if individual physical examination findings were compared to a broader region of vessels rather than specific anatomically correlated vessels and if ≥ 1 physical examination findings were combined. In patients with established LVV, physical examination alone is worthwhile to detect arterial disease but does not always localize or reveal the full extent of arteriographic lesions. Abnormal vascular system findings on physical examination are highly associated with the presence of arterial lesions, but normal findings on physical examination do not exclude the possibility of arterial disease. Serial angiographic assessment is advisable to monitor arterial disease in patients with established LVV.

  10. Association of Vascular Physical Examination Findings and Arteriographic Lesions in Large Vessel Vasculitis

    PubMed Central

    GRAYSON, PETER C.; TOMASSON, GUNNAR; CUTHBERTSON, DAVID; CARETTE, SIMON; HOFFMAN, GARY S.; KHALIDI, NADER A.; LANGFORD, CAROL A.; McALEAR, CAROL A.; MONACH, PAUL A.; SEO, PHILIP; WARRINGTON, KENNETH J.; YTTERBERG, STEVEN R.; MERKEL, PETER A.

    2013-01-01

    Objective To assess the utility of the vascular physical examination to detect arteriographic lesions in patients with established large vessel vasculitis (LVV), including Takayasu’s arteritis (TAK) and giant cell arteritis (GCA). Methods In total, 100 patients (TAK = 68, GCA = 32) underwent standardized physical examination and angiography of the carotid, subclavian, and axillary arteries. Sensitivity and specificity were calculated for the association between findings on physical examination focusing on the vascular system (absent pulse, bruit, and blood pressure difference) and arteriographic lesions defined as stenosis, occlusion, or aneurysm. Results We found 67% of patients had at least 1 abnormality on physical examination (74% TAK, 53% GCA). Arteriographic lesions were seen in 76% of patients (82% TAK, 63% GCA). Individual physical examination findings had poor sensitivity (range 14%–50%) and good-excellent specificity (range 71%–98%) to detect arteriographic lesions. Even when considering physical examination findings in combination, at least 30% of arteriographic lesions were missed. Specificity improved (range 88%–100%) if individual physical examination findings were compared to a broader region of vessels rather than specific anatomically correlated vessels and if ≥ 1 physical examination findings were combined. Conclusion In patients with established LVV, physical examination alone is worthwhile to detect arterial disease but does not always localize or reveal the full extent of arteriographic lesions. Abnormal vascular system findings on physical examination are highly associated with the presence of arterial lesions, but normal findings on physical examination do not exclude the possibility of arterial disease. Serial angiographic assessment is advisable to monitor arterial disease in patients with established LVV. PMID:22174204

  11. Finding-specific display presets for computed radiography soft-copy reading.

    PubMed

    Andriole, K P; Gould, R G; Webb, W R

    1999-05-01

    Much work has been done to optimize the display of cross-sectional modality imaging examinations for soft-copy reading (i.e., window/level tissue presets, and format presentations such as tile and stack modes, four-on-one, nine-on-one, etc). Less attention has been paid to the display of digital forms of the conventional projection x-ray. The purpose of this study is to assess the utility of providing presets for computed radiography (CR) soft-copy display, based not on the window/level settings, but on processing applied to the image optimized for visualization of specific findings, pathologies, etc (i.e., pneumothorax, tumor, tube location). It is felt that digital display of CR images based on finding-specific processing presets has the potential to: speed reading of digital projection x-ray examinations on soft copy; improve diagnostic efficacy; standardize display across examination type, clinical scenario, important key findings, and significant negatives; facilitate image comparison; and improve confidence in and acceptance of soft-copy reading. Clinical chest images are acquired using an Agfa-Gevaert (Mortsel, Belgium) ADC 70 CR scanner and Fuji (Stamford, CT) 9000 and AC2 CR scanners. Those demonstrating pertinent findings are transferred over the clinical picture archiving and communications system (PACS) network to a research image processing station (Agfa PS5000), where the optimal image-processing settings per finding, pathologic category, etc, are developed in conjunction with a thoracic radiologist, by manipulating the multiscale image contrast amplification (Agfa MUSICA) algorithm parameters. Soft-copy display of images processed with finding-specific settings are compared with the standard default image presentation for 50 cases of each category. Comparison is scored using a 5-point scale with the positive scale denoting the standard presentation is preferred over the finding-specific processing, the negative scale denoting the finding-specific processing is preferred over the standard presentation, and zero denoting no difference. Processing settings have been developed for several findings including pneumothorax and lung nodules, and clinical cases are currently being collected in preparation for formal clinical trials. Preliminary results indicate a preference for the optimized-processing presentation of images over the standard default, particularly by inexperienced radiology residents and referring clinicians.

  12. Determining Content Validity for the Transition Awareness and Possibilities Scale (TAPS)

    ERIC Educational Resources Information Center

    Ross, Melynda Burck

    2011-01-01

    The Transition Awareness & Possibilities Scale (TAPS) was crafted after an extensive review of literature was conducted to find research that examined and described specific aspects of transition programming: inputs, including supports and skill instruction; processes, including parent and support provider perceptions of the transition experience;…

  13. Does This Child Have Pneumonia?: The Rational Clinical Examination Systematic Review.

    PubMed

    Shah, Sonal N; Bachur, Richard G; Simel, David L; Neuman, Mark I

    2017-08-01

    Pneumonia is a leading cause of morbidity and mortality in children. It is important to identify the clinical symptoms and physical examination findings associated with pneumonia to improve timely diagnosis, prevent significant morbidity, and limit antibiotic overuse. To systematically review the accuracy of symptoms and physical examination findings in identifying children with radiographic pneumonia. MEDLINE and Embase (1956 to May 2017) were searched, along with reference lists from retrieved articles, to identify diagnostic studies of pediatric pneumonia across a broad age range that had to include children younger than age 5 years (although some studies enrolled children up to age 19 years); 3644 unique articles were identified, of which 23 met inclusion criteria. Two authors independently abstracted raw data and assessed methodological quality. A third author resolved disputes. Likelihood ratios (LRs), sensitivity, and specificity were calculated for individual symptoms and physical examination findings for the diagnosis of pneumonia. An infiltrate on chest radiograph was considered the reference standard for the diagnosis of pneumonia. Twenty-three prospective cohort studies of children (N = 13 833) with possible pneumonia were included (8 from North America), with a range of 78 to 2829 patients per study. The prevalence of radiographic pneumonia in North American studies was 19% (95% CI, 11%-31%) and 37% (95% CI, 26%-50%) outside of North America. No single symptom was strongly associated with pneumonia; however, the presence of chest pain in 2 studies that included adolescents was associated with pneumonia (LR, 1.5-5.5; sensitivity, 8%-14%; specificity, 94%-97%). Vital sign abnormalities such as fever (temperature >37.5°C [LR range, 1.7-1.8]; sensitivity, 80%-92%; specificity, 47%-54%) and tachypnea (respiratory rate >40 breaths/min; LR, 1.5 [95% CI, 1.3-1.7]; sensitivity, 79%; specificity, 51%) were not strongly associated with pneumonia diagnosis. Similarly, auscultatory findings were not associated with pneumonia diagnosis. The presence of moderate hypoxemia (oxygen saturation ≤96%; LR, 2.8 [95% CI, 2.1-3.6]; sensitivity, 64%; specificity, 77%) and increased work of breathing (grunting, flaring, and retractions; positive LR, 2.1 [95% CI, 1.6-2.7]) were signs most associated with pneumonia. The presence of normal oxygenation (oxygen saturation >96%) decreased the likelihood of pneumonia (LR, 0.47 [95% CI, 0.32-0.67]). Although no single finding reliably differentiates pneumonia from other causes of childhood respiratory illness, hypoxia and increased work of breathing are more important than tachypnea and auscultatory findings.

  14. Dynamics of individual perceptual decisions

    PubMed Central

    Clark, Torin K.; Lu, Yue M.; Karmali, Faisal

    2015-01-01

    Perceptual decision making is fundamental to a broad range of fields including neurophysiology, economics, medicine, advertising, law, etc. Although recent findings have yielded major advances in our understanding of perceptual decision making, decision making as a function of time and frequency (i.e., decision-making dynamics) is not well understood. To limit the review length, we focus most of this review on human findings. Animal findings, which are extensively reviewed elsewhere, are included when beneficial or necessary. We attempt to put these various findings and data sets, which can appear to be unrelated in the absence of a formal dynamic analysis, into context using published models. Specifically, by adding appropriate dynamic mechanisms (e.g., high-pass filters) to existing models, it appears that a number of otherwise seemingly disparate findings from the literature might be explained. One hypothesis that arises through this dynamic analysis is that decision making includes phasic (high pass) neural mechanisms, an evidence accumulator and/or some sort of midtrial decision-making mechanism (e.g., peak detector and/or decision boundary). PMID:26467513

  15. Informed Purchasing Can Stretch Short Dollars.

    ERIC Educational Resources Information Center

    Miller, John B.; Miller, Kathryn Madera

    1979-01-01

    Provides purchasing tips for programs on a tight budget. Topics include writing specifications for the merchandise needed, finding and developing sources (vendors), receiving and analyzing bids, writing purchase orders, and receiving merchandise. (CM)

  16. Ability of preoperative 3.0-Tesla magnetic resonance imaging to predict the absence of side-specific extracapsular extension of prostate cancer.

    PubMed

    Hara, Tomohiko; Nakanishi, Hiroyuki; Nakagawa, Tohru; Komiyama, Motokiyo; Kawahara, Takashi; Manabe, Tomoko; Miyake, Mototaka; Arai, Eri; Kanai, Yae; Fujimoto, Hiroyuki

    2013-10-01

    Recent studies have shown an improvement in prostate cancer diagnosis with the use of 3.0-Tesla magnetic resonance imaging. We retrospectively assessed the ability of this imaging technique to predict side-specific extracapsular extension of prostate cancer. From October 2007 to August 2011, prostatectomy was carried out in 396 patients after preoperative 3.0-Tesla magnetic resonance imaging. Among these, 132 (primary sample) and 134 patients (validation sample) underwent 12-core prostate biopsy at the National Cancer Center Hospital of Tokyo, Japan, and at other institutions, respectively. In the primary dataset, univariate and multivariate analyses were carried out to predict side-specific extracapsular extension using variables determined preoperatively, including 3.0-Tesla magnetic resonance imaging findings (T2-weighted and diffusion-weighted imaging). A prediction model was then constructed and applied to the validation study sample. Multivariate analysis identified four significant independent predictors (P < 0.05), including a biopsy Gleason score of ≥8, positive 3.0-Tesla diffusion-weighted magnetic resonance imaging findings, ≥2 positive biopsy cores on each side and a maximum percentage of positive cores ≥31% on each side. The negative predictive value was 93.9% in the combination model with these four predictors, meanwhile the positive predictive value was 33.8%. Good reproducibility of these four significant predictors and the combination model was observed in the validation study sample. The side-specific extracapsular extension prediction by the biopsy Gleason score and factors associated with tumor location, including a positive 3.0-Tesla diffusion-weighted magnetic resonance imaging finding, have a high negative predictive value, but a low positive predictive value. © 2013 The Japanese Urological Association.

  17. 77 FR 51044 - Laguna Cartagena National Wildlife Refuge, PR; Final Comprehensive Conservation Plan and Finding...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-23

    ... plants, haying, research studies, wildlife surveying and monitoring, scientific collections, and camping... interest, including West Indian whistling ducks and kestrels. Under this alternative, specific activities...

  18. Finding Family Support Resource Card

    MedlinePlus

    ... led by a peer (e.g., survivor ) or mental health specialist . Some groups are specifically for patients or parents while others welcome the whole family , including siblings and grandparents . The focus of conversation can also ...

  19. Prevalence of vulvovaginitis and relation to physical findings in girls assessed for suspected child sexual abuse.

    PubMed

    Rahman, Gisel; Ocampo, Dolores; Rubinstein, Anahí; Risso, Paula

    2015-10-01

    The presence of sexually transmitted infections (STIs) in patients with suspected sexual abuse is uncommon in the field of pediatrics. To establish the prevalence of anogenital findings and their relation to the presence of STIs in girls referred for suspected child sexual abuse. Retrospective study conducted between January 1st, 2003 and December 31st, 2013. Physical findings and detection of STIs in girls with suspected child sexual abuse were analyzed. One thousand thirty-four patients were included. Their median age was 7.9 years old. Anogenital findings were classified as class I (normal):38.4%, class II (nonspecific):38.1%, class III (specific):19.9% and class IV (definitive):3.6%. STIs were observed in 42 patients (4.1%). A relation was established between STIs and the classification of physical findings: 10 (class II: 9; class III: 1) Neisseria gonorrhoeae, 17 (class I: 2; class II: 8; class III: 7) Chlamydia trachomatis, 15 (class I: 2; class II: 10; class III: 3) Trichomonas vaginalis. Statistically significant differences for Trichomonas vaginalis (p= 0.01) and Neisseria gonorrhoeae (p < 0.0001) were observed, with predominance of nonspecific clinical signs. Both nonspecific and specific findings were similarly observed for Chlamydia trachomatis (p= 0.03). Most cases of girls with suspected child sexual abuse had normal or nonspecific anogenital findings. The prevalence of STIs in these girls is low. Trichomonas vaginalis and Neisseria gonorrhoeae were related to nonspecific findings, while both nonspecific and specific findings were observed for Chlamydia trachomatis.

  20. The roles of effective communication and client engagement in delivering culturally sensitive care to immigrant parents of children with disabilities.

    PubMed

    King, Gillian; Desmarais, Chantal; Lindsay, Sally; Piérart, Geneviève; Tétreault, Sylvie

    2015-01-01

    Delivering pediatric rehabilitation services to immigrant parents of children with disabilities requires the practice of culturally sensitive care. Few studies have examined the specific nature of culturally sensitive care in pediatric rehabilitation, especially the notions of effective communication and client engagement. Interviews were held with 42 therapists (10 social workers, 16 occupational therapists and 16 speech language pathologists) from two locations in Canada (Toronto and Quebec City). Data were analyzed using an inductive content analysis approach. Study themes included the importance and nature of effective communication and client engagement in service delivery involving immigrant parents. Participants discussed using four main types of strategies to engage immigrant parents, including understanding the family situation, building a collaborative relationship, tailoring practice to the client's situation and ensuring parents' understanding of therapy procedures. The findings illuminate the importance of effective, two-way communication in providing the mutual understanding needed by therapists to engage parents in the intervention process. The findings also richly describe the engagement strategies used by therapists. Clinical implications include recommendations for strategies for therapists to employ to engage this group of parents. Furthermore, the findings are applicable to service provision in general, as engaging families in a collaborative relationship through attention to their specific situation is a general principle of good quality, family-centered care. Implications for Rehabilitation Effective communication permeates the delivery of culturally sensitive care and provides mutual understanding, which is fundamental to client engagement. The findings illuminate the nature of "partnership" by indicating the role of collaborative therapist strategies in facilitating engagement. Four main strategies facilitate effective communication and client engagement, including understanding the family situation, building a collaborative relationship, tailoring practice to the client's situation and ensuring parents' understanding of therapy procedures. Engaging families in a collaborative relationship through attention to their specific situation is a general principle of good quality, family-centered care.

  1. Functional Characterization of Schizophrenia-Associated Variation in CACNA1C

    PubMed Central

    Eckart, Nicole; Song, Qifeng; Yang, Rebecca; Wang, Ruihua; Zhu, Heng; McCallion, Andrew S.; Avramopoulos, Dimitrios

    2016-01-01

    Calcium channel subunits, including CACNA1C, have been associated with multiple psychiatric disorders. Specifically, genome wide association studies (GWAS) have repeatedly identified the single nucleotide polymorphism (SNP) rs1006737 in intron 3 of CACNA1C to be strongly associated with schizophrenia and bipolar disorder. Here, we show that rs1006737 marks a quantitative trait locus for CACNA1C transcript levels. We test 16 SNPs in high linkage disequilibrium with rs1007637 and find one, rs4765905, consistently showing allele-dependent regulatory function in reporter assays. We find allele-specific protein binding for 13 SNPs including rs4765905. Using protein microarrays, we identify several proteins binding ≥3 SNPs, but not control sequences, suggesting possible functional interactions and combinatorial haplotype effects. Finally, using circular chromatin conformation capture, we show interaction of the disease-associated region including the 16 SNPs with the CACNA1C promoter and other potential regulatory regions. Our results elucidate the pathogenic relevance of one of the best-supported risk loci for schizophrenia and bipolar disorder. PMID:27276213

  2. A Collection of NIDA NOTES. Articles That Address Research on Heroin.

    ERIC Educational Resources Information Center

    National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

    Included in this document are selections of topic-specific articles on heroin research reprinted from the National Institute on Drug Abuses (NIDA) research newsletter, NIDA Notes. Titles include: Buprenorphine Taken Three Times Per Week Is as Effective as Daily Doses in Treating Heroin Addiction; 33-Year Study Finds Lifelong, Lethal Consequences…

  3. Long-Term Memory: A Review and Meta-Analysis of Studies of Declarative and Procedural Memory in Specific Language Impairment

    ERIC Educational Resources Information Center

    Lum, Jarrad A. G.; Conti-Ramsden, Gina

    2013-01-01

    This review examined the status of long-term memory systems in specific language impairment (SLI)--declarative memory and aspects of procedural memory in particular. Studies included in the review were identified following a systematic search of the literature and findings combined using meta-analysis. This review showed that individuals with SLI…

  4. The association of suicide and bullying in childhood to young adulthood: a review of cross-sectional and longitudinal research findings.

    PubMed

    Brunstein Klomek, Anat; Sourander, Andre; Gould, Madelyn

    2010-05-01

    To review the research addressing the association of suicide and bullying, from childhood to young adulthood, including cross-sectional and longitudinal research findings. Relevant publications were identified via electronic searches of PsycNet and MEDLINE without date specification, in addition to perusing the reference lists of relevant articles. Cross-sectional findings indicate that there is an increased risk of suicidal ideation and (or) suicide attempts associated with bullying behaviour and cyberbullying. The few longitudinal findings available indicate that bullying and peer victimization lead to suicidality but that this association varies by sex. Discrepancies between the studies available may be due to differences in the studies' participants and methods. Bullying and peer victimization constitute more than correlates of suicidality. Future research with long-term follow-up should continue to identify specific causal paths between bullying and suicide.

  5. Cognitions and distress in caregivers after their child's sexual abuse disclosure.

    PubMed

    Runyon, Melissa K; Spandorfer, Ellen D; Schroeder, Christine M

    2014-01-01

    The impact of child sexual abuse on children is well documented, but few studies have examined the impact of a child's sexual abuse disclosure on maternal caregivers. The studies that have been conducted suggest that parental response postdisclosure is variable. The present study examined the association between maternal attributions and abuse-specific cognitions with depression and trauma symptoms postdisclosure. Participants included 68 nonoffending maternal caregivers of children between the ages of 3 and 17 years who experienced child sexual abuse. Findings indicated that caregivers' abuse-specific cognitions were the best predictor of self-reported symptoms of depression after controlling for general negative attributions. These findings suggest that in order to reduce caregivers' distress and to enhance their support of their children, it is important to assess and treat caregivers' abuse-specific cognitions.

  6. Image manipulation as research misconduct.

    PubMed

    Parrish, Debra; Noonan, Bridget

    2009-06-01

    A growing number of research misconduct cases handled by the Office of Research Integrity involve image manipulations. Manipulations may include simple image enhancements, misrepresenting an image as something different from what it is, and altering specific features of an image. Through a study of specific cases, the misconduct findings associated with image manipulation, detection methods and those likely to identify such manipulations, are discussed. This article explores sanctions imposed against guilty researchers and the factors that resulted in no misconduct finding although relevant images clearly were flawed. Although new detection tools are available for universities and journals to detect questionable images, this article explores why these tools have not been embraced.

  7. IgG4-related tumour-forming mastitis with histological appearances of granulomatous lobular mastitis: comparison with other types of tumour-forming mastitis.

    PubMed

    Ogura, Kanako; Matsumoto, Toshiharu; Aoki, Yuji; Kitabatake, Toshiaki; Fujisawa, Minoru; Kojima, Kuniaki

    2010-07-01

    Sometimes, mastitis needs to be differentiated from carcinoma because of its association with induration and with ultrasound findings (such as low-echo lesions) that resemble those in carcinoma. The aim was to define this type of mastitis and to examine 18 cases to clarify its clinicopathological features. All cases were categorized into three types: non-specific mastitis with neutrophilic infiltration (n = 7); non-specific mastitis with lymphoplasmacytic infiltration (n = 9); and granulomatous lobular mastitis (n = 2). The three types of mastitis presented similar ultrasound findings and shared certain histological features including fibrosis and diffuse or lobulocentric inflammation. Granulomatous lobular mastitis showed specific clinicopathological features including lobulocentric inflammation with giant cells, diffuse IgG4+ plasma cells, and also a high level of serum IgG4. Granulomatous lobular mastitis could be categorized into IgG4-related and non-IgG4-related granulomatous lobular mastitis. IgG4 immunohistochemistry serum IgG4 might be useful for diagnosis of IgG4-related granulomatous lobular mastitis and could help to avoid overtreatment such as wide excision.

  8. Perceptions and Determinants of Eating for Health and Performance in High-Level Male Adolescent Rugby Union Players.

    PubMed

    Stokes, Emily G; Hughes, Roger; Shaw, David M; O'Connor, Helen T; Beck, Kathryn L

    2018-05-28

    Sports nutrition recommendations provide guidance on dietary strategies to optimise sports performance. However, research indicates that young athletes often find it difficult to follow these guidelines in practice. Limited research exists on the determinants that influence adherence to sports nutrition guidelines. This study aimed to explore the perceptions and determinants of eating for health and performance in high-level male adolescent rugby union players. Determinants were explored using semi-structured individual interviews in New Zealand high-level male rugby union players ( n = 20, 16⁻18 years). Interviews were recorded, transcribed, and then underwent thematic analysis. Perceptions of eating for health and performance included balance and variety, appropriate portions, and specific foods. Both adolescent- and sport-specific determinants influenced the food choices of participants. Determinants relevant to adolescent lifestyles included the influence of significant others such as peers and family but also included the taste, cost, convenience, and availability of food. Sports-specific determinants revolved around the desire to enhance sports performance, motivation to perform, and team culture. The media (mainstream and social media), physical appearance, and feeling good were identified as both adolescent- and sport-specific factors influencing food choice. These findings highlight the importance of having support and positive role modelling to help young athletes make optimal food choices for health and performance. Strategies to further enable healthy eating practices should aim to strengthen the support available to young athletes in the home, school, and sporting environments and should include education on appropriate social media use to inform eating for health and performance.

  9. Computed tomography of intramural hematoma of the small intestime: a report of 3 cases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Plojoux, O.; Hauser, H.; Wettstein, P.

    1982-08-01

    CT findings in 3 cases of intramural hematoma of the small intestine are described. One patient needed surgery. CT characteristics were specific and included a region of increased density (50-80 H) representing the hematoma. The differential diagnosis includes tumor (lymphoma or melanoma) and inflammatory disease (Crohn disease or pancreatic cyst.)

  10. Advancement of Latent Trait Theory.

    DTIC Science & Technology

    1988-02-01

    if I am the principal investigator, I find it practically impossible to include and systematize all the important findings and implications within a...methods are described in [1.21. Two important features of the principal investigator’s approach are the following. (1) It does not assume any specific...were described in the preceding chapter, the maximum likelihood estimate 0 of ability 0 , and also f of the transformed ability r play important roles

  11. Functional mapping of the neural circuitry of rat maternal motivation: effects of site-specific transient neural inactivation

    PubMed Central

    Pereira, Mariana; Morrell, Joan I.

    2011-01-01

    The present review focuses on recent studies from our laboratory examining the neural circuitry subserving rat maternal motivation across postpartum. We employed a site-specific neural inactivation method by infusion of bupivacaine to map the maternal motivation circuitry using two complementary behavioral approaches: unconditioned maternal responsiveness and choice of pup- over cocaine-conditioned incentives in a concurrent pup/cocaine choice conditioned place preference task. Our findings revealed that during the early postpartum period, distinct brain structures, including the medial preoptic area, ventral tegmental area and medial prefrontal cortex infralimbic and anterior cingulate subregions, contribute a pup-specific bias to the motivational circuitry. As the postpartum period progresses and the pups grow older, our findings further revealed that maternal responsiveness becomes progressively less dependent on medial preoptic area and medial prefrontal cortex infralimbic activity, and more distributed in the maternal circuitry, such that additional network components, including the medial prefrontal cortex prelimbic subregion, are recruited with maternal experience, and contribute to the expression of late postpartum maternal behavior. Collectively, our findings provide strong evidence that the remarkable ability of postpartum females to successfully care for their developing infants is subserved by a distributed neural network that carries out efficient and dynamic processing of complex, constantly changing incoming environmental and pup-related stimuli, ultimately allowing the progression of appropriate expression and waning of maternal responsiveness across the postpartum period. PMID:21815954

  12. Return of results in translational iPS cell research: considerations for donor informed consent

    PubMed Central

    2013-01-01

    Efforts have emerged internationally to recruit donors with specific disease indications and to derive induced pluripotent cell lines. These disease-specific induced pluripotent stem cell lines have the potential to accelerate translational goals such as drug discovery and testing. One consideration for donor recruitment and informed consent is the possibility that research will result in findings that are clinically relevant to the cell donor. Management protocols for such findings should be developed a priori and disclosed during the informed consent process. The California Institute for Regenerative Medicine has developed recommendations for informing donors in sponsored research. These recommendations include obtaining consent to recontact tissue donors for a range of scientific, medical and ethical considerations. This article reviews the basis for these recommendations and suggests conditions that may be appropriate when reporting findings to donors. PMID:23336317

  13. Bowel obstruction complicated by ischemia: analysis of CT findings.

    PubMed

    Cox, Veronica L; Tahvildari, Ali M; Johnson, Benjamin; Wei, Wei; Jeffrey, R Brooke

    2018-06-01

    To analyze CT signs of bowel ischemia in patients with surgical bowel obstruction, and thereby improve CT diagnosis in this common clinical scenario. Surgical and histopathological findings were used as the reference standard. We retrospectively analyzed CT findings in patients brought to surgery for bowel obstruction over 13 years. Etiology of obstruction (adhesion, hernia, etc.) was recorded. Specific CT features of acute mesenteric ischemia (AMI) were analyzed, including bowel wall thickening, mucosal hypoenhancement, and others. 173 cases were eligible for analysis. 21% of cases were positive for bowel ischemia. Volvulus, internal hernia, and closed-loop obstructions showed ischemia rates of 60%, 43%, and 43%; ischemia rate in obstruction from simple adhesion was 21%. Patients with bowel obstruction related to malignancy were never ischemic. Sensitivities and specificities for CT features predicting ischemia were calculated, with wall thickening, hypoenhancement, and pneumatosis showing high specificity for ischemia (86%-100%). Wall thickening, hypoenhancement, and pneumatosis are highly specific CT signs of ischemia in the setting of obstruction. None of the evaluated CT signs were found to be highly sensitive. Overall frequency of ischemia in surgical bowel obstruction is 21%, and 2-3 times that for complex obstructions (volvulus, closed loop, etc.). Obstructions related to malignancy virtually never become ischemic.

  14. An overview of very high level software design methods

    NASA Technical Reports Server (NTRS)

    Asdjodi, Maryam; Hooper, James W.

    1988-01-01

    Very High Level design methods emphasize automatic transfer of requirements to formal design specifications, and/or may concentrate on automatic transformation of formal design specifications that include some semantic information of the system into machine executable form. Very high level design methods range from general domain independent methods to approaches implementable for specific applications or domains. Applying AI techniques, abstract programming methods, domain heuristics, software engineering tools, library-based programming and other methods different approaches for higher level software design are being developed. Though one finds that a given approach does not always fall exactly in any specific class, this paper provides a classification for very high level design methods including examples for each class. These methods are analyzed and compared based on their basic approaches, strengths and feasibility for future expansion toward automatic development of software systems.

  15. Conservation of small RNA pathways in platypus

    PubMed Central

    Murchison, Elizabeth P.; Kheradpour, Pouya; Sachidanandam, Ravi; Smith, Carly; Hodges, Emily; Xuan, Zhenyu; Kellis, Manolis; Grützner, Frank; Stark, Alexander; Hannon, Gregory J.

    2008-01-01

    Small RNA pathways play evolutionarily conserved roles in gene regulation and defense from parasitic nucleic acids. The character and expression patterns of small RNAs show conservation throughout animal lineages, but specific animal clades also show variations on these recurring themes, including species-specific small RNAs. The monotremes, with only platypus and four species of echidna as extant members, represent the basal branch of the mammalian lineage. Here, we examine the small RNA pathways of monotremes by deep sequencing of six platypus and echidna tissues. We find that highly conserved microRNA species display their signature tissue-specific expression patterns. In addition, we find a large rapidly evolving cluster of microRNAs on platypus chromosome X1, which is unique to monotremes. Platypus and echidna testes contain a robust Piwi-interacting (piRNA) system, which appears to be participating in ongoing transposon defense. PMID:18463306

  16. Conservation of small RNA pathways in platypus.

    PubMed

    Murchison, Elizabeth P; Kheradpour, Pouya; Sachidanandam, Ravi; Smith, Carly; Hodges, Emily; Xuan, Zhenyu; Kellis, Manolis; Grützner, Frank; Stark, Alexander; Hannon, Gregory J

    2008-06-01

    Small RNA pathways play evolutionarily conserved roles in gene regulation and defense from parasitic nucleic acids. The character and expression patterns of small RNAs show conservation throughout animal lineages, but specific animal clades also show variations on these recurring themes, including species-specific small RNAs. The monotremes, with only platypus and four species of echidna as extant members, represent the basal branch of the mammalian lineage. Here, we examine the small RNA pathways of monotremes by deep sequencing of six platypus and echidna tissues. We find that highly conserved microRNA species display their signature tissue-specific expression patterns. In addition, we find a large rapidly evolving cluster of microRNAs on platypus chromosome X1, which is unique to monotremes. Platypus and echidna testes contain a robust Piwi-interacting (piRNA) system, which appears to be participating in ongoing transposon defense.

  17. The evaluation of eye pain with a normal ocular exam.

    PubMed

    Lee, Andrew G; Brazis, Paul W

    2003-12-01

    Eye pain with or without associated head or face pain is a common complaint to the ophthalmologist. The ocular exam may reveal the etiology (e.g., corneal disease, angle closure glaucoma) but typically the exam is normal. This paper reviews the evaluation and management of eye pain with a "normal" ocular exam, including: 1) subtle findings on ocular exam; 2) transient findings on exam, and 3) no abnormal ocular findings. Ophthalmologists should be aware of the various etiologies for eye pain and the specific and distinctive features that make the diagnosis.

  18. Diagnostic performance and useful findings of ultrasound re-evaluation for patients with equivocal CT features of acute appendicitis.

    PubMed

    Kim, Mi Sung; Kwon, Heon-Ju; Kang, Kyung A; Do, In-Gu; Park, Hee-Jin; Kim, Eun Young; Hong, Hyun Pyo; Choi, Yoon Jung; Kim, Young Hwan

    2018-02-01

    To evaluate the diagnostic performance of ultrasound and to determine which ultrasound findings are useful to differentiate appendicitis from non-appendicitis in patients who underwent ultrasound re-evaluation owing to equivocal CT features of acute appendicitis. 62 patients who underwent CT examinations for suspected appendicitis followed by ultrasound re-evaluation owing to equivocal CT findings were included. Equivocal CT findings were considered based on the presence of only one or two findings among the CT criteria, and ultrasound re-evaluation was done based on a predefined structured report form. The diagnostic performance of ultrasound and independent variables to discriminate appendicitis from non-appendicitis were assessed. There were 27 patients in the appendicitis group. The overall diagnostic performance of ultrasound re-evaluation was sensitivity of 96.3%, specificity of 91.2% and accuracy of 91.9%. In terms of the performance of individual ultrasound findings, probe-induced tenderness showed the highest accuracy (86.7%) with sensitivity of 74% and specificity of 97%, followed by non-compressibility (accuracy 71.7%, sensitivity 85.2% and specificity 60.6%). The independent ultrasound findings for discriminating appendicitis were non-compressibility (p = 0.002) and increased flow on the appendiceal wall (p = 0.001). Ultrasound re-evaluation can be used to improve diagnostic accuracy in cases with equivocal CT features for diagnosing appendicitis. The presence of non-compressibility and increased vascular flow on the appendix wall are useful ultrasound findings to discriminate appendicitis from non-appendicitis. Advances in knowledge: Ultrasound re-evaluation is useful to discriminate appendicitis from non-appendicitis when CT features are inconclusive.

  19. Microcomputer Software for Libraries: A Survey.

    ERIC Educational Resources Information Center

    Nolan, Jeanne M.

    1983-01-01

    Reports on findings of research done by Nolan Information Management Services concerning availability of microcomputer software for libraries. Highlights include software categories (specific, generic-database management programs, original); number of programs available in 1982 for 12 applications; projections for 1983; and future software…

  20. Lead and Copper Control 101

    EPA Science Inventory

    This presentation is an overview of the most important water treatment strategies for the control of lead and copper release from drinking water corrosion. In addition to the sections specifically on lead and copper treatment, sections are included that cover sampling to find le...

  1. 78 FR 25044 - Listing Endangered or Threatened Species: 90-Day Finding on a Petition To Include the Killer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-29

    ... determination that the action is warranted. Under specific facts, we may also issue a determination that the... the Center for Environmental Science Accuracy and Reliability, Empresas Del Bosque, and Coburn Ranch...

  2. Delineation and Diagnostic Criteria of Oral-Facial-Digital Syndrome Type VI

    PubMed Central

    2012-01-01

    Oral-Facial-Digital Syndrome type VI (OFD VI) represents a rare phenotypic subtype of Joubert syndrome and related disorders (JSRD). In the original report polydactyly, oral findings, intellectual disability, and absence of the cerebellar vermis at post-mortem characterized the syndrome. Subsequently, the molar tooth sign (MTS) has been found in patients with OFD VI, prompting the inclusion of OFD VI in JSRD. We studied the clinical, neurodevelopmental, neuroimaging, and genetic findings in a cohort of 16 patients with OFD VI. We derived the following inclusion criteria from the literature: 1) MTS and one oral finding and polydactyly, or 2) MTS and more than one typical oral finding. The OFD VI neuroimaging pattern was found to be more severe than in other JSRD subgroups and includes severe hypoplasia of the cerebellar vermis, hypoplastic and dysplastic cerebellar hemispheres, marked enlargement of the posterior fossa, increased retrocerebellar collection of cerebrospinal fluid, abnormal brainstem, and frequently supratentorial abnormalities that occasionally include characteristic hypothalamic hamartomas. Additionally, two new JSRD neuroimaging findings (ascending superior cerebellar peduncles and fused thalami) have been identified. Tongue hamartomas, additional frenula, upper lip notch, and mesoaxial polydactyly are specific findings in OFD VI, while cleft lip/palate and other types of polydactyly of hands and feet are not specific. Involvement of other organs may include ocular findings, particularly colobomas. The majority of the patients have absent motor development and profound cognitive impairment. In OFD VI, normal cognitive functions are possible, but exceptional. Sequencing of known JSRD genes in most patients failed to detect pathogenetic mutations, therefore the genetic basis of OFD VI remains unknown. Compared with other JSRD subgroups, the neurological findings and impairment of motor development and cognitive functions in OFD VI are significantly worse, suggesting a correlation with the more severe neuroimaging findings. Based on the literature and this study we suggest as diagnostic criteria for OFD VI: MTS and one or more of the following: 1) tongue hamartoma(s) and/or additional frenula and/or upper lip notch; 2) mesoaxial polydactyly of one or more hands or feet; 3) hypothalamic hamartoma. PMID:22236771

  3. Comparing the effectiveness of using generic and specific search terms in electronic databases to identify health outcomes for a systematic review: a prospective comparative study of literature search methods

    PubMed Central

    MacLean, Alice; Sweeting, Helen; Hunt, Kate

    2012-01-01

    Objective To compare the effectiveness of systematic review literature searches that use either generic or specific terms for health outcomes. Design Prospective comparative study of two electronic literature search strategies. The ‘generic’ search included general terms for health such as ‘adolescent health’, ‘health status’, ‘morbidity’, etc. The ‘specific’ search focused on terms for a range of specific illnesses, such as ‘headache’, ‘epilepsy’, ‘diabetes mellitus’, etc. Data sources The authors searched Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO and the Education Resources Information Center for studies published in English between 1992 and April 2010. Main outcome measures Number and proportion of studies included in the systematic review that were identified from each search. Results The two searches tended to identify different studies. Of 41 studies included in the final review, only three (7%) were identified by both search strategies, 21 (51%) were identified by the generic search only and 17 (41%) were identified by the specific search only. 5 of the 41 studies were also identified through manual searching methods. Studies identified by the two ELS differed in terms of reported health outcomes, while each ELS uniquely identified some of the review's higher quality studies. Conclusions Electronic literature searches (ELS) are a vital stage in conducting systematic reviews and therefore have an important role in attempts to inform and improve policy and practice with the best available evidence. While the use of both generic and specific health terms is conventional for many reviewers and information scientists, there are also reviews that rely solely on either generic or specific terms. Based on the findings, reliance on only the generic or specific approach could increase the risk of systematic reviews missing important evidence and, consequently, misinforming decision makers. However, future research should test the generalisability of these findings. PMID:22734117

  4. Diffusion-Tensor Imaging Findings and Cognitive Function Following Hospitalized Mixed-Mechanism Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

    PubMed

    Oehr, Lucy; Anderson, Jacqueline

    2017-11-01

    To undertake a systematic review and meta-analysis of the relationship between microstructural damage and cognitive function after hospitalized mixed-mechanism (HMM) mild traumatic brain injury (mTBI). PsycInfo, EMBASE, and MEDLINE were used to find relevant empirical articles published between January 2002 and January 2016. Studies that examined the specific relationship between diffusion tensor imaging (DTI) and cognitive test performance were included. The final sample comprised previously medically and psychiatrically healthy adults with HMM mTBI. Specific data were extracted including mTBI definitional criteria, descriptive statistics, outcome measures, and specific results of associations between DTI metrics and cognitive test performance. Of the 248 original articles retrieved and reviewed, 8 studies met all inclusion criteria and were included in the meta-analysis. The meta-analysis revealed statistically significant associations between reduced white matter integrity and poor performance on measures of attention (fractional anisotropy [FA]: d=.413, P<.001; mean diffusivity [MD]: d=-.407, P=.001), memory (FA: d=.347, P<.001; MD: d=-.568, P<.001), and executive function (FA: d=.246, P<.05), which persisted beyond 1 month postinjury. The findings from the meta-analysis provide clear support for an association between in vivo markers of underlying neuropathology and cognitive function after mTBI. Furthermore, these results demonstrate clearly for the first time that in vivo markers of structural neuropathology are associated with cognitive dysfunction within the domains of attention, memory, and executive function. These findings provide an avenue for future research to examine the causal relationship between mTBI-related neuropathology and cognitive dysfunction. Furthermore, they have important implications for clinical management of patients with mTBI because they provide a more comprehensive understanding of factors that are associated with cognitive dysfunction after mTBI. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. LGBQ-Specific Elderly Housing as a "Sparkling Sanctuary": Boundary Work on LGBQ Identity and Community in Relationship to Potential LGBQ-Specific Elderly Housing in Sweden.

    PubMed

    Rosenberg, Lena; Kottorp, Anders; Johansson, Karin

    2017-09-08

    This study explored how boundaries in relationship to community and identity were created and negotiated among lesbian, gay, bisexual, and queer (LGBQ) people within the framework of picturing LGBQ-specific elderly housing as a housing alternative in older age, by applying focus group methodology. "An island as a sparkling sanctuary" was identified as a metaphor for how symbolic resources defining the LGBQ community can be manifested in LGBQ-specific qualities of elderly housing. The boundary work underlying this manifestation included elaborations on the dilemma between exclusiveness and normality. The findings illustrate further how symbolic resources and collective identities were developed through dialectic interplay between internal and external definitions. Further, the findings show how boundary work generated shared feelings of similarity and group membership. The associated symbolic and social resources not only served to deal with difficult situations but also to manifest LGBQ identity and sense of community as a "gold medal."

  6. Differentiating perforated from non-perforated appendicitis on contrast-enhanced magnetic resonance imaging.

    PubMed

    Rosenbaum, Daniel G; Askin, Gulce; Beneck, Debra M; Kovanlikaya, Arzu

    2017-10-01

    The role of magnetic resonance imaging (MRI) in pediatric appendicitis is increasing; MRI findings predictive of appendiceal perforation have not been specifically evaluated. To assess the performance of MRI in differentiating perforated from non-perforated appendicitis. A retrospective review of pediatric patients undergoing contrast-enhanced MRI and subsequent appendectomy was performed, with surgicopathological confirmation of perforation. Appendiceal diameter and the following 10 MRI findings were assessed: appendiceal restricted diffusion, wall defect, appendicolith, periappendiceal free fluid, remote free fluid, restricted diffusion within free fluid, abscess, peritoneal enhancement, ileocecal wall thickening and ileus. Two-sample t-test and chi-square tests were used to analyze continuous and discrete data, respectively. Sensitivity and specificity for individual MRI findings were calculated and optimal thresholds for measures of accuracy were selected. Seventy-seven patients (mean age: 12.2 years) with appendicitis were included, of whom 22 had perforation. The perforated group had a larger mean appendiceal diameter and mean number of MRI findings than the non-perforated group (12.3 mm vs. 8.6 mm; 5.0 vs. 2.0, respectively). Abscess, wall defect and restricted diffusion within free fluid had the greatest specificity for perforation (1.00, 1.00 and 0.96, respectively) but low sensitivity (0.36, 0.25 and 0.32, respectively). The receiver operator characteristic curve for total number of MRI findings had an area under the curve of 0.92, with an optimal threshold of 3.5. A threshold of any 4 findings had the best ability to accurately discriminate between perforated and non-perforated cases, with a sensitivity of 82% and specificity of 85%. Contrast-enhanced MRI can differentiate perforated from non-perforated appendicitis. The presence of multiple findings increases diagnostic accuracy, with a threshold of any four findings optimally discriminating between perforated and non-perforated cases. These results may help guide management decisions as MRI assumes a greater role in the work-up of pediatric appendicitis.

  7. Toward a Better Understanding of Patient Health Literacy: A Focus on the Skills Patients Need to Find Health Information.

    PubMed

    Champlin, Sara; Mackert, Michael; Glowacki, Elizabeth M; Donovan, Erin E

    2017-07-01

    While many health literacy assessments exist, this area of research lacks an instrument that isolates and reflects the four components driving this concept (abilities to find, understand, use, and communicate about health information). The purpose of this study was to determine what abilities comprise the first component, how a patient finds health information. Low ( n = 13) and adequate ( n = 14) health literacy patients, and health professionals ( n = 10) described their experiences when looking for health information and the skills they employed to complete these tasks. Major skills/themes elicited included knowing when to search, credibility assessments, finding text and numerical information, interpersonal seeking, technology and online search, and spatial navigation. Findings from this study suggest that each of the dimensions included in the definition of health literacy warrants specific attention and assessment. Given identification of the skills comprising each dimension, interventions targeting deficits across health literacy dimensions could be developed to improve patient health.

  8. Imaging Findings in Elder Abuse: A Role for Radiologists in Detection.

    PubMed

    Wong, Natalie Z; Rosen, Tony; Sanchez, Allen M; Bloemen, Elizabeth M; Mennitt, Kevin W; Hentel, Keith; Nicola, Refky; Murphy, Kieran J; LoFaso, Veronica M; Flomenbaum, Neal E; Lachs, Mark S

    2017-02-01

    Emergency department assessment represents a critical but often missed opportunity to identify elder abuse, which is common and has serious consequences. Among emergency care providers, diagnostic radiologists are optimally positioned to raise suspicion for mistreatment when reviewing imaging of geriatric injury victims. However, little literature exists describing relevant injury patterns, and most radiologists currently receive neither formal nor informal training in elder abuse identification. We present 2 cases to begin characterisation of the radiographic findings in elder abuse. Findings from these cases demonstrate similarities to suspicious findings in child abuse including high-energy fractures that are inconsistent with reported mechanisms and the coexistence of acute and chronic injuries. Specific injuries uncommon to accidental injury are also noted, including a distal ulnar diaphyseal fracture. We hope to raise awareness of elder abuse among diagnostic radiologists to encourage future large-scale research, increased focus on chronic osseous findings, and the addition of elder abuse to differential diagnoses. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Lead and Copper Control 101-slides

    EPA Science Inventory

    This presentation is an overview of the most important water treatment strategies for the control of lead and copper release from drinking water corrosion. In addition to the sections specifically on lead and copper treatment, sections are included that cover sampling to find le...

  10. Reduced autobiographical memory specificity in bereaved Afghan adolescents.

    PubMed

    Neshat Doost, Hamid Taher; Yule, William; Kalantari, Mehrdad; Rezvani, Sayed Rohollah; Dyregrov, Atle; Jobson, Laura

    2014-01-01

    This study investigated the effect of bereavement (father death due to war in Afghanistan) on autobiographical memory specificity in Afghan adolescents living in Iran. Participants consisted of bereaved (n=70) and non-bereaved (n=33) Afghan adolescents. The measures included Farsi versions of the Autobiographical Memory Test, Mood and Feeling Questionnaire, Revised Children's Manifest Anxiety Scale, and Impact of Event Scale. Results indicated that the bereaved group retrieved a significantly lower proportion of specific memories and a significantly greater proportion of extended and categoric memories than the non-bereaved group. Additionally, depression symptoms and reduced autobiographical memory specificity were significantly correlated. These findings suggest that bereaved adolescents have impaired autobiographical memory specificity.

  11. Tardigrade workbench: comparing stress-related proteins, sequence-similar and functional protein clusters as well as RNA elements in tardigrades

    PubMed Central

    2009-01-01

    Background Tardigrades represent an animal phylum with extraordinary resistance to environmental stress. Results To gain insights into their stress-specific adaptation potential, major clusters of related and similar proteins are identified, as well as specific functional clusters delineated comparing all tardigrades and individual species (Milnesium tardigradum, Hypsibius dujardini, Echiniscus testudo, Tulinus stephaniae, Richtersius coronifer) and functional elements in tardigrade mRNAs are analysed. We find that 39.3% of the total sequences clustered in 58 clusters of more than 20 proteins. Among these are ten tardigrade specific as well as a number of stress-specific protein clusters. Tardigrade-specific functional adaptations include strong protein, DNA- and redox protection, maintenance and protein recycling. Specific regulatory elements regulate tardigrade mRNA stability such as lox P DICE elements whereas 14 other RNA elements of higher eukaryotes are not found. Further features of tardigrade specific adaption are rapidly identified by sequence and/or pattern search on the web-tool tardigrade analyzer http://waterbear.bioapps.biozentrum.uni-wuerzburg.de. The work-bench offers nucleotide pattern analysis for promotor and regulatory element detection (tardigrade specific; nrdb) as well as rapid COG search for function assignments including species-specific repositories of all analysed data. Conclusion Different protein clusters and regulatory elements implicated in tardigrade stress adaptations are analysed including unpublished tardigrade sequences. PMID:19821996

  12. Tardigrade workbench: comparing stress-related proteins, sequence-similar and functional protein clusters as well as RNA elements in tardigrades.

    PubMed

    Förster, Frank; Liang, Chunguang; Shkumatov, Alexander; Beisser, Daniela; Engelmann, Julia C; Schnölzer, Martina; Frohme, Marcus; Müller, Tobias; Schill, Ralph O; Dandekar, Thomas

    2009-10-12

    Tardigrades represent an animal phylum with extraordinary resistance to environmental stress. To gain insights into their stress-specific adaptation potential, major clusters of related and similar proteins are identified, as well as specific functional clusters delineated comparing all tardigrades and individual species (Milnesium tardigradum, Hypsibius dujardini, Echiniscus testudo, Tulinus stephaniae, Richtersius coronifer) and functional elements in tardigrade mRNAs are analysed. We find that 39.3% of the total sequences clustered in 58 clusters of more than 20 proteins. Among these are ten tardigrade specific as well as a number of stress-specific protein clusters. Tardigrade-specific functional adaptations include strong protein, DNA- and redox protection, maintenance and protein recycling. Specific regulatory elements regulate tardigrade mRNA stability such as lox P DICE elements whereas 14 other RNA elements of higher eukaryotes are not found. Further features of tardigrade specific adaption are rapidly identified by sequence and/or pattern search on the web-tool tardigrade analyzer http://waterbear.bioapps.biozentrum.uni-wuerzburg.de. The work-bench offers nucleotide pattern analysis for promotor and regulatory element detection (tardigrade specific; nrdb) as well as rapid COG search for function assignments including species-specific repositories of all analysed data. Different protein clusters and regulatory elements implicated in tardigrade stress adaptations are analysed including unpublished tardigrade sequences.

  13. Making it work: health care provider perspectives on strategies to increase colorectal cancer screening in federally qualified health centers.

    PubMed

    Gwede, Clement K; Davis, Stacy N; Quinn, Gwendolyn P; Koskan, Alexis M; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G; Meade, Cathy D

    2013-12-01

    Colorectal cancer screening (CRCS) rates are low among men and women who seek health care at federally qualified health centers (FQHCs). This study explores health care providers' perspectives about their patient's motivators and impediments to CRCS and receptivity to preparatory education. A mixed methods design consisting of in-depth interviews, focus groups, and a short survey is used in this study. The participants of this study are 17 health care providers practicing in FQHCs in the Tampa Bay area. Test-specific patient impediments and motivations were identified including fear of abnormal findings, importance of offering less invasive fecal occult blood tests, and need for patient-centered test-specific educational materials in clinics. Opportunities to improve provider practices were identified including providers' reliance on patients' report of symptoms as a cue to recommend CRCS and overemphasis of clinic-based guaiac stool tests. This study adds to the literature on CRCS test-specific motivators and impediments. Providers offered unique approaches for motivating patients to follow through with recommended CRCS and were receptive to in-clinic patient education. Findings readily inform the design of educational materials and interventions to increase CRCS in FQHCs.

  14. Reduced memory specificity predicts the acquisition of problem solving skills in psychoeducation.

    PubMed

    Van Daele, Tom; Van den Bergh, Omer; Van Audenhove, Chantal; Raes, Filip; Hermans, Dirk

    2013-03-01

    Research has shown that overgeneral autobiographical memory (OGM) is a valid predictor for the course of depression. It is not known, however, whether OGM also moderates information uptake and consolidation in a psychoeducation program to prevent stress, anxiety and depression. The present study was designed to investigate whether the Autobiographical Memory Test (AMT; Williams, & Broadbent, 1986) is a valid predictor for the actual unfolding of skills learned through psychoeducation. The questionnaire included primarily the AMT and the Stress Anxiety Depression Means-Ends Problem Solving Questionnaire (SAD-MEPS). It was filled in prior to and after the psychoeducational course by 23 participants. Correlations were calculated for the AMT at baseline and the differences between the pre and post measurements on the SAD-MEPS. Significant correlations were observed between the number of specific responses and the changes in the number of relevant means (r = .49, p < .01). The sample size was rather small, but several checks were able to reduce the chance of spurious findings. These findings may have important implications for the guidance to and the setup of psychoeducational interventions. Suggestions include screening and memory specificity training prior to course commencement. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Focal dystonia in musicians: phenomenology, pathophysiology, triggering factors, and treatment.

    PubMed

    Altenmüller, Eckart; Jabusch, Hans-Christian

    2010-03-01

    Musician's dystonia is a task-specific movement disorder that manifests itself as a loss of voluntary motor control in extensively trained movements. Approximately 1% of all professional musicians develop musician's dystonia, and in many cases, the disorder terminates the careers of affected musicians. The pathophysiology of the disorder is not completely clarified. Findings include 1) reduced inhibition at different levels of the central nervous system, 2) maladaptive plasticity and altered sensory perception, and 3) alterations in sensorimotor integration. Epidemiological data demonstrate a higher risk for those musicians who play instruments requiring maximal fine-motor skills. For instruments where workload differs across hands, focal dystonia appears more often in the more intensely used hand. In psychological studies, musicians with dystonia have more anxiety and perfectionist tendencies than healthy musicians. These findings strengthen the assumption that behavioral factors may be involved in the etiology of musician's dystonia. Preliminary findings also suggest a genetic contribution to focal task-specific dystonia with phenotypic variations including musician's dystonia. Treatment options include pharmacological interventions, such as trihexyphenidyl or botulinum toxin-A, as well as retraining programs and ergonomic changes in the instrument. Patient-tailored treatment strategies may significantly improve the situation of musicians with focal dystonia. Positive results after retraining and unmonitored technical exercises underline the benefit of an active involvement of patients in the treatment process. Only a minority of musicians, however, return to normal motor control using the currently available therapies.

  16. Cross-cultural differences and sexual risk behavior of emerging adults.

    PubMed

    Thomas, Tami L; Yarandi, Hossein N; Dalmida, Safiya George; Frados, Andrew; Klienert, Kathleen

    2015-01-01

    The authors examined population-specific risk factors that increase emerging adults' risk of acquiring sexually transmitted infections (STIs), including the human papillomavirus (HPV). A cross-sectional sample of 335 diverse, emerging adults ages 18 to 24 years was recruited from a health center at a large university in the Southeastern United States. The mean age was 20.6 ± 1.9 years, majority were females (74.0%), and 61.0% were Hispanic. Findings revealed inconsistent condom use, reasons for not using condoms, and a need for more culturally specific intervention strategies. Healthcare providers should identify culturally specific reasons for inconsistent condom use, examine cultural and geographic differences in sexual risk behaviors among groups and communities, and modify communication, educational programs, and interventions accordingly. By adopting a multicultural approach to the control of STIs, nurses can address specific cultural attitudes and behaviors that may influence exposure to STIs, including HPV. © The Author(s) 2014.

  17. Black megachurch websites: an assessment of health content for congregations and communities.

    PubMed

    Campbell, Anthony D; Wallace, Gail

    2015-01-01

    This study examines the health-related content of Black megachurch websites in the southeastern United States. Data collection resulted in the identification of qualitative themes and frequencies of references to general health, specific health conditions, and corresponding general and specific health ministries. The most salient qualitative themes included holistic definitions of health, attention to racial health disparities, belief in divine health and protection from illness, emphasis on individual health responsibility, and belief in a religion-health connection. Nearly all websites referred to general health, and 74% mentioned a general health ministry. The most frequent references to specific health conditions included addiction, cancer, and HIV/AIDS, roughly corresponding to the top mentioned specific health ministries. This study provides baseline data on Black megachurch efforts to convey health information to their virtual congregations and communities. Findings support recent initiatives to involve megachurches in the provision of health messages within cultural frames to reach African Americans.

  18. Mind-body Therapies for Menopausal Symptoms: A Systematic Review

    PubMed Central

    Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek

    2010-01-01

    Objective To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms. Methods To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria. Results Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N=719), 1 non-randomized controlled trial (N=58), and 5 uncontrolled trials (N=105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings. Conclusions Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms. PMID:20167444

  19. Risk Factors for Social Networking Site Scam Victimization Among Malaysian Students.

    PubMed

    Kirwan, Gráinne H; Fullwood, Chris; Rooney, Brendan

    2018-02-01

    Social networking sites (SNSs) can provide cybercriminals with various opportunities, including gathering of user data and login credentials to enable fraud, and directing of users toward online locations that may install malware onto their devices. The techniques employed by such cybercriminals can include clickbait (text or video), advertisement of nonexistent but potentially desirable products, and hoax competitions/giveaways. This study aimed to identify risk factors associated with falling victim to these malicious techniques. An online survey was completed by 295 Malaysian undergraduate students, finding that more than one-third had fallen victim to SNS scams. Logistic regression analysis identified several victimization risk factors including having higher scores in impulsivity (specifically cognitive complexity), using fewer devices for SNSs, and having been on an SNS for a longer duration. No reliable model was found for vulnerability to hoax valuable gift giveaways and "friend view application" advertising specifically, but vulnerability to video clickbait was predicted by lower extraversion scores, higher levels of openness to experience, using fewer devices, and being on an SNS for a longer duration. Other personality traits were not associated with either overall victimization susceptibility or increased risk of falling victim to the specific techniques. However, age approached significance within both the video clickbait and overall victimization models. These findings suggest that routine activity theory may be particularly beneficial in understanding and preventing SNSs scam victimization.

  20. Sport-specific balance.

    PubMed

    Zemková, Erika

    2014-05-01

    This review includes the latest findings based on experimental studies addressing sport-specific balance, an area of research that has grown dramatically in recent years. The main objectives of this work were to investigate the postural sway response to different forms of exercise under laboratory and sport-specific conditions, to examine how this effect can vary with expertise, and to provide examples of the association of impaired balance with sport performance and/or increasing risk of injury. In doing so, sports where body balance is one of the limiting factors of performance were analyzed. While there are no significant differences in postural stability between athletes of different specializations and physically active individuals during standing in a standard upright position (e.g., bipedal stance), they have a better ability to maintain balance in specific conditions (e.g., while standing on a narrow area of support). Differences in magnitude of balance impairment after specific exercises (rebound jumps, repeated rotations, etc.) and mainly in speed of its readjustment to baseline are also observed. Besides some evidence on an association of greater postural sway with the increasing risk of injuries, there are many myths related to the negative influence of impaired balance on sport performance. Though this may be true for shooting or archery, findings have shown that in many other sports, highly skilled athletes are able to perform successfully in spite of increased postural sway. These findings may contribute to better understanding of the postural control system under various performance requirements. It may provide useful knowledge for designing training programs for specific sports.

  1. The heterogeneity of attention-deficit/hyperactivity disorder symptoms and conduct problems: Cognitive inhibition, emotion regulation, emotionality, and disorganized attachment.

    PubMed

    Forslund, Tommie; Brocki, Karin C; Bohlin, Gunilla; Granqvist, Pehr; Eninger, Lilianne

    2016-09-01

    This study examined the contributions of several important domains of functioning to attention-deficit/hyperactivity disorder (ADHD) symptoms and conduct problems. Specifically, we investigated whether cognitive inhibition, emotion regulation, emotionality, and disorganized attachment made independent and specific contributions to these externalizing behaviour problems from a multiple pathways perspective. The study included laboratory measures of cognitive inhibition and disorganized attachment in 184 typically developing children (M age = 6 years, 10 months, SD = 1.7). Parental ratings provided measures of emotion regulation, emotionality, and externalizing behaviour problems. Results revealed that cognitive inhibition, regulation of positive emotion, and positive emotionality were independently and specifically related to ADHD symptoms. Disorganized attachment and negative emotionality formed independent and specific relations to conduct problems. Our findings support the multiple pathways perspective on ADHD, with poor regulation of positive emotion and high positive emotionality making distinct contributions to ADHD symptoms. More specifically, our results support the proposal of a temperamentally based pathway to ADHD symptoms. The findings also indicate that disorganized attachment and negative emotionality constitute pathways specific to conduct problems rather than to ADHD symptoms. © 2016 The British Psychological Society.

  2. 21 CFR 13.30 - Proceedings of a Board.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... persons making and participating in the presentation and Federal Government executive branch employees and... prepare a decision on all issues. The decision is to include specific findings and references supporting and explaining the Board's conclusions, and a detailed statement of the reasoning on which the...

  3. New Supervisors' Struggles and Successes with Corrective Feedback

    ERIC Educational Resources Information Center

    Borders, L. DiAnne; Welfare, Laura E.; Sackett, Corrine R.; Cashwell, Craig

    2017-01-01

    Seven doctoral supervisors described their experiences giving corrective feedback, including events when constructive feedback and confrontation did and did not go well. Findings reveal their thoughts and feelings before, during, and after each event. The authors suggest several specific pedagogical directions for facilitating supervisor…

  4. How To Tutor Students with Reading Comprehension Problems.

    ERIC Educational Resources Information Center

    Parker, Richard; Hasbrouck, Jan E.; Denton, Carolyn

    2002-01-01

    Suggestions for tutoring students with reading comprehension problems include careful selection of books with readable text segments, use of comprehension strategies such as paraphrasing brief sections, and reading to find specific information. Several reading comprehension strategies for students are summarized. (Contains 7 references.) (DB)

  5. Special Issue: Book Reviews. Resources for Career Management, Counseling, Training and Development.

    ERIC Educational Resources Information Center

    Horvath, Clara, Ed.; And Others

    1995-01-01

    This special issue includes reviews of 32 books on the following topics: management, human resources, and organizational development; career counseling, guidance, and assessment; job search; resumes; careers in specific fields; careers for special populations; career transitions; and finding balance. (SK)

  6. Coping and posttraumatic growth in women with limb amputations.

    PubMed

    Stutts, Lauren A; Bills, Sarah E; Erwin, Savannah R; Good, Jessica J

    2015-01-01

    While ample research has examined the psychological experiences of men with limb amputations, minimal research has examined the psychological experiences of women with limb amputations. The present study utilizes a qualitative design to examine coping and posttraumatic growth in women with limb amputations. Thirty women completed the posttraumatic growth inventory (PTGI) and provided open-ended responses about coping, social support, discrimination, support groups, and acceptance. Interpretative phenomenological analysis was used to discern emergent and superordinate themes in qualitative responses. Superordinate themes included social support (friendships/family and community), self-beliefs, resources, physical complications, spirituality, specific strategies, and acceptance. Concerns related specifically to participants' gender identity included appearance and motherhood. Overall, women reported moderate-to-high PTGI scores. The current findings address a void in the literature by illuminating the unique perspective of women with amputations. Future research should use quantitative methodology to expand on our research findings, as well as assess interventions to assist women adjusting to limb loss.

  7. Are nutrition messages lost in transmission? Assessing the quality and consistency of diabetes guideline recommendations on the delivery of nutrition therapy.

    PubMed

    Hale, Kelli; Capra, Sandra; Bauer, Judy

    2016-12-01

    To provide an overview of (1) the consistency of Type 2 Diabetes Clinical Practice Guidelines recommendations on the delivery of nutrition therapy and (2) Clinical Practice Guideline quality. Large international clinical practice guideline repositories, diabetes organisation websites, and electronic databases (Pubmed, Scopus), were searched to identify Clinical Practice Guidelines for adults with type 2 diabetes published 2005 to August 2014. Recommendations on the delivery of nutrition therapy were extracted and inductive content analysis was used to analyse consistency. Two researchers independently assessed guideline quality using the AGREE II tool. Nine topics were identified from the recommendations. Overall the consistency of the recommendations was related to guideline type. Compared with nutrition-specific guidelines, the broad ones had a broader focus and included more patient-focused recommendations. The ten Clinical Practice Guidelines assessed included six broad guidelines and four nutrition specific guidelines. Based on AGREE II analysis, the broad guidelines were higher quality than nutrition-specific ones. Broad Clinical Practice Guidelines were higher quality and included more patient-focused recommendations than nutrition-specific ones. Our findings suggest a need for nutrition-specific guidelines to be modified to include greater patient-focus, or for practitioners delivering nutrition therapy to adopt broad Clinical Practice Guidelines. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Urethral polyp-like lesions on prostatic urethra caused by Chlamydia trachomatis infection: a case report.

    PubMed

    Muranaka, Takashi; Takahashi, Satoshi; Hirose, Takaoki; Hattori, Atsuo

    2014-11-01

    Urethral polyp is one of differential diagnoses for the male patients complain of gross-hematuria and/or hematospermia. However, there have been limited numbers of case reports including infectious etiology. Here we reported clinical course and pathological findings of one rare case who was diagnosed and treated as urethral polyp-like lesions on the prostatic urethra caused by Chlamydia trachomatis infection. A 25 year-old man who had a past history of frequent sexual intercourse with unspecified female sexual partner visited the clinic. His chief complaint was gross-hematuria and hematospermia. Endoscopic findings showed that non-specific hemorrhagic polyp-like lesions. To determine the pathological findings including malignant diseases and diagnosis, transurethral resection was performed. Because the pathological findings were similar to those of chlamydial proctitis, additional examination was done. As the results, nucleic acid amplification test of C. trachomatis in urine specimen was positive and immunohistochemical staining of specific chlamydia antigen in resected specimen was also positive. Treatment by orally minocyline 100 mg twice daily for 4 weeks was introduced. After the treatment, symptom was disappeared and nucleic acid amplification test of C. trachomatis in urine specimen turned to be negative. No recurrence was reported 2 years posttreatment. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  9. Reliability of magnetic resonance imaging for the detection of hypopituitarism in children with optic nerve hypoplasia.

    PubMed

    Ramakrishnaiah, Raghu H; Shelton, Julie B; Glasier, Charles M; Phillips, Paul H

    2014-01-01

    It is essential to identify hypopituitarism in children with optic nerve hypoplasia (ONH) because they are at risk for developmental delay, seizures, or death. The purpose of this study is to determine the reliability of neurohypophyseal abnormalities on magnetic resonance imaging (MRI) for the detection of hypopituitarism in children with ONH. Cross-sectional study. One hundred one children with clinical ONH who underwent MRI of the brain and orbits and a detailed pediatric endocrinologic evaluation. Magnetic resonance imaging studies were performed on 1.5-Tesla scanners. The imaging protocol included sagittal T1-weighted images, axial fast fluid-attenuated inversion-recovery/T2-weighted images, and diffusion-weighted images of the brain. Orbital imaging included fat-saturated axial and coronal images and high-resolution axial T2-weighted images. The MRI studies were reviewed by 2 pediatric neuroradiologists for optic nerve hypoplasia, absent or ectopic posterior pituitary, absent pituitary infundibulum, absent septum pellucidum, migration anomalies, and hemispheric injury. Medical records were reviewed for clinical examination findings and endocrinologic status. All patients underwent a clinical evaluation by a pediatric endocrinologist and a standardized panel of serologic testing that included serum insulin-like growth factor-1, insulin-like growth factor binding protein-3, prolactin, cortisol, adrenocorticotropic hormone, thyroid-stimulating hormone, and free thyroxine levels. Radiologists were masked to patients' endocrinologic status and funduscopic findings. Sensitivity and specificity of MRI findings for the detection of hypopituitarism. Neurohypophyseal abnormalities, including absent pituitary infundibulum, ectopic posterior pituitary bright spot, and absent posterior pituitary bright spot, occurred in 33 children. Magnetic resonance imaging disclosed neurohypophyseal abnormalities in 27 of the 28 children with hypopituitarism (sensitivity, 96%). A normal neurohypophysis occurred in 67 of 73 children with normal endocrinologic function (specificity, 92%). Neurohypophyseal abnormalities on MRI are sensitive and specific indicators of hypopituitarism in children with ONH. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  10. Clinical and cerebrospinal fluid findings contribute to the early differentiation between infectious and noninfectious encephalitis.

    PubMed

    Wilken, Miguel; Ameghino, Lucía; Cammarota, Ángel; Nogués, Martín A; Del Castillo, Marcelo; Farez, Mauricio F

    2017-01-01

    Early recognition and prompt specific treatment are crucial factors influencing the outcome of patients with acute encephalitis. The aim of this study was to determine the main causes of acute encephalitis in our population and to find predictors that may lead to specific diagnosis. Adult patients admitted to our hospital with suspected diagnosis of encephalitis in the period 2006-2013 were included. One hundred and five medical records were analyzed. Eighty-two patients with infectious encephalitis were identified (78% of total cases), 53 (65%) men and 29 (35%) women, mean age 47.8 years. The most common microorganisms identified were: HSV-1 (11%), VZV (10%), HSV-2 (5%) and EBV (5%). Twenty-three patients (22% of the series) had non-infectious encephalitis. Headache (p < 0.0001) and fever (p = 0.008) were more frequent in encephalitis of infectious origin. Protein levels and white blood cell counts in the cerebrospinal fluid were significantly higher in patients affected by infectious encephalitis than in those affected by noninfectious encephalitis (OR 95% CI 12.3 [2.9-51.7] and OR 95% CI 7.4 [2-27], respectively). Identifying specific causal agents of acute encephalitis remains a major challenge. Cerebrospinal fluid markers, as well as specific clinical findings, may however contribute to initial differentiation between infectious and noninfectious causes.

  11. Phonological working memory impairments in children with specific language impairment: where does the problem lie?

    PubMed

    Alt, Mary

    2011-01-01

    The purpose of this study was to determine which factors contribute to the lexical learning deficits of children with specific language impairment (SLI). Participants included 40 7-8-year old participants, half of whom were diagnosed with SLI and half of whom had normal language skills. We tested hypotheses about the contributions to word learning of the initial encoding of phonological information and the link to long-term memory. Children took part in a computer-based fast-mapping task which manipulated word length and phonotactic probability to address the hypotheses. The task had a recognition and a production component. Data were analyzed using mixed ANOVAs with post-hoc testing. Results indicate that the main problem for children with SLI is with initial encoding, with implications for limited capacity. There was not strong evidence for specific deficits in the link to long-term memory. We were able to ascertain which aspects of lexical learning are most problematic for children with SLI in terms of fast-mapping. These findings may allow clinicians to focus intervention on known areas of weakness. Future directions include extending these findings to slow mapping scenarios. The reader will understand how different components of phonological working memory contribute to the word learning problems of children with specific language impairment. Copyright © 2010 Elsevier Inc. All rights reserved.

  12. More experiences with the Tzanck smear test: cytologic findings in cutaneous granulomatous disorders.

    PubMed

    Durdu, Murat; Baba, Mete; Seçkin, Deniz

    2009-09-01

    Granulomatous dermatitis is a distinctive histopathologic cutaneous reaction pattern against various infectious and noninfectious agents. Cytologically, granulomatous dermatitis shows granulomas and multinucleated giant cells. Various etiologic agents of granulomatous diseases can also be identified. We aimed to investigate Tzanck smear findings in granulomatous skin diseases. Patients who had granulomas and/or multinucleated giant cells of Langhans, foreign body- and/or Touton type in Tzanck smear tests were included in the study. In these patients, Tzanck preparations were then further evaluated for additional cytologic findings. Samples stained with May-Grünwald-Giemsa stain were evaluated by the same dermatologist throughout the study. In some patients, methylene blue, Gram and/or Erlich-Ziehl-Nielsen stains were also performed. In all of the study cases, the final diagnosis was established after the evaluation of clinical and laboratory findings (including, when appropriate, potassium hydroxide examination; bacterial, leishmanial, and fungal cultures; histopathology; tuberculosis and leishmania polymerase chain reaction). We also calculated the sensitivity and specificity of the Leishman-Donovan body for cutaneous leishmaniasis. Over a 2-year period, 94 of 950 patients (9.9%) in whom Tzanck smear tests were performed had cytologic findings consistent with a granulomatous reaction. In 74 (78.7%) and 20 (21.3%) patients, the granulomatous reaction was due to infectious and noninfectious causes, respectively. Infectious causes included cutaneous leishmaniasis in 65 patients (87.8%), candidal granuloma in two patients, botyromycosis in two patients, and aspergillosis, blastomycosis, mucormycosis, leprosy, and cutaneous tuberculosis in one patient each. In 58 of 74 patients (78.4%) with infectious granulomatous dermatitis, the causes of the granulomas were identified. Noninfectious granulomatous reactions were due to granuloma annulare in 7 patients, sarcoidosis in 5 patients, a foreign body in 4 patients, necrobiosis lipoidica in 2 patients, and juvenile xanthogranuloma in 2 patients. In 17 of 20 patients (85%) with noninfectious granulomatous reactions, the cytologic findings were characteristic of the final diagnoses. The sensitivity and specificity of Leishman-Donovan bodies for cutaneous leishmaniasis were 76.9% and 100%, respectively. All of the samples were evaluated by the same dermatologist throughout the study; therefore no comment could be made regarding the reliability of the Tzanck smear test. In addition, the sensitivity and specificity of Tzanck smear test findings for diseases other than cutaneous leishmaniasis could not be calculated because of an insufficient number of patients. The Tzanck smear test may be a useful diagnostic tool for certain granulomatous skin diseases.

  13. The Intersection of Information and Science Literacy

    ERIC Educational Resources Information Center

    Klucevsek, Kristin

    2017-01-01

    To achieve higher science literacy, both students and the public require discipline-specific information literacy in the sciences. Scientific information literacy is a core component of the scientific process. In addition to teaching how to find and evaluate resources, scientific information literacy should include teaching the process of…

  14. Consumer Experiences Calling Toll-Free Corporate Hotlines.

    ERIC Educational Resources Information Center

    Martin, Charles L.; Smart, Denise T.

    1994-01-01

    Finds that dimensions that contribute to caller satisfaction (of toll-free corporate hotlines) included operator characteristics such as knowledge, courtesy, and interest; specific behaviors such as apologizing for a problem, thanking the consumer for calling, and encouraging them to call again; and reducing time placed on "hold." (SR)

  15. Effects of Cognitive Demand on Word Encoding in Adults Who Stutter

    ERIC Educational Resources Information Center

    Tsai, Pei-Tzu

    2011-01-01

    The etiology of persistent stuttering is unknown, but stuttering has been attributed to multiple potential factors, including difficulty in processing language-related information, but findings remain inconclusive regarding any "specific" linguistic deficit potentially causing stuttering. One particular challenge in drawing conclusions is the…

  16. Cognitive arithmetic and problem solving: a comparison of children with specific and general mathematics difficulties.

    PubMed

    Jordan, N C; Montani, T O

    1997-01-01

    This study examined problem-solving and number-fact skills in two subgroups of third-grade children with mathematics difficulties (MD): MD-specific (n = 12) and MD-general (n = 12). The MD-specific group had difficulties in mathematics but not in reading, and the MD-general group had difficulties in reading as well as in mathematics. A comparison group of nonimpaired children (n = 24) also was included. The findings showed that on both story and number-fact problems, the MD-specific group performed worse than the nonimpaired group in timed conditions but not in untimed conditions. The MD-general group, on the other hand, performed worse than the nonimpaired group, regardless of whether tasks were timed or not. An analysis of children's strategies in untimed conditions showed that both the MD-specific and the MD-general groups relied more on backup strategies than the nonimpaired group. However, children in the MD-specific group executed backup strategies more skillfully than children in the MD-general group, allowing them to achieve parity with children in the nonimpaired group when tasks were not timed. The findings suggest that children with specific MD have circumscribed deficits associated with fact retrieval, whereas children with general MD have more basic delays associated with problem conceptualization and execution of calculation procedures.

  17. An investigation of content and media images in gay men's magazines.

    PubMed

    Saucier, Jason A; Caron, Sandra L

    2008-01-01

    This study provides an analysis of gay men's magazines, examining both the content and advertisements. Four magazine titles were selected, including The Advocate, Genre, Instinct, and Out, each targeting gay men as its target audience. These magazines were coded for both article content and advertisement content. In the advertisement analysis, both the type of advertisement and characteristics of the men depicted within the advertisement when present. The results mirror previous research findings relating to the portrayal of women, including the objectification of specific body parts and the high community standards set by the images depicted. These findings were reinforced by both the advertisements and content analyzed to include a high degree of importance being placed on having the right body type. Implications for further research are discussed.

  18. Physical examination and ECG screening in relation to echocardiography findings in young healthy adults.

    PubMed

    Landau, Dan-Avi; Grossman, Alon; Sherer, Yaniv; Harpaz, David; Azaria, Bella; Carter, Dan; Barenboim, Erez; Goldstein, Liav

    2008-01-01

    Cardiovascular screening in young adults is an important tool in many occupational settings. Our aim was to test whether screening physical examination and ECG influence the rate of abnormal echocardiogarphic findings in young healthy subjects. Consecutive echocardiography results of 18- to 20-year-old flight candidates were analyzed retrospectively. Echocardiographies were performed as part of a screening protocol, which includes ECG, physical examination and referral for echocardiography for any positive finding. A second stage includes universal echocardiography for all candidates. 1,066 subjects were evaluated; 489 subjects underwent echocardiography following referral because of abnormal auscultatory or ECG findings. Findings (mostly mild valvular insufficiencies) were demonstrated in 12.7%, with only 0.6% of subjects disqualified. In subjects who underwent universal echocardiography (n = 577), findings (mostly mild valvular insufficiencies) were detected in 18%, with only 0.5% of subjects disqualified. The rate of significant echocardiography findings is extremely low in this young and healthy population. The presence of abnormal findings on either physical examination or ECG screening was not demonstrated to alter the rate of abnormal echocardiographic findings. We suggest that the low yield of screening should be weighed against the cost of an unidentified congenital cardiac lesion in the specific setting. Copyright 2007 S. Karger AG, Basel.

  19. GenderMedDB: an interactive database of sex and gender-specific medical literature.

    PubMed

    Oertelt-Prigione, Sabine; Gohlke, Björn-Oliver; Dunkel, Mathias; Preissner, Robert; Regitz-Zagrosek, Vera

    2014-01-01

    Searches for sex and gender-specific publications are complicated by the absence of a specific algorithm within search engines and by the lack of adequate archives to collect the retrieved results. We previously addressed this issue by initiating the first systematic archive of medical literature containing sex and/or gender-specific analyses. This initial collection has now been greatly enlarged and re-organized as a free user-friendly database with multiple functions: GenderMedDB (http://gendermeddb.charite.de). GenderMedDB retrieves the included publications from the PubMed database. Manuscripts containing sex and/or gender-specific analysis are continuously screened and the relevant findings organized systematically into disciplines and diseases. Publications are furthermore classified by research type, subject and participant numbers. More than 11,000 abstracts are currently included in the database, after screening more than 40,000 publications. The main functions of the database include searches by publication data or content analysis based on pre-defined classifications. In addition, registrants are enabled to upload relevant publications, access descriptive publication statistics and interact in an open user forum. Overall, GenderMedDB offers the advantages of a discipline-specific search engine as well as the functions of a participative tool for the gender medicine community.

  20. Theoretical rationale for music selection in oncology intervention research: an integrative review.

    PubMed

    Burns, Debra S

    2012-01-01

    Music-based interventions have helped patients with cancer improve their quality of life, decrease treatment related distress, and manage pain. However, quantitative findings from music intervention studies are inconsistent. The purpose of this review was to explore the theoretical underpinnings for the selection of the music stimuli used to influence targeted outcomes. It was hypothesized that disparate findings were due in part to the atheoretical nature of music selection and the resulting diversity in music stimuli between and within studies. A systematic research synthesis including a comprehensive database and reference list search resulted in 22 studies. Included studies were compiled into two tables cataloging intervention theory, intervention content, and outcomes. A majority of studies did not provide a rationale or intervention theory for the delivery of music or choice of outcomes. Recorded music was the most common delivery method, but the specific music was rarely included within the report. Only two studies that included a theoretical framework reported null results on at least some of the outcomes. Null results are partially explained by an incomplete or mismatch in intervention theory and music selection and delivery. While the inclusion of an intervention theory does not guarantee positive results, including a theoretical rationale for the use of music, particular therapeutic processes or mechanisms, and the specifics of how music is selected and delivered increases scientific rigor and the probability of clinical translation.

  1. Self-Efficacy and Social Support as Mediators Between Culturally Specific Dance and Lifestyle Physical Activity

    PubMed Central

    Murrock, Carolyn J.; Madigan, Elizabeth

    2013-01-01

    Culturally specific dance has the potential to generate health benefits but is seldom used even among studies advocating culturally specific interventions. This study examined the components of self-efficacy and social support as mediators between culturally specific dance and lifestyle physical activity in African American women (N = 126). An experimental design compared intervention and control groups for mediating effects of self-efficacy and social support on lifestyle physical activity. Findings indicated that only outcome expectations and social support from friends mediated effects. Culturally specific dance is a first step in encouraging African American women to become more physically active and improve health outcomes. The implications are that culturally specific dance programs can improve health outcomes by including members of underserved populations. PMID:18763475

  2. Self-efficacy and social support as mediators between culturally specific dance and lifestyle physical activity.

    PubMed

    Murrock, Carolyn J; Madigan, Elizabeth

    2008-01-01

    Culturally specific dance has the potential to generate health benefits but is seldom used even among studies advocating culturally specific interventions. This study examined the components of self-efficacy and social support as mediators between culturally specific dance and lifestyle physical activity in African American women (N = 126). An experimental design compared intervention and control groups for mediating effects of self-efficacy and social support on lifestyle physical activity. Findings indicated that only outcome expectations and social support from friends mediated effects. Culturally specific dance is a first step in encouraging African American women to become more physically active and improve health outcomes. The implications are that culturally specific dance programs can improve health outcomes by including members of underserved populations.

  3. Clinical and Magnetic Resonance Imaging Findings of Neurotoxocariasis.

    PubMed

    Sánchez, Sofia S; García, Hector H; Nicoletti, Alessandra

    2018-01-01

    Human toxocariasis is one of the most prevalent helminthiases worldwide. Toxocara canis larvae can cross the blood-brain barrier leading to the neurotoxocariasis. The clinical presentation consists of a wide spectrum of neurological manifestations, but asymptomatic infection is probably common. Neurotoxocariasis is not a frequent diagnosis probably due to the non-specific nature of its symptoms as well as the lack of confirmatory diagnostic tests. Diagnosis of neurotoxocariasis is based on the presence of a high titer of anti- Toxocara antibody in the cerebrospinal fluid or in the serum, presence of eosinophilia in the serum or cerebrospinal fluid, and clinical and radiological improvement after anthelmintic therapy; however, universally accepted diagnostic criteria are lacking. Magnetic resonance imaging (MRI) findings include single or multiple, subcortical, cortical or white matter hyperintense lesions, best visualized on FLAIR and T2-weighted imaging, and usually isointense or hypointense on T1. These imaging findings are suggestive but not specific to neurotoxocariasis. Definitive diagnosis is made by histological confirmation, but it is rarely followed. This review provides an overview of the clinical manifestations, management options, and MRI findings of neurotoxocariasis.

  4. Clinical and Magnetic Resonance Imaging Findings of Neurotoxocariasis

    PubMed Central

    Sánchez, Sofia S.; García, Hector H.; Nicoletti, Alessandra

    2018-01-01

    Human toxocariasis is one of the most prevalent helminthiases worldwide. Toxocara canis larvae can cross the blood–brain barrier leading to the neurotoxocariasis. The clinical presentation consists of a wide spectrum of neurological manifestations, but asymptomatic infection is probably common. Neurotoxocariasis is not a frequent diagnosis probably due to the non-specific nature of its symptoms as well as the lack of confirmatory diagnostic tests. Diagnosis of neurotoxocariasis is based on the presence of a high titer of anti-Toxocara antibody in the cerebrospinal fluid or in the serum, presence of eosinophilia in the serum or cerebrospinal fluid, and clinical and radiological improvement after anthelmintic therapy; however, universally accepted diagnostic criteria are lacking. Magnetic resonance imaging (MRI) findings include single or multiple, subcortical, cortical or white matter hyperintense lesions, best visualized on FLAIR and T2-weighted imaging, and usually isointense or hypointense on T1. These imaging findings are suggestive but not specific to neurotoxocariasis. Definitive diagnosis is made by histological confirmation, but it is rarely followed. This review provides an overview of the clinical manifestations, management options, and MRI findings of neurotoxocariasis. PMID:29472889

  5. STAFF REPORT ON CONFERENCE FINDINGS. APPENDIX II.

    ERIC Educational Resources Information Center

    National Council on the Aging, Inc., New York, NY.

    CONFERENCE SPEAKERS, PANELISTS, AND WORKSHOPS WERE ASKED TO FOCUS ON THE PROBLEMS OF THE 45-PLUS AGE GROUP AND TO MAKE SPECIFIC RECOMMENDATIONS ON PUBLIC POLICY, LEGISLATION, AND PUBLIC AND PRIVATE RESEARCH, PROGRAM AND ACTION. IN ADDITION, STAFF RECOMMENDATIONS WHICH WERE IMPLICIT IN THE PROCEEDINGS WERE INCLUDED. UNDER EACH SUB-HEADING,…

  6. Selected Aspects of Vocational Image as Perceived by a Public Categorized by Occupational Levels.

    ERIC Educational Resources Information Center

    Shultz, Fred A.; Terry, H. Robert

    In six north-central Oklahoma cities, representatives from professional, technical, skilled, semiskilled, and unskilled occupations were interviewed to determine their perceptions of the image of vocational education in Oklahoma. Findings for the seven specific research objectives included: (1) Concerning the adequacy of available vocational…

  7. The Process of Brainstorming.

    ERIC Educational Resources Information Center

    Pinkston, Ria R.

    In brainstorming a group attempts to find a solution for a specific problem by amassing all the ideas spontaneously contributed by members. Brainstorming is recommended when the generation of ideas will be beneficial to the solution of problems. Four fundamental rules of brainstorming include: (1) criticism is not allowed during the thinking…

  8. Rethinking Multicultural Group Work as Intercultural Learning

    ERIC Educational Resources Information Center

    Reid, Robin; Garson, Kyra

    2017-01-01

    This article presents our findings of an exploration of students' perceptions of multicultural group work when specific changes in pedagogy and methods of evaluation were made to include the processes students navigate, instead of merely the end product of their collaboration. Shifting demographics and increasing cultural diversity in higher…

  9. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kalousek, D.K.; Fitch, N.; Paradice, B.

    Topics covered in this book include a general review of normal embryonic and fetal development; abortion and the basic approach to the examination of aborted embryos and fetuses; and pathologic findings detected on examination of products of conception. The authors illustrate specific morphologic lesions and the variable expression of genetic syndromes in the embryonic and fetal periods.

  10. 40 CFR 60.539 - Hearing and appeal procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... intervene, making specific reference to the factors set forth in the foregoing sentence and paragraph (c)(3.... Copies of transcripts of proceedings may be purchased by the applicant from the reporter. (5) All written... decision which shall include written findings and conclusions and the reasons or basis therefor on all the...

  11. Designing Assessment into a Study Abroad Course

    ERIC Educational Resources Information Center

    Santanello, Cathy; Wolff, Laura

    2008-01-01

    One faces several challenges when designing an education abroad program. These include engaging non-traditional majors in study abroad experiences; facilitating learning activities that directly align with the learning goals of the courses; assessing specific learning outcomes; and finding ways to close the circle after the study abroad programs…

  12. A Profile of Clinical Nutrition Knowledge Among Physicians and Medical Students

    ERIC Educational Resources Information Center

    Podell, Richard N.; And Others

    1975-01-01

    An assessment of the clinical nutritional knowledge of third- and fourth-year medical students and practicing physicians revealed that overall nutritional knowledge is modest and that knowledge is highest among topics which have received the most publicity in the popular press. Methodology and specific findings are included. (JT)

  13. Methods for Instructional Diagnosis with Limited Available Resources.

    ERIC Educational Resources Information Center

    Gillmore, Gerald M.; Clark, D. Joseph

    College teaching should be approached with the same careful delineation of problems and systematic attempts to find solutions which characterize research. Specific methods for the diagnosis of instructional problems include audio-video taping, use of teaching assistants, colleague assistance, classroom tests, student projects in and out of class,…

  14. Families Are Learning in Science Museums.

    ERIC Educational Resources Information Center

    Borun, Minda; And Others

    1996-01-01

    Reports on a study designed to identify and measure family learning in science museums. Findings indicate that families do learn from exhibits and the level of learning is related to specific observed behaviors. Grouping these behaviors as performance indicators provides a useful measure of exhibit learning. Appendixes include a demographic…

  15. Criteria for Performing Cranial Computed Tomography for Chinese Patients With Mild Traumatic Brain Injury: Canadian Computed Tomography Head Rule or New Orleans Criteria?

    PubMed

    Yang, Xiao-Feng; Meng, Yuan-Yuan; Wen, Liang; Wang, Hao

    2017-09-01

    Computed tomography (CT) provides the primary diagnostic evidence for traumatic brain injury (TBI), but few positive traumatic findings are discovered in patients with mild TBI. In China, there are no existing criteria for selecting patients with mild TBI to undergo CT, and almost all of these patients undergo cranial CT in the emergency department. This retrospective study was performed to evaluate the necessity of cranial CT among patients with mild TBI, as well as the feasibility of 2 popular criteria (Canadian CT head rule [CCHR] and New Orleans Criteria [NOC]) in China. Patients with mild TBI who underwent cranial CT within 24 hours of the trauma were included in our institute. Two neurosurgeons reviewed the CT images independently to identify positive CT findings. The sensitivity and specificity of CCHR and NOC for positive CT findings related to TBI were analyzed. Finally, this study included 625 patients. Positive CT findings related to TBI were discovered in 13.12% (82/625) of these patients on cranial CT, and 6.88% (43/625) of them were admitted to the hospital for further management. Ultimately, 11 patients (1.76%, 11/625) underwent neurosurgery. In this study, the sensitivities of both the CCHR and NOC were 100%, but the specificity of CCHR was 43.36% and that of NOC was 33.12%. Based on our study, both CCHR and NOC have high sensitivity for the detection of positive CT findings related to head trauma in patients with mild TBI.

  16. Partitioning heritability by functional annotation using genome-wide association summary statistics.

    PubMed

    Finucane, Hilary K; Bulik-Sullivan, Brendan; Gusev, Alexander; Trynka, Gosia; Reshef, Yakir; Loh, Po-Ru; Anttila, Verneri; Xu, Han; Zang, Chongzhi; Farh, Kyle; Ripke, Stephan; Day, Felix R; Purcell, Shaun; Stahl, Eli; Lindstrom, Sara; Perry, John R B; Okada, Yukinori; Raychaudhuri, Soumya; Daly, Mark J; Patterson, Nick; Neale, Benjamin M; Price, Alkes L

    2015-11-01

    Recent work has demonstrated that some functional categories of the genome contribute disproportionately to the heritability of complex diseases. Here we analyze a broad set of functional elements, including cell type-specific elements, to estimate their polygenic contributions to heritability in genome-wide association studies (GWAS) of 17 complex diseases and traits with an average sample size of 73,599. To enable this analysis, we introduce a new method, stratified LD score regression, for partitioning heritability from GWAS summary statistics while accounting for linked markers. This new method is computationally tractable at very large sample sizes and leverages genome-wide information. Our findings include a large enrichment of heritability in conserved regions across many traits, a very large immunological disease-specific enrichment of heritability in FANTOM5 enhancers and many cell type-specific enrichments, including significant enrichment of central nervous system cell types in the heritability of body mass index, age at menarche, educational attainment and smoking behavior.

  17. Universal, developmental, and variable aspects of young children's play: a cross-cultural comparison of pretending at home.

    PubMed

    Haight, W L; Wang, X L; Fung, H H; Williams, K; Mintz, J

    1999-01-01

    Using longitudinal data from five Irish American families in the United States and nine Chinese families in Taiwan, in conjunction with an emerging body of evidence in the cultural psychology literature, we propose universal, culturally variable, and developmental dimensions of young children's pretend play. Possible universal dimensions include the use of objects, and the predominantly social nature of pretend play. Developmental dimensions include increases in the proportion of social pretend play initiated by the child, the proportion of partner initiations elaborated upon by the child, and caregivers' use of pretend play initiations to serve other, nonplay social functions. Culturally variable dimensions include the centrality of objects, the participation of specific play partners, the extent of child initiations of social pretend play with caregivers, the various functions of social pretend play in interaction, and specific themes. These findings raise the theoretical issue of how universal and variable dimensions of pretend play interact in specific communities to create distinctive development pathways.

  18. ERK Signaling in the Pituitary Is Required for Female But Not Male Fertility

    PubMed Central

    Bliss, Stuart P.; Miller, Andrew; Navratil, Amy M.; Xie, JianJun; McDonough, Sean P.; Fisher, Patricia J.; Landreth, Gary E.; Roberson, Mark S.

    2009-01-01

    Males and females require different patterns of pituitary gonadotropin secretion for fertility. The mechanisms underlying these gender-specific profiles of pituitary hormone production are unknown; however, they are fundamental to understanding the sexually dimorphic control of reproductive function at the molecular level. Several studies suggest that ERK1 and -2 are essential modulators of hypothalamic GnRH-mediated regulation of pituitary gonadotropin production and fertility. To test this hypothesis, we generated mice with a pituitary-specific depletion of ERK1 and 2 and examined a range of physiological parameters including fertility. We find that ERK signaling is required in females for ovulation and fertility, whereas male reproductive function is unaffected by this signaling deficiency. The effects of ERK pathway ablation on LH biosynthesis underlie this gender-specific phenotype, and the molecular mechanism involves a requirement for ERK-dependent up-regulation of the transcription factor Egr1, which is necessary for LHβ expression. Together, these findings represent a significant advance in elucidating the molecular basis of gender-specific regulation of the hypothalamic-pituitary-gonadal axis and sexually dimorphic control of fertility. PMID:19372235

  19. Benefit Finding in Maternal Caregivers of Pediatric Cancer Survivors: A Mixed Methods Approach.

    PubMed

    Willard, Victoria W; Hostetter, Sarah A; Hutchinson, Katherine C; Bonner, Melanie J; Hardy, Kristina K

    2016-09-01

    Benefit finding has been described as the identification of positive effects resulting from otherwise stressful experiences. In this mixed methods study, we examined the relations between qualitative themes related to benefit finding and quantitative measures of psychosocial adjustment and coping as reported by maternal caregivers of survivors of pediatric cancer. Female caregivers of survivors of pediatric cancer (n = 40) completed a qualitative questionnaire about their experiences caring for their child, along with several quantitative measures. Qualitative questionnaires were coded for salient themes, including social support and personal growth. Correlation matrices evaluated associations between qualitative themes and quantitative measures of stress and coping. Identified benefits included social support and personal growth, as well as child-specific benefits. Total benefits reported were significantly positively correlated with availability of emotional resources. Coping methods were also associated, with accepting responsibility associated with fewer identified benefits. Despite the stress of their child's illness, many female caregivers of survivors of pediatric cancer reported finding benefits associated with their experience. Benefit finding in this sample was associated with better adjustment. © 2016 by Association of Pediatric Hematology/Oncology Nurses.

  20. Factors influencing food choices of adolescents: findings from focus-group discussions with adolescents.

    PubMed

    Neumark-Sztainer, D; Story, M; Perry, C; Casey, M A

    1999-08-01

    To assess adolescents' perceptions about factors influencing their food choices and eating behaviors. Data were collected in focus-group discussions. The study population included 141 adolescents in 7th and 10th grade from 2 urban schools in St Paul, Minn, who participated in 21 focus groups. Data were analyzed using qualitative research methodology, specifically, the constant comparative method. Factors perceived as influencing food choices included hunger and food cravings, appeal of food, time considerations of adolescents and parents, convenience of food, food availability, parental influence on eating behaviors (including the culture or religion of the family), benefits of foods (including health), situation-specific factors, mood, body image, habit, cost, media, and vegetarian beliefs. Major barriers to eating more fruits, vegetables, and dairy products and eating fewer high-fat foods included a lack of sense of urgency about personal health in relation to other concerns, and taste preferences for other foods. Suggestions for helping adolescents eat a more healthful diet include making healthful food taste and look better, limiting the availability of unhealthful options, making healthful food more available and convenient, teaching children good eating habits at an early age, and changing social norms to make it "cool" to eat healthfully. The findings suggest that if programs to improve adolescent nutrition are to be effective, they need to address a broad range of factors, in particular environmental factors (e.g., the increased availability and promotion of appealing, convenient foods within homes schools, and restaurants).

  1. Incidental genetic findings in randomized clinical trials: recommendations from the Genomics and Randomized Trials Network (GARNET)

    PubMed Central

    2013-01-01

    Recommendations and guidance on how to handle the return of genetic results to patients have offered limited insight into how to approach incidental genetic findings in the context of clinical trials. This paper provides the Genomics and Randomized Trials Network (GARNET) recommendations on incidental genetic findings in the context of clinical trials, and discusses the ethical and practical issues considered in formulating our recommendations. There are arguments in support of as well as against returning incidental genetic findings in clinical trials. For instance, reporting incidental findings in clinical trials may improve the investigator-participant relationship and the satisfaction of participation, but it may also blur the line between clinical care and research. The issues of whether and how to return incidental genetic findings, including the costs of doing so, should be considered when developing clinical trial protocols. Once decided, plans related to sharing individual results from the aim(s) of the trial, as well as incidental findings, should be discussed explicitly in the consent form. Institutional Review Boards (IRBs) and other study-specific governing bodies should be part of the decision as to if, when, and how to return incidental findings, including when plans in this regard are being reconsidered. PMID:23363732

  2. Antihistamine Use in Early Pregnancy and Risk of Birth Defects

    PubMed Central

    Li, Qian; Mitchell, Allen A.; Werler, Martha M.; Yau, Wai-Ping; Hernández-Díaz, Sonia

    2014-01-01

    Background Several studies have reported an association between use of specific antihistamines in early pregnancy and certain specific birth defects. Objective To test 16 previously-hypothesized associations between specific antihistamines and specific birth defects, and identify possible new associations. Methods We used 1998-2010 data from the Slone Epidemiology Center Birth Defects Study, a multicenter case-control surveillance program of birth defects in North America. Mothers were interviewed within six months of delivery about demographic, reproductive, medical, and behavioral factors, and details on use of prescription and non-prescription medications. We compared 1st trimester exposure to specific antihistamines between 13,213 infants with specific malformations and 6,982 non-malformed controls, using conditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustment for potential confounders, including indication for use. Results Overall, 13.7% of controls were exposed to antihistamines during the 1st trimester. The most commonly-used medications were diphenhydramine (4.2%), loratadine (3.1%), doxylamine (1.9%), and chlorpheniramine (1.7%). Where estimates were stable, none supported the previously-hypothesized associations. Among over 100 exploratory comparisons of other specific antihistamine/defect pairs, 14 had ORs ≥1.5 of which 6 had 95% CI bounds excluding 1.0 before but not after adjustment for multiple comparisons. Conclusion Our findings do not provide meaningful support for previously-posited associations between antihistamines and major congenital anomalies; at the same time, we identified associations that had not been previously suggested. We suspect that previous associations may be chance findings in the context of multiple comparisons, a situation which may also apply to our new findings. PMID:24565715

  3. Identifying Neurofibromin-Specific Regulatory Nodes for Therapeutic Targeting in NF1

    DTIC Science & Technology

    2016-10-01

    adapter protein SPRED1, to function, and we are utilizing the latest technical innovations including CRISPR technology to find genes that regulate...neurofibromin depends on the adapter protein SPRED1, to function, and we are utilizing the latest technical innovations including CRISPR technology...signaling NF1-Null HEK 293T cells have been generated using CRISPR /Cas9 and single clones have been expanded for biochemical assays (Figure 2). NF1-Null

  4. Where are the strongest associations between autistic traits and traits of ADHD? evidence from a community-based twin study.

    PubMed

    Taylor, Mark J; Charman, Tony; Ronald, Angelica

    2015-09-01

    Autism spectrum conditions (ASC) and attention-deficit/hyperactivity disorder (ADHD) regularly co-occur. Twin studies increasingly indicate that these conditions may have overlapping genetic causes. Less is known about the degree to which specific autistic traits relate to specific behaviours characteristic of ADHD. We hence tested, using the classical twin design, whether specific dimensional autistic traits, including social difficulties, communication atypicalities and repetitive behaviours, would display differential degrees of aetiological overlap with specific traits of ADHD, including hyperactivity/impulsivity and inattention. Parents of approximately 4,000 pairs of 12-year-old twins completed the Childhood Autism Spectrum Test and Conners' Parent Rating Scale. These measures were divided into subscales corresponding to different types of autistic and ADHD behaviours. Twin model fitting suggested that the degree of genetic overlap was particularly strong between communication difficulties and traits of ADHD (genetic correlations = .47-.51), while repetitive behaviours and social difficulties showed moderate (genetic correlations = .12-.33) and modest (.05-.11) genetic overlap respectively. Environmental overlap was low across all subscales (correlations = .01-.23). These patterns were also apparent at the extremes of the general population, with communication difficulties showing the highest genetic overlap with traits of ADHD. These findings indicate that molecular genetic studies seeking to uncover the shared genetic basis of ASC and ADHD would benefit from taking a symptom-specific approach. Furthermore, they could also help to explain why studies of the communication abilities of individuals with ASC and ADHD have produced overlapping findings.

  5. MRI of placenta percreta: differentiation from other entities of placental adhesive disorder.

    PubMed

    Thiravit, Shanigarn; Lapatikarn, Sukanya; Muangsomboon, Kobkun; Suvannarerg, Voraparee; Thiravit, Phakphoom; Korpraphong, Pornpim

    2017-01-01

    To retrospectively review the MRI findings of placenta percreta and identify those helpful for differentiation from non-placenta percreta. The MRI images of 21 patients with a preliminary diagnosis of placental adhesive disorder scanned between 2005 and 2014 were evaluated. Radiologists blinded to the final diagnosis evaluated six previously described MRI findings of placenta adhesive disorder. The sensitivity, specificity, accuracy, negative predictive value (NPV), and positive predictive value (PPV) of MRI for the diagnosis of placenta percreta were also calculated. The study included 12 cases of placenta percreta and 9 cases of non-placenta percreta. Invasion of placental tissue outside the uterus was found only in placenta percreta (p = 0.045; sensitivity 41.7 %; specificity 100 %). All placenta percreta cases also had a moderate to marked degree of heterogeneous placental signal intensity (p = 0.063; sensitivity 100 %; specificity 33.3 %). The size of the dark bands on T2-weighted imaging, and the presence of disorganized intra-placental vessels, showed no statistically significant difference between placenta percreta and non-placenta percreta. The sensitivity, specificity, NPV, PPV, and accuracy of MRI for detection of placenta percreta were 91.7, 44, 80, 68, and 71.4 %, respectively. MRI is recommended for the evaluation of placenta percreta, with the most specific signs including the invasion of placental tissue outside the uterus on B-FFE sequences, and consideration of the degree of placental signal heterogeneity. The size of the T2 dark band alone, or bizarre disorganized intra-placental vessels, did not correlate with the severity of invasion.

  6. Sixth Grade Students' Content-Specific Competencies and Challenges in Learning the Seasons Through Modeling

    NASA Astrophysics Data System (ADS)

    Sung, Ji Young; Oh, Phil Seok

    2017-06-01

    Recent science education reform initiatives suggest that learning in science should be organized on the basis of scientists' actual practices including the development and use of models. In line with this, the current study adapted three types of modeling practices to teach two Korean 6th grade science classes the causes of the Earth's seasons. Specifically, the study aimed to identify the students' content-specific competencies and challenges based on fine-grained descriptions and analyses of two target groups' cases. Data included digital recordings of modeling-based science lessons in the two classes, the teacher's and students' artifacts, and interviews with the students. These multiple types of data were analyzed complementarily and qualitatively. It was revealed that the students had a competency in constructing models to generate the desired phenomenon (i.e., seasons). They had difficulty, however, in considering the tilt of the Earth's rotation axis as a cause of the seasons and in finding a proper way of representing the Sun's meridian altitude on a globe. But, when the students were helped and guided by the teacher and peers' interventions, they were able to revise their models in alignment with the scientific understanding of the seasons. Based on these findings, the teacher's pedagogical roles, which include using student competencies as resources, asking physical questions, and explicit guidance on experimentation skills, were recommended to support successful incorporations of modeling practices in the science classroom.

  7. Hantavirus pulmonary syndrome clinical findings: evaluating a surveillance case definition.

    PubMed

    Knust, Barbara; Macneil, Adam; Rollin, Pierre E

    2012-05-01

    Clinical cases of hantavirus pulmonary syndrome (HPS) can be challenging to differentiate from other acute respiratory diseases, which can lead to delays in diagnosis, treatment, and disease reporting. Rapid onset of severe disease occurs, at times before diagnostic test results are available. This study's objective was to examine the clinical characteristics of patients that would indicate HPS to aid in detection and reporting. Test results of blood samples from U.S. patients suspected of having HPS submitted to the Centers for Disease Control and Prevention from 1998-2010 were reviewed. Patient information collected by case report forms was compared between HPS-confirmed and test-negative patients. Diagnostic sensitivity, specificity, predictive values, and likelihood ratios were calculated for individual clinical findings and combinations of variables. Of 567 patients included, 36% were HPS-confirmed. Thrombocytopenia, chest x-rays with suggestive signs, and receiving supplemental oxygenation were highly sensitive (>95%), while elevated hematocrit was highly specific (83%) in detecting HPS. Combinations that maximized sensitivity required the presence of thrombocytopenia. Using a national sample of suspect patients, we found that thrombocytopenia was a highly sensitive indicator of HPS and should be included in surveillance definitions for suspected HPS. Using a sensitive suspect case definition to identify potential HPS patients that are confirmed by highly specific diagnostic testing will ensure accurate reporting of this disease.

  8. Medications and Impaired Driving: A Review of the Literature

    PubMed Central

    Hetland, Amanda; Carr, David B

    2013-01-01

    Objective To describe the association of specific medication classes with driving outcomes and provide clinical recommendations. Data sources The MEDLINE and EMBASE databases were searched for articles published from January 1973 to June 2013 on specific classes of medications known to be associated with driving impairment. The search included outcome terms such as automobile driving, motor vehicle crash, driving simulator, and road tests. Study selection and data extraction Only English-language articles that contained findings from observational or interventional designs were included. Cross-sectional studies, case series, and case reports were excluded. Studies of ≥ 10 subjects were included in this review. Data synthesis Driving is an important task and activity for the majority of adults. Unfortunately, some specific classes of commonly prescribed medications have been associated with driving impairment as measured by road performance, driving simulation, and/or motor vehicle crashes. This review of 30 studies identified findings with barbiturates, benzodiazepines, certain non-benzodiazepine hypnotics, various antidepressants, opioid and non-steroidal analgesics, anticonvulsants, antipsychotics, antiparkinsonian agents, skeletal muscle relaxants, antihistamines, anticholinergic medications, and hypoglycemic agents. Additional studies identifying medication impacts on sedation, sleep latency, and psychomotor function – as well as the role of alcohol – are also discussed. Conclusions Psychotropic agents and those with CNS side effects were associated with various measures of impaired driving performance. It is difficult to determine if such associations are actually a result of medication use or perhaps the medical diagnosis itself. Regardless, clinicians should be aware of the increased risk of impaired driving with specific populations and classes of medications when prescribing these agents, educate their patients, and/or consider safer alternatives. PMID:24473486

  9. Prospective relations between family conflict and adolescent maladjustment: security in the family system as a mediating process.

    PubMed

    Cummings, E Mark; Koss, Kalsea J; Davies, Patrick T

    2015-04-01

    Conflict in specific family systems (e.g., interparental, parent-child) has been implicated in the development of a host of adjustment problems in adolescence, but little is known about the impact of family conflict involving multiple family systems. Furthermore, questions remain about the effects of family conflict on symptoms of specific disorders and adjustment problems and the processes mediating these effects. The present study prospectively examines the impact of family conflict and emotional security about the family system on adolescent symptoms of specific disorders and adjustment problems, including the development of symptoms of anxiety, depression, conduct problems, and peer problems. Security in the family system was examined as a mediator of these relations. Participants included 295 mother-father-adolescent families (149 girls) participating across three annual time points (grades 7-9). Including auto-regressive controls for initial levels of emotional insecurity and multiple adjustment problems (T1), higher-order emotional insecurity about the family system (T2) mediated relations between T1 family conflict and T3 peer problems, anxiety, and depressive symptoms. Further analyses supported specific patterns of emotional security/insecurity (i.e., security, disengagement, preoccupation) as mediators between family conflict and specific domains of adolescent adjustment. Family conflict was thus found to prospectively predict the development of symptoms of multiple specific adjustment problems, including symptoms of depression, anxiety, conduct problems, and peer problems, by elevating in in adolescent's emotional insecurity about the family system. The clinical implications of these findings are considered.

  10. Large-Scale functional network overlap is a general property of brain functional organization: Reconciling inconsistent fMRI findings from general-linear-model-based analyses

    PubMed Central

    Xu, Jiansong; Potenza, Marc N.; Calhoun, Vince D.; Zhang, Rubin; Yip, Sarah W.; Wall, John T.; Pearlson, Godfrey D.; Worhunsky, Patrick D.; Garrison, Kathleen A.; Moran, Joseph M.

    2016-01-01

    Functional magnetic resonance imaging (fMRI) studies regularly use univariate general-linear-model-based analyses (GLM). Their findings are often inconsistent across different studies, perhaps because of several fundamental brain properties including functional heterogeneity, balanced excitation and inhibition (E/I), and sparseness of neuronal activities. These properties stipulate heterogeneous neuronal activities in the same voxels and likely limit the sensitivity and specificity of GLM. This paper selectively reviews findings of histological and electrophysiological studies and fMRI spatial independent component analysis (sICA) and reports new findings by applying sICA to two existing datasets. The extant and new findings consistently demonstrate several novel features of brain functional organization not revealed by GLM. They include overlap of large-scale functional networks (FNs) and their concurrent opposite modulations, and no significant modulations in activity of most FNs across the whole brain during any task conditions. These novel features of brain functional organization are highly consistent with the brain’s properties of functional heterogeneity, balanced E/I, and sparseness of neuronal activity, and may help reconcile inconsistent GLM findings. PMID:27592153

  11. Brain magnetic resonance imaging findings in young patients with hepatosplenic schistosomiasis mansoni without overt symptoms.

    PubMed

    Manzella, Adonis; Borba-Filho, Paulo; Brandt, Carlos T; Oliveira, Keyla

    2012-06-01

    The purpose of this study was to describe the brain magnetic resonance imaging (MRI) findings in young patients with hepatosplenic schistosomiasis mansoni without overt neurologic manifestations. This study included 34 young persons (age range = 9-25 years) with hepatosplenic schistosomiasis mansoni who had been previously treated. Patients were scanned on a 1.5-T system that included multiplanar pre-contrast and post-contrast sequences, and reports were completed by two radiologists after a consensus review. Twenty (58.8%) patients had MRI signal changes that were believed to be related to schistosomiasis mansoni. Twelve of the 20 patients had small focal hyperintensities on T2WI in the cerebral white matter, and eight patients had symmetric hyperintense basal ganglia on T1WI. There was a high frequency of brain MRI signal abnormalities in this series. Although not specific, these findings may be related to schistosomiasis.

  12. Molecular inversion probe assay for allelic quantitation

    PubMed Central

    Ji, Hanlee; Welch, Katrina

    2010-01-01

    Molecular inversion probe (MIP) technology has been demonstrated to be a robust platform for large-scale dual genotyping and copy number analysis. Applications in human genomic and genetic studies include the possibility of running dual germline genotyping and combined copy number variation ascertainment. MIPs analyze large numbers of specific genetic target sequences in parallel, relying on interrogation of a barcode tag, rather than direct hybridization of genomic DNA to an array. The MIP approach does not replace, but is complementary to many of the copy number technologies being performed today. Some specific advantages of MIP technology include: Less DNA required (37 ng vs. 250 ng), DNA quality less important, more dynamic range (amplifications detected up to copy number 60), allele specific information “cleaner” (less SNP crosstalk/contamination), and quality of markers better (fewer individual MIPs versus SNPs needed to identify copy number changes). MIPs can be considered a candidate gene (targeted whole genome) approach and can find specific areas of interest that otherwise may be missed with other methods. PMID:19488872

  13. Radical Prostatectomy Findings in Men on Active Surveillance: Variable Findings Dependent on Reason for Surgery and Entry Criteria.

    PubMed

    Matoso, Andres; Hassan, Oudai; Petrozzino, Florencia; Rao, B Vishal; Carter, H Ballentine; Epstein, Jonathan I

    2015-09-01

    We studied adverse radical prostatectomy findings in men on an active surveillance program with different entry and exit criteria. The study included 80 men with biopsy progression, 33 who opted out for personal reasons and 24 who initially did not meet entry criteria mainly due to increased prostate specific antigen density. Of men who opted out 78.8% had a higher Gleason score of 6 than men who progressed on biopsy (46.2%, p = 0.002) and men with high prostate specific antigen density (45.8%, p = 0.02). Men with high prostate specific antigen density had less organ confined disease than the group that opted out (p <0.006) and a trend compared to the biopsy progression group (p = 0.07). Mean dominant tumor volume was lower in men who opted out than in those with biopsy progression (0.56 vs 1.1 cc, p = 0.03). The incidence of insignificant cancer was higher in men who opted out (48.4%) than in those with biopsy progression (28.4%, p = 0.05) and those with high prostate specific antigen density (20.8%, p = 0.035). There was a higher incidence of anterior tumor in men with high prostate specific antigen density (55.0%) than with biopsy progression (21.3%, p = 0.009) and a trend compared to those who opted out (27.3%, p = 0.06). The majority of men with biopsy progression still had tumors with features of curable disease. Men who opted out without biopsy progression had even less adverse findings, which supports counseling men to stay on active surveillance while they meet followup criteria. Men with elevated prostate specific antigen density had more anterior tumors and less organ confined cancer, substantiating that the ideal patients for active surveillance are those who meet all entry criteria. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. HCN1 channels in cerebellar Purkinje cells promote late stages of learning and constrain synaptic inhibition

    PubMed Central

    Rinaldi, Arianna; Defterali, Cagla; Mialot, Antoine; Garden, Derek L F; Beraneck, Mathieu; Nolan, Matthew F

    2013-01-01

    Neural computations rely on ion channels that modify neuronal responses to synaptic inputs. While single cell recordings suggest diverse and neurone type-specific computational functions for HCN1 channels, their behavioural roles in any single neurone type are not clear. Using a battery of behavioural assays, including analysis of motor learning in vestibulo-ocular reflex and rotarod tests, we find that deletion of HCN1 channels from cerebellar Purkinje cells selectively impairs late stages of motor learning. Because deletion of HCN1 modifies only a subset of behaviours involving Purkinje cells, we asked whether the channel also has functional specificity at a cellular level. We find that HCN1 channels in cerebellar Purkinje cells reduce the duration of inhibitory synaptic responses but, in the absence of membrane hyperpolarization, do not affect responses to excitatory inputs. Our results indicate that manipulation of subthreshold computation in a single neurone type causes specific modifications to behaviour. PMID:24000178

  15. Differential requirements of androgen receptor in luminal progenitors during prostate regeneration and tumor initiation

    PubMed Central

    Chua, Chee Wai; Epsi, Nusrat J; Leung, Eva Y; Xuan, Shouhong; Lei, Ming; Li, Bo I; Bergren, Sarah K; Hibshoosh, Hanina; Mitrofanova, Antonina

    2018-01-01

    Master regulatory genes of tissue specification play key roles in stem/progenitor cells and are often important in cancer. In the prostate, androgen receptor (AR) is a master regulator essential for development and tumorigenesis, but its specific functions in prostate stem/progenitor cells have not been elucidated. We have investigated AR function in CARNs (CAstration-Resistant Nkx3.1-expressing cells), a luminal stem/progenitor cell that functions in prostate regeneration. Using genetically--engineered mouse models and novel prostate epithelial cell lines, we find that progenitor properties of CARNs are largely unaffected by AR deletion, apart from decreased proliferation in vivo. Furthermore, AR loss suppresses tumor formation after deletion of the Pten tumor suppressor in CARNs; however, combined Pten deletion and activation of oncogenic Kras in AR-deleted CARNs result in tumors with focal neuroendocrine differentiation. Our findings show that AR modulates specific progenitor properties of CARNs, including their ability to serve as a cell of origin for prostate cancer. PMID:29334357

  16. Finding knowledge translation articles in CINAHL.

    PubMed

    Lokker, Cynthia; McKibbon, K Ann; Wilczynski, Nancy L; Haynes, R Brian; Ciliska, Donna; Dobbins, Maureen; Davis, David A; Straus, Sharon E

    2010-01-01

    The process of moving research into practice has a number of names including knowledge translation (KT). Researchers and decision makers need to be able to readily access the literature on KT for the field to grow and to evaluate the existing evidence. To develop and validate search filters for finding KT articles in the database Cumulative Index to Nursing and Allied Health (CINAHL). A gold standard database was constructed by hand searching and classifying articles from 12 journals as KT Content, KT Applications and KT Theory. Sensitivity, specificity, precision, and accuracy of the search filters. Optimized search filters had fairly low sensitivity and specificity for KT Content (58.4% and 64.9% respectively), while sensitivity and specificity increased for retrieving KT Application (67.5% and 70.2%) and KT Theory articles (70.4% and 77.8%). Search filter performance was suboptimal marking the broad base of disciplines and vocabularies used by KT researchers. Such diversity makes retrieval of KT studies in CINAHL difficult.

  17. Emotion and working memory: evidence for domain-specific processes for affective maintenance.

    PubMed

    Mikels, Joseph A; Reuter-Lorenz, Patricia A; Beyer, Jonathan A; Fredrickson, Barbara L

    2008-04-01

    Working memory is comprised of separable subsystems for visual and verbal information, but what if the information is affective? Does the maintenance of affective information rely on the same processes that maintain nonaffective information? The authors address this question using a novel delayed-response task developed to investigate the short-term maintenance of affective memoranda. Using selective interference methods the authors find that a secondary emotion-regulation task impaired affect intensity maintenance, whereas secondary cognitive tasks disrupted brightness intensity maintenance, but facilitated affect maintenance. Additionally, performance on the affect maintenance task depends on the valence of the maintained feeling, further supporting the domain-specific nature of the task. The importance of affect maintenance per se is further supported by demonstrating that the observed valence effects depend on a memory delay and are not evident with simultaneous presentation of stimuli. These findings suggest that the working memory system may include domain-specific components that are specialized for the maintenance of affective memoranda. (Copyright) 2008 APA.

  18. Role of phytohormones in insect-specific plant reactions

    PubMed Central

    Erb, Matthias; Meldau, Stefan; Howe, Gregg A.

    2012-01-01

    The capacity to perceive and respond is integral to biological immune systems, but to what extent can plants specifically recognize and respond to insects? Recent findings suggest that plants possess surveillance systems that are able to detect general patterns of cellular damage as well as highly specific herbivore-associated cues. The jasmonate (JA) pathway has emerged as the major signaling cassette that integrates information perceived at the plant–insect interface into broad-spectrum defense responses. Specificity can be achieved via JA-independent processes and spatio-temporal changes of JA-modulating hormones, including ethylene, salicylic acid, abscisic acid, auxin, cytokinins, brassinosteroids and gibberellins. The identification of receptors and ligands and an integrative view of hormone-mediated response systems are crucial to understand specificity in plant immunity to herbivores. PMID:22305233

  19. Magnetic Resonance Imaging Currently Fails to Fully Evaluate the Biceps-Labrum Complex and Bicipital Tunnel.

    PubMed

    Taylor, Samuel A; Newman, Ashley M; Nguyen, Joseph; Fabricant, Peter D; Baret, Nikolas J; Shorey, Mary; Ramkumar, Prem; O'Brien, Stephen J

    2016-02-01

    To determine the diagnostic accuracy of magnetic resonance imaging (MRI) for biceps-labrum complex (BLC) lesions, including the extra-articular bicipital tunnel. A retrospective review of 277 shoulders with chronic refractory BLC symptoms that underwent arthroscopic subdeltoid transfer of the long head of the biceps tendon (LHBT) to the conjoint tendon was conducted. Intraoperative lesions were categorized as "inside" (labral tears and dynamic LHBT incarceration), "junctional" (LHBT partial tears, LHBT subluxation, and biceps chondromalacia), or "bicipital tunnel" (extra-articular bicipital tunnel scar/stenosis, loose bodies, LHBT instability, and LHBT partial tears) based on anatomic location. Attending radiologist-generated MRI reports were graded dichotomously as positive or negative for biceps and labral damage and then compared with intraoperative findings. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for MRI with respect to intraoperative findings. With regard to inside lesions, MRI had an overall sensitivity, specificity, PPV, and NPV for labrum lesions of 77.3%, 68.2%, 57.3%, and 84.5% respectively. The sensitivity, specificity, PPV, and NPV of MRI for junctional lesions were 43.3%, 55.6%, 73.1%, and 26.0%, respectively. For the bicipital tunnel, MRI had a sensitivity, specificity, PPV, and NPV of 50.4%, 61.4%, 48.7%, and 63.0%, respectively. MRI was unreliable for ruling out BLC lesions among chronically symptomatic patients, including when the bicipital tunnel was affected. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  20. Domestic Violence Shelters as Prevention Agents for HIV/AIDS?

    ERIC Educational Resources Information Center

    Rountree, Michele A.; Pomeroy, Elizabeth C.; Marsiglia, Flavio F.

    2008-01-01

    The article reports findings from a pilot study of 21 domestic violence shelters in a southwestern state in the United States. The survey instrument included descriptive information on shelter service delivery. Specifically, questions were asked about the practice of assessing a client's risk of HIV/AIDS, the provision of HIV/AIDS educational and…

  1. Field Dependence-Independence Cognitive Style and Academic Achievement: A Review of Research and Theory.

    ERIC Educational Resources Information Center

    Tinajero, Carolina; Paramo, M. Fernanda

    1998-01-01

    Reviews research into the possible effects of field dependence/independence on achievement at school. Finds that field-independent subjects perform better than field-dependent subjects, whether in a specific discipline or across all subjects. Discusses possible explanations for this difference in performance. Includes a chart summarizing the…

  2. Larry P.: A Case of Segregation, Testing, or Program Efficacy?

    ERIC Educational Resources Information Center

    Prasse, David P.; Reschly, Daniel J.

    1986-01-01

    The article describes the background of Larry P. v. Riles, a class action law suit involving disproportionate placement of minorities in classes for the educable mentally retarded in California, and outlines the specific findings and remedies underlying issues, including stigmatization of being classified retarded and the nature/nurture debate.…

  3. Vocational Psychology and Ex-Offenders' Reintegration: A Call for Action

    ERIC Educational Resources Information Center

    Brown, Chris

    2011-01-01

    Failure to find steady and rewarding employment and stabilizing economic resources are key contributors to recidivism among ex-offenders. Within 3 years of their release, almost two thirds of ex-offenders return to prison. Ex-offenders face formidable barriers to employment including legal limitations and those specific to their skills, education,…

  4. Introduction to Problem Solving: Strategies for the Elementary Math Classroom.

    ERIC Educational Resources Information Center

    O'Connell, Susan

    This book is designed to help better understand problem-solving instruction. It presents information on helping students understand the problem-solving process as well as information on teaching specific strategies, including: Choose an Operation; Find a Pattern; Make a Table; Make an Organized List; Draw a Picture or Diagram; Guess, Check, and…

  5. Perceived Learning in Three MOOCS Targeting Attitudinal Change

    ERIC Educational Resources Information Center

    Kim, WooRi; Watson, Sunnie L.; Watson, William R.

    2016-01-01

    Massive open online courses (MOOCs) have gained significant attention in recent years for their potential to impact education at a global scale. This paper presents the findings from a study that examined the cases of three MOOCs, including Human Trafficking, US Food System, and Animal Behavior and Welfare, that were specifically designed to…

  6. Urban Middle-School Teachers' Beliefs about Astronomy Learner Characteristics: Implications for Curriculum

    ERIC Educational Resources Information Center

    Miranda, Rommel J.

    2010-01-01

    This study addresses the link between urban teachers' beliefs about their students' ability to succeed in astronomy and their instructional decisions and practices in response to those beliefs. The findings suggest that teachers believe that the student characteristics that are necessary for high achievement in astronomy include specific cognitive…

  7. 15 CFR 16.4 - Finding of need to establish a specification for labeling a consumer product.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... writing and will, to the extent practicable, include the following information: (1) Identification of the... difficulty experienced by consumers in making informed purchase decisions because of a lack of knowledge... requests and shall notify the requester of her decision in writing. If the Secretary determines that there...

  8. 15 CFR 16.4 - Finding of need to establish a specification for labeling a consumer product.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... writing and will, to the extent practicable, include the following information: (1) Identification of the... difficulty experienced by consumers in making informed purchase decisions because of a lack of knowledge... requests and shall notify the requester of her decision in writing. If the Secretary determines that there...

  9. 15 CFR 16.4 - Finding of need to establish a specification for labeling a consumer product.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... writing and will, to the extent practicable, include the following information: (1) Identification of the... difficulty experienced by consumers in making informed purchase decisions because of a lack of knowledge... requests and shall notify the requester of her decision in writing. If the Secretary determines that there...

  10. 15 CFR 16.4 - Finding of need to establish a specification for labeling a consumer product.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... writing and will, to the extent practicable, include the following information: (1) Identification of the... difficulty experienced by consumers in making informed purchase decisions because of a lack of knowledge... requests and shall notify the requester of her decision in writing. If the Secretary determines that there...

  11. A View from the Aisle Revisited: Delight and Outrage in the Classroom

    ERIC Educational Resources Information Center

    Swanson, Scott R.; Azab, Carol; Davis, J. Charlene

    2015-01-01

    This research explores marketing students' emotional reactions to classroom encounters. We identify what types of critical incidents lead to specific emotional outcomes. The study included a sample of 1,208 marketing undergraduates. Findings confirm the viability of the taxonomies identified by Swanson and Davis (2000). We expand their framework…

  12. 78 FR 40997 - Enhanced Document Requirements To Support Use of the Dolphin Safe Label on Tuna Products

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ...; modifies the reporting requirements associated with tracking domestic tuna canning and processing... products. The law addressed a Congressional finding that ``consumers would like to know if the tuna they... implement the DPCIA, including specifically the authority to establish a domestic tracking and verification...

  13. The Impact of Different Teaching Approaches and Languages on Student Learning of Introductory Programming Concepts

    ERIC Educational Resources Information Center

    Kunkle, Wanda M.

    2010-01-01

    Many students experience difficulties learning to program. They find learning to program in the object-oriented paradigm particularly challenging. As a result, computing educators have tried a variety of instructional methods to assist beginning programmers. These include developing approaches geared specifically toward novices and experimenting…

  14. Public and Private School Costs. A Local Analysis, 1994.

    ERIC Educational Resources Information Center

    Public Policy Forum, Inc., Milwaukee, WI.

    This document presents findings of a study that identified key factors of cost-per-pupil differences between public and private school spending among selected Milwaukee area public and private schools. The analysis was limited to cost factors only, specifically, to per-pupil spending. Methodology included a review of the school budgets of 7 public…

  15. Exploring the Psycho-Social Therapies Through the Personalities of Effective Therapists.

    ERIC Educational Resources Information Center

    Dent, James K.; Furse, George A.

    Several specific research approaches are compared with regard to cost-effectiveness, types of disorders to which they best respond, general strategies, and therapist personality. Replicated findings include: (1) support for both the functional reversal and semantic reversal of the "A-B Scale;" (2) characterization of therapists who are effective…

  16. Algebra: A Challenge at the Crossroads of Policy and Practice

    ERIC Educational Resources Information Center

    Stein, Mary Kay; Kaufman, Julia Heath; Sherman, Milan; Hillen, Amy F.

    2011-01-01

    The authors review what is known about early and universal algebra, including who is getting access to algebra and student outcomes associated with algebra course taking in general and specifically with universal algebra policies. The findings indicate that increasing numbers of students, some of whom are underprepared, are taking algebra earlier.…

  17. Mathematicians' Views on Current Publishing Issues: A Survey of Researchers

    ERIC Educational Resources Information Center

    Fowler, Kristine K.

    2011-01-01

    This article reports research mathematicians' attitudes about and activity in specific scholarly communication areas, as captured in a 2010 survey of more than 600 randomly-selected mathematicians worldwide. Key findings include: (1) Most mathematicians have papers in the arXiv, but posting to their own web pages remains more common; (2) A third…

  18. Getting Help: Finding an Answer to a Specific Problem is Almost Impossible These Days.

    ERIC Educational Resources Information Center

    Levy, Steven

    1984-01-01

    Discusses the very limited information sources currently available to microcomputer users, including computer salespersons, user support groups, and computer books, and suggests that the newly emerging hotline-style computer advisory services may be able to provide the accurate answers and expert advice not easily available elsewhere. (MBR)

  19. Poverty, Academic Achievement, and Giftedness: A Literature Review

    ERIC Educational Resources Information Center

    Olszewski-Kubilius, Paula; Corwith, Susan

    2018-01-01

    In this article, we review research on poverty, both poverty rates and the effects of poverty on academic achievement more generally and on the identification and services for low-income gifted children specifically. This review sets the stage for further discussion of the research findings on identification practices including the efficacy of…

  20. Discover 4-H Clubs: The Essential Resource for 4-H

    ERIC Educational Resources Information Center

    MacArthur, Stacey; Nelson, Cindy; Brower, Naomi; Memmott, Margie; Peterson, Gaelynn

    2016-01-01

    Obstacles facing new 4-H volunteers include time constraints and difficulty finding project-specific information, resources, and opportunities available for club members. As a solution to these obstacles and an aid for assisting volunteers in becoming confident in delivering information to youth, content experts produced Discover 4-H Clubs, a…

  1. A Corpus-Based Evaluation of Metaphors in a Business English Textbook

    ERIC Educational Resources Information Center

    Skorczynska Sznajder, Hanna

    2010-01-01

    This study aims to evaluate the selection of metaphors in a published business English textbook using findings from a specialised corpus of written business English. While most scholars agree that metaphors should be included in English for Specific Purposes (ESP) syllabuses as a potentially problematic area in successful language learning, it is…

  2. Suicidal ideation among individuals whose parents have divorced: findings from a representative Canadian community survey.

    PubMed

    Fuller-Thomson, Esme; Dalton, Angela D

    2011-05-15

    This study used a large, nationally representative sample to examine the gender-specific association between parental divorce and the cumulative lifetime incidence of suicidal ideation. Known risk factors for suicidal ideation, such as childhood stressors, socioeconomic factors, adult health behaviors and stressors, marital status, and any history of mood and/or anxiety disorders were controlled. Gender-specific analyses revealed that for men, the parental divorce-suicidal ideation relationship remained statistically significant even when the above-listed cluster of risk factors were included in the analyses (odds ratio (OR)=2.36, 95% confidence interval (CI)=1.56, 3.58). For women, the association between parental divorce and suicidal ideation was reduced to non-significance when other adverse childhood experiences were included in the analyses (full adjustment OR=1.04, 95% CI=0.72, 1.50). These findings indicate a need for screening of suicidal ideation among individuals, particularly men and those with mood and/or anxiety disorders, who have experienced parental divorce. Future research should focus on the mechanisms linking parental divorce and suicidal ideation. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Possible Deficiencies in Predicting Transonic Aerodynamics on the X-43A

    NASA Technical Reports Server (NTRS)

    Labbe, Steven G.; Gilbert, Michael G.; Kehoe, Michael W.

    2009-01-01

    The initial X-43A flight test, June 2, 2001, resulted in a mishap and loss of the vehicle. A mishap investigation board (MIB) report and findings, including the established root cause, were publicly released on July, 23, 2003. The X-43A Flight 1 Hyper-X Launch Vehicle (HXLV) failed because the vehicle control system design was deficient for the trajectory flown due to inaccurate analytical models (Pegasus heritage and HXLV specific), which overestimated the (control) system margin ? X-43A Mishap Investigation Report, Vol. I. ? included as Reference 1. Several specific errors were noted, 1) HXLV aerodynamics ? failure to model changes to wing, fin and rudder airfoil shapes due to addition of thermal protection system (TPS); 2) Fin actuation system (FAS) modeling ? under prediction of the control surface hinge moments and FAS compliance; and 3) Parametric uncertainties ? insufficient variation in the aerodynamic, FAS and control system models. In response to the MIB findings, the X-43A program has been working RTF through an approved Corrective Action Plan (CAP) over the last two years.

  4. SP and KLF Transcription Factors in Digestive Physiology and Diseases.

    PubMed

    Kim, Chang-Kyung; He, Ping; Bialkowska, Agnieszka B; Yang, Vincent W

    2017-06-01

    Specificity proteins (SPs) and Krüppel-like factors (KLFs) belong to the family of transcription factors that contain conserved zinc finger domains involved in binding to target DNA sequences. Many of these proteins are expressed in different tissues and have distinct tissue-specific activities and functions. Studies have shown that SPs and KLFs regulate not only physiological processes such as growth, development, differentiation, proliferation, and embryogenesis, but pathogenesis of many diseases, including cancer and inflammatory disorders. Consistently, these proteins have been shown to regulate normal functions and pathobiology in the digestive system. We review recent findings on the tissue- and organ-specific functions of SPs and KLFs in the digestive system including the oral cavity, esophagus, stomach, small and large intestines, pancreas, and liver. We provide a list of agents under development to target these proteins. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  5. Evaluation of cardiac auscultation skills in pediatric residents.

    PubMed

    Kumar, Komal; Thompson, W Reid

    2013-01-01

    Auscultation skills are in decline, but few studies have shown which specific aspects are most difficult for trainees. We evaluated individual aspects of cardiac auscultation among pediatric residents using recorded heart sounds to determine which elements pose the most difficulty. Auscultation proficiency was assessed among 34 trainees following a pediatric cardiology rotation using an open-set format evaluation module, similar to the actual clinical auscultation description process. Diagnostic accuracy for distinguishing normal from abnormal cases was 73%. Findings most commonly correctly identified included pathological systolic and diastolic murmurs and widely split second heart sounds. Those least likely to be identified included continuous murmurs and clicks. Accuracy was low for identifying specific diagnoses. Given time constraints for clinical skills teaching, this suggests that focusing on distinguishing normal from abnormal heart sounds and murmurs instead of making specific diagnoses may be a more realistic goal for pediatric resident auscultation training.

  6. Implementation of Motor Imagery during Specific Aerobic Training Session in Young Tennis Players

    PubMed Central

    Guillot, Aymeric; Di Rienzo, Franck; Pialoux, Vincent; Simon, Germain; Skinner, Sarah; Rogowski, Isabelle

    2015-01-01

    The aim of this study was to investigate the effects of implementing motor imagery (MI) during specific tennis high intensity intermittent training (HIIT) sessions on groundstroke performance in young elite tennis players. Stroke accuracy and ball velocity of forehand and backhand drives were evaluated in ten young tennis players, immediately before and after having randomly performed two HIIT sessions. One session included MI exercises during the recovery phases, while the other included verbal encouragements for physical efforts and served as control condition. Results revealed that similar cardiac demand was observed during both sessions, while implementing MI maintained groundstroke accuracy. Embedding MI during HIIT enabled the development of physical fitness and the preservation of stroke performance. These findings bring new insight to tennis and conditioning coaches in order to fulfil the benefits of specific playing HIIT sessions, and therefore to optimise the training time. PMID:26580804

  7. Young women's experiences of psychotic illness: a systematic review of qualitative research.

    PubMed

    Chernomas, Wanda M; Rieger, Kendra L; Karpa, Jane V; Clarke, Diana E; Marchinko, Shelley; Demczuk, Lisa

    2017-03-01

    The relationship between young adulthood, women and psychosis was the focus for this systematic review. Age and gender are factors that can influence responses to illness. Research indicates that there are differences in how young men and women are affected biologically and psychosocially, including the presentation of a constellation of symptoms, response to anti-psychotic medications and how they assess their life circumstances. Yet in literature that examines experiences of young people with psychosis, the specific needs of young women are usually not presented separately. To better understand and address young adult women's healthcare and social service needs, a synthesis of evidence addressing the relationship between young adulthood, women and psychosis is needed. The aim of this systematic review was to synthesize the best available evidence on the experiences of young adult women (aged 18-35 years) living with a psychotic illness in the community. Specifically, the review question was:What are the experiences of young adult women living with a psychotic illness? Participants were young women between 18 and 35 years of age who were living with a psychotic illness in the community. The phenomenon of interest was the experiences of living with a psychotic illness of women aged 18-35 years in the community. Experiences were defined broadly as and inclusive of perceptions and experiences with health and social systems. The context for this review was the community setting. The current review included studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, feminist research and the qualitative component of mixed methods studies. A three-step search strategy was used to locate both published and unpublished studies. The search was limited to studies published from 1995 to the search date of May 13, 2015. Two reviewers independently appraised the nine included studies using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) assessment tool. Data were extracted from included papers using the standardized data extraction tool from JBI-QARI. Two reviewers independently reviewed the extracted findings to identify potential categories to pool similar findings. A third member of the team met with the reviewers to collaboratively review these derived categories to create a meta-synthesis that reflected a comprehensive set of synthesized findings. Based on the thematic findings from nine qualitative studies, two synthesized findings were identified: (1) the complexity of living with psychosis and finding health, and (2) the presence of harming and healing relationships in young women's lives. The included studies explored a range of experiences relevant for women within the broader phenomenon of experiences of living with a psychotic illness, including experiences within healthcare and social systems. The systematic exploration of the literature resulted in identification of nine studies of moderate-to-high methodological quality that met the inclusion criteria. The ConQual evaluation of the level of evidence resulted in synthesized finding 1 (the complexity of living with psychosis and finding health) rated as moderate and synthesized finding 2 (the presence of harming and healing relationships in young women's lives) rated as low. Practitioners can use these findings to guide practice. Further research exploring other experiences relevant for this population is needed.

  8. Contribution of formative research to design an environmental program for obesity prevention in schools in Mexico City.

    PubMed

    Bonvecchio, Anabelle; Théodore, Florence L; Safdie, Margarita; Duque, Tiffany; Villanueva, María Ángeles; Torres, Catalina; Rivera, Juan

    2014-01-01

    This paper describes the methods and key findings of formative research conducted to design a school-based program for obesity prevention. Formative research was based on the ecological model and the principles of social marketing. A mixed method approach was used. Qualitative (direct observation, indepth interviews, focus group discussions and photo-voice) and quantitative (closed ended surveys, checklists, anthropometry) methods were employed. Formative research key findings, including barriers by levels of the ecological model, were used for designing a program including environmental strategies to discourage the consumption of energy dense foods and sugar beverages. Formative research was fundamental to developing a context specific obesity prevention program in schools that seeks environment modification and behavior change.

  9. Automated volumetry of hippocampus is useful to confirm unilateral mesial temporal sclerosis in patients with radiologically positive findings.

    PubMed

    Silva, Guilherme; Martins, Cristina; Moreira da Silva, Nádia; Vieira, Duarte; Costa, Dias; Rego, Ricardo; Fonseca, José; Silva Cunha, João Paulo

    2017-08-01

    Background and purpose We evaluated two methods to identify mesial temporal sclerosis (MTS): visual inspection by experienced epilepsy neuroradiologists based on structural magnetic resonance imaging sequences and automated hippocampal volumetry provided by a processing pipeline based on the FMRIB Software Library. Methods This retrospective study included patients from the epilepsy monitoring unit database of our institution. All patients underwent brain magnetic resonance imaging in 1.5T and 3T scanners with protocols that included thin coronal T2, T1 and fluid-attenuated inversion recovery and isometric T1 acquisitions. Two neuroradiologists with experience in epilepsy and blinded to clinical data evaluated magnetic resonance images for the diagnosis of MTS. The diagnosis of MTS based on an automated method included the calculation of a volumetric asymmetry index between the two hippocampi of each patient and a threshold value to define the presence of MTS obtained through statistical tests (receiver operating characteristics curve). Hippocampi were segmented for volumetric quantification using the FIRST tool and fslstats from the FMRIB Software Library. Results The final cohort included 19 patients with unilateral MTS (14 left side): 14 women and a mean age of 43.4 ± 10.4 years. Neuroradiologists had a sensitivity of 100% and specificity of 73.3% to detect MTS (gold standard, k = 0.755). Automated hippocampal volumetry had a sensitivity of 84.2% and specificity of 86.7% (k = 0.704). Combined, these methods had a sensitivity of 84.2% and a specificity of 100% (k = 0.825). Conclusions Automated volumetry of the hippocampus could play an important role in temporal lobe epilepsy evaluation, namely on confirmation of unilateral MTS diagnosis in patients with radiological suggestive findings.

  10. Diagnostic performance of major depression disorder case-finding instruments used among mothers of young children in the United States: A systematic review.

    PubMed

    Owora, Arthur H; Carabin, Hélène; Reese, Jessica; Garwe, Tabitha

    2016-09-01

    Growing recognition of the interrelated negative outcomes associated with major depression disorder (MDD) among mothers and their children has led to renewed public health interest in the early identification and treatment of maternal MDD. Healthcare providers, however, remain unsure of the validity of existing case-finding instruments. We conducted a systematic review to identify the most valid maternal MDD case-finding instrument used in the United States. We identified articles reporting the sensitivity and specificity of MDD case-finding instruments based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) by systematically searching through three electronic bibliographic databases, PubMed, PsycINFO, and EMBASE, from 1994 to 2014. Study eligibility and quality were evaluated using the Standards for the Reporting of Diagnostic Accuracy studies and Quality Assessment of Diagnostic Accuracy Studies guidelines respectively. Overall, we retrieved 996 unduplicated articles and selected 74 for full-text review. Of these, 14 articles examining 21 different instruments were included in the systematic review. The 10 item Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale had the most stable (lowest variation) and highest diagnostic performance during the antepartum and postpartum periods (sensitivity range: 0.63-0.94 and 0.67-0.95; specificity range: 0.83-0.98 and 0.68-0.97 respectively). Greater variation in diagnostic performance was observed among studies with higher MDD prevalence. Factors that explain greater variation in instrument diagnostic performance in study populations with higher MDD prevalence were not examined. Findings suggest that the diagnostic performance of maternal MDD case-finding instruments is peripartum period-specific. Published by Elsevier B.V.

  11. Mechanisms of gender-related outcome differences after carotid endarterectomy.

    PubMed

    den Hartog, Anne G; Algra, Ale; Moll, Frans L; de Borst, Gert J

    2010-10-01

    Large randomized trials have confirmed a difference in outcome after carotid endarterectomy (CEA) between men and women. In this review, we aimed to provide an overview of the gender-specific characteristics causing these perioperative and long-term outcome differences between men and women after CEA. A systematic search strategy with the synonyms of 'gender' and 'carotid endarterectomy' was conducted from PubMed and EMBASE databases. Only 11 relevant studies specifically discussing gender-specific related characteristics and their influence on outcome after CEA could be identified. Due to the limited number of included studies, pooling of findings was impossible, and results are presented in a descriptive manner. Each included study described only one possible gender-specific factor. Differences in carotid artery diameter, sex hormones, sensitivity for antiplatelet therapy, plaque morphology, occurrence of microembolic signals, and restenosis rate have all been suggested as gender-specific characteristics influencing outcome after CEA. Higher embolic potential in women and relatively stable female plaque morphology are the best-described factors influencing the difference in outcomes between men and women. However, the overall evidence for outcome differences by gender-specific characteristics in the literature is limited. Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  12. The Neurological Complications of Nutritional Deficiency following Bariatric Surgery

    PubMed Central

    Becker, Danielle A.; Balcer, Laura J.; Galetta, Steven L.

    2012-01-01

    Neurologic complications of bariatric surgery have become increasingly recognized with the rising numbers of procedures and the increasing prevalence of obesity in the US. Deficits are most commonly seen with thiamine, vitamin B12, folate, vitamin D, vitamin E, and copper deficiencies. The neurological findings observed with these nutritional deficiencies are variable and include encephalopathy, optic neuropathy, myelopathy, polyradiculoneuropathy, and polyneuropathy. We review the neurological complications of bariatric surgery and emphasize that these findings may vary based on the specific type of bariatric surgery and time elapsed from the procedure. PMID:22970351

  13. The Use of Visual Thinking Strategies and Art to Help Nurses Find Their Voices.

    PubMed

    Moorman, Margaret

    2017-08-01

    Health care is increasingly complex, as nurses navigate working in teams and conveying critical information to others. Clear communication and accuracy are critical for nurses because they communicate to patients and other members of the health care team. Art, and more specifically, Visual Thinking Strategies (VTS), are ways for nurses to practice communication and clear articulation of ideas. VTS also allows nurses to explore finding their voices and working with others to provide safe and effective communication among the team, including patients and their families.

  14. The Accuracy and Prognostic Value of Point-of-care Ultrasound for Nephrolithiasis in the Emergency Department: A Systematic Review and Meta-analysis.

    PubMed

    Wong, Charles; Teitge, Braden; Ross, Marshall; Young, Paul; Robertson, Helen Lee; Lang, Eddy

    2018-06-01

    Point-of-care ultrasound (POCUS) has been suggested as an initial investigation in the management of renal colic. Our objectives were: 1) to determine the accuracy of POCUS for the diagnosis of nephrolithiasis and 2) to assess its prognostic value in the management of renal colic. The review protocol was registered to the PROSPERO database (CRD42016035331). An electronic database search of MEDLINE, Embase, and PubMed was conducted utilizing subject headings, keywords, and synonyms that address our research question. Bibliographies of included studies and narrative reviews were manually examined. Studies of adult emergency department patients with renal colic symptoms were included. Any degree of hydronephrosis was considered a positive POCUS finding. Accepted criterion standards were computed tomography evidence of renal stone or hydronephrosis, direct stone visualization, or surgical findings. Screening of abstracts, quality assessment with the QUADAS-2 instrument, and data extraction were performed by two reviewers, with discrepancies resolved by consensus with a third reviewer. Test performance was assessed by pooled sensitivity and specificity, calculated likelihood ratios, and a summary receiver operator curve (SROC). The secondary objective of prognostic value was reported as a narrative summary. The electronic search yielded 627 unique titles. After relevance screening, 26 papers underwent full-text review, and nine articles met all inclusion criteria. Of these, five high-quality studies (N = 1,773) were included in the meta-analysis for diagnostic accuracy and the remaining yielded data on prognostic value. The pooled results for sensitivity and specificity were 70.2% (95% confidence interval [CI] = 67.1%-73.2%) and 75.4% (95% CI = 72.5%-78.2%), respectively. The calculated positive and negative likelihood ratios were 2.85 and 0.39. The SROC generated did not show evidence of a threshold effect. Two of the studies in the meta-analysis found that the finding of moderate or greater hydronephrosis yielded a specificity of 94.4% (95% CI = 92.7%-95.8%). Four studies examining prognostic value noted a higher likelihood of a large stone when positive POCUS findings were present. The largest randomized trial showed lower cumulative radiation exposure and no increase in adverse events in those who received POCUS investigation as the initial renal colic investigation. Point-of-care ultrasound has modest diagnostic accuracy for diagnosing nephrolithiasis. The finding of moderate or severe hydronephrosis is highly specific for the presence of any stone, and the presence of any hydronephrosis is suggestive of a larger (>5 mm) stone in those presenting with renal colic. © 2018 by the Society for Academic Emergency Medicine.

  15. RCT of a Psychological Intervention for Patients With Cancer: I. Mechanisms of Change

    PubMed Central

    Andersen, Barbara L.; Shelby, Rebecca A.; Golden-Kreutz, Deanna M.

    2008-01-01

    Little is known about the therapeutic processes contributing to efficacy of psychological interventions for patients with cancer. Data from a randomized clinical trial yielding robust biobehavioral and health effects (B. L. Andersen et al., 2004, 2007) were used to examine associations between process variables, treatment utilization, and outcomes. Novel findings emerged. Patients were highly satisfied with the treatment, but their higher levels of felt support (group cohesion) covaried with lower distress and fewer symptoms. Also, specific. treatment strategies were associated with specific outcomes, including lower distress, improved dietary habits, reduced symptomatology, and higher chemotherapy dose intensity. These data provide a comprehensive test of multiple therapeutic processes and mechanisms for biobehavioral change with an intervention including both intensive and maintenance phases. PMID:18085909

  16. Eye Tracking Indices of Attentional Bias in Children of Depressed Mothers: Polygenic Influences Help to Clarify Previous Mixed Findings

    PubMed Central

    Owens, Max; Harrison, Ashley J.; Burkhouse, Katie L.; McGeary, John E.; Knopik, Valerie S.; Palmer, Rohan H. C.; Gibb, Brandon E.

    2016-01-01

    Information-processing biases may contribute to the intergenerational transmission of depression. There is growing evidence that children of depressed mothers exhibit attentional biases for sad faces. However, findings are mixed as to whether this bias reflects preferential attention toward, versus attentional avoidance of, sad faces suggesting the presence of unmeasured moderators. To address these mixed findings, we focused on the potential moderating role of genes associated with HPA-axis reactivity. Participants included children (8–14 years old) of mothers with (n = 81) and without (n = 81) a history of depression. Eye movements were recorded while children passively viewed arrays of angry, happy, sad, and neutral faces. DNA was obtained from buccal cells. Children of depressed mothers exhibited more sustained attention to sad faces than did children of nondepressed mothers. Importantly, however, this relation was moderated by children’s genotype. Specifically, children of depressed mothers who carried reactive genotypes across the CHRH1 TAT haplotype and FKBP5 rs1360780 (but not SLC6A4 5-HTTLPR) exhibited less sustained attention to sad faces and more sustained attention to happy faces. These findings highlight the role played by specific genetic influences and suggest that previous mixed findings may have been due to genetic heterogeneity across the samples. PMID:26030911

  17. HIV Molecular Immunology 2014

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yusim, Karina; Korber, Bette Tina Marie; Barouch, Dan

    HIV Molecular Immunology is a companion volume to HIV Sequence Compendium. This publication, the 2014 edition, is the PDF version of the web-based HIV Immunology Database (http://www.hiv.lanl.gov/content/immunology/). The web interface for this relational database has many search options, as well as interactive tools to help immunologists design reagents and interpret their results. In the HIV Immunology Database, HIV-specific B-cell and T-cell responses are summarized and annotated. Immunological responses are divided into three parts, CTL, T helper, and antibody. Within these parts, defined epitopes are organized by protein and binding sites within each protein, moving from left to right through themore » coding regions spanning the HIV genome. We include human responses to natural HIV infections, as well as vaccine studies in a range of animal models and human trials. Responses that are not specifically defined, such as responses to whole proteins or monoclonal antibody responses to discontinuous epitopes, are summarized at the end of each protein section. Studies describing general HIV responses to the virus, but not to any specific protein, are included at the end of each part. The annotation includes information such as crossreactivity, escape mutations, antibody sequence, TCR usage, functional domains that overlap with an epitope, immune response associations with rates of progression and therapy, and how specific epitopes were experimentally defined. Basic information such as HLA specificities for T-cell epitopes, isotypes of monoclonal antibodies, and epitope sequences are included whenever possible. All studies that we can find that incorporate the use of a specific monoclonal antibody are included in the entry for that antibody. A single T-cell epitope can have multiple entries, generally one entry per study. Finally, maps of all defined linear epitopes relative to the HXB2 reference proteins are provided.« less

  18. Tobacco cessation with patients recovering from alcohol and other substance abuse.

    PubMed

    McIlvain, H E; Bobo, J K

    1999-09-01

    This article focuses on the problem of tobacco cessation in the patient recovering from alcohol or other substance abuse. The authors review the epidemiology of the problem, specific health risks to this population from continued tobacco use, and recent research findings that address previous treatment concerns. Recommendations for counseling by physicians are made. These include an algorithm for determining the patient's stage of readiness for making a quit attempt, specific counseling tasks based on the patients stage, and motivational counseling strategies aimed at increasing the patients motivation to quit.

  19. MAIL LOG, program summary and specifications

    NASA Technical Reports Server (NTRS)

    Harris, D. K.

    1979-01-01

    The summary and specifications to obtain the software package, MAIL LOG, developed for the Scout Project Automatic Data System, SPADS are provided. The MAIL LOG program has four modes of operation: (1) input - putting new records into the data base; (2) revise - changing or modifying existing records in the data base; (3) search - finding special records existing in the data base; and (4) archive - store or put away existing records in the data base. The output includes special printouts of records in the data base and results from the input and search modes.

  20. Do MRI findings identify patients with low back pain or sciatica who respond better to particular interventions? A systematic review.

    PubMed

    Steffens, Daniel; Hancock, Mark J; Pereira, Leani S M; Kent, Peter M; Latimer, Jane; Maher, Chris G

    2016-04-01

    Magnetic resonance imaging (MRI) can reveal a range of degenerative findings and anatomical abnormalities; however, the clinical importance of these remains uncertain and controversial. We aimed to investigate if the presence of MRI findings identifies patients with low back pain (LBP) or sciatica who respond better to particular interventions. MEDLINE, EMBASE and CENTRAL databases were searched. We included RCTs investigating MRI findings as treatment effect modifiers for patients with LBP or sciatica. We excluded studies with specific diseases as the cause of LBP. Risk of bias was assessed using the criteria of the Cochrane Back Review Group. Each MRI finding was examined for its individual capacity for effect modification. Eight published trials met the inclusion criteria. The methodological quality of trials was inconsistent. Substantial variability in MRI findings, treatments and outcomes across the eight trials prevented pooling of data. Patients with Modic type 1 when compared with patients with Modic type 2 had greater improvements in function when treated by Diprospan (steroid) injection, compared with saline. Patients with central disc herniation when compared with patients without central disc herniation had greater improvements in pain when treated by surgery, compared with rehabilitation. Although individual trials suggested that some MRI findings might be effect modifiers for specific interventions, none of these interactions were investigated in more than a single trial. High quality, adequately powered trials investigating MRI findings as effect modifiers are essential to determine the clinical importance of MRI findings in LBP and sciatica ( CRD42013006571).

  1. Invariant TAD Boundaries Constrain Cell-Type-Specific Looping Interactions between Promoters and Distal Elements around the CFTR Locus

    PubMed Central

    Smith, Emily M.; Lajoie, Bryan R.; Jain, Gaurav; Dekker, Job

    2016-01-01

    Three-dimensional genome structure plays an important role in gene regulation. Globally, chromosomes are organized into active and inactive compartments while, at the gene level, looping interactions connect promoters to regulatory elements. Topologically associating domains (TADs), typically several hundred kilobases in size, form an intermediate level of organization. Major questions include how TADs are formed and how they are related to looping interactions between genes and regulatory elements. Here we performed a focused 5C analysis of a 2.8 Mb chromosome 7 region surrounding CFTR in a panel of cell types. We find that the same TAD boundaries are present in all cell types, indicating that TADs represent a universal chromosome architecture. Furthermore, we find that these TAD boundaries are present irrespective of the expression and looping of genes located between them. In contrast, looping interactions between promoters and regulatory elements are cell-type specific and occur mostly within TADs. This is exemplified by the CFTR promoter that in different cell types interacts with distinct sets of distal cell-type-specific regulatory elements that are all located within the same TAD. Finally, we find that long-range associations between loci located in different TADs are also detected, but these display much lower interaction frequencies than looping interactions within TADs. Interestingly, interactions between TADs are also highly cell-type-specific and often involve loci clustered around TAD boundaries. These data point to key roles of invariant TAD boundaries in constraining as well as mediating cell-type-specific long-range interactions and gene regulation. PMID:26748519

  2. Use of PCR with Sequence-specific Primers for High-Resolution Human Leukocyte Antigen Typing of Patients with Narcolepsy

    PubMed Central

    Woo, Hye In; Joo, Eun Yeon; Lee, Kyung Wha

    2012-01-01

    Background Narcolepsy is a neurologic disorder characterized by excessive daytime sleepiness, symptoms of abnormal rapid eye movement (REM) sleep, and a strong association with HLA-DRB1*1501, -DQA1*0102, and -DQB1*0602. Here, we investigated the clinico-physical characteristics of Korean patients with narcolepsy, their HLA types, and the clinical utility of high-resolution PCR with sequence-specific primers (PCR-SSP) as a simple typing method for identifying DRB1*15/16, DQA1, and DQB1 alleles. Methods The study population consisted of 67 consecutively enrolled patients having unexplained daytime sleepiness and diagnosed narcolepsy based on clinical and neurological findings. Clinical data and the results of the multiple sleep latency test and polysomnography were reviewed, and HLA typing was performed using both high-resolution PCR-SSP and sequence-based typing (SBT). Results The 44 narcolepsy patients with cataplexy displayed significantly higher frequencies of DRB1*1501 (Pc= 0.003), DQA1*0102 (Pc=0.001), and DQB1*0602 (Pc=0.014) than the patients without cataplexy. Among patients carrying DRB1*1501-DQB1*0602 or DQA1*0102, the frequencies of a mean REM sleep latency of less than 20 min in nocturnal polysomnography and clinical findings, including sleep paralysis and hypnagogic hallucination were significantly higher. SBT and PCR-SSP showed 100% concordance for high-resolution typing of DRB1*15/16 alleles and DQA1 and DQB1 loci. Conclusions The clinical characteristics and somnographic findings of narcolepsy patients were associated with specific HLA alleles, including DRB1*1501, DQA1*0102, and DQB1*0602. Application of high-resolution PCR-SSP, a reliable and simple method, for both allele- and locus-specific HLA typing of DRB1*15/16, DQA1, and DQB1 would be useful for characterizing clinical status among subjects with narcolepsy. PMID:22259780

  3. Decision-making, financial risk aversion, and behavioral biases: The role of testosterone and stress.

    PubMed

    Nofsinger, John R; Patterson, Fernando M; Shank, Corey A

    2018-05-01

    We examine the relation between testosterone, cortisol, and financial decisions in a sample of naïve investors. We find that testosterone level is positively related to excess risk-taking, whereas cortisol level is negatively related to excess risk-taking (correlation coefficient [r]: 0.75 and -0.21, respectively). Additionally, we find support for the dual-hormone hypothesis in a financial context. Specifically, the testosterone-to-cortisol ratio is significantly related to loss aversion. Individuals with a higher ratio are 3.4 times more likely to sell losing stocks (standard error [SE]: 1.63). Furthermore, we find a positive feedback loop between financial success, testosterone, and cortisol. Specifically, financial success is significantly related to higher post-trial testosterone and cortisol by a factor of 0.53 (SE: 0.14). Finally, we find that in a competitive environment, testosterone level increases significantly, leading to greater risk-taking than in noncompetitive environment. Overall, this study underscores the importance of the endocrine system on financial decision-making. The results of this study are relevant to a broad audience, including investors looking to optimize financial performance, industry human resources, market regulators, and researchers. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Correlation between Clinical Features and Magnetic Resonance Imaging Findings in Lumbar Disc Prolapse.

    PubMed

    Thapa, S S; Lakhey, R B; Sharma, P; Pokhrel, R K

    2016-05-01

    Magnetic resonance imaging is routinely done for diagnosis of lumbar disc prolapse. Many abnormalities of disc are observed even in asymptomatic patient.This study was conducted tocorrelate these abnormalities observed on Magnetic resonance imaging and clinical features of lumbar disc prolapse. A This prospective analytical study includes 57 cases of lumbar disc prolapse presenting to Department of Orthopedics, Tribhuvan University Teaching Hospital from March 2011 to August 2012. All patientshad Magnetic resonance imaging of lumbar spine and the findings regarding type, level and position of lumbar disc prolapse, any neural canal or foraminal compromise was recorded. These imaging findings were then correlated with clinical signs and symptoms. Chi-square test was used to find out p-value for correlation between clinical features and Magnetic resonance imaging findings using SPSS 17.0. This study included 57 patients, with mean age 36.8 years. Of them 41(71.9%) patients had radicular leg pain along specific dermatome. Magnetic resonance imaging showed 104 lumbar disc prolapselevel. Disc prolapse at L4-L5 and L5-S1 level constituted 85.5%.Magnetic resonance imaging findings of neural foramina compromise and nerve root compression were fairly correlated withclinical findings of radicular pain and neurological deficit. Clinical features and Magnetic resonance imaging findings of lumbar discprolasehad faircorrelation, but all imaging abnormalities do not have a clinical significance.

  5. Prospective Relations between Family Conflict and Adolescent Maladjustment: Security in the Family System as a Mediating Process

    PubMed Central

    Cummings, E. Mark; Koss, Kalsea J.; Davies, Patrick T.

    2018-01-01

    Conflict in specific family systems (e.g., interparental, parent-child) has been implicated in the development of a host of adjustment problems in adolescence, but little is known about the impact of family conflict involving multiple family systems. Furthermore, questions remain about the effects of family conflict on symptoms of specific disorders and adjustment problems and the processes mediating these effects. The present study prospectively examines the impact of family conflict and emotional security about the family system on adolescent symptoms of specific disorders and adjustment problems, including the development of symptoms of anxiety, depression, conduct problems, and peer problems. Security in the family system was examined as a mediator of these relations. Participants included 295 mother-father-adolescent families (149 girls) participating across three annual time points (grades 7–9). Including auto-regressive controls for initial levels of emotional insecurity and multiple adjustment problems (T1), higher-order emotional insecurity about the family system (T2) mediated relations between T1 family conflict and T3 peer problems, anxiety, and depressive symptoms. Further analyses supported specific patterns of emotional security/insecurity (i.e., security, disengagement, preoccupation) as mediators between family conflict and specific domains of adolescent adjustment. Family conflict was thus found to prospectively predict the development of symptoms of multiple specific adjustment problems, including symptoms of depression, anxiety, conduct problems, and peer problems, by elevating in in adolescent’s emotional insecurity about the family system. The clinical implications of these findings are considered. PMID:25131144

  6. Experiences and Perceptions of Problem Gamblers on Cognitive and Exposure Therapies When Taking Part in a Randomised Controlled Trial: A Qualitative Study.

    PubMed

    Smith, David; Pols, Rene; Lavis, Tiffany; Battersby, Malcolm; Harvey, Peter

    2016-12-01

    In South Australia (SA) problem gambling is mainly a result of the widespread availability of electronic gaming machines. A key treatment provider in SA offers free cognitive and behavioural therapy (CBT) to help-seeking problem gamblers. The CBT program focuses on the treatment of clients' urge to gamble using exposure therapy (ET) and cognitive therapy (CT) to restructure erroneous gambling beliefs. The aim of this study was to explore treatment specific and non-specific effects for CT alone and ET alone using qualitative interviews. Interviewees were a sub-sample of participants from a randomised trial that investigated the relative efficacy of CT versus ET. Findings revealed that all interviewees gained benefit from their respective therapies and their comments did not appear to favour one therapy over another. Both treatment specific and treatment non-specific effects were well supported as playing a therapeutic role to recovery. Participants' comments in both therapy groups suggested that symptom reduction was experienced on a gambling related urge-cognition continuum. In addition to symptom improvement from therapy-specific mechanisms, ET participants described a general acquisition of "rational thought" from their program of therapy and CT participants had "taken-over" their gambling urges. The findings also highlighted areas for further improvement including therapy drop-out.

  7. Effects of Task Instruction on Autobiographical Memory Specificity in Young and Older Adults

    PubMed Central

    Ford, Jaclyn Hennessey; Rubin, David C.; Giovanello, Kelly S.

    2013-01-01

    Older adults tend to retrieve autobiographical information that is overly general (i.e. not restricted to a single event, termed the overgenerality effect) relative to young adults’ specific memories. A vast majority of studies that have reported overgenerality effects explicitly instruct participants to retrieve specific memories, thereby requiring participants to maintain task goals, inhibit inappropriate responses, and control their memory search. Since these processes are impaired in healthy aging, it is important to determine whether such task instructions influence the magnitude of the overgenerality effect in older adults. In the current study, participants retrieved autobiographical memories during presentation of musical clips. Task instructions were manipulated to separate age-related differences in the specificity of underlying memory representations from age-related differences in following task instructions. Whereas young adults modulated memory specificity based on task demands, older adults did not. These findings suggest that reported rates of overgenerality in older adults’ memories may include age-related differences in memory representation, as well as differences in task compliance. Such findings provide a better understanding of the underlying cognitive mechanisms involved in age-related changes in autobiographical memory and may also be valuable for future research examining effects of overgeneral memory on general well-being. PMID:23915176

  8. Premenstrual dysphoric disorder--review of actual findings about mental disorders related to menstrual cycle and possibilities of their therapy.

    PubMed

    Zukov, I; Ptácek, R; Raboch, J; Domluvilová, D; Kuzelová, H; Fischer, S; Kozelek, P

    2010-01-01

    It is known that mood disorders in women explicitly relates to estrogen production. Except for these findings phenomenon as Premenstrual Syndrome and Premenstrual Dysphoric Disorder, directly connected to menstrual cycle in women, is widely discussed. Premenstrual dysphoric disorder (PMDD) is a set of subjectively unpleasant mental and somatic symptoms. It appears in luteal phase of ovarian cycle. During menstruation it remits and disappears up to one week from its termination. DSM IV classified PMDD into the category of "Other specific depressive disorders" and further revision DSM IV-TR classifies PMDD as a separate strictly defined psychiatric diagnosis. The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) does not include any specific category as PMDD or similar. The closest category F38.8 does not represent the core of the phenomenon because it relates only to general depressive symptomatology and does not give specific diagnostic criteria to menstrual cycle related mood disorders (Grady-Weliky, 2003). In the presented article, possible effectivity of PMDD treatment with the focus to antidepressants of SSRI type (Serotonin selective reuptake inhibitors) is discussed. In spite of interesting and significant findings, the treatment of PMDD and accordingly PMS is above all multidisciplinary question and it must be treated like that.

  9. Transcutaneous bowel sonography for inflammatory bowel disease is sensitive and specific when performed in a nonexpert low-volume North American center.

    PubMed

    Sey, Michael Sai Lai; Gregor, Jamie; Chande, Nilesh; Ponich, Terry; Bhaduri, Mousumi; Lum, Andrea; Zaleski, Witek; Yan, Brian

    2013-08-01

    Transcutaneous bowel sonography is a nonionizing imaging modality used in inflammatory bowel disease. Although available in Europe, its uptake in North America has been limited. Since the accuracy of bowel sonography is highly operator dependent, low-volume centers in North America may not achieve the same diagnostic accuracy reported in the European literature. Our objective was to determine the diagnostic accuracy of bowel sonography in a nonexpert low-volume center. All cases of bowel sonography at a single tertiary care center during an 18-month period were reviewed. Bowel sonography was compared with reference standards, including small-bowel follow-through, computed tomography, magnetic resonance imaging, colonoscopy, and surgical findings. A total of 103 cases were included for analysis during the study period. The final diagnoses included Crohn disease (72), ulcerative colitis (8), hemolytic uremic syndrome (1), and normal (22). The sensitivity and specificity of bowel sonography for intestinal wall inflammation were 87.8% and 92.6%, respectively. In the subset of patients who had complications of Crohn disease, the sensitivity and specificity were 50% and 100% for fistulas and 14% and 100% for strictures. One patient had an abscess, which was detected by bowel sonography. Abnormal bowel sonographic findings contributed to the escalation of treatment in 55% of cases. Bowel sonography for inflammatory bowel disease can be performed in low-volume centers and provides diagnostic accuracy for luminal disease comparable with published data, although it is less sensitive for complications of Crohn disease.

  10. Episodic specificity induction impacts activity in a core brain network during construction of imagined future experiences

    PubMed Central

    Madore, Kevin P.; Szpunar, Karl K.; Addis, Donna Rose; Schacter, Daniel L.

    2016-01-01

    Recent behavioral work suggests that an episodic specificity induction—brief training in recollecting the details of a past experience—enhances performance on subsequent tasks that rely on episodic retrieval, including imagining future experiences, solving open-ended problems, and thinking creatively. Despite these far-reaching behavioral effects, nothing is known about the neural processes impacted by an episodic specificity induction. Related neuroimaging work has linked episodic retrieval with a core network of brain regions that supports imagining future experiences. We tested the hypothesis that key structures in this network are influenced by the specificity induction. Participants received the specificity induction or one of two control inductions and then generated future events and semantic object comparisons during fMRI scanning. After receiving the specificity induction compared with the control, participants exhibited significantly more activity in several core network regions during the construction of imagined events over object comparisons, including the left anterior hippocampus, right inferior parietal lobule, right posterior cingulate cortex, and right ventral precuneus. Induction-related differences in the episodic detail of imagined events significantly modulated induction-related differences in the construction of imagined events in the left anterior hippocampus and right inferior parietal lobule. Resting-state functional connectivity analyses with hippocampal and inferior parietal lobule seed regions and the rest of the brain also revealed significantly stronger core network coupling following the specificity induction compared with the control. These findings provide evidence that an episodic specificity induction selectively targets episodic processes that are commonly linked to key core network regions, including the hippocampus. PMID:27601666

  11. Learners' Perceptions on the Structure and Usefulness of E-Resources for the Thesis Courses

    ERIC Educational Resources Information Center

    Aghaee, Naghmeh; Hansson, Henrik; Tedre, Matti; Drougge, Ulrika

    2014-01-01

    The use of information and communication technology (ICT) in education is a way to facilitate interaction and accessing information for learning in higher education. However, finding a set of structured e-resources to facilitate learning within specific courses is still a big challenge in most higher education institutions. This includes the…

  12. Adobe InDesign vs. QuarkXPress and PageMaker: The Best of Both Worlds?

    ERIC Educational Resources Information Center

    Wilson, Bradley

    2000-01-01

    Evaluates the newly released Adobe InDesign software, finding that while it brings new life into desktop publishing, it is not yet a "must buy" for publications advisers. Compares specific features that are relevant for student publications, including: character, paragraph, drop caps, define styles, page setup, text wrap, defining and using…

  13. Plant-based microRNA presences in mice and human sera to breast milk

    USDA-ARS?s Scientific Manuscript database

    Plant foods contain hundreds of thousands of different small RNAs, including microRNAs (miRNAs). A microRNA (miRNA) is a tiny (19-24 nucleotide) piece of RNA that attaches to a specific protein-making mRNA, thus inhibiting protein production. A recent finding shows that a miRNA in rice survives dige...

  14. The Lyrics of Hurting and Healing: Finding Words that Are Revealing

    ERIC Educational Resources Information Center

    Gladding, Samuel T.; Newsome, Deborah; Binkley, Erin; Henderson, Donna A.

    2008-01-01

    Musical lyrics play a significant role in many people's lives, including those of clients. This article describes ways lyrics can be used to help clients convey feelings of hurting and healing. Examples of lyrics that deal with pain (hurt and grief) and restoration (recovery and healing) are shared. The article then outlines six specific ways…

  15. Graduate Leaders in Early Childhood Education and Care Settings, the Practitioner Perspective

    ERIC Educational Resources Information Center

    Davis, Geraldine

    2014-01-01

    Since 2006, UK policy has identified a professionalisation agenda for staff working in early childhood education and care settings. This has included the development of graduate leaders with a specific purpose to lead improvements in these settings by leading change, and hence improving outcomes for children. This article reports on findings from…

  16. Looking Forward: Increased Attention to LGBTQ Students and Families in Middle Grade Classrooms

    ERIC Educational Resources Information Center

    Wickens, Corrine M.; Wedwick, Linda

    2011-01-01

    Looking backwards, discussions around sexual orientation and sexual identity have been noticeably absent at the middle grades. As a result, middle grade teachers may find it difficult to know how to effectively select age-appropriate materials that include LGBTQ issues and content. To move the field forward, the authors specifically highlight four…

  17. "I'm Scared and I Like It": Using Fear to Empower the Freshman Writer

    ERIC Educational Resources Information Center

    Douglass-Little, Clare

    2015-01-01

    While a thematic approach to teaching is not a novel idea, the specific needs of the developmental writer and a diverse student body can find the continuity of a theme especially beneficial, and the theme of fear has proven particularly successful. The typical developmental composition course at Embry-Riddle Aeronautical University includes a…

  18. Introduction to the problem

    NASA Technical Reports Server (NTRS)

    Ramohalli, Kumar

    1989-01-01

    Solid propellant rockets were used extensively in space missions ranging from large boosters to orbit-raising upper stages. The smaller motors find exclusive use in various earth-based applications. The advantage of the solids include simplicity, readiness, volumetric efficiency, and storability. Important recent progress in related fields (combustion, rheology, micro-instrumentation/diagnostics, and chaos theory) can be applied to solid rockets to derive maximum advantage and avoid waste. Main objectives of research in solid propellants include: to identify critical parameters, to establish specification rules, and to develop quantitative criteria.

  19. Specific Shoulder Pathoanatomy in Semiprofessional Water Polo Players

    PubMed Central

    Klein, Maria; Tarantino, Ignazio; Warschkow, René; Berger, Claus Joachim; Zdravkovic, Vilijam; Jost, Bernhard; Badulescu, Michael

    2014-01-01

    Background: Shoulders of throwing and swimming athletes are highly stressed joints that often show structural abnormalities on magnetic resonance imaging (MRI). However, while water polo players exhibit a combination of throwing and swimming movements, a specific pattern of pathological findings has not been described. Purpose: To assess specific MRI abnormalities in shoulders of elite water polo players and to compare these findings with a healthy control group. Study Design: Cross-sectional study; Level of evidence, 3. Methods: After performing a power analysis, volunteers were recruited for this study. Both shoulders of 28 semiprofessional water polo players and 15 healthy volunteers were assessed clinically (based on the Constant score) and had bilateral shoulder MRIs. The shoulders were clustered into 3 groups: 28 throwing and 28 nonthrowing shoulders of water polo athletes and 30 shoulders of healthy control subjects. Results: Twenty-eight male water polo players with an average age of 24 years and 15 healthy subjects (30 shoulders) with an average age of 31 years were examined. Compared with controls, significantly more MRI abnormalities in the water polo players' throwing shoulders could be found in the subscapularis, infraspinatus, and posterior labrum (P = .001, P = .024, and P = .041, respectively). Other structures showed no statistical differences between the 3 groups, including the supraspinatus tendon, which had abnormalities in 36% of throwing versus 32% of nonthrowing shoulders and 33% of control shoulders. All throwing shoulders showed abnormal findings in the MRI, but only 8 (29%) were symptomatic. Conclusion: The shoulders of semiprofessional water polo players demonstrated abnormalities in subscapularis and infraspinatus tendons that were not typical abnormalities for swimmers or throwing athletes. Clinical Relevance: The throwing shoulders of water polo players have specific MRI changes. Clinical symptoms do not correlate with the MRI findings. PMID:26535326

  20. Evaluating Level of Specificity of Normative Referents in Relation to Personal Drinking Behavior*

    PubMed Central

    Larimer, Mary E.; Kaysen, Debra L.; Lee, Christine M.; Kilmer, Jason R.; Lewis, Melissa A.; Dillworth, Tiara; Montoya, Heidi D.; Neighbors, Clayton

    2009-01-01

    Objective: Research has found perceived descriptive norms to be one of the strongest predictors of college student drinking, and several intervention approaches have incorporated normative feedback to correct misperceptions of peer drinking behavior. Little research has focused on the role of the reference group in normative perceptions. The current study sought to examine whether normative perceptions vary based on specificity of the reference group and whether perceived norms for more specific reference-group norms are related to individual drinking behavior. Method: Participants were first-year undergraduates (n = 1,276, 58% female) randomly selected from a university list of incoming students. Participants reported personal drinking behavior and perceived descriptive norms for eight reference groups, including typical student; same gender, ethnicity, or residence; and combinations of those reference groups (e.g., same gender and residence). Results: Findings indicated that participants distinguished among different reference groups in estimating descriptive drinking norms. Moreover, results indicated misperceptions in drinking norms were evident at all levels of specificity of the reference group. Additionally, findings showed perceived norms for more specific groups were uniquely related to participants' own drinking. Conclusions: These results suggest that providing normative feedback targeting at least one level of specificity to the participant (i.e., beyond what the “typical” student does) may be an important tool in normative feedback interventions. PMID:19538919

  1. Lattice specific heat for the RMIn5 (R=Gd, La, Y; M=Co, Rh) compounds: Non-magnetic contribution subtraction

    NASA Astrophysics Data System (ADS)

    Facio, Jorge I.; Betancourth, D.; Cejas Bolecek, N. R.; Jorge, G. A.; Pedrazzini, Pablo; Correa, V. F.; Cornaglia, Pablo S.; Vildosola, V.; García, D. J.

    2016-06-01

    We analyze theoretically a common experimental process used to obtain the magnetic contribution to the specific heat of a given magnetic material. In the procedure, the specific heat of a non-magnetic analog is measured and used to subtract the non-magnetic contributions, which are generally dominated by the lattice degrees of freedom in a wide range of temperatures. We calculate the lattice contribution to the specific heat for the magnetic compounds GdMIn5 (M=Co, Rh) and for the non-magnetic YMIn5 and LaMIn5 (M=Co, Rh), using density functional theory based methods. We find that the best non-magnetic analog for the subtraction depends on the magnetic material and on the range of temperatures. While the phonon specific heat contribution of YRhIn5 is an excellent approximation to the one of GdCoIn5 in the full temperature range, for GdRhIn5 we find a better agreement with LaCoIn5, in both cases, as a result of an optimum compensation effect between masses and volumes. We present measurements of the specific heat of the compounds GdMIn5 (M=Co, Rh) up to room temperature where it surpasses the value expected from the Dulong-Petit law. We obtain a good agreement between theory and experiment when we include anharmonic effects in the calculations.

  2. Systemic mastocytosis: CT and US features of abdominal manifestations.

    PubMed

    Avila, N A; Ling, A; Worobec, A S; Mican, J M; Metcalfe, D D

    1997-02-01

    To study the imaging findings in patients with systemic mastocytosis and to correlate the findings with the severity of disease on the basis of an established classification system. Pathologic findings, when available, were correlated with imaging findings. Computed tomographic (CT) and ultrasound (US) scans and corresponding pathologic findings, when available, were retrospectively reviewed in 27 patients with systemic mastocytosis. Only five (19%) of the patients in our series had normal abdominal CT and/or US examination results. Common abdominal imaging findings associated with systemic mastocytosis were hepatosplenomegaly, retroperitoneal adenopathy, periportal adenopathy, mesenteric adenopathy, thickening of the omentum and the mesentery, and ascites. Less common findings included hepatofugal portal venous flow, Budd-Chiari syndrome, cavernous transformation of the portal vein, ovarian mass, and complications such as chloroma. The findings were more common in patients with category II and those with category III disease. Abdominal findings at CT and US are common in patients with systemic mastocytosis. Although the findings in patients with systemic mastocytosis are not specific to the disease, they are useful in directing further studies for diagnostic confirmation and in estimating the extent of systemic involvement.

  3. Has the DOTS Strategy Improved Case Finding or Treatment Success? An Empirical Assessment

    PubMed Central

    Obermeyer, Ziad; Abbott-Klafter, Jesse; Murray, Christopher J. L.

    2008-01-01

    Background Nearly fifteen years after the start of WHO's DOTS strategy, tuberculosis remains a major global health problem. Given the lack of empirical evidence that DOTS reduces tuberculosis burden, considerable debate has arisen about its place in the future of global tuberculosis control efforts. An independent evaluation of DOTS, one of the most widely-implemented and longest-running interventions in global health, is a prerequisite for meaningful improvements to tuberculosis control efforts, including WHO's new Stop TB Strategy. We investigate the impact of the expansion of the DOTS strategy on tuberculosis case finding and treatment success, using only empirical data. Methods and Findings We study the effect of DOTS using time-series cross-sectional methods. We first estimate the impact of DOTS expansion on case detection, using reported case notification data and controlling for other determinants of change in notifications, including HIV prevalence, GDP, and country-specific effects. We then estimate the effect of DOTS expansion on treatment success. DOTS programme variables had no statistically significant impact on case detection in a wide range of models and specifications. DOTS population coverage had a significant effect on overall treatment success rates, such that countries with full DOTS coverage benefit from at least an 18% increase in treatment success (95% CI: 5–31%). Conclusions The DOTS technical package improved overall treatment success. By contrast, DOTS expansion had no effect on case detection. This finding is less optimistic than previous analyses. Better epidemiological and programme data would facilitate future monitoring and evaluation efforts. PMID:18320042

  4. The Effect of the MassHealth Hospital Pay-for-Performance Program on Quality

    PubMed Central

    Ryan, Andrew M; Blustein, Jan

    2011-01-01

    Objective To test the effect of Massachusetts Medicaid's (MassHealth) hospital-based pay-for-performance (P4P) program, implemented in 2008, on quality of care for pneumonia and surgical infection prevention (SIP). Data Hospital Compare process of care quality data from 2004 to 2009 for acute care hospitals in Massachusetts (N = 62) and other states (N = 3,676) and American Hospital Association data on hospital characteristics from 2005. Study Design Panel data models with hospital fixed effects and hospital-specific trends are estimated to test the effect of P4P on composite quality for pneumonia and SIP. This base model is extended to control for the completeness of measure reporting. Further sensitivity checks include estimation with propensity-score matched control hospitals, excluding hospitals in other P4P programs, varying the time period during which the program was assumed to have an effect, and testing the program effect across hospital characteristics. Principal Findings Estimates from our preferred specification, including hospital fixed effects, trends, and the control for measure completeness, indicate small and nonsignificant program effects for pneumonia (−0.67 percentage points, p>.10) and SIP (−0.12 percentage points, p>.10). Sensitivity checks indicate a similar pattern of findings across specifications. Conclusions Despite offering substantial financial incentives, the MassHealth P4P program did not improve quality in the first years of implementation. PMID:21210796

  5. CT-based radiomics signature for differentiating Borrmann type IV gastric cancer from primary gastric lymphoma.

    PubMed

    Ma, Zelan; Fang, Mengjie; Huang, Yanqi; He, Lan; Chen, Xin; Liang, Cuishan; Huang, Xiaomei; Cheng, Zixuan; Dong, Di; Liang, Changhong; Xie, Jiajun; Tian, Jie; Liu, Zaiyi

    2017-06-01

    To evaluate the value of CT-based radiomics signature for differentiating Borrmann type IV gastric cancer (GC) from primary gastric lymphoma (PGL). 40 patients with Borrmann type IV GC and 30 patients with PGL were retrospectively recruited. 485 radiomics features were extracted and selected from the portal venous CT images to build a radiomics signature. Subjective CT findings, including gastric wall peristalsis, perigastric fat infiltration, lymphadenopathy below the renal hila and enhancement pattern, were assessed to construct a subjective findings model. The radiomics signature, subjective CT findings, age and gender were integrated into a combined model by multivariate analysis. The diagnostic performance of these three models was assessed with receiver operating characteristics curves (ROC) and were compared using DeLong test. The subjective findings model, the radiomics signature and the combined model showed a diagnostic accuracy of 81.43% (AUC [area under the curve], 0.806; 95% CI [confidence interval]: 0.696-0.917; sensitivity, 63.33%; specificity, 95.00%), 84.29% (AUC, 0.886 [95% CI: 0.809-0.963]; sensitivity, 86.67%; specificity, 82.50%), 87.14% (AUC, 0.903 [95%CI: 0.831-0.975]; sensitivity, 70.00%; specificity, 100%), respectively. There were no significant differences in AUC among these three models (P=0.051-0.422). Radiomics analysis has the potential to accurately differentiate Borrmann type IV GC from PGL. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Whole-body MRI including diffusion-weighted MRI compared with 5-HTP PET/CT in the detection of neuroendocrine tumors

    PubMed Central

    Carlbom, Lina; Caballero-Corbalán, José; Granberg, Dan; Sörensen, Jens; Eriksson, Barbro; Ahlström, Håkan

    2017-01-01

    Aim We wanted to explore if whole-body magnetic resonance imaging (MRI) including diffusion-weighted (DW) and liver-specific contrast agent-enhanced imaging could be valuable in lesion detection of neuroendocrine tumors (NET). [11C]-5-Hydroxytryptophan positron emission tomography/computed tomography (5-HTP PET/CT) was used for comparison. Materials and methods Twenty-one patients with NET were investigated with whole-body MRI, including DW imaging (DWI) and contrast-enhanced imaging of the liver, and whole-body 5-HTP PET/CT. Seven additional patients underwent upper abdomen MRI including DWI, liver-specific contrast agent-enhanced imaging, and 5-HTP PET/CT. Results There was a patient-based concordance of 61% and a lesion-based concordance of 53% between the modalities. MRI showed good concordance with PET in detecting bone metastases but was less sensitive in detecting metastases in mediastinal lymph nodes. MRI detected more liver metastases than 5-HTP PET/CT. Conclusion Whole-body MRI with DWI did not detect all NET lesions found with whole-body 5-HTP PET/CT. Our findings indicate that MRI of the liver including liver-specific contrast agent-enhanced imaging and DWI could be a useful complement to whole-body 5-HTP PET/CT. PMID:27894208

  7. Dual p16 and Ki-67 Expression in Liquid-Based Cervical Cytological Samples Compared to Pap Cytology Findings, Biopsies, and HPV Testing in Cervical Cancer Screening: A Diagnostic Accuracy Study.

    PubMed

    Prigenzi, Karla Calaça Kabbach; Heinke, Thaís; Salim, Rafael Calil; Focchi, Gustavo Rubino de Azevedo

    2018-01-01

    Our objective was to verify the sensitivity and specificity of dual immunocytochemistry staining for p16 and Ki-67 in liquid-based samples (the "dual" assay) for cervical lesion screening, compared to biopsy findings and human papillomavirus (HPV) DNA molecular detection. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values for the "dual immunocytochemistry assay" were calculated and compared to histopathological results and to high-risk HPV DNA detection in adult women or teenagers submitted to cervical cancer screening. A total of 151 women were included. The majority (96.2%) of those with negative dual assay results had lower biopsy grades (p < 0.001). Women with cytology results suggestive of cervical cancer had positive dual immunocytochemistry assay results more frequently (p < 0.001), and these positive results were also significantly associated with biopsy findings (p < 0.001) and with high-risk genotype HPV infection (p = 0.007). Specificity and PPV for the dual assay were 0.972 (0.855-0.999) and 0.800 (0.284-0.995), respectively, and 1.000 (0.590-1.000) and 1.000 (0.631-1.000) for HPV detection. The dual immunocytochemistry assay had high specificity and PPV. It reveals a persistent HPV infection, avoiding the need for new tissue collections for biopsies or hybrid capture. © 2018 S. Karger AG, Basel.

  8. Can the efficiency of modified Alvarado scoring system in the diagnosis acute appendicitis be increased with tenesmus?

    PubMed

    Bulus, Hakan; Tas, Adnan; Morkavuk, Baris; Koklu, Seyfettin; Soy, Derya; Coskun, Ali

    2013-01-01

    Acute appendicitis is one of the main pathological conditions requiring emergency surgical intervention. The most widely accepted scoring system is modified Alvarado scoring system (MASS). In this study we aimed to improve the efficiency of MASS by adding a new parameter and to evaluate its efficiency in the diagnosis of acute appendicitis. This study included 158 patients who underwent acute appendectomy in Keçiören Training and Research Hospital General Surgery Department. In addition to criteria of MASS, all patients were questioned about the presence of tenesmus. The validity of MASS and MASS with additional parameter was evaluated with respect to sensitivity, specificity and positive and negative predictive values. Accuracy rates of MASS, clinical findings, ultrasonography and MASS with additional parameter in the diagnosis of acute appendicitis were 64, 76, 85 and 80 %. False positivity rates for clinical findings, MASS and MASS with additional parameter in the diagnosis of acute appendicitis were 17, 26 and 10 %, respectively. Sensitivity and specificity of clinical findings in the diagnosis of acute appendicitis were 83 and 66 %, respectively. Sensitivity and specificity of MASS in the diagnosis of acute appendicitis were 74 and 39 %, respectively, and those of MASS with additional parameter were appendicitis increased to 83 and 66 %, respectively. MASS is a simple, cheap and objective scoring system and does not require expertise. When tenesmus is added to standard MASS, rates of accuracy, sensitivity and specificity become better than those in MASS in the diagnosis of acute appendicitis.

  9. Comparison of clinical characteristics and laboratory findings of malaria, dengue, and enteric fever in returning travelers: 8-year experience at a referral center in Tokyo, Japan.

    PubMed

    Kutsuna, Satoshi; Hayakawa, Kayoko; Kato, Yasuyuki; Fujiya, Yoshihiro; Mawatari, Momoko; Takeshita, Nozomi; Kanagawa, Shuzo; Ohmagari, Norio

    2015-07-01

    Without specific symptoms, diagnosis of febrile illness in returning travelers is challenging. Dengue, malaria, and enteric fever are common causes of fever in returning travelers and timely and appropriate treatment is important. However, differentiation is difficult without specific diagnostic tests. A retrospective study was conducted at the National Centre for Global Health and Medicine (NCGM) from April 2005 to March 2013. Febrile travelers returning from overseas who were diagnosed with dengue, malaria, or enteric fever were included in this study. Clinical characteristics and laboratory findings were compared for each diagnosis. During the study period, 86 malaria, 85 dengue, and 31 enteric fever cases were identified. The mean age of the study cohort was 33.1 ± 12 years and 134 (66.3%) study participants were male. Asia was the most common area visited by returning travelers with fevers (89% of dengue, 18.6% of malaria, and 100% of enteric fever cases), followed by Africa (1.2% of dengue and 70.9% of malaria cases). Clinical characteristics and laboratory findings were significantly different among each group with each diagnosis. Decision tree models revealed that returning from Africa and CRP levels < 10 mg/L were factors specific for diagnosis of malaria and dengue fever, respectively. Clinical manifestations, simple laboratory test results, and regions of travel are helpful to distinguish between dengue, malaria, and enteric fever in febrile returning travelers with non-specific symptoms.

  10. Pesticides, chemical and industrial exposures in relation to systemic lupus erythematosus

    PubMed Central

    Parks, Christine G.; De Roos, Anneclaire J.

    2013-01-01

    Growing evidence suggests exposure to chemicals and industrial pollutants may increase risk of SLE. Here we review research on SLE associations with occupational and industrial exposures, primarily drawing on studies in human populations and summarizing epidemiologic research published in the past decade. The association of occupational silica exposure with SLE is well established, but key questions remain, including the required dose and susceptibility factors, and SLE risk due to other silicate exposures. Research on SLE and other exposures is less well developed, though several potential associations merit further consideration due to the consistency of preliminary human findings, experimental animal research, and biologic plausibility. These include pesticides and solvents, for which experimental findings also support investigation of specific agents, including organochlorines and trichloroethylene. Experimental findings and biologic plausibility suggest research on SLE and occupational exposure to hydrocarbons (i.e., mineral oils) is warranted, especially given the widespread exposures in the population. Experimental and limited human findings support further investigation of SLE related to mercury exposure, especially in dental occupations. Research on environmental risk factors in risk-enriched cohorts (family based) is recommended, as is further investigation of exposures in relation to intermediate markers of effect (e.g., antinuclear antibodies), clinical features (e.g., nephritis) and outcomes. PMID:24763537

  11. The GSK-3 family as therapeutic target for myocardial diseases

    PubMed Central

    Lal, Hind; Ahmad, Firdos; Woodgett, James; Force, Thomas

    2014-01-01

    GSK-3 is one of the very few signaling molecules that regulate a truly astonishing number of critical intracellular signaling pathways. It has been implicated in a number of diseases including heart failure, bipolar disorder, diabetes, Alzheimer’s disease, aging, inflammation and cancer. Furthermore, a recent clinical trial has validated the feasibility of targeting GSK-3 with small molecule inhibitors for human diseases. In the current review we will focus on its expanding role in the heart, concentrating primarily on recent studies that have employed cardiomyocyte- and fibroblast-specific conditional gene deletion in mouse models. We will highlight the role of the GSK-3 isoforms in various pathological conditions including myocardial aging, ischemic injury, myocardial fibrosis and cardiomyocyte proliferation. We will discuss our recent findings that deletion of GSK-3α specifically in cardiomyocytes attenuates ventricular remodeling and cardiac dysfunction post-MI by limiting scar expansion and promoting cardiomyocyte proliferation. The recent emergence of GSK-3β as a regulator of myocardial fibrosis will also be discussed. We will review our very recent findings that specific deletion of GSK-3β in cardiac fibroblasts leads to fibrogenesis, left ventricular dysfunction and excessive scarring in the ischemic heart. Finally, we will examine the underlying mechanisms that drive the aberrant myocardial fibrosis in the models in which GSK-3β is specifically deleted in cardiac fibroblasts. We will summarize these recent results and offer explanations, whenever possible, and hypotheses when not. For these studies we will rely heavily on our models and those of others to reconcile some of the apparent inconsistencies in the literature. PMID:25552693

  12. Systematic Review and Meta-Analysis of CT Features for Differentiating Complicated and Uncomplicated Appendicitis.

    PubMed

    Kim, Hae Young; Park, Ji Hoon; Lee, Yoon Jin; Lee, Sung Soo; Jeon, Jong-June; Lee, Kyoung Ho

    2018-04-01

    Purpose To perform a systematic review and meta-analysis to identify computed tomographic (CT) features for differentiating complicated appendicitis in patients suspected of having appendicitis and to summarize their diagnostic accuracy. Materials and Methods Studies on diagnostic accuracy of CT features for differentiating complicated appendicitis (perforated or gangrenous appendicitis) in patients suspected of having appendicitis were searched in Ovid-MEDLINE, EMBASE, and the Cochrane Library. Overlapping descriptors used in different studies to denote the same image finding were subsumed under a single CT feature. Pooled diagnostic accuracy of the CT features was calculated by using a bivariate random effects model. CT features with pooled diagnostic odds ratios with 95% confidence intervals not including 1 were considered as informative. Results Twenty-three studies were included, and 184 overlapping descriptors for various CT findings were subsumed under 14 features. Of these, 10 features were informative for complicated appendicitis. There was a general tendency for these features to show relatively high specificity but low sensitivity. Extraluminal appendicolith, abscess, appendiceal wall enhancement defect, extraluminal air, ileus, periappendiceal fluid collection, ascites, intraluminal air, and intraluminal appendicolith showed pooled specificity greater than 70% (range, 74%-100%), but sensitivity was limited (range, 14%-59%). Periappendiceal fat stranding was the only feature that showed high sensitivity (94%; 95% confidence interval: 86%, 98%) but low specificity (40%; 95% confidence interval, 23%, 60%). Conclusion Ten informative CT features for differentiating complicated appendicitis were identified in this study, nine of which showed high specificity, but low sensitivity. © RSNA, 2017 Online supplemental material is available for this article.

  13. Neuromuscular Ultrasound in the Assessment of Polyneuropathies and Motor Neuron Disease

    PubMed Central

    Shen, Jack; Cartwright, Michael S.

    2015-01-01

    Neuromuscular ultrasound is an emerging technology for the evaluation of conditions affecting nerve and muscle, with the majority of research focusing on focal neuropathies. Despite this focus, researchers have also investigated the ultrasonographic changes that occur in the nerves and muscles of those with more diffuse polyneuropathies and motor neuron diseases, and this review will detail the findings in these conditions. Specific findings are discussed in this paper, but general themes will also be presented and include the following: hereditary polyneuropathies show diffuse nerve enlargement whereas immune-mediated polyneuropathies show more patchy involvement; nerve enlargement is more profound in demyelinating than axonal polyneuropathies; and muscle changes in motor neuron diseases include heterogeneous increases in echogenicity, atrophy, readily detectable fasciculations, and increased subcutaneous tissue thickness. PMID:27035248

  14. Traumatic Rib Injury: Patterns, Imaging Pitfalls, Complications, and Treatment.

    PubMed

    Talbot, Brett S; Gange, Christopher P; Chaturvedi, Apeksha; Klionsky, Nina; Hobbs, Susan K; Chaturvedi, Abhishek

    2017-01-01

    The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures. Specific attention is also required for flail chest and for fractures due to pediatric nonaccidental trauma. Rib fractures are associated with significant morbidity and mortality, both of which increase as the number of fractured ribs increases. Key complications associated with rib fracture include pain, hemothorax, pneumothorax, extrapleural hematoma, pulmonary contusion, pulmonary laceration, acute vascular injury, and abdominal solid-organ injury. Congenital anomalies, including supernumerary or accessory ribs, vestigial anterior ribs, bifid ribs, and synostoses, are common and should not be confused with traumatic pathologic conditions. Nontraumatic mimics of traumatic rib injury, with or without fracture, include metastatic disease, primary osseous neoplasms (osteosarcoma, chondrosarcoma, Ewing sarcoma, Langerhans cell histiocytosis, and osteochondroma), fibrous dysplasia, and Paget disease. Principles of management include supportive and procedural methods of alleviating pain, treating complications, and stabilizing posttraumatic deformity. By recognizing and accurately reporting the imaging findings, the radiologist will add value to the care of patients with thoracic trauma. Online supplemental material is available for this article. © RSNA, 2017.

  15. Development of a situation-specific theory for explaining health-related quality of life among older South Korean adults with type 2 diabetes.

    PubMed

    Chang, Sun Ju; Im, Eun-Ok

    2014-01-01

    The purpose of the study was to develop a situation-specific theory for explaining health-related quality of life (QOL) among older South Korean adults with type 2 diabetes. To develop a situation-specific theory, three sources were considered: (a) the conceptual model of health promotion and QOL for people with chronic and disabling conditions (an existing theory related to the QOL in patients with chronic diseases); (b) a literature review using multiple databases including Cumulative Index for Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, and two Korean databases; and (c) findings from our structural equation modeling study on health-related QOL in older South Korean adults with type 2 diabetes. The proposed situation-specific theory is constructed with six major concepts including barriers, resources, perceptual factors, psychosocial factors, health-promoting behaviors, and health-related QOL. The theory also provides the interrelationships among concepts. Health care providers and nurses could incorporate the proposed situation-specific theory into development of diabetes education programs for improving health-related QOL in older South Korean adults with type 2 diabetes.

  16. Golf and racquet sports injuries.

    PubMed

    Jacobson, Jon A; Miller, Bruce S; Morag, Yoav

    2005-12-01

    There are specific injuries that are common in golf and racquet sports. These abnormalities have a predilection for specific structures as well and can be divided into two categories on the basis of etiology as either chronic repetitive injury or acute trauma. With golf injuries, upper extremity abnormalities prevail and include rotator cuff disease, epicondylitis, wrist tenosynovitis, and hamate hook fracture. Thoracolumbar spine pain can also occur. The order of frequency of these ailments is different for professional and recreational athletes. With racquet injuries, as in tennis, lower extremity injuries are more common and include medial gastrocnemius and Achilles tendon abnormalities, although shoulder, elbow, and wrist abnormalities may also occur. Knowledge of the biomechanics behind each sport is also helpful in understanding the pathophysiology of injury and in part explains the findings seen at imaging.

  17. Working appreciatively to improve services for children and families.

    PubMed

    Onyett, Steve

    2009-10-01

    Service improvement approaches are described that specifically focus on appreciating the positive that individuals bring to contexts related to children and family services. This includes application of Solution-Focused approaches, Appreciative Inquiry and other approaches that promote a positive emotional climate and focus on what works. Their conceptual foundations are explored and particularly their value in supporting working well with complex adaptive systems. Specific applications described include leadership and management practice, work in school settings, engaging clinicians in healthcare improvement, establishing clinical networks, work with homeless youth, child protection and approaches to drawing out best practice and community development. The theme that unites is a focus on developing effective relationships at all levels and a pragmatic focus on what works so that we can find opportunities to do more of it.

  18. The Associations between Loss and Posttraumatic Stress and Depressive Symptoms Following Hurricane Ike

    PubMed Central

    Paul, Lisa A.; Price, Matthew; Gros, Daniel F.; Gros, Kirstin Stauffacher; McCauley, Jenna L.; Resnick, Heidi S.; Acierno, Ron; Ruggiero, Kenneth J.

    2013-01-01

    Disasters can have wide-ranging effects on individuals and their communities. Loss of specific resources (e.g., household contents, job) following a disaster has not been well studied, despite the implications for preparedness efforts and post-disaster interventions. The present study used random-digit-dial methodology to recruit hurricane-affected adults from Galveston and Chambers, TX, counties one year after Hurricane Ike. Data from 1,249 survivors were analyzed to identify predictors of distress, including specific resource losses. Variables that were significantly associated with PTSD symptoms included sustained losses, hurricane exposure and socio-demographic characteristics; similar results were obtained for depressive symptoms. Together, these findings suggest risk factors that may be associated with the development of post-hurricane distress that can inform preparedness efforts and post-hurricane interventions. PMID:23852826

  19. Gendered mental disorders: masculine and feminine stereotypes about mental disorders and their relation to stigma.

    PubMed

    Boysen, Guy; Ebersole, Ashley; Casner, Robert; Coston, Nykhala

    2014-01-01

    Research indicates that stereotypes can intersect. For example, the intersection of stereotypes about gender and mental disorders could result in perceptions of gendered mental disorders. In the current research, Studies 1 and 2 showed that people view specific disorders as being masculine or feminine. The masculine stereotype included antisocial personality disorder, addictions, and paraphilias. The feminine stereotype included eating disorders, histrionic personality disorder, body dysmorphia, and orgasmic disorder. In both studies, the perception of disorders as masculine was positively correlated with stigma. Study 3 showed that the positive correlation between masculinity and stigma also occurred when examining specific symptoms rather than full mental disorders. The findings provide further evidence for the intersection of stereotypes and indicate a novel factor in the understanding of stigma.

  20. Friends or Foes? A Review of Peer Influence on Self-Care and Glycemic Control in Adolescents With Type 1 Diabetes

    PubMed Central

    Helgeson, Vicki S.

    2012-01-01

    Objective We reviewed studies published from 1990 to 2010 examining the relation of peer influence to diabetes outcomes for adolescents with type 1 diabetes. Methods We searched PsychInfo and MedLine databases and personal archives for studies meeting our criteria. 24 articles were included in the final review. Results Qualitative studies revealed that teens believe peers have an impact on diabetes behaviors, but quantitative findings are inconclusive. We found more evidence that social conflict was harmful than social support was helpful. Associations were more likely in studies that measured specific support and specific self-care variables. Studies addressing how individual differences interact with social context had promising findings. Conclusions The literature linking peer relations to diabetes outcomes is mixed. Future research should consider moderator variables, expand the conceptualization of peer relationships, and consider interactions between person and social context. PMID:22460759

  1. Juvenile Psychopathic Personality Traits are Associated with Poor Reading Achievement

    PubMed Central

    DeLisi, Matt; Beaver, Kevin M.; Wexler, Jade; Barth, Amy; Fletcher, Jack

    2011-01-01

    The current study sought to further the understanding of the linkage between maladaptive behavior and cognitive problems by examining the relations between psychopathic personality traits and reading comprehension performance. Data were derived from a study of 432 predominately African-American and Hispanic middle-school students. Dependent variables consisted of three measures of reading comprehension. Psychopathy measures included the Inventory of Callous-Unemotional traits (ICU—teacher rated) and the self-reported Youth Psychopathic traits Inventory (YPI). Findings from regression models indicated that self-report and teacher ratings of psychopathy were statistically significant inverse predictors of reading performance. Specifically, affective facets of psychopathy were potent predictors of reading comprehension over and above ADHD, IQ, and an impulsivity component of psychopathy. Study results extend the utility of psychopathy construct generally and affective traits specifically to reading achievement, which has broad implications. Findings are discussed with respect to future research and prevention. PMID:20957434

  2. Temporomandibular disorders. Part 2: conservative management

    PubMed Central

    Shaffer, Stephen M; Brismée, Jean-Michel; Sizer, Phillip S; Courtney, Carol A

    2014-01-01

    Appropriate management of temporomandibular disorders (TMD) requires an understanding of the underlying dysfunction associated with the temporomandibular joint (TMJ) and surrounding structures. A comprehensive examination process, as described in part 1 of this series, can reveal underlying clinical findings that assist in the delivery of comprehensive physical therapy services for patients with TMD. Part 2 of this series focuses on management strategies for TMD. Physical therapy is the preferred conservative management approach for TMD. Physical therapists are professionally well-positioned to step into the void and provide clinical services for patients with TMD. Clinicians should utilize examination findings to design rehabilitation programs that focus on addressing patient-specific impairments. Potentially appropriate plan of care components include joint and soft tissue mobilization, trigger point dry needling, friction massage, therapeutic exercise, patient education, modalities, and outside referral. Management options should address both symptom reduction and oral function. Satisfactory results can often be achieved when management focuses on patient-specific clinical variables. PMID:24976744

  3. Forecasting urban water demand: A meta-regression analysis.

    PubMed

    Sebri, Maamar

    2016-12-01

    Water managers and planners require accurate water demand forecasts over the short-, medium- and long-term for many purposes. These range from assessing water supply needs over spatial and temporal patterns to optimizing future investments and planning future allocations across competing sectors. This study surveys the empirical literature on the urban water demand forecasting using the meta-analytical approach. Specifically, using more than 600 estimates, a meta-regression analysis is conducted to identify explanations of cross-studies variation in accuracy of urban water demand forecasting. Our study finds that accuracy depends significantly on study characteristics, including demand periodicity, modeling method, forecasting horizon, model specification and sample size. The meta-regression results remain robust to different estimators employed as well as to a series of sensitivity checks performed. The importance of these findings lies in the conclusions and implications drawn out for regulators and policymakers and for academics alike. Copyright © 2016. Published by Elsevier Ltd.

  4. Investigating the Interaction Between Sleep Symptoms of Arousal and Acquired Capability in Predicting Suicidality.

    PubMed

    Hochard, Kevin D; Heym, Nadja; Townsend, Ellen

    2017-06-01

    Heightened arousal significantly interacts with acquired capability to predict suicidality. We explore this interaction with insomnia and nightmares independently of waking state arousal symptoms, and test predictions of the Interpersonal Theory of Suicide (IPTS) and Escape Theory in relation to these sleep arousal symptoms. Findings from our e-survey (n = 540) supported the IPTS over models of Suicide as Escape. Sleep-specific measurements of arousal (insomnia and nightmares) showed no main effect, yet interacted with acquired capability to predict increased suicidality. The explained variance in suicidality by the interaction (1%-2%) using sleep-specific measures was comparable to variance explained by interactions previously reported in the literature using measurements composed of a mix of waking and sleep state arousal symptoms. Similarly, when entrapment (inability to escape) was included in models, main effects of sleep symptoms arousal were not detected yet interacted with entrapment to predict suicidality. We discuss findings in relation to treatment options suggesting that sleep-specific interventions be considered for the long-term management of at-risk individuals. © 2016 The American Association of Suicidology.

  5. GeoSciGraph: An Ontological Framework for EarthCube Semantic Infrastructure

    NASA Astrophysics Data System (ADS)

    Gupta, A.; Schachne, A.; Condit, C.; Valentine, D.; Richard, S.; Zaslavsky, I.

    2015-12-01

    The CINERGI (Community Inventory of EarthCube Resources for Geosciences Interoperability) project compiles an inventory of a wide variety of earth science resources including documents, catalogs, vocabularies, data models, data services, process models, information repositories, domain-specific ontologies etc. developed by research groups and data practitioners. We have developed a multidisciplinary semantic framework called GeoSciGraph semantic ingration of earth science resources. An integrated ontology is constructed with Basic Formal Ontology (BFO) as its upper ontology and currently ingests multiple component ontologies including the SWEET ontology, GeoSciML's lithology ontology, Tematres controlled vocabulary server, GeoNames, GCMD vocabularies on equipment, platforms and institutions, software ontology, CUAHSI hydrology vocabulary, the environmental ontology (ENVO) and several more. These ontologies are connected through bridging axioms; GeoSciGraph identifies lexically close terms and creates equivalence class or subclass relationships between them after human verification. GeoSciGraph allows a community to create community-specific customizations of the integrated ontology. GeoSciGraph uses the Neo4J,a graph database that can hold several billion concepts and relationships. GeoSciGraph provides a number of REST services that can be called by other software modules like the CINERGI information augmentation pipeline. 1) Vocabulary services are used to find exact and approximate terms, term categories (community-provided clusters of terms e.g., measurement-related terms or environmental material related terms), synonyms, term definitions and annotations. 2) Lexical services are used for text parsing to find entities, which can then be included into the ontology by a domain expert. 3) Graph services provide the ability to perform traversal centric operations e.g., finding paths and neighborhoods which can be used to perform ontological operations like computing transitive closure (e.g., finding all subclasses of rocks). 4) Annotation services are used to adorn an arbitrary block of text (e.g., from a NOAA catalog record) with ontology terms. The system has been used to ontologically integrate diverse sources like Science-base, NOAA records, PETDB.

  6. Ultrasonography in the diagnosis of nasal bone fractures: a comparison with conventional radiography and computed tomography.

    PubMed

    Lee, In Sook; Lee, Jung-Hoon; Woo, Chang-Ki; Kim, Hak Jin; Sol, Yu Li; Song, Jong Woon; Cho, Kyu-Sup

    2016-02-01

    The purpose of this study was to evaluate and compare the diagnostic efficacy of ultrasonography (US) with radiography and multi-detector computed tomography (CT) for the detection of nasal bone fractures. Forty-one patients with a nasal bone fracture who underwent prospective US examinations were included. Plain radiographs and CT images were obtained on the day of trauma. For US examinations, radiologist used a linear array transducer (L17-5 MHz) in 24 patients and hockey-stick probe (L15-7 MHz) in 17. The bony component of the nose was divided into three parts (right and left lateral nasal walls, and midline of nasal bone). Fracture detection by three modalities was subjected to analysis. Furthermore, findings made by each modality were compared with intraoperative findings. Nasal bone fractures were located in the right lateral wall (n = 28), midline of nasal bone (n = 31), or left lateral wall (n = 31). For right and left lateral nasal walls, CT had greater sensitivity and specificity than US or radiography, and better agreed with intraoperative findings. However, for midline fractures of nasal bone, US had higher specificity, positive predictive value, and negative predictive value than CT. Although two US evaluations showed good agreements at all three sites, US findings obtained by the hockey-stick probe showed closer agreement with intraoperative findings for both lateral nasal wall and midline of nasal bone. Although CT showed higher sensitivity and specificity than US or radiography, US found to be helpful for evaluating the midline of nasal bone. Furthermore, for US examinations of the nasal bone, a smaller probe and higher frequency may be required.

  7. Application of miRNAs as Biomarkers of Exposure and Effects ...

    EPA Pesticide Factsheets

    Of the known epigenetic mechanisms, non-coding RNA and more specifically, microRNA (miRNA), offer the most immediate promise for risk assessment applications because these molecules can serve as excellent biomarkers of toxicity. The advantages of miRNA versus more classical protein toxicity biomarkers include: greater stability and earlier appearance in biofluids that can be obtained by relatively non-invasive approaches; tissue- and/or cell-specific expression patterns; evolutionary conservation in both sequence and function across species; and novel technologies for sensitive and accurate quantification. Further, information on individual miRNA is readily available through databases such as miRBase and others. Thus miRNA biomarkers offer substantial benefits in terms of cost, time, convenience, sensitivity, and specificity when assessing environmental-induced toxicity in model systems or human cohorts. Although this field is rapidly expanding, documented examples include associations of miR-155 with lymphocytic leukemia, miR-122 with liver toxicity; miR-206 with skeletal muscle disease; and miR-208a-3p with cardiac toxicity. Despite their promise, some challenges in using miRNAs as toxicity biomarkers remain, including the need for improved methods for normalizing miRNA measurements, translating findings of biofluid-based miRNA biomarker alterations in experimental models to human health and specific cell/tissue injury, and finally, the need to better defi

  8. Summary and Findings of the ARL Dynamic Failure Forum

    DTIC Science & Technology

    2016-09-29

    short beam shear, quasi -static indentation, depth of penetration, and V50 limit velocity. o Experimental technique suggestions for improvement included...art in experimental , theoretical, and computational studies of dynamic failure. The forum also focused on identifying technologies and approaches...Army-specific problems. Experimental exploration of material behavior and an improved ability to parameterize material models is essential to improving

  9. Access to Educational and Community Activities for Young Children with Disabilities: Selected Findings from the Pre-Elementary Education Longitudinal Study (PEELS). NCSER 2011-3000

    ERIC Educational Resources Information Center

    Carlson, Elaine; Bitterman, Amy; Daley, Tamara

    2010-01-01

    This report uses data from the Pre-Elementary Education Longitudinal Study (PEELS) to describe access for young children with disabilities in two specific domains: community activities, including extracurricular activities and family recreation, and kindergarten classroom experiences. While PEELS is a broad, descriptive study, the analyses…

  10. Corrosion Control Specialist Career Ladder AFSC 53530, 53550, 53570, and 53690. Occupational Survey Report.

    ERIC Educational Resources Information Center

    Air Force Occupational Measurement Center, Lackland AFB, TX.

    The report describes the results of a detailed occupational survey of the corrosion control career ladder. Responses to a 457-task, time rating inventory from 1,015 personnel (representing 64 percent of the career field) were analyzed to produce seven specific findings and the career ladder structure. The career ladder includes a variety of jobs…

  11. Domain-Specific Relationships in Sexual Measures of Impulsive Behavior.

    PubMed

    Mahoney, Colin T; Lawyer, Steven R

    2018-04-25

    Impulsivity is an important construct for understanding sexual behaviors, but behavioral and self-report measures of impulsivity often are not correlated. One possible explanation for this is that there is little shared variance in the measures because behavioral measures index impulsivity by asking questions about monetary preferences, while self-report measures index impulsivity by asking about a broad range of real-world outcomes (including those of a sexual nature) largely unrelated to money-related preferences. Undergraduate students (total N = 105; female n = 77, male n = 28) completed laboratory measures-delay discounting (DD) and probability discounting (PD)-for two different outcomes-money and sexual activity. Participants also completed the Delaying Gratification Inventory (DGI), which measures difficulty with delaying gratification (i.e., impulsivity) across different domains, including money and physical pleasures. Findings indicated that DD and PD for money were not related to any of the DGI subscales. However, DD for sexual activity was significantly related to the DGI Physical Pleasures subscale, but not other subscales. These findings suggest that the relationship between behavioral and self-report measures of impulsive choice may be stronger when both are measuring domain-specific rather than domain-general behavioral patterns, but further research is warranted.

  12. Difference in brain activations during appreciating paintings and photographic analogs

    PubMed Central

    Mizokami, Yoshinori; Terao, Takeshi; Hatano, Koji; Hoaki, Nobuhiko; Kohno, Kentaro; Araki, Yasuo; Kodama, Kensuke; Makino, Mayu; Izumi, Toshihiko; Shimomura, Tsuyoshi; Fujiki, Minoru; Kochiyama, Takanori

    2014-01-01

    Several studies have investigated neural correlates of aesthetic appreciation for paintings but to date the findings have been heterogeneous. This heterogeneity may be attributed to previous studies’ measurement of aesthetic appreciation of not only the beauty of paintings but also the beauty of motifs of the paintings. In order to better elucidate the beauty of paintings, it seems necessary to compare aesthetic appreciation of paintings and photographic analogs which included corresponding real images. We prepared for famous painters’ pictures and their photographic analogs which were set up to resemble each painting in order to investigate the hypothesis that there exist specific neural correlates associated with the aesthetic appreciation for paintings. Forty-four subjects participated in functional magnetic resonance study which required comparisons of aesthetic appreciation of paintings of still life and landscape versus photographic analogs including corresponding real images of still life and landscape. Bilateral cuneus and the left lingual gyrus were activated in the comparison of aesthetic appreciation of paintings versus photographic analogs. In conclusion, the present findings suggest a possibility of the existence of specific neural correlates associated with the aesthetic appreciation for paintings and that bilateral cuneus and the left lingual gyrus may be involved. PMID:25071508

  13. Representing metarepresentations: is there theory of mind-specific cognition?

    PubMed

    Egeth, Marc; Kurzban, Robert

    2009-03-01

    What cognitive mechanisms underlie Theory of Mind? Some infer domain-specific Theory of Mind cognition based the pattern of children diagnosed with autism failing the False Belief test but passing the False Photograph test. However, we argue that the False Belief test entails various task demands the False Photograph task does not, including the necessity to represent a higher-order representation (a metarepresentation), thus confounding the inference of domain-specificity. Instead, a general difficulty that affects representations of metarepresentations might account for the seeming domain-specific failure. Here we find that False-Belief failing False-Photograph passing children fail the Meta Photograph test, a new photograph-domain test that requires subjects to represent a metarepresentation. We conclude that people who fail the False Belief test but pass the False Photograph test do not necessarily have a content-specific Theory of Mind deficit. Instead, the general ability to represent representations and metarepresentations might underlie Theory of Mind.

  14. Life review based on remembering specific positive events in active aging.

    PubMed

    Latorre, José M; Serrano, Juan P; Ricarte, Jorge; Bonete, Beatriz; Ros, Laura; Sitges, Esther

    2015-02-01

    The aim of this study is to evaluate the effectiveness of life review (LR) based on specific positive events in non-depressed older adults taking part in an active aging program. Fifty-five older adults were randomly assigned to an experimental group or an active control (AC) group. A six-session individual training of LR based on specific positive events was carried out with the experimental group. The AC group undertook a "media workshop" of six sessions focused on learning journalistic techniques. Pre-test and post-test measures included life satisfaction, depressive symptoms, experiencing the environment as rewarding, and autobiographical memory (AM) scales. LR intervention decreased depressive symptomatology, improved life satisfaction, and increased specific memories. The findings suggest that practice in AM for specific events is an effective component of LR that could be a useful tool in enhancing emotional well-being in active aging programs, thus reducing depressive symptoms. © The Author(s) 2014.

  15. Lincoln's vertical strabismus.

    PubMed

    Goldstein, J H

    1997-01-01

    The vertical strabismus manifested by Abraham Lincoln has been noted. This article reviews the historical findings and provides a specific diagnosis. Previous reports of symptoms and history relating to Lincoln's left hypertropia were reviewed. A series of photographs were reviewed. Lincoln's own description of his symptoms is provided. Previous history indicates an intermittent left hypertropia. A family history of vertical strabismus was noted with regard to Mr Lincoln's cousin. There also is a history of trauma to the left frontal area and life-mask evidence of fracture over the left eye. The findings include a history of head tilt and diplopia, presumably most readily in downgaze. Given the history and findings, the diagnosis of left superior oblique paresis of either congenital or traumatic origin seems appropriate.

  16. Gender research in the National Institute on Drug Abuse National Treatment Clinical Trials Network: a summary of findings.

    PubMed

    Greenfield, Shelly F; Rosa, Carmen; Putnins, Susan I; Green, Carla A; Brooks, Audrey J; Calsyn, Donald A; Cohen, Lisa R; Erickson, Sarah; Gordon, Susan M; Haynes, Louise; Killeen, Therese; Miele, Gloria; Tross, Susan; Winhusen, Theresa

    2011-09-01

    The National Institute of Drug Abuse's National Drug Abuse Treatment Clinical Trials Network (CTN) was established to foster translation of research into practice in substance abuse treatment settings. The CTN provides a unique opportunity to examine in multi-site, translational clinical trials, the outcomes of treatment interventions targeting vulnerable subgroups of women; the comparative effectiveness of gender-specific protocols to reduce risk behaviors; and gender differences in clinical outcomes. To review gender-related findings from published CTN clinical trials and related studies from January 2000 to March 2010. CTN studies were selected for review if they focused on treatment outcomes or services for special populations of women with substance use disorders (SUDs) including those with trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors; or implemented gender-specific protocols. The CTN has randomized 11,500 participants (41% women) across 200 clinics in 24 randomized controlled trials in community settings, of which 4 have been gender-specific. This article summarizes gender-related findings from CTN clinical trials and related studies, focusing on trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors. These published studies have expanded the evidence base regarding interventions for vulnerable groups of women with SUDs as well as gender-specific interventions to reduce HIV risk behaviors in substance-using men and women. The results also underscore the complexity of accounting for gender in the design of clinical trials and analysis of results. To fully understand the relevance of gender-specific moderators and mediators of outcome, it is essential that future translational studies adopt more sophisticated approaches to understanding and measuring gender-relevant factors and plan sample sizes that are adequate to support more nuanced analytic methods.

  17. Invariant TAD Boundaries Constrain Cell-Type-Specific Looping Interactions between Promoters and Distal Elements around the CFTR Locus.

    PubMed

    Smith, Emily M; Lajoie, Bryan R; Jain, Gaurav; Dekker, Job

    2016-01-07

    Three-dimensional genome structure plays an important role in gene regulation. Globally, chromosomes are organized into active and inactive compartments while, at the gene level, looping interactions connect promoters to regulatory elements. Topologically associating domains (TADs), typically several hundred kilobases in size, form an intermediate level of organization. Major questions include how TADs are formed and how they are related to looping interactions between genes and regulatory elements. Here we performed a focused 5C analysis of a 2.8 Mb chromosome 7 region surrounding CFTR in a panel of cell types. We find that the same TAD boundaries are present in all cell types, indicating that TADs represent a universal chromosome architecture. Furthermore, we find that these TAD boundaries are present irrespective of the expression and looping of genes located between them. In contrast, looping interactions between promoters and regulatory elements are cell-type specific and occur mostly within TADs. This is exemplified by the CFTR promoter that in different cell types interacts with distinct sets of distal cell-type-specific regulatory elements that are all located within the same TAD. Finally, we find that long-range associations between loci located in different TADs are also detected, but these display much lower interaction frequencies than looping interactions within TADs. Interestingly, interactions between TADs are also highly cell-type-specific and often involve loci clustered around TAD boundaries. These data point to key roles of invariant TAD boundaries in constraining as well as mediating cell-type-specific long-range interactions and gene regulation. Copyright © 2016 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  18. Female-Specific Intergenerational Transmission Patterns of the Human Corticolimbic Circuitry

    PubMed Central

    Yamagata, Bun; Murayama, Kou; Black, Jessica M.; Hancock, Roeland; Mimura, Masaru; Yang, Tony T.; Reiss, Allan L.

    2016-01-01

    Parents have large genetic and environmental influences on offspring's cognition, behavior, and brain. These intergenerational effects are observed in mood disorders, with particularly robust association in depression between mothers and daughters. No studies have thus far examined the neural bases of these intergenerational effects in humans. Corticolimbic circuitry is known to be highly relevant in a wide range of processes, including mood regulation and depression. These findings suggest that corticolimbic circuitry may also show matrilineal transmission patterns. Therefore, we examined human parent–offspring association in this neurocircuitry and investigated the degree of association in gray matter volume between parent and offspring. We used voxelwise correlation analysis in a total of 35 healthy families, consisting of parents and their biological offspring. We found positive associations of regional gray matter volume in the corticolimbic circuit, including the amygdala, hippocampus, anterior cingulate cortex, and ventromedial prefrontal cortex between biological mothers and daughters. This association was significantly greater than mother–son, father–daughter, and father–son associations. The current study suggests that the corticolimbic circuitry, which has been implicated in mood regulation, shows a matrilineal-specific transmission patterns. Our preliminary findings are consistent with what has been found behaviorally in depression and may have clinical implications for disorders known to have dysfunction in mood regulation such as depression. Studies such as ours will likely bridge animal work examining gene expression in the brains and clinical symptom-based observations and provide promising ways to investigate intergenerational transmission patterns in the human brain. SIGNIFICANCE STATEMENT Parents have large genetic and environmental influences on the offspring, known as intergenerational effects. Specifically, depression has been shown to exhibit strong matrilineal transmission patterns. Although intergenerational transmission patterns in the human brain are virtually unknown, this would suggest that the corticolimbic circuitry relevant to a wide range of processes including mood regulation may also show matrilineal transmission patterns. Therefore, we examined the degree of association in corticolimbic gray matter volume (GMV) between parent and offspring in 35 healthy families. We found that positive correlations in maternal corticolimbic GMV with daughters were significantly greater than other parent–offspring dyads. Our findings provide new insight into the potential neuroanatomical basis of circuit-based female-specific intergenerational transmission patterns in depression. PMID:26818513

  19. Text-in-context: a method for extracting findings in mixed-methods mixed research synthesis studies.

    PubMed

    Sandelowski, Margarete; Leeman, Jennifer; Knafl, Kathleen; Crandell, Jamie L

    2013-06-01

    Our purpose in this paper is to propose a new method for extracting findings from research reports included in mixed-methods mixed research synthesis studies. International initiatives in the domains of systematic review and evidence synthesis have been focused on broadening the conceptualization of evidence, increased methodological inclusiveness and the production of evidence syntheses that will be accessible to and usable by a wider range of consumers. Initiatives in the general mixed-methods research field have been focused on developing truly integrative approaches to data analysis and interpretation. The data extraction challenges described here were encountered, and the method proposed for addressing these challenges was developed, in the first year of the ongoing (2011-2016) study: Mixed-Methods Synthesis of Research on Childhood Chronic Conditions and Family. To preserve the text-in-context of findings in research reports, we describe a method whereby findings are transformed into portable statements that anchor results to relevant information about sample, source of information, time, comparative reference point, magnitude and significance and study-specific conceptions of phenomena. The data extraction method featured here was developed specifically to accommodate mixed-methods mixed research synthesis studies conducted in nursing and other health sciences, but reviewers might find it useful in other kinds of research synthesis studies. This data extraction method itself constitutes a type of integration to preserve the methodological context of findings when statements are read individually and in comparison to each other. © 2012 Blackwell Publishing Ltd.

  20. Technical assistance for law-enforcement communications: Grant summary

    NASA Technical Reports Server (NTRS)

    Reilly, N. B.

    1979-01-01

    A summary overview of project activities and results are presented. The goals and objectives are reviewed and a description of the approaches used to attain them is given. The feedback received from the seminars conducted as part of the project, and results from a questionnaire about the project are included. Significant findings of the project in such areas as radio channel loading, dispatch system design, training and technology transfer are discussed. Several specific problem areas are identified and evaluated. Specific recommendations for future technical assistance efforts are presented along with an inventory of technical-assistance reports generated throughout the project.

  1. Targeting EGFRvIII for glioblastoma multiforme.

    PubMed

    Yang, Ju; Yan, Jing; Liu, Baorui

    2017-09-10

    Glioblastoma multiforme (GBM) is the most progressive primary brain tumor. Targeting a novel and highly specific tumor antigen is one of the strategies to overcome tumors. EGFR variant III (EGFRvIII) is present in 25%-33% of all patients with GBM and is exclusively expressed on tumor tissue cells. Currently, there are various approaches to target EGFRvIII, including CAR T-cell therapy, therapeutic vaccines, antibodies, and Bi-specific T Cell Engager. In this review, we focus on the preclinical and clinical findings of targeting EGFRvIII for GBM. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Ewing sarcoma: a chronicle of molecular pathogenesis.

    PubMed

    Kim, Sang Kyum; Park, Yong-Koo

    2016-09-01

    Sarcomas have traditionally been classified according to their chromosomal alterations regardless of whether they accompany simple or complex genetic changes. Ewing sarcoma, a classic small round cell bone tumor, is a well-known mesenchymal malignancy that results from simple sarcoma-specific genetic alterations. The genetic alterations are translocations between genes of the TET/FET family (TLS/FUS, EWSR1, and TAF15) and genes of the E26 transformation-specific (ETS) family. In this review, we intend to summarize a chronicle of molecular findings of Ewing sarcoma including recent advances and explain resultant molecular pathogenesis. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Sexual Anxiety and Eroticism Predict the Development of Sexual Problems in Youth With a History of Sexual Abuse

    PubMed Central

    Simon, Valerie A.; Feiring, Candice

    2017-01-01

    Youth with confirmed histories of sexual abuse (N = 118) were followed longitudinally to examine associations between their initial sexual reactions to abuse and subsequent sexual functioning. Participants were interviewed at abuse discovery (ages 8 through 15) and again 1 and 6 years later. Eroticism and sexual anxiety emerged as distinct indices of abuse-specific sexual reactions and predicted subsequent sexual functioning. Eroticism was associated with indicators of heightened sexuality, including more sexual risk behavior and views of sexual intimacy focused on partners’ needs. Sexual anxiety was associated with indicators of diminished sexuality, including few sexual partners and avoidant views of sexual intimacy. Age at abuse discovery moderated some associations, suggesting that the timing of abuse-specific reactions affects trajectories of sexual development. Findings point to the need for a developmental approach to understanding how abuse-specific sexual reactions disrupt sexual development and the need for early interventions promoting healthy sexual development. PMID:18408212

  4. Non-communicable diseases at a regional hospital in Nepal: Findings of a high burden of alcohol-related disease.

    PubMed

    Amundsen, M S; Kirkeby, T M G; Giri, S; Koju, R; Krishna, S S; Ystgaard, B; Solligård, E; Risnes, K

    2016-12-01

    Recent global burden of disease reports find that a major proportion of global deaths and disability worldwide can be attributed to alcohol use. Thus, it may be surprising that very few studies have reported on the burden of alcohol-related disease in low income settings. The evidence of non-communicable disease (NCD) burden in Nepal was recently reviewed and concluded that data is still lacking, particularly to describe the burden of alcohol-related diseases (ARDs). Therefore, here we report on NCD burden and specifically ARDs, in hospitalized patients at a regional hospital in Nepal. We conducted a retrospective chart-review that included detailed information on all discharged patients during a four month period. A local database that included sociodemographic information and diagnoses at discharge was established. All doctor-assigned discharge diagnoses were retrospectively assigned ICD-10 codes. A total of 1,139 hospitalized adult patients were included in the study and one third of these were NCDs (n = 332). The main NCDs were chronic obstructive pulmonary disease (COPD) (n = 148, 45%) and ARDs (n = 57, 17%). Patients with ARD often presented with signs of liver cirrhosis and were typically younger men, with a median age at 43 years, from specific ethnic groups. These data demonstrate that severe alcohol-related organ failure in relatively young men contributed to a high proportion of NCDs in a regional hospital in Nepal. These findings are novel and alarming and warrant further studies that can establish the burden of ARDs and alcohol use in Nepal and other similar low-income countries. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Prospective evaluation of 64 serum autoantibodies as biomarkers for early detection of colorectal cancer in a true screening setting.

    PubMed

    Chen, Hongda; Werner, Simone; Butt, Julia; Zörnig, Inka; Knebel, Phillip; Michel, Angelika; Eichmüller, Stefan B; Jäger, Dirk; Waterboer, Tim; Pawlita, Michael; Brenner, Hermann

    2016-03-29

    Novel blood-based screening tests are strongly desirable for early detection of colorectal cancer (CRC). We aimed to identify and evaluate autoantibodies against tumor-associated antigens as biomarkers for early detection of CRC. 380 clinically identified CRC patients and samples of participants with selected findings from a cohort of screening colonoscopy participants in 2005-2013 (N=6826) were included in this analysis. Sixty-four serum autoantibody markers were measured by multiplex bead-based serological assays. A two-step approach with selection of biomarkers in a training set, and validation of findings in a validation set, the latter exclusively including participants from the screening setting, was applied. Anti-MAGEA4 exhibited the highest sensitivity for detecting early stage CRC and advanced adenoma. Multi-marker combinations substantially increased sensitivity at the price of a moderate loss of specificity. Anti-TP53, anti-IMPDH2, anti-MDM2 and anti-MAGEA4 were consistently included in the best-performing 4-, 5-, and 6-marker combinations. This four-marker panel yielded a sensitivity of 26% (95% CI, 13-45%) for early stage CRC at a specificity of 90% (95% CI, 83-94%) in the validation set. Notably, it also detected 20% (95% CI, 13-29%) of advanced adenomas. Taken together, the identified biomarkers could contribute to the development of a useful multi-marker blood-based test for CRC early detection.

  6. What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings.

    PubMed

    Jellema, Sandra; van Hees, Suzanne; Zajec, Jana; van der Sande, Rob; Nijhuis-van der Sanden, Maria Wg; Steultjens, Esther Mj

    2017-07-01

    Identify the environmental factors that influence stroke-survivors' reengagement in personally valued activities and determine what specific environmental factors are related to specific valued activity types. PubMed, CINAHL and PsycINFO were searched until June 2016 using multiple search-terms for stroke, activities, disability, and home and community environments. An integrated mixed-method systematic review of qualitative, quantitative and mixed-design studies was conducted. Two researchers independently identified relevant studies, assessed their methodological quality and extracted relevant findings. To validly compare and combine the various findings, all findings were classified and grouped by environmental category and level of evidence. The search yielded 4024 records; 69 studies were included. Most findings came from low-evidence-level studies such as single qualitative studies. All findings were consistent in that the following factors facilitated reengagement post-stroke: personal adapted equipment; accessible environments; transport; services; education and information. Barriers were: others' negative attitudes and behaviour; long distances and inconvenient environmental conditions (such as bad weather). Each type of valued activity, such as mobility or work, had its own pattern of environmental influences, social support was a facilitator to all types of activities. Although in many qualitative studies others' attitudes, behaviour and stroke-related knowledge were seen as important for reengagement, these factors were hardly studied quantitatively. A diversity of environmental factors was related to stroke-survivors' reengagement. Most findings came from low-evidence-level studies so that evidence on causal relationships was scarce. In future, more higher-level-evidence studies, for example on the attitudes of significant others, should be conducted.

  7. Review of Prenatal Maternal Mental Health and the Development of Infant Temperament.

    PubMed

    Erickson, Nora L; Gartstein, Maria A; Dotson, Jo Ann Walsh

    To present a systematic review of literature and evaluate effects of prenatal maternal depression and anxiety on the development of infant temperament. A literature search for studies published between January 1981 and January 2017 was undertaken using the electronic databases PsycINFO and PubMed, as well as reference lists from select resources. Search terms included variations on infant temperament, prenatal/pregnancy, depression, mood, and anxiety. Studies were included if researchers measured psychological distress during pregnancy as indicated by maternal depression, anxiety, pregnancy-specific anxiety, or a combination of these factors in relation to the development of infant temperament (i.e., parent report or laboratory observations of temperament from 1 to 12 months). In total, 34 articles met inclusion criteria. Authors, year of publication, country of origin, sample information, methods, timing, and applicable results were summarized and compared across studies. No standardized data analysis was conducted because of methodologic differences across the identified studies. Of the 34 identified studies, 22 included an indicator of depression (11 with significant results), 26 included an indicator of anxiety (14 with significant results), and 9 included an indicator of pregnancy-specific anxiety (7 with significant results). Overall research outcomes were equivocal. Across studies on symptoms of depression and anxiety, findings related to the potential effect on infant temperament were mixed. Nonetheless, support for the role of prenatal psychological factors in the development of infant temperament emerged in a subset of population-based studies, including research to target the effects of pregnancy-specific anxiety. Future research is needed with greater consistency across studies with respect to methods (e.g., timing and assessment tools). Specific recommendations for nurses and providers include more routine screening and psychoeducation for expectant mothers about prenatal symptoms of depression and anxiety and about pregnancy-specific anxiety in particular. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  8. Genome-Wide Association Studies of Metabolites in Patients with CKD Identify Multiple Loci and Illuminate Tubular Transport Mechanisms.

    PubMed

    Li, Yong; Sekula, Peggy; Wuttke, Matthias; Wahrheit, Judith; Hausknecht, Birgit; Schultheiss, Ulla T; Gronwald, Wolfram; Schlosser, Pascal; Tucci, Sara; Ekici, Arif B; Spiekerkoetter, Ute; Kronenberg, Florian; Eckardt, Kai-Uwe; Oefner, Peter J; Köttgen, Anna

    2018-05-01

    Background The kidneys have a central role in the generation, turnover, transport, and excretion of metabolites, and these functions can be altered in CKD. Genetic studies of metabolite concentrations can identify proteins performing these functions. Methods We conducted genome-wide association studies and aggregate rare variant tests of the concentrations of 139 serum metabolites and 41 urine metabolites, as well as their pairwise ratios and fractional excretions in up to 1168 patients with CKD. Results After correction for multiple testing, genome-wide significant associations were detected for 25 serum metabolites, two urine metabolites, and 259 serum and 14 urinary metabolite ratios. These included associations already known from population-based studies. Additional findings included an association for the uremic toxin putrescine and variants upstream of an enzyme catalyzing the oxidative deamination of polyamines ( AOC1 , P -min=2.4×10 -12 ), a relatively high carrier frequency (2%) for rare deleterious missense variants in ACADM that are collectively associated with serum ratios of medium-chain acylcarnitines ( P -burden=6.6×10 -16 ), and associations of a common variant in SLC7A9 with several ratios of lysine to neutral amino acids in urine, including the lysine/glutamine ratio ( P =2.2×10 -23 ). The associations of this SLC7A9 variant with ratios of lysine to specific neutral amino acids were much stronger than the association with lysine concentration alone. This finding is consistent with SLC7A9 functioning as an exchanger of urinary cationic amino acids against specific intracellular neutral amino acids at the apical membrane of proximal tubular cells. Conclusions Metabolomic indices of specific kidney functions in genetic studies may provide insight into human renal physiology. Copyright © 2018 by the American Society of Nephrology.

  9. Mass screening of multiple abdominal solid organs using mobile helical computed tomography scanner--a preliminary report.

    PubMed

    Ishikawa, Susumu; Aoki, Jun; Ohwada, Susumu; Takahashi, Toru; Morishita, Yasuo; Ueda, Keisuke

    2007-04-01

    The possibility of a new screening procedure for multiple abdominal solid organs using a mobile helical computed tomography (CT) scanner was evaluated. A total of 4,543 residents, who were 40 years of age or older, received CT scanning without contrast medium. The mean age of participants was 64 years including 2,022 males and 2,521 females. A total of 2,105 abnormal findings were uniquely detected in 1,594 participants. Liver and kidney diseases including ureter occupied around 30% of total abnormal findings, respectively. Besides frequent cystic or calcified lesions, solid tumours were suspected in 56 lesions, which received further examination by specialized physicians. Five (9%) of them were confirmed as being malignant tumours including pancreatic cancer in two patients, and liver, lung and ovary cancers in one patient each, respectively. All five patients with each malignant lesion received curative operations. Small-sized abdominal aortic aneurysms and heart valve diseases were uniquely found in 22 and two patients, respectively. Qualitative diagnoses of solid tumours were difficult using CT findings without contrast medium. CT screening procedures require further investigation in aspect of the selection of examinees, CT scanning procedure, sensitivity and specificity, and cost-effectiveness.

  10. Regulation of DNA Replication Timing on Human Chromosome by a Cell-Type Specific DNA Binding Protein SATB1

    PubMed Central

    Oda, Masako; Kanoh, Yutaka; Watanabe, Yoshihisa; Masai, Hisao

    2012-01-01

    Background Replication timing of metazoan DNA during S-phase may be determined by many factors including chromosome structures, nuclear positioning, patterns of histone modifications, and transcriptional activity. It may be determined by Mb-domain structures, termed as “replication domains”, and recent findings indicate that replication timing is under developmental and cell type-specific regulation. Methodology/Principal Findings We examined replication timing on the human 5q23/31 3.5-Mb segment in T cells and non-T cells. We used two independent methods to determine replication timing. One is quantification of nascent replicating DNA in cell cycle-fractionated stage-specific S phase populations. The other is FISH analyses of replication foci. Although the locations of early- and late-replicating domains were common between the two cell lines, the timing transition region (TTR) between early and late domains were offset by 200-kb. We show that Special AT-rich sequence Binding protein 1 (SATB1), specifically expressed in T-cells, binds to the early domain immediately adjacent to TTR and delays the replication timing of the TTR. Measurement of the chromosome copy number along the TTR during synchronized S phase suggests that the fork movement may be slowed down by SATB1. Conclusions Our results reveal a novel role of SATB1 in cell type-specific regulation of replication timing along the chromosome. PMID:22879953

  11. Nephron segment specific microRNA biomarkers of pre-clinical drug-induced renal toxicity: Opportunities and challenges

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nassirpour, Rounak, E-mail: Rounak.nassirpour@pfiz

    Drug-induced nephrotoxicity is a common drug development complication for pharmaceutical companies. Sensitive, specific, translatable and non-invasive biomarkers of renal toxicity are urgently needed to diagnose nephron segment specific injury. The currently available gold standard biomarkers for nephrotoxicity are not kidney-specific, lack sensitivity for early detection, and are not suitable for renal damage localization (glomerular vs tubulointerstitial injury). MicroRNAs (miRNAs) are increasingly gaining momentum as promising biomarkers of various organ toxicities, including drug induced renal injury. This is mostly due to their stability in easily accessible biofluids, ease of developing nucleic acids detection compared to protein detection assays, as well asmore » their interspecies translatability. Increasing concordance of miRNA findings by standardizing methodology most suitable for their detection and quantitation, as well as characterization of their expression pattern in a cell type specific manner, will accelerate progress toward validation of these miRNAs as biomarkers in pre-clinical, and clinical settings. This review aims to highlight the current pre-clinical findings surrounding miRNAs as biomarkers in two important segments of the nephron, the glomerulus and tubules. - Highlights: • miRNAs are promising biomarkers of drug-induced kidney injury. • Summarized pre-clinical miRNA biomarkers of drug-induced nephrotoxicity. • Described the strengths and challenges associated with miRNAs as biomarkers.« less

  12. Comparison of the efficacy of three PubMed search filters in finding randomized controlled trials to answer clinical questions.

    PubMed

    Yousefi-Nooraie, Reza; Irani, Shirin; Mortaz-Hedjri, Soroush; Shakiba, Behnam

    2013-10-01

    The aim of this study was to compare the performance of three search methods in the retrieval of relevant clinical trials from PubMed to answer specific clinical questions. Included studies of a sample of 100 Cochrane reviews which recorded in PubMed were considered as the reference standard. The search queries were formulated based on the systematic review titles. Precision, recall and number of retrieved records for limiting the results to clinical trial publication type, and using sensitive and specific clinical queries filters were compared. The number of keywords, presence of specific names of intervention and syndrome in the search keywords were used in a model to predict the recalls and precisions. The Clinical queries-sensitive search strategy retrieved the largest number of records (33) and had the highest recall (41.6%) and lowest precision (4.8%). The presence of specific intervention name was the only significant predictor of all recalls and precisions (P = 0.016). The recall and precision of combination of simple clinical search queries and methodological search filters to find clinical trials in various subjects were considerably low. The limit field strategy yielded in higher precision and fewer retrieved records and approximately similar recall, compared with the clinical queries-sensitive strategy. Presence of specific intervention name in the search keywords increased both recall and precision. © 2010 John Wiley & Sons Ltd.

  13. Ultrasonographic Findings of the Shoulder in Patients with Rheumatoid Arthritis and Comparison with Physical Examination

    PubMed Central

    Kim, Su Ho; Seo, Young-Il

    2007-01-01

    The objectives of this study were: 1) to identify the ultrasonographic (US) abnormalities and 2) to compare the findings of physical examination with US findings in rheumatoid arthritis (RA) patients with shoulder pain. We studied 30 RA patients. Physical examination was performed systemically as follows: 1) area of tenderness; 2) range of passive and active shoulder motion; 3) impingement tests; 4) maneuvers for determining the location of the tendon lesions. US investigations included the biceps, the supraspinatus, infraspinatus, and subscapularis tendons; the subacromial-subdeltoid bursa; and the glenohumeral and acromioclavicular joints. Thirty RA patients with 35 painful and 25 non-painful shoulders were examined. The range of motion affected the most by shoulder pain was abduction. The most frequent US finding of shoulder joint was effusion in the long head of the biceps tendon. Among the rotator cuff tendons, subscapularis was the most frequently involved. Tendon tear was also common among non-painful shoulders. Physical examination used for the diagnosis of shoulder pain had low sensitivity and specificity for detecting abnormalities in the rheumatoid shoulder joint. In conclusion, US abnormalities showed frequent tendon tears in our RA patients. Physical examination had low sensitivity and specificity for detecting rotator cuff tear in the rheumatoid shoulder joint. PMID:17728506

  14. Architecture engineering of supercapacitor electrode materials

    NASA Astrophysics Data System (ADS)

    Chen, Kunfeng; Li, Gong; Xue, Dongfeng

    2016-02-01

    The biggest challenge for today’s supercapacitor systems readily possessing high power density is their low energy density. Their electrode materials with controllable structure, specific surface area, electronic conductivity, and oxidation state, have long been highlighted. Architecture engineering of functional electrode materials toward powerful supercapacitor systems is becoming a big fashion in the community. The construction of ion-accessible tunnel structures can microscopically increase the specific capacitance and materials utilization; stiff 3D structures with high specific surface area can macroscopically assure high specific capacitance. Many exciting findings in electrode materials mainly focus on the construction of ice-folded graphene paper, in situ functionalized graphene, in situ crystallizing colloidal ionic particles and polymorphic metal oxides. This feature paper highlights some recent architecture engineering strategies toward high-energy supercapacitor electrode systems, including electric double-layer capacitance (EDLC) and pseudocapacitance.

  15. Reported masculinity ratio in Pakistan: a triumph of anthropology and economics over biology.

    PubMed

    Krotki, K J

    1985-01-01

    Reported sex ratios in Pakistan for the 1960s and 1970s are examined, and attempts at explaining the findings are presented. Available data, including census- and survey-reported sex ratios, are considered. Attention is given to sex ratios at birth, expected age-specific sex ratios, and implied versus reported sex ratios at death. Conclusions concerning sex differentials in mortality at selected ages are summarized. In a final section, the author considers the relationship of sex ratios to sex roles. Comments by Syeda Abida Hussain are included (pp. 298-303).

  16. A modular telerobotic task execution system

    NASA Technical Reports Server (NTRS)

    Backes, Paul G.; Tso, Kam S.; Hayati, Samad; Lee, Thomas S.

    1990-01-01

    A telerobot task execution system is proposed to provide a general parametrizable task execution capability. The system includes communication with the calling system, e.g., a task planning system, and single- and dual-arm sensor-based task execution with monitoring and reflexing. A specific task is described by specifying the parameters to various available task execution modules including trajectory generation, compliance control, teleoperation, monitoring, and sensor fusion. Reflex action is achieved by finding the corresponding reflex action in a reflex table when an execution event has been detected with a monitor.

  17. Clinical significance of preoperative imaging in oral squamous cell carcinoma compared with lymph node status: a comparative retrospective study.

    PubMed

    Mazzawi, Elias; El-Naaj, Imad Abu; Ghantous, Yasmine; Balan, Salim; Sabo, Edmond; Rachmiel, Adi; Leiser, Yoav

    2018-05-01

    The accuracy and sensitivity of commonly used imaging modalities in evaluating oral cavity cancer was evaluated by comparing the preoperative radiologic findings and the postoperative pathology report. Patients with oral squamous cell carcinoma, who had undergone at least 1 imaging test 2 weeks before surgery were included. Radiologic findings were compared with the dissected neck findings to assess the lymph node status. Sensitivity and specificity of the imaging modalities were calculated by using the χ 2 test. Sensitivities for detecting metastatic neck lymph nodes at a threshold of 1 cm were 48% (P = .02) and 43.8% (P = .3) for computed tomography (CT) and magnetic resonance imaging respectively. Specificities were 76.3% and 70%, respectively. As for the 1.5 cm threshold, sensitivities were 36% (P = .002) and 31.3% (P = .5), respectively, and specificities were 91.5% and 76.7%, respectively. PET-CT was the most sensitive modality in the present study, with a P value of .02. The different studied imaging modalities used for preoperative neck staging are not sensitive enough and would lead to underdiagnoses of a significant proportion of patients. Thus, prophylactic neck dissection for occult neck disease is of extreme importance and remains the gold standard for oral cancer treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Do patient surveys work? The influence of a national survey programme on local quality-improvement initiatives

    PubMed Central

    Reeves, R; Seccombe, I

    2008-01-01

    Objectives: To assess current attitudes towards the national patient survey programme in England, establish the extent to which survey results are used and identify barriers and incentives for using them. Design: Qualitative interviews with hospital staff responsible for implementing the patient surveys (survey leads). Setting: National Health Service (NHS) hospital organisations (trusts) in England. Participants: Twenty-four patient survey leads for NHS trusts. Results: Perceptions of the patient surveys were mainly positive and were reported to be improving. Interviewees welcomed the surveys’ regular repetition and thought the questionnaires, survey methods and reporting of results, particularly inter-organisational benchmark charts, were of a good standard. The survey results were widely used in action planning and were thought to support organisational patient-centredness. There was variation in the extent to which trusts disseminated survey findings to patients, the public, staff and their board members. The most common barrier to using results was difficulty engaging clinicians because survey findings were not sufficiently specific to specialties, departments or wards. Limited statistical expertise and concerns that the surveys only covered a short time frame also contributed to some scepticism. Other perceived barriers included a lack of knowledge of effective interventions, and limited time and resources. Actual and potential incentives for using survey findings included giving the results higher weightings in the performance management system, financial targets, Payment by Results (PbR), Patient Choice, a patient-centred culture, leadership by senior members of the organisation, and boosting staff morale by disseminating positive survey findings. Conclusion: The national patient surveys are viewed positively, their repetition being an important factor in their success. The results could be used more effectively if they were more specific to smaller units. PMID:19064659

  19. Do patient surveys work? The influence of a national survey programme on local quality-improvement initiatives.

    PubMed

    Reeves, R; Seccombe, I

    2008-12-01

    To assess current attitudes towards the national patient survey programme in England, establish the extent to which survey results are used and identify barriers and incentives for using them. Qualitative interviews with hospital staff responsible for implementing the patient surveys (survey leads). National Health Service (NHS) hospital organisations (trusts) in England. Twenty-four patient survey leads for NHS trusts. Perceptions of the patient surveys were mainly positive and were reported to be improving. Interviewees welcomed the surveys' regular repetition and thought the questionnaires, survey methods and reporting of results, particularly inter-organisational benchmark charts, were of a good standard. The survey results were widely used in action planning and were thought to support organisational patient-centredness. There was variation in the extent to which trusts disseminated survey findings to patients, the public, staff and their board members. The most common barrier to using results was difficulty engaging clinicians because survey findings were not sufficiently specific to specialties, departments or wards. Limited statistical expertise and concerns that the surveys only covered a short time frame also contributed to some scepticism. Other perceived barriers included a lack of knowledge of effective interventions, and limited time and resources. Actual and potential incentives for using survey findings included giving the results higher weightings in the performance management system, financial targets, Payment by Results (PbR), Patient Choice, a patient-centred culture, leadership by senior members of the organisation, and boosting staff morale by disseminating positive survey findings. The national patient surveys are viewed positively, their repetition being an important factor in their success. The results could be used more effectively if they were more specific to smaller units.

  20. Improving continuing medical education by enhancing interactivity: lessons from Iran.

    PubMed

    Faghihi, Seyed Aliakbar; Khankeh, Hamid Reza; Hosseini, Seyed Jalil; Soltani Arabshahi, Seyed Kamran; Faghih, Zahra; Parikh, Sagar V; Shirazi, Mandana

    2016-04-01

    Continuing Medical Education (CME) has been considered as a lifelong commitment for doctors to provide the optimal care for patients. Despite a long history of creating CME programs, outcomes are far from ideal. The present qualitative study aims to clarify the barriers affecting effectiveness of the CME programs in Iran based on the experiences of general practitioners. Sixteen general practitioners were recruited to participate in in-depth interviews and field observations concerning experiences with CME. The study was performed using a qualitative content analysis method. The codes, categories and themes were explored through an inductive process in which the researchers moved from specific to general. The participants' experiences identified a number of barriers, particularly insufficient interaction with the instructors; additional problems included the teachers' use of an undifferentiated approach; unreal and abstract CME; and ignorance of the diverse reasons to participate in CME. Based on the study results, there are multiple barriers to effective implementation of CME in Iran. The key barriers include insufficient interaction between the trainees and providers, which must be considered by other stakeholders and program designers. Such interactions would facilitate improved program design, invite more specific tailoring of the education to the participants, allow for more effective educational methods and set the stage for outcome evaluation from the learners actually applying their new knowledge in practice. Replication of these findings with another sample would improve confidence in these recommendations, but these findings are broadly consistent with findings in the educational literature on improving the efficacy of CME.

  1. Where Would You Go for Your Next Hospitalization?

    PubMed Central

    Jung, Kyoungrae; Feldman, Roger; Scanlon, Dennis

    2014-01-01

    We examine the effects of diverse dimensions of hospital quality – including consumers’ perceptions of unobserved attributes – on future hospital choice. We utilize consumers’ stated preference weights to obtain hospital-specific estimates of perceptions about unmeasured attributes such as reputation. We report three findings. First, consumers’ perceptions of reputation and medical services contribute substantially to utility for a hospital choice. Second, consumers tend to select hospitals with high clinical quality scores even before the scores are publicized. However, the effect of clinical quality on hospital choice is relatively small. Third, satisfaction with a prior hospital admission has a large impact on future hospital choice. Our findings suggest that including measures of consumers’ experience in report cards may increase their responsiveness to publicized information, but other strategies are needed to overcome the large effects of consumers’ beliefs about other quality attributes. PMID:21665300

  2. Functional abdominal pain in childhood: background studies and recent research trends.

    PubMed

    Levy, Rona L; van Tilburg, Miranda A L

    2012-01-01

    The present review summarizes many of the major research trends investigated in the past five years regarding pediatric functional abdominal pain, and also summarizes the primary related findings from the authors' research program. Specific areas discussed based on work within the authors' group include familial illness patterns, genetics, traits, and mechanisms or processes related to abdominal pain. Topics covered from research published in the past five years include prevalence and cost, longitudinal follow-up, overlap with other disorders, etiology and mechanisms behind functional abdominal pain and treatment studies. It is hoped that findings from this work in abdominal pain will be interpreted as a framework for understanding the processes by which other pain phenomena and, more broadly, reactions to any physical state, can be developed and maintained in children. The present article concludes with recommendations for clinical practice and research.

  3. Comparison of clinical characteristics and laboratory findings of malaria, dengue, and enteric fever in returning travelers: 8-year experience at a referral center in Tokyo, Japan.

    PubMed

    Kutsuna, Satoshi; Hayakawa, Kayoko; Kato, Yasuyuki; Fujiya, Yoshihiro; Mawatari, Momoko; Takeshita, Nozomi; Kanagawa, Shuzo; Ohmagari, Norio

    2015-04-01

    Without specific symptoms, diagnosis of febrile illness in returning travelers is challenging. Dengue, malaria, and enteric fever are common causes of fever in returning travelers and timely and appropriate treatment is important. However, differentiation is difficult without specific diagnostic tests. A retrospective study was conducted at the National Centre for Global Health and Medicine (NCGM) from April 2005 to March 2013. Febrile travelers returning from overseas who were diagnosed with dengue, malaria, or enteric fever were included in this study. Clinical characteristics and laboratory findings were compared for each diagnosis. During the study period, 86 malaria, 85 dengue, and 31 enteric fever cases were identified. The mean age of the study cohort was 33.1 ± 12 years and 134 (66.3%) study participants were male. Asia was the most common area visited by returning travelers with fevers (89% of dengue, 18.6% of malaria, and 100% of enteric fever cases), followed by Africa (1.2% of dengue and 70.9% of malaria cases). Clinical characteristics and laboratory findings were significantly different among each group with each diagnosis. Decision tree models revealed that returning from Africa and CRP levels <10 mg/L were factors specific for diagnosis of malaria and dengue fever, respectively. Clinical manifestations, simple laboratory test results, and regions of travel are helpful to distinguish between dengue, malaria, and enteric fever in febrile returning travelers with non-specific symptoms. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  4. Epileptogenic zone localization using magnetoencephalography predicts seizure freedom in epilepsy surgery

    PubMed Central

    Englot, Dario J.; Nagarajan, Srikantan S.; Imber, Brandon S.; Raygor, Kunal P.; Honma, Susanne M.; Mizuiri, Danielle; Mantle, Mary; Knowlton, Robert C.; Kirsch, Heidi E.; Chang, Edward F.

    2015-01-01

    Objective The efficacy of epilepsy surgery depends critically upon successful localization of the epileptogenic zone. Magnetoencephalography (MEG) enables non-invasive detection of interictal spike activity in epilepsy, which can then be localized in three dimensions using magnetic source imaging (MSI) techniques. However, the clinical value of MEG in the pre-surgical epilepsy evaluation is not fully understood, as studies to date are limited by either a lack of long-term seizure outcomes or small sample size. Methods We performed a retrospective cohort study of focal epilepsy patients who received MEG for interictal spike mapping followed by surgical resection at our institution. Results We studied 132 surgical patients, with mean post-operative follow-up of 3.6 years (minimum 1 year). Dipole source modelling was successful in 103 (78%) patients, while no interictal spikes were seen in others. Among patients with successful dipole modelling, MEG findings were concordant with and specific to: i) the region of resection in 66% of patients, ii) invasive electrocorticography (ECoG) findings in 67% of individuals, and iii) the MRI abnormality in 74% of cases. MEG showed discordant lateralization in ~5% of cases. After surgery, 70% of all patients achieved seizure-freedom (Engel class I outcome). Whereas 85% of patients with concordant and specific MEG findings became seizure-free, this outcome was achieved by only 37% of individuals with MEG findings that were non-specific or discordant with the region of resection (χ2 = 26.4, p < 0.001). MEG reliability was comparable in patients with or without localized scalp EEG, and overall, localizing MEG findings predicted seizure freedom with an odds ratio of 5.11 (2.23–11.8, 95% CI). Significance MEG is a valuable tool for non-invasive interictal spike mapping in epilepsy surgery, including patients with non-localized findings on long-term EEG monitoring, and localization of the epileptogenic zone using MEG is associated with improved seizure outcomes. PMID:25921215

  5. Carrying the pain of abuse: gender-specific findings on the relationship between childhood physical abuse and obesity in adulthood.

    PubMed

    Fuller-Thomson, Esme; Sinclair, Deborah A; Brennenstuhl, Sarah

    2013-01-01

    Childhood abuse has been associated with negative adult health outcomes, including obesity. This study sought to investigate the association between childhood physical abuse and adult obesity, while controlling for five clusters of potentially confounding factors: childhood stressors, socioeconomic indicators, marital status, health behaviors, and mental health. Representative data from the 2005 Canadian Community Health Survey were selected. The response rate was approximately 84%. Gender-specific logistic regression analyses determined the association between abuse and obesity, while controlling for age and race and five clusters of potentially confounding factors. Of the 12,590 respondents with complete data, 2,787 were obese and 976 reported physical abuse as a child or adolescent by someone close to them. Among women with childhood physical abuse compared to no abuse, the odds of obesity were 35% higher, even when controlling for age, race, and the five clusters of factors (odds ratio (OR) = 1.35; 95% confidence interval (CI) = 1.09, 1.67). Childhood physical abuse was not associated with adult obesity among men (OR = 1.12; 95% CI = 0.82, 1.53). This study provides one of the first population-based, gender-specific analyses of the association between childhood physical abuse and obesity controlling for a wide range of factors. The gender-specific findings require further exploration.

  6. Differences between clinical and laboratory findings in patients with recent diagnosis of SLE according to the positivity of anti-dsDNA by the Crithidia luciliae method.

    PubMed

    Sarbu, M I; Salman-Monte, T C; Rubio Muñoz, P; Lisbona, M P; Almirall Bernabé, M; Carbonell, J

    2015-10-01

    Of all anti-dsDNA antibody detection methods, the Crithidia luciliae immunofluorescence test (CLIF) is considered to have the highest specificity for systemic lupus erythematosus (SLE). The objective of this report is to evaluate whether the presence of anti-dsDNA antibodies detected by the CLIF method is associated with a specific clinical phenotype in recently diagnosed SLE. This retrospective cross-sectional study included all patients with newly diagnosed SLE between 1990 and 2011 and followed up in our institution. Demographic, clinical and laboratory findings were assessed. Correlations between positivity of anti-dsDNA by the CLIF method, clinical and laboratory data were analyzed. A total of 104 patients were included in the analysis. Patients who were positive for anti-dsDNA by the CLIF method at the time of diagnosis had (statistically) significantly higher titers of anti-dsDNA by the ELISA method, antinuclear (ANA) and anticardiolipin antibodies, lymphopenia and complement consumption compared with the other two groups. Also they presented significantly more musculoskeletal symptoms at baseline. The presence of anti-dsDNA by the CLIF method in newly diagnosed SLE was associated with certain markers of increased disease activity. Its use could be a useful biomarker for a specific clinical phenotype suggestive of a more severe involvement at the time of the diagnosis. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  7. A Connectionist Approach to Embodied Conceptual Metaphor

    PubMed Central

    Flusberg, Stephen J.; Thibodeau, Paul H.; Sternberg, Daniel A.; Glick, Jeremy J.

    2010-01-01

    A growing body of data has been gathered in support of the view that the mind is embodied and that cognition is grounded in sensory-motor processes. Some researchers have gone so far as to claim that this paradigm poses a serious challenge to central tenets of cognitive science, including the widely held view that the mind can be analyzed in terms of abstract computational principles. On the other hand, computational approaches to the study of mind have led to the development of specific models that help researchers understand complex cognitive processes at a level of detail that theories of embodied cognition (EC) have sometimes lacked. Here we make the case that connectionist architectures in particular can illuminate many surprising results from the EC literature. These models can learn the statistical structure in their environments, providing an ideal framework for understanding how simple sensory-motor mechanisms could give rise to higher-level cognitive behavior over the course of learning. Crucially, they form overlapping, distributed representations, which have exactly the properties required by many embodied accounts of cognition. We illustrate this idea by extending an existing connectionist model of semantic cognition in order to simulate findings from the embodied conceptual metaphor literature. Specifically, we explore how the abstract domain of time may be structured by concrete experience with space (including experience with culturally specific spatial and linguistic cues). We suggest that both EC researchers and connectionist modelers can benefit from an integrated approach to understanding these models and the empirical findings they seek to explain. PMID:21833256

  8. Functional Requirements for Heparan Sulfate Biosynthesis in Morphogenesis and Nervous System Development in C. elegans.

    PubMed

    Blanchette, Cassandra R; Thackeray, Andrea; Perrat, Paola N; Hekimi, Siegfried; Bénard, Claire Y

    2017-01-01

    The regulation of cell migration is essential to animal development and physiology. Heparan sulfate proteoglycans shape the interactions of morphogens and guidance cues with their respective receptors to elicit appropriate cellular responses. Heparan sulfate proteoglycans consist of a protein core with attached heparan sulfate glycosaminoglycan chains, which are synthesized by glycosyltransferases of the exostosin (EXT) family. Abnormal HS chain synthesis results in pleiotropic consequences, including abnormal development and tumor formation. In humans, mutations in either of the exostosin genes EXT1 and EXT2 lead to osteosarcomas or multiple exostoses. Complete loss of any of the exostosin glycosyltransferases in mouse, fish, flies and worms leads to drastic morphogenetic defects and embryonic lethality. Here we identify and study previously unavailable viable hypomorphic mutations in the two C. elegans exostosin glycosyltransferases genes, rib-1 and rib-2. These partial loss-of-function mutations lead to a severe reduction of HS levels and result in profound but specific developmental defects, including abnormal cell and axonal migrations. We find that the expression pattern of the HS copolymerase is dynamic during embryonic and larval morphogenesis, and is sustained throughout life in specific cell types, consistent with HSPGs playing both developmental and post-developmental roles. Cell-type specific expression of the HS copolymerase shows that HS elongation is required in both the migrating neuron and neighboring cells to coordinate migration guidance. Our findings provide insights into general principles underlying HSPG function in development.

  9. Sex-specific factors for bone density in patients with schizophrenia.

    PubMed

    Lin, Chieh-Hsin; Lin, Chun-Yuan; Huang, Tiao-Lai; Wang, Hong-Song; Chang, Yue-Cune; Lane, Hsien-Yuan

    2015-03-01

    Patients with schizophrenia are susceptible to low bone mineral density (BMD). Many risk factors have been suggested. However, it remains uncertain whether the risk factors differ between men and women. In addition, the study of bone density in men is neglected more often than that in women. This study aims to examine specific risk factors of low BMD in different sexes. Men (n=80) and women (n=115) with schizophrenia, similar in demographic and clinical characteristics, were enrolled in three centers. Clinical and laboratory variables (including blood levels of prolactin, sex and thyroid hormones, cortisol, calcium, and alkaline phosphatase) were collected. BMD was measured using a dual-energy X-ray absorptiometer. Men had lower BMD than women. Predictors for BMD in men included hyperprolactinemia (B=-0.821, P=0.009), body weight (B=0.024, P=0.046), and Global Assessment of Functioning score (B=0.027, P=0.043); in women, BMD was associated with menopause (B=-1.070, P<0.001), body weight (B=0.027, P=0.003), and positive symptoms (B=0.094, P<0.001). In terms of the effect of psychotic symptoms, positive symptoms were related positively to BMD in women, but not in men. The findings suggest that sex-specific risk factors should be considered for an individualized intervention of bone loss in patients with schizophrenia. Physicians should pay particular attention to bone density in men with hyperprolactinemia and postmenopausal women. Further prospective studies in other populations are warranted to confirm these findings.

  10. Pharmacy Information Systems in Teaching Hospitals: A Multi-dimensional Evaluation Study.

    PubMed

    Kazemi, Alireza; Rabiei, Reza; Moghaddasi, Hamid; Deimazar, Ghasem

    2016-07-01

    In hospitals, the pharmacy information system (PIS) is usually a sub-system of the hospital information system (HIS). The PIS supports the distribution and management of drugs, shows drug and medical device inventory, and facilitates preparing needed reports. In this study, pharmacy information systems implemented in general teaching hospitals affiliated to medical universities in Tehran (Iran) were evaluated using a multi-dimensional tool. This was an evaluation study conducted in 2015. To collect data, a checklist was developed by reviewing the relevant literature; this checklist included both general and specific criteria to evaluate pharmacy information systems. The checklist was then validated by medical informatics experts and pharmacists. The sample of the study included five PIS in general-teaching hospitals affiliated to three medical universities in Tehran (Iran). Data were collected using the checklist and through observing the systems. The findings were presented as tables. Five PIS were evaluated in the five general-teaching hospitals that had the highest bed numbers. The findings showed that the evaluated pharmacy information systems lacked some important general and specific criteria. Among the general evaluation criteria, it was found that only two of the PIS studied were capable of restricting repeated attempts made for unauthorized access to the systems. With respect to the specific evaluation criteria, no attention was paid to the patient safety aspect. The PIS studied were mainly designed to support financial tasks; little attention was paid to clinical and patient safety features.

  11. Women's sexual responses to heterosexual and lesbian erotica: the role of stimulus intensity, affective reaction, and sexual history.

    PubMed

    Peterson, Zoë D; Janssen, Erick; Laan, Ellen

    2010-08-01

    Past research has demonstrated that women do not show a "category-specific" genital response to erotic stimuli. That is, on average, heterosexual and lesbian women are indistinguishable in terms of their physiological genital responses to heterosexual versus lesbian erotica. In two studies with heterosexual women (n = 28 for Study 1; n = 30 for Study 2) and lesbians (n = 24 for Study 1; n = 25 for Study 2), results confirmed that, on average, women did not show category-specific genital responses or category-specific subjective sexual arousal. However, there was evidence of notable within-group variability; many women did respond to the stimuli in a category-specific manner. Heterosexual women were more likely than lesbian women to demonstrate category-specificity. Findings also revealed that category-specificity was associated with multiple factors, including affective responses to the erotic stimuli and sexual history. Results of this study highlight the complexity of women's sexual identities and sexual responses.

  12. Office design and health: a systematic review.

    PubMed

    Richardson, Ann; Potter, John; Paterson, Margaret; Harding, Thomas; Tyler-Merrick, Gaye; Kirk, Ray; Reid, Kate; McChesney, Jane

    2017-12-15

    To carry out a systematic review of recent research into the effects of workplace design, comparing individual with shared workspaces, on the health of employees. The research question was "Does workplace design (specifically individual offices compared with shared workspaces) affect the health of workers?" A literature search limited to articles published between 2000 and 2017 was undertaken. A systematic review was carried out, and the findings of the reviewed studies grouped into themes according to the primary outcomes measured in the studies. The literature search identified 15 relevant studies addressing health effects of shared or open-plan offices compared with individual offices. Our systematic review found that, compared with individual offices, shared or open-plan office space is not beneficial to employees' health, with consistent findings of deleterious effects on staff health, wellbeing and productivity. Our findings are also consistent with those of earlier reviews. These findings have public health implications for the New Zealand workforce. Decisions about workplace design should include weighing the short-term financial benefits of open-plan or shared workspaces against the significant harms, including increased sickness absence, lower job satisfaction and productivity, and possible threats to recruitment and retention of staff.

  13. Health websites: accessibility and usability for American sign language users.

    PubMed

    Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

    2015-01-01

    To date, there have been efforts toward creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our article focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users' perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (n = 32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to (a) navigation to find the task, (b) website usability, and (c) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This article also describes the participants' preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users.

  14. Postsecondary study and mental ill-health: a meta-synthesis of qualitative research exploring students' lived experiences.

    PubMed

    Ennals, Priscilla; Fossey, Ellie; Howie, Linsey

    2015-04-01

    The postsecondary educational experiences of students living with mental health issues are not well understood. Existing studies are generally qualitative, small and context-specific in nature, and individually have limited influence on policy and practice. To identify and synthesise the findings of qualitative studies exploring student views of studying while living with mental ill-health. A systematic search of six electronic databases including CINAHL, ERIC, PsycINFO and Medline up to March 2013 was conducted. Findings were extracted from included studies and combined using qualitative meta-synthesis to identify core processes. The search identified 16 studies from five countries, with a total of 231 participants. Meta-synthesis of the findings revealed three common core processes: (1) knowing oneself and managing one's mental illness, (2) negotiating the social space, and (3) doing the academic work required for successful postsecondary participation. Beyond the learning processes that underpin studying, these findings suggest knowing oneself and negotiating social spaces of educational settings are key processes for students living with mental ill-health seeking to survive and thrive in postsecondary education. With increased awareness of these processes, students and policy makers may conceive new ways to optimise student experiences of postsecondary study.

  15. NOTCH3 inactivation increases triple negative breast cancer sensitivity to gefitinib by promoting EGFR tyrosine dephosphorylation and its intracellular arrest.

    PubMed

    Diluvio, Giulia; Del Gaudio, Francesca; Giuli, Maria Valeria; Franciosa, Giulia; Giuliani, Eugenia; Palermo, Rocco; Besharat, Zein Mersini; Pignataro, Maria Gemma; Vacca, Alessandra; d'Amati, Giulia; Maroder, Marella; Talora, Claudio; Capalbo, Carlo; Bellavia, Diana; Checquolo, Saula

    2018-05-25

    Notch dysregulation has been implicated in numerous tumors, including triple-negative breast cancer (TNBC), which is the breast cancer subtype with the worst clinical outcome. However, the importance of individual receptors in TNBC and their specific mechanism of action remain to be elucidated, even if recent findings suggested a specific role of activated-Notch3 in a subset of TNBCs. Epidermal growth factor receptor (EGFR) is overexpressed in TNBCs but the use of anti-EGFR agents (including tyrosine kinase inhibitors, TKIs) has not been approved for the treatment of these patients, as clinical trials have shown disappointing results. Resistance to EGFR blockers is commonly reported. Here we show that Notch3-specific inhibition increases TNBC sensitivity to the TKI-gefitinib in TNBC-resistant cells. Mechanistically, we demonstrate that Notch3 is able to regulate the activated EGFR membrane localization into lipid rafts microdomains, as Notch3 inhibition, such as rafts depletion, induces the EGFR internalization and its intracellular arrest, without involving receptor degradation. Interestingly, these events are associated with the EGFR tyrosine dephosphorylation at Y1173 residue (but not at Y1068) by the protein tyrosine phosphatase H1 (PTPH1), thus suggesting its possible involvement in the observed Notch3-dependent TNBC sensitivity response to gefitinib. Consistent with this notion, a nuclear localization defect of phospho-EGFR is observed after combined blockade of EGFR and Notch3, which results in a decreased TNBC cell survival. Notably, we observed a significant correlation between EGFR and NOTCH3 expression levels by in silico gene expression and immunohistochemical analysis of human TNBC primary samples. Our findings strongly suggest that combined therapies of TKI-gefitinib with Notch3-specific suppression may be exploited as a drug combination advantage in TNBC treatment.

  16. High Energy Astrophysics with the Fermi Large Area Telescope

    NASA Technical Reports Server (NTRS)

    Hays, Elizabeth

    2009-01-01

    This slide presentation reviews some of the findings of the Large Area Telescope (LAT) aboard the Fermi Observatory. It includes information about the LAT, and the Gamma-Ray Burst Monitor (GBM), detection of the quiet sun and the moon in gamma rays, Pulsars observed by the observatory, Globular Star Clusters, Active Galactic Nucleus, and Gamma-Ray Bursts, with specific information about GRB 080916C.

  17. Utilization, Health and Performance of Enlisted Navy Women.

    DTIC Science & Technology

    1978-02-01

    women, the highest rates were evi- denced for abortions, infectious mononucleosis (not included in the table), symptoms referable to the abdomen and...women’s hospitalization rates for specific non- infectious disorders, the highest rates during the past few years were noted for abortions, deliveries...supports other researchers, findings in that younger people have more injuries, accidents, infectious diseases, and adjustment problems than others

  18. Deficiencies in Journal Vouchers that Affected the FY 2009 Air Force General Fund Statement of Budgetary Resources

    DTIC Science & Technology

    2011-12-01

    internal control over financial reporting to: • properly support reconciliations with specific accounting transactions and discontinue forcing...agreement of amounts to meet budgetary financial reporting requirements; • include adequate detailed evidence with journal vouchers so that audit trails...Finding A. Forced Journal Voucher Adjustments Weaken the Reliability of Financial Reporting 5 Reimbursable Activity Adjustments Need Detailed

  19. Personnel Needs and Training for Biomedical and Behavioral Research. The 1985 Report of the Committee on National Needs for Biomedical and Behavioral Research Personnel.

    ERIC Educational Resources Information Center

    Institute of Medicine (NAS), Washington, DC.

    Designed to provide assistance in the assessment of the need for biomedical and behavioral research personnel, this report presents research findings related to specific medical careers. The review includes an examination of the system under which biomedical and behavioral scientists are trained for research careers and the United States…

  20. 25 CFR 900.29 - What is the Secretary required to do if the Secretary decides to decline all or a portion of a...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false What is the Secretary required to do if the Secretary... UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Declination Procedures § 900.29 What is..., including a specific finding that clearly demonstrates that (or that is supported by a controlling legal...

  1. Reserve Compensation System Study

    DTIC Science & Technology

    1978-06-30

    exactly the same manner as active duty CPY. Because Training Pay is based upon the three cash elements, rather than basic pay alone, the exercise ...controversial. • Planned improvements to the Defense Forre Planning Data Base do not include: r.oftware to interface with the per- sonnel...systems for future. Based on its findings of manpower shortfalls, overages and problems in specific areas in both officer and enlisted ranks, the

  2. Revenues and Expenditures for Public Elementary and Secondary Education: School Year 2012-13 (Fiscal Year 2013). First Look. NCES 2015-301

    ERIC Educational Resources Information Center

    Cornman, Stephen Q.

    2016-01-01

    This First Look report introduces new data for national and state-level public elementary and secondary revenues and expenditures for fiscal year 2013 (FY 13). Specifically, this report includes findings from the following types of school finance data: (1) revenue and expenditure totals; (2) revenues by source; (3) expenditures by function and…

  3. Revenues and Expenditures for Public Elementary and Secondary Education: School Year 2011-12 (Fiscal Year 2012). First Look. NCES 2014-301

    ERIC Educational Resources Information Center

    Cornman, Stephen Q.

    2015-01-01

    This First Look report introduces new data for national and state-level public elementary and secondary revenues and expenditures for fiscal year (FY) 2012. Specifically, this report includes findings from the following types of school finance data: (1) Revenue and expenditure totals; (2) Revenues by source; (3) Expenditures by function and…

  4. Access to and use of research by rural nurses.

    PubMed

    Winters, C A; Lee, H J; Besel, J; Strand, A; Echeverri, R; Jorgensen, K P; Dea, J E

    2007-01-01

    The use of relevant research findings to inform clinical practice is important for nurses, regardless of setting. Although there have been studies addressing the use of research among various practitioners, little is known about how nurses in rural areas access health information (specifically research findings), nor how such findings are incorporated into daily practice. The purpose of this study was to explore rural nurses' access, use and perceived usefulness of research for rural practice. The study was conducted in a sparsely populated state located in the western part of the USA. An ethnographic method was chosen to answer the research questions for this descriptive study. Semi-structured interviews were conducted with 29 rural nurses from nine communities by graduate nursing students enrolled in a rural nursing course following in-class instruction and practice. Field notes taken by the students supplemented the interview data. The students' notes included a windshield survey or description of the context and location within which the participants lived and/or practiced as well as the interviewers' observations, thoughts and impressions about the research project. Interviews were audiotaped and transcribed verbatim. Once transcribed, the interview narratives, windshield data and field notes were analyzed by the students for common themes; the students then wrote and submitted papers to the faculty addressing the themes that emerged from their interviews. The analysis conducted by the faculty members included four sources of data: transcriptions of interviews; field notes; windshield data; and students' papers. The process of identifying themes was facilitated by using the software program NUD*IST (QSR International; Melbourne, VIC, Australia). Demographic information was entered into the Statistical Package for Social Scientists (SPSS Inc; Chicago, IL, USA) to compile descriptive information about the sample. Twenty-seven female and two male nurses participated in the study. The nurses' ages ranged from 31-72 years and their experience in nursing spanned 3-50 years with a range of 1 to 35 years in rural nursing. The interviews revealed that most of the nurses used the term 'research' to mean 'gathering information'. When asked how often they used 'research' the responses ranged from 2-3 times per day to 2-3 times per month. The preferred means of obtaining information was asking a colleague. Additional resources included work-place journals, books, in-services, conferences and the internet. Twenty-three of the nurses reported having internet access at work; 25 had internet access at home. Supportive supervisors and articles in general nursing journals were identified as helpful. Barriers to using research included: lack of knowledge of research methods; lack of time at work or at home to look up information; and the lack of computers and internet access on the nursing units. When computers were available, the nurses reported that poor computer literacy decreased their ability to quickly find and evaluate information. Additional barriers included diminishing financial support from employers and the long travel distances required to attend conferences. The nurses reported finding little clinical research specifically related to rural practice. Education and mentorship is needed about how to evaluate the types and strength of evidence, access research using the internet, interpret findings, and incorporate evidence in clinical practice. Interventions that foster the appreciation and use of research by staff nurses and managers are needed in order to build an evidence based culture. Research is needed, specifically as related to rural clinical practice.

  5. Does This Patient Have Infectious Mononucleosis?: The Rational Clinical Examination Systematic Review.

    PubMed

    Ebell, Mark H; Call, Marlene; Shinholser, JoAnna; Gardner, Jack

    2016-04-12

    Early, accurate diagnosis of infectious mononucleosis can help clinicians target treatment, avoid antibiotics, and provide an accurate prognosis. To systematically review the literature regarding the value of the clinical examination and white blood cell count for the diagnosis of mononucleosis. The databases of PubMed (from 1966-2016) and EMBASE (from 1947-2015) were searched and a total of 670 articles and abstracts were reviewed for eligibility. Eleven studies were included that reported data sufficient to calculate sensitivity, specificity, or both for clinical examination findings and white blood cell count parameters compared with a valid reference standard. Data were abstracted from each article by at least 2 reviewers, with discrepancies reconciled by consensus. Clinical findings evaluated in only 1 study are reported with sensitivity, specificity, likelihood ratio (LR), and 95% confidence interval, which were calculated from the available data. Findings evaluated in only 2 studies were summarized with their range, findings evaluated in 3 studies were summarized with a univariate random-effects summary, and findings evaluated in 4 or more studies were summarized with a bivariate random-effects meta-analysis. Sensitivity, specificity, and LRs for the diagnosis of mononucleosis. Mononucleosis is most commonly present among patients aged 5 to 25 years (especially those aged 16-20 years, among whom approximately 1 in 13 patients presenting with sore throat has mononucleosis). The likelihood of mononucleosis is reduced with the absence of any lymphadenopathy (summary sensitivity, 0.91; positive LR range, 0.23-0.44), whereas the likelihood increases with the presence of posterior cervical adenopathy (summary specificity, 0.87; positive LR, 3.1 [95% CI, 1.6-5.9]), inguinal or axillary adenopathy (specificity range, 0.82-0.91; positive LR range, 3.0-3.1), palatine petechiae (specificity, 0.95; positive LR, 5.3 [95% CI, 2.1-13]), and splenomegaly (specificity range, 0.71-0.99; positive LR range, 1.9-6.6). Symptoms are of limited value for the diagnosis of mononucleosis; sore throat and fatigue are sensitive (range, 0.81-0.83) but nonspecific. The presence of atypical lymphocytosis significantly increases the likelihood of mononucleosis (summary LR, 11.4 [95% CI, 2.7-35] for atypical lymphocytes ≥10%, 26 [95% CI, 9.6-68] for those with 20%, and 50 [95% CI, 38-64] for those with 40%). The combination of a patient having greater than 50% lymphocytes and greater than 10% atypical lymphocytes also is useful (specificity, 0.99; positive LR, 54 [95% CI, 8.4-189]). In adolescent and adult patients presenting with sore throat, the presence of posterior cervical, inguinal or axillary adenopathy, palatine petechiae, splenomegaly, or atypical lymphocytosis is associated with an increased likelihood of mononucleosis.

  6. Molecular interactions between chondroitin-dermatan sulfate and growth factors/receptors/matrix proteins.

    PubMed

    Mizumoto, Shuji; Yamada, Shuhei; Sugahara, Kazuyuki

    2015-10-01

    Recent functional studies on chondroitin sulfate-dermatan sulfate (CS-DS) demonstrated its indispensable roles in various biological events including brain development and cancer. CS-DS proteoglycans exert their physiological activity through interactions with specific proteins including growth factors, cell surface receptors, and matrix proteins. The characterization of these interactions is essential for regulating the biological functions of CS-DS proteoglycans. Although amino acid sequences on the bioactive proteins required for these interactions have already been elucidated, the specific saccharide sequences involved in the binding of CS-DS to target proteins have not yet been sufficiently identified. In this review, recent findings are described on the interaction between CS-DS and some proteins which are especially involved in the central nervous system and cancer development/metastasis. Copyright © 2015. Published by Elsevier Ltd.

  7. Type, Content, and Source of Social Support Perceived by Women during Pregnancy: Evidence from Matlab, Bangladesh

    PubMed Central

    Paul, Moni; Sibley, Lynn M.

    2011-01-01

    Specific and contextualized data on social support during distinct health events are needed to improve social support interventions. This study identified the type, content, and source of social support perceived by women during pregnancy. In-depth interviews with 25 women, aged 18-49 years, living in Matlab, Bangladesh, were conducted. The findings demonstrated that women perceived, the receipt of eight distinct types of support. The four most frequently-mentioned types included: practical help with routine activities, information/advice, emotional support and assurance, as well as the provision of resources and material goods. Sources varied by type of support and most frequently included-—mothers, mothers-in-law, sisters-in-law, and husbands. Examples depicting the content of each type of support revealed culturally-specific issues that can inform community-based social support interventions. PMID:21608426

  8. Systematic Evaluation of the Patient-Reported Outcome (PRO) Content of Clinical Trial Protocols

    PubMed Central

    Kyte, Derek; Duffy, Helen; Fletcher, Benjamin; Gheorghe, Adrian; Mercieca-Bebber, Rebecca; King, Madeleine; Draper, Heather; Ives, Jonathan; Brundage, Michael; Blazeby, Jane; Calvert, Melanie

    2014-01-01

    Background Qualitative evidence suggests patient-reported outcome (PRO) information is frequently absent from clinical trial protocols, potentially leading to inconsistent PRO data collection and risking bias. Direct evidence regarding PRO trial protocol content is lacking. The aim of this study was to systematically evaluate the PRO-specific content of UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme trial protocols. Methods and Findings We conducted an electronic search of the NIHR HTA programme database (inception to August 2013) for protocols describing a randomised controlled trial including a primary/secondary PRO. Two investigators independently reviewed the content of each protocol, using a specially constructed PRO-specific protocol checklist, alongside the ‘Standard Protocol Items: Recommendations for Interventional Trials’ (SPIRIT) checklist. Disagreements were resolved through discussion with a third investigator. 75 trial protocols were included in the analysis. Protocols included a mean of 32/51 (63%) SPIRIT recommendations (range 16–41, SD 5.62) and 11/33 (33%) PRO-specific items (range 4–18, SD 3.56). Over half (61%) of the PRO items were incomplete. Protocols containing a primary PRO included slightly more PRO checklist items (mean 14/33 (43%)). PRO protocol content was not associated with general protocol completeness; thus, protocols judged as relatively ‘complete’ using SPIRIT were still likely to have omitted a large proportion of PRO checklist items. Conclusions The PRO components of HTA clinical trial protocols require improvement. Information on the PRO rationale/hypothesis, data collection methods, training and management was often absent. This low compliance is unsurprising; evidence shows existing PRO guidance for protocol developers remains difficult to access and lacks consistency. Study findings suggest there are a number of PRO protocol checklist items that are not fully addressed by the current SPIRIT statement. We therefore advocate the development of consensus-based supplementary guidelines, aimed at improving the completeness and quality of PRO content in clinical trial protocols. PMID:25333349

  9. Guidelines for reporting methodological challenges and evaluating potential bias in dementia research

    PubMed Central

    Weuve, Jennifer; Proust-Lima, Cécile; Power, Melinda C.; Gross, Alden L.; Hofer, Scott M.; Thiébaut, Rodolphe; Chêne, Geneviève; Glymour, M. Maria; Dufouil, Carole

    2015-01-01

    Clinical and population research on dementia and related neurologic conditions, including Alzheimer’s disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on “best practices.” We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) high-dimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research. PMID:26397878

  10. Maintaining an outward image: a Korean immigrant's life with type 2 diabetes mellitus and hypertension.

    PubMed

    Pistulka, Gina M; Winch, Peter J; Park, Hyunjeong; Han, Hae-Ra; Kim, Miyong T

    2012-06-01

    Type 2 diabetes mellitus (DM) and hypertension (HTN) disproportionately affect minority populations in the United States, including Korean American immigrants (KAI). We conducted qualitative interviews with middle-aged KAI in Maryland living with DM and HTN to examine the illness experience to inform future intervention strategies. Study results show that participants utilized strategies to maintain respect and Korean identity, including an image of being healthy and in control of their behavior in the public arena. These strategies included the lack of disclosure of their illness, even to family members, and avoiding outside assistance when engaging in problem solving. Maintaining an outward image of health was a common goal that affected the self-care of KAI in this study, a finding that might prove significant in the management of other chronic illnesses affecting this population. The study findings demonstrate the importance of in-depth understanding of specific populations when treating chronic illness, and caretakers' sensitivity to each population's unique cultural issues regarding identity, image, and disclosure.

  11. The association between socioeconomic factors and breast cancer-specific survival varies by race.

    PubMed

    Agarwal, Shailesh; Ying, Jian; Boucher, Kenneth M; Agarwal, Jayant P

    2017-01-01

    Although racial disparity is well described for oncologic outcomes, factors associated with survival within racial groups remains unexplored. The objective of this study is to determine whether breast cancer survival among White or Black patients is associated with differing patient factors. Women diagnosed with breast cancer from 1998 through 2012 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Cox proportional hazard logistic regression was used to estimate cause-specific survival in the combined cohort, and separate cohorts of Black or White patients only. Main outcomes included cause-specific survival in cohorts of Black only, White only, or all patients adjusted for demographic and oncologic factors. A total of 406,907 Black (10.8%) or White (89.2%) patients diagnosed with breast cancer from 1998 through 2012 were isolated. Cancer-specific survival analysis of the combined cohort showed significantly decreased hazard ratio (H.R.) in patients from the higher economic quartiles (Q1: 1.0 (ref), Q2: 0.95 (p<0.01), Q3: 0.94 (p<0.01), Q4: 0.87 (p<0.001)). Analysis of the White only cohort showed a similar relationship with income (Q1: 1.0 (ref), Q2: 0.95 (p<0.01), Q3: 0.95 (p<0.01), Q4: 0.86 (p<0.001)). However, analysis of the Black only cohort did not show a relationship with income (Q1: 1.0 (ref), Q2: 1.04 (p = 0.34), Q3: 0.97 (p = 0.53), Q4: 1.04 (p = 0.47)). A test of interaction confirmed that the association between income and cancer-specific survival is dependent on patient race, both with and without adjustment for demographic and oncologic characteristics (p<0.01). While median county income is positively associated with cancer-specific survival among White patients, this is not the case with Black patients. Similar findings were noted for education level. These findings suggest that the association between socioeconomic status and breast cancer survival commonly reported in the literature is specific to White patients. These findings provide insight into differences between White and Black patients in cancer-specific survival.

  12. Ultrasound imaging in an experimental model of fatty liver disease and cirrhosis in rats

    PubMed Central

    2010-01-01

    Background Domestic dogs and cats are very well known to develop chronic hepatic diseases, including hepatic lipidosis and cirrhosis. Ultrasonographic examination is extensively used to detect them. However, there are still few reports on the use of the ultrasound B-mode scan in correlation with histological findings to evaluate diffuse hepatic changes in rodents, which represent the most important animal group used in experimental models of liver diseases. The purpose of this study was to determine the reliability of ultrasound findings in the assessment of fatty liver disease and cirrhosis when compared to histological results in Wistar rats by following up a murine model of chronic hepatic disease. Results Forty Wistar rats (30 treated, 10 controls) were included. Liver injury was induced by dual exposure to CCl4 and ethanol for 4, 8 and 15 weeks. Liver echogenicity, its correlation to the right renal cortex echogenicity, measurement of portal vein diameter (PVD) and the presence of ascites were evaluated and compared to histological findings of hepatic steatosis and cirrhosis. Liver echogenicity correlated to hepatic steatosis when it was greater or equal to the right renal cortex echogenicity, with a sensitivity of 90%, specificity of 100%, positive and negative predictive values of 100% and 76.9% respectively, and accuracy of 92.5%. Findings of heterogeneous liver echogenicity and irregular surface correlated to liver cirrhosis with a sensitivity of 70.6%, specificity of 100%, positive and negative predictive values of 100% and 82.1% respectively, and accuracy of 87.5%. PVD was significantly increased in both steatotic and cirrhotic rats; however, the later had greater diameters. PVD cut-off point separating steatosis from cirrhosis was 2.1 mm (sensitivity of 100% and specificity of 90.5%). One third of cirrhotic rats presented with ascites. Conclusion The use of ultrasound imaging in the follow-up of murine diffuse liver disease models is feasible and efficient, especially when the studied parameters are used in combination. The potential implication of this study is to provide a non-invasive method that allows follow-up studies of fatty liver disease and cirrhosis of individual rats for pre-clinical drug or cell based therapies. PMID:20113491

  13. Electronic fitness function for screening semiconductors as thermoelectric materials

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Xing, Guangzong; Sun, Jifeng; Li, Yuwei

    Here, we introduce a simple but efficient electronic fitness function (EFF) that describes the electronic aspect of the thermoelectric performance. This EFF finds materials that overcome the inverse relationship between σ and S based on the complexity of the electronic structures regardless of specific origin (e.g., isosurface corrugation, valley degeneracy, heavy-light bands mixture, valley anisotropy or reduced dimensionality). This function is well suited for application in high throughput screening. We applied this function to 75 different thermoelectric and potential thermoelectric materials including full- and half-Heuslers, binary semiconductors, and Zintl phases. We find an efficient screening using this transport function. Themore » EFF identifies known high-performance p- and n-type Zintl phases and half-Heuslers. In addition, we find some previously unstudied phases with superior EFF.« less

  14. Measurement and associations of pregnancy risk factors with genetic influences, postnatal environmental influences, and toddler behavior

    PubMed Central

    Marceau, Kristine; Hajal, Nastassia; Leve, Leslie D.; Reiss, David; Shaw, Daniel S.; Ganiban, Jody M.; Mayes, Linda C.; Neiderhiser, Jenae M.

    2014-01-01

    This study demonstrates the unique contributions of perinatal risk and genetic and environmental influences on child behavior using data from 561 domestic US adoption triads (birth mothers, adopted child, and adoptive parents). Findings show distinct patterns of associations among genetic (birth mother psychopathology), prenatal (six maternal reported aggregate scores characterizing total obstetric complications, perinatal internalizing symptoms, pregnancy complications, exposure to toxins, substance use, and neonatal complications), and postnatal influences (adoptive parent 18-month internalizing symptoms and over-reactive parenting) and toddler behavior problems (CBCL subscales at 27 months). Findings highlight multiple pathways for toddler’s behavioral development, including genetic, pregnancy, and postnatal main effects. Findings suggest distinct types of pregnancy risk may transmit genetic influences for specific behavior problems rather than broadband problems. PMID:24839336

  15. Electronic fitness function for screening semiconductors as thermoelectric materials

    DOE PAGES

    Xing, Guangzong; Sun, Jifeng; Li, Yuwei; ...

    2017-11-17

    Here, we introduce a simple but efficient electronic fitness function (EFF) that describes the electronic aspect of the thermoelectric performance. This EFF finds materials that overcome the inverse relationship between σ and S based on the complexity of the electronic structures regardless of specific origin (e.g., isosurface corrugation, valley degeneracy, heavy-light bands mixture, valley anisotropy or reduced dimensionality). This function is well suited for application in high throughput screening. We applied this function to 75 different thermoelectric and potential thermoelectric materials including full- and half-Heuslers, binary semiconductors, and Zintl phases. We find an efficient screening using this transport function. Themore » EFF identifies known high-performance p- and n-type Zintl phases and half-Heuslers. In addition, we find some previously unstudied phases with superior EFF.« less

  16. Contributions of GABA to alcohol responsivity during adolescence: Insights from preclinical and clinical studies

    PubMed Central

    Silveri, Marisa M.

    2015-01-01

    There is a considerable body of literature demonstrating that adolescence is a unique age period, which includes rapid and dramatic maturation of behavioral, cognitive, hormonal and neurobiological systems. Most notably, adolescence is also a period of unique responsiveness to alcohol effects, with both hyposensitivity and hypersensitivity observed to the various effects of alcohol. Multiple neurotransmitter systems are undergoing fine-tuning during this critical period of brain development, including those that contribute to the rewarding effects of drugs of abuse. The role of developmental maturation of the γ-amino-butyric acid (GABA) system, however, has received less attention in contributing to age-specific alcohol sensitivities. This review integrates GABA findings from human magnetic resonance spectroscopy studies as they may translate to understanding adolescent-specific responsiveness to alcohol effects. Better understanding of the vulnerability of the GABA system both during adolescent development, and in psychiatric conditions that include alcohol dependence, could point to a putative mechanism, boosting brain GABA, that may have increased effectiveness for treating alcohol abuse disorders. PMID:24631274

  17. Tanning and beauty: Mother and teenage daughters in discussion.

    PubMed

    Hay, Jennifer L; Geller, Alan C; Schoenhammer, Maria; Gordon, Mallorie; Bishop, Marilyn; Shuk, Elyse; Oliveria, Susan; Halpern, Allan C

    2016-07-01

    Tanning increases dramatically through the teenage years, but the family context of this health risk behavior is relatively unstudied. We conducted videotaped conversations between teenage girls (10th and 11th grade) and their mothers. We developed a coding system for discussion content and highlight findings including inadequate knowledge concerning the harms of tanning and positive views of outdoor tanning over indoor tanning, yet agreement that all tans are attractive. Many teens believed that indoor tanning is sometimes necessary to achieve the tanned look. These findings can usefully guide intervention development regarding the harms of all tanning, rather than indoor or outdoor tanning specifically. © The Author(s) 2014.

  18. Tanning and beauty: Mother and teenage daughters in discussion

    PubMed Central

    Hay, Jennifer L.; Geller, Alan C.; Schoenhammer, Maria; Gordon, Mallorie; Bishop, Marilyn; Shuk, Elyse; Oliveria, Susan; Halpern, Allan C.

    2017-01-01

    Tanning increases dramatically through the teenage years, but the family context of this health risk behavior is relatively unstudied. We conducted videotaped conversations between teenage girls (10th and 11th grade) and their mothers. We developed a coding system for discussion content, and highlight findings including inadequate knowledge concerning the harms of tanning, positive views of outdoor tanning over indoor tanning, yet agreement that all tans are attractive. Many teens believed that indoor tanning is sometimes necessary to achieve the tanned look. These findings can usefully guide intervention development regarding the harms of all tanning, rather than indoor or outdoor tanning specifically. PMID:25318997

  19. Complex Decision-Making in Heart Failure: A Systematic Review and Thematic Analysis.

    PubMed

    Hamel, Aimee V; Gaugler, Joseph E; Porta, Carolyn M; Hadidi, Niloufar Niakosari

    Heart failure follows a highly variable and difficult course. Patients face complex decisions, including treatment with implantable cardiac defibrillators, mechanical circulatory support, and heart transplantation. The course of decision-making across multiple treatments is unclear yet integral to providing informed and shared decision-making. Recognizing commonalities across treatment decisions could help nurses and physicians to identify opportunities to introduce discussions and support shared decision-making. The specific aims of this review are to examine complex treatment decision-making, specifically implantable cardiac defibrillators, ventricular assist device, and cardiac transplantation, and to recognize commonalities and key points in the decisional process. MEDLINE, CINAHL, PsycINFO, and Web of Science were searched for English-language studies that included qualitative findings reflecting the complexity of heart failure decision-making. Using a 3-step process, findings were synthesized into themes and subthemes. Twelve articles met criteria for inclusion. Participants included patients, caregivers, and clinicians and included decisions to undergo and decline treatment. Emergent themes were "processing the decision," "timing and prognostication," and "considering the future." Subthemes described how participants received and understood information about the therapy, making and changing a treatment decision, timing their decision and gauging health status outcomes in the context of their decision, the influence of a life or death decision, and the future as a factor in their decisional process. Commonalities were present across therapies, which involved the timing of discussions, the delivery of information, and considerations of the future. Exploring this further could help support patient-centered care and optimize shared decision-making interventions.

  20. Fundamental constructs in food parenting practices: a content map to guide future research

    PubMed Central

    Ward, Dianne S.; Fisher, Jennifer O.; Faith, Myles S.; Hughes, Sheryl O.; Kremers, Stef P.J.; Musher-Eizenman, Dara R.; O’Connor, Teresia M.; Patrick, Heather; Power, Thomas G.

    2016-01-01

    Although research shows that “food parenting practices” can impact children’s diet and eating habits, current understanding of the impact of specific practices has been limited by inconsistencies in terminology and definitions. This article represents a critical appraisal of food parenting practices, including clear terminology and definitions, by a working group of content experts. The result of this effort was the development of a content map for future research that presents 3 overarching, higher-order food parenting constructs – coercive control, structure, and autonomy support – as well as specific practice subconstructs. Coercive control includes restriction, pressure to eat, threats and bribes, and using food to control negative emotions. Structure includes rules and limits, limited/guided choices, monitoring, meal- and snacktime routines, modeling, food availability and accessibility, food preparation, and unstructured practices. Autonomy support includes nutrition education, child involvement, encouragement, praise, reasoning, and negotiation. Literature on each construct is reviewed, and directions for future research are offered. Clear terminology and definitions should facilitate cross-study comparisons and minimize conflicting findings resulting from previous discrepancies in construct operationalization. PMID:26724487

  1. Blastogenetic associations: General considerations.

    PubMed

    Lubinsky, Mark

    2015-11-01

    Associations of anomalies, with VACTERL as the prototype, have been the source of much debate, including questions about the validity and definition of this category. Evidence is presented for a teratologic basis for associations involving interactions between disruptive events and specific vulnerabilities. Because the embryo is organized in time and space, differences in the timing, location, and severity of exposures will create variable sequelae for any specific vulnerability, creating associations. The blastogenetic stage of development involves distinct properties that affect the nature of associations arising during this time, including relatively undifferentiated developmental fields and causally nonspecific malformations. With this, single anomalies can be part of the spectrum of findings that comprise a specific association. A specific defect defines a subset of disturbances, biasing frequencies of other defects. Processes are basic, integrated, and general, so disruptions are often lethal, and can have multiple effects, accounting for high incidences of multiple anomalies, and overlaps between associations. Blastogenetic disturbances also do not affect the late "fine tuning" of minor anomalies, although pathogenetic sequences can occur. This model suggests that certain combinations of congenital anomalies can arise from causally nonspecific teratogenetic fields determined by timing, location, and vulnerabilities, rather than polytopic developmental fields. © 2015 Wiley Periodicals, Inc.

  2. [Pathological features of myositis with myositis -specific autoantibodies].

    PubMed

    Shimizu, Jun; Mimori, Tsuneyo

    2014-01-01

    Myositis is a heterogeneous group of systemic autoimmune disorders characterized by inflammation of skeletal muscle. Historically, myositis has been defined using clinical features including muscle weakness, skin disease, internal organ involvement, and an association with cancer in adults. From a clinicopathologic approach, myositis has been classified into pathologically distinct subsets, polymyositis, dermatomyositis(DM), necrotizing autoimmune myositis, amyopathic DM, and non-specific myositis. Although the characteristic pathological changes are believed to be important in pathological mechanisms of each subset of myositis, in clinical practices, the percentages of the patients with typical pathological findings are usually not high. On the other hand, with the recent discovery of new myositis-specific autoantibodies (MSAs), it has been revealed that around 60% of patients with IIMs have been shown to have a anti-myositis-specific autoantibody, including anti-synthetase, anti-Mi-2, anti-MDA5, anti-TIF1 and anti-SRP antibodies. Because of striking association between unique MSAs and distinct clinical phenotypes, these antibodies are thought to be important not only for classifications of IIMs, but also as factors involved in the mechanism underlying their pathogenesis. This review reports recent progress in understanding of pathological features of myositis with MSAs.

  3. Phase 111A Crew Interface Specifications Development for Inflight Maintenance and Stowage Functions

    NASA Technical Reports Server (NTRS)

    Carl, John G.

    1973-01-01

    This report presents the findings and data products developed during the Phase IIIA Crew Interface Specification Study for Inflight Maintenance and Stowage Functions, performed by General Electric for the NASA, Johnson Space Center with a set of documentation that can be used as definitive guidelines to improve the present process of defining, controlling and managing flight crew interface requirements that are related to inflight maintenance (including assembly and servicing) and stowage functions. During the Phase IIIA contract period, the following data products were developed: 1) Projected NASA Crew Procedures/Flight Data File Development Process. 2) Inflight Maintenance Management Process Description. 3) Preliminary Draft, General Specification, Inflight Maintenance Management Requirements. 4) Inflight Maintenance Operational Process Description. 5) Preliminary Draft, General Specification, Inflight Maintenance Task and Support Requirements Analysis. 6) Suggested IFM Data Processing Reports for Logistics Management The above Inflight Maintenance data products have been developed during the Phase IIIA study after review of Space Shuttle Program Documentation, including the Level II Integrated Logistics Requirements and other DOD and NASA data relative to Payloads Accommodations and Satellite On-Orbit Servicing. These Inflight Maintenance data products were developed to be in consonance with Space Shuttle Program technical and management requirements.

  4. Will Neuroimaging Reveal a Severe Intracranial Injury in This Adult With Minor Head Trauma?: The Rational Clinical Examination Systematic Review.

    PubMed

    Easter, Joshua S; Haukoos, Jason S; Meehan, William P; Novack, Victor; Edlow, Jonathan A

    Adults with apparently minor head trauma (Glasgow Coma Scale [GCS] scores ≥13 who appear well on examination) may have severe intracranial injuries requiring prompt intervention. Findings from clinical examination can aid in determining which adults with minor trauma have severe intracranial injuries visible on computed tomography (CT). To assess systematically the accuracy of symptoms and signs in adults with minor head trauma in order to identify those with severe intracranial injuries. We performed a systematic search of MEDLINE (1966-2015) and the Cochrane Library to identify studies assessing the diagnosis of intracranial injuries. Studies were included that measured the performance of findings for identifying intracranial injury with a reference standard of neuroimaging or follow-up evaluation. Fourteen studies (range, 431-7955 patients) met inclusion criteria with patients having GCS scores between 13 and 15 and 50% or more older than 18 years. Three authors independently performed critical appraisal and data extraction. The prevalence of severe intracranial injury (requiring prompt intervention) among the 23,079 patients with minor head trauma was 7.1% (95% CI, 6.8%-7.4%) and the prevalence of injuries leading to death or requiring neurosurgical intervention was 0.9% (95% CI, 0.78%-1.0%). The presence of physical examination findings suggestive of skull fracture (likelihood ratio [LR], 16; 95% CI, 3.1-59; specificity, 99%), GCS score of 13 (LR, 4.9; 95% CI, 2.8-8.5; specificity, 97%), 2 or more vomiting episodes (LR, 3.6; 95% CI, 3.1-4.1; specificity, 92%), any decline in GCS score (LR range, 3.4-16; specificity range, 91%-99%;), and pedestrians struck by motor vehicles (LR range, 3.0-4.3; specificity range, 96%-97%) were associated with severe intracranial injury on CT. Among patients with apparent minor head trauma, the absence of any of the features of the Canadian CT Head Rule (≥65 years; ≥2 vomiting episodes, amnesia >30 minutes, pedestrian struck, ejected from vehicle, fall >1 m, suspected skull fracture, or GCS score <15 at 2 hours) had an LR of 0.04 (95% CI, 0-0.65), lowering the probability of severe injury to 0.31% (95% CI, 0%-4.7%). The absence of all the New Orleans Criteria findings (>60 years, intoxication, headache, vomiting, amnesia, seizure, or trauma above the clavicle) had an LR of 0.08 (95% CI, 0.01-0.84), lowering the probability of severe intracranial injury to 0.61% (95% CI, 0.08%-6.0%). Combinations of history and physical examination features in clinical decision rules can identify patients with minor head trauma at low risk of severe intracranial injuries. Certain findings, including signs of skull fracture, GCS score of 13, 2 or more vomiting episodes, decrease in GCS score, and pedestrians struck by motor vehicles, may help identify patients at increased risk of severe intracranial injuries.

  5. Cognitive and Neural Correlates of Mathematical Giftedness in Adults and Children: A Review

    PubMed Central

    Myers, Timothy; Carey, Emma; Szűcs, Dénes

    2017-01-01

    Most mathematical cognition research has focused on understanding normal adult function and child development as well as mildly and moderately impaired mathematical skill, often labeled developmental dyscalculia and/or mathematical learning disability. In contrast, much less research is available on cognitive and neural correlates of gifted/excellent mathematical knowledge in adults and children. In order to facilitate further inquiry into this area, here we review 40 available studies, which examine the cognitive and neural basis of gifted mathematics. Studies associated a large number of cognitive factors with gifted mathematics, with spatial processing and working memory being the most frequently identified contributors. However, the current literature suffers from low statistical power, which most probably contributes to variability across findings. Other major shortcomings include failing to establish domain and stimulus specificity of findings, suggesting causation without sufficient evidence and the frequent use of invalid backward inference in neuro-imaging studies. Future studies must increase statistical power and neuro-imaging studies must rely on supporting behavioral data when interpreting findings. Studies should investigate the factors shown to correlate with math giftedness in a more specific manner and determine exactly how individual factors may contribute to gifted math ability. PMID:29118725

  6. Text-in-Context: A Method for Extracting Findings in Mixed-Methods Mixed Research Synthesis Studies

    PubMed Central

    Leeman, Jennifer; Knafl, Kathleen; Crandell, Jamie L.

    2012-01-01

    Aim Our purpose in this paper is to propose a new method for extracting findings from research reports included in mixed-methods mixed research synthesis studies. Background International initiatives in the domains of systematic review and evidence synthesis have been focused on broadening the conceptualization of evidence, increased methodological inclusiveness and the production of evidence syntheses that will be accessible to and usable by a wider range of consumers. Initiatives in the general mixed-methods research field have been focused on developing truly integrative approaches to data analysis and interpretation. Data source The data extraction challenges described here were encountered and the method proposed for addressing these challenges was developed, in the first year of the ongoing (2011–2016) study: Mixed-Methods Synthesis of Research on Childhood Chronic Conditions and Family. Discussion To preserve the text-in-context of findings in research reports, we describe a method whereby findings are transformed into portable statements that anchor results to relevant information about sample, source of information, time, comparative reference point, magnitude and significance and study-specific conceptions of phenomena. Implications for nursing The data extraction method featured here was developed specifically to accommodate mixed-methods mixed research synthesis studies conducted in nursing and other health sciences, but reviewers might find it useful in other kinds of research synthesis studies. Conclusion This data extraction method itself constitutes a type of integration to preserve the methodological context of findings when statements are read individually and in comparison to each other. PMID:22924808

  7. Point-of-Care Ultrasonography Findings and Care Use Among Patients Undergoing Ultrasound-Guided Shoulder Injections.

    PubMed

    Lee, Se Won; Tiu, Timothy; Roberts, Jeremy; Lee, Brian; Bartels, Matthew N; Oh-Park, Mooyeon

    2018-01-01

    The aims of the study were to assess the overall reduction of pain in patients undergoing ultrasound-guided shoulder injections and to characterize the preinjection point-of-care ultrasound findings and use of clinical services postinjection including the use of magnetic resonance imaging and surgeries. Data of 172 patients who underwent ultrasound-guided subacromial subdeltoid injection or glenohumeral joint injection were reviewed for preinjection point-of-care ultrasound findings, change in pain intensity at 2 mos from baseline, and use of care at 6 mos' postinjection. Pain intensity was measured by the numeric rating scale and a dichotomous report of global impression of significant improvement in pain. Responders were defined as those with 50% or more reduction in numeric rating scale or those with global impression of 50% or more improvement. There were 141 responders among the 172 patients analyzed. Full-thickness rotator cuff tears were higher in the ultrasound-guided subacromial subdeltoid injection group when compared with the glenohumeral joint injection group (P = 0.038) and abnormal bicipital tendon findings higher in the glenohumeral joint injection group (P = 0.016). There were no significant differences in specific abnormal U findings between responders versus nonresponders. Twelve patients had a shoulder magnetic resonance imaging and four patients underwent operative interventions after the injection. Overall pain reduction after ultrasound-guided shoulder injections was favorable in the short term. There was no specific preinjection point-of-care ultrasound findings associated with clinical pain reduction after injection. Additional imaging and operative intervention after ultrasound-guided shoulder injections seemed to be relatively low.

  8. Hypnotic Approaches for Chronic Pain Management

    PubMed Central

    Jensen, Mark P.; Patterson, David R.

    2015-01-01

    The empirical support for hypnosis for chronic pain management has flourished over the past two decades. Clinical trials show that hypnosis is effective for reducing chronic pain, although outcomes vary between individuals. The findings from these clinical trials also show that hypnotic treatments have a number of positive effects beyond pain control. Neurophysiological studies reveal that hypnotic analgesia has clear effects on brain and spinal-cord functioning that differ as a function of the specific hypnotic suggestions made, providing further evidence for the specific effects of hypnosis. The research results have important implications for how clinicians can help their clients experience maximum benefits from hypnosis and treatments that include hypnotic components. PMID:24547802

  9. Use of Pathogen-Specific Antibody Biomarkers to Estimate Waterborne Infections in Population-Based Settings

    PubMed Central

    Exum, Natalie G.; Pisanic, Nora; Granger, Douglas A.; Schwab, Kellogg J.; Detrick, Barbara; Kosek, Margaret; Egorov, Andrey I.; Griffin, Shannon M.; Heaney, Christopher D.

    2016-01-01

    Purpose of review This review discusses the utility of pathogen-specific antibody biomarkers for improving estimates of the population burden of waterborne infections, assessing the fraction of infections that can be prevented by specific water treatments, and understanding transmission routes and the natural history and ecology of disease in different populations (including asymptomatic infection rates). Recent findings We review recent literature on the application of pathogen-specific antibody response data to estimate incidence and prevalence of acute infections and their utility to assess the contributions of waterborne transmission pathways. Advantages and technical challenges associated with the use of serum versus minimally invasive salivary antibody biomarkers in cross-sectional and prospective surveys are discussed. Summary We highlight recent advances and challenges and outline future directions for research, development, and application of antibody-based and other immunological biomarkers of waterborne infections. PMID:27352014

  10. Eye tracking indices of attentional bias in children of depressed mothers: Polygenic influences help to clarify previous mixed findings.

    PubMed

    Owens, Max; Harrison, Ashley J; Burkhouse, Katie L; McGeary, John E; Knopik, Valerie S; Palmer, Rohan H C; Gibb, Brandon E

    2016-05-01

    Information-processing biases may contribute to the intergenerational transmission of depression. There is growing evidence that children of depressed mothers exhibit attentional biases for sad faces. However, findings are mixed as to whether this bias reflects preferential attention toward, versus attentional avoidance of, sad faces, suggesting the presence of unmeasured moderators. To address these mixed findings, we focused on the potential moderating role of genes associated with hypothalamic-pituitary-adrenal axis reactivity. Participants included children (8-14 years old) of mothers with (n = 81) and without (n = 81) a history of depression. Eye movements were recorded while children passively viewed arrays of angry, happy, sad, and neutral faces. DNA was obtained from buccal cells. Children of depressed mothers exhibited more sustained attention to sad faces than did children of nondepressed mothers. However, it is important that this relation was moderated by children's genotype. Specifically, children of depressed mothers who carried reactive genotypes across the corticotropin-releasing hormone type 1 receptor (CHRH1) TAT haplotype and FK506 binding protein 5 (FKBP5) rs1360780 (but not the solute carrier family C6 member 4 [SLC6A4] of the serotonin transporter linked polymorphic region [5-HTTLPR]) exhibited less sustained attention to sad faces and more sustained attention to happy faces. These findings highlight the role played by specific genetic influences and suggest that previous mixed findings may have been due to genetic heterogeneity across the samples.

  11. 25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards for law enforcement functions in Indian country? BIA will ensure... 25 Indians 1 2013-04-01 2013-04-01 false Where can I find specific policies and standards for law...

  12. 25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards for law enforcement functions in Indian country? BIA will ensure... 25 Indians 1 2012-04-01 2011-04-01 true Where can I find specific policies and standards for law...

  13. 25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards for law enforcement functions in Indian country? BIA will ensure... 25 Indians 1 2011-04-01 2011-04-01 false Where can I find specific policies and standards for law...

  14. 25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards for law enforcement functions in Indian country? BIA will ensure... 25 Indians 1 2014-04-01 2014-04-01 false Where can I find specific policies and standards for law...

  15. Induction of specific micro RNA (miRNA) species by ROS-generating metal sulfates in primary human brain cells

    PubMed Central

    Lukiw, Walter J.; Pogue, Aileen I.

    2007-01-01

    Iron- and aluminum-sulfate together, at nanomolar concentrations, trigger the production of reactive oxygen species (ROS) in cultures of human brain cells. Previous studies have shown that following ROS induction, a family of pathogenic brain genes that promote inflammatory signalling, cellular apoptosis and brain cell death is significantly over-expressed. Notably, iron- and aluminum-sulfate induce genes in cultured human brain cells that exhibit expression patterns similar to those observed to be up-regulated in moderate- to late-stage Alzheimer's disease (AD). In this study we have extended our investigations to analyze the expression of micro RNA (miRNA) populations in iron- and aluminum-sulfate treated human neural cells in primary culture. The main finding was that these ROS-generating neurotoxic metal sulfates also up-regulate a specific set of miRNAs that includes miR-9, miR-125b and miR-128. Notably, these same miRNAs are up-regulated in AD brain. These findings further support the idea that iron- and aluminum-sulfates induce genotoxicity via a ROS-mediated up-regulation of specific regulatory elements and pathogenic genes that redirect brain cell fate towards progressive dysfunction and apoptotic cell death. PMID:17629564

  16. On the composition of the preimmune repertoire of T cells specific for Peptide-major histocompatibility complex ligands.

    PubMed

    Jenkins, Marc K; Chu, H Hamlet; McLachlan, James B; Moon, James J

    2010-01-01

    Millions of T cells are produced in the thymus, each expressing a unique alpha/beta T cell receptor (TCR) capable of binding to a foreign peptide in the binding groove of a host major histocompatibility complex (MHC) molecule. T cell-mediated immunity to infection is due to the proliferation and differentiation of rare clones in the preimmune repertoire that by chance express TCRs specific for peptide-MHC (pMHC) ligands derived from the microorganism. Here we review recent findings that have altered our understanding of how the preimmune repertoire is established. Recent structural studies indicate that a germline-encoded tendency of TCRs to bind MHC molecules contributes to the MHC bias of T cell repertoires. It has also become clear that the preimmune repertoire contains functionally heterogeneous subsets including recent thymic emigrants, mature naive phenotype cells, memory phenotype cells, and natural regulatory T cells. In addition, sensitive new detection methods have revealed that the repertoire of naive phenotype T cells consists of distinct pMHC-specific populations that consistently vary in size in different individuals. The implications of these new findings for the clonal selection theory, self-tolerance, and immunodominance are discussed.

  17. Enzyme localization, crowding, and buffers collectively modulate diffusion-influenced signal transduction: Insights from continuum diffusion modeling

    PubMed Central

    Kekenes-Huskey, Peter M.; Eun, Changsun; McCammon, J. A.

    2015-01-01

    Biochemical reaction networks consisting of coupled enzymes connect substrate signaling events with biological function. Substrates involved in these reactions can be strongly influenced by diffusion “barriers” arising from impenetrable cellular structures and macromolecules, as well as interactions with biomolecules, especially within crowded environments. For diffusion-influenced reactions, the spatial organization of diffusion barriers arising from intracellular structures, non-specific crowders, and specific-binders (buffers) strongly controls the temporal and spatial reaction kinetics. In this study, we use two prototypical biochemical reactions, a Goodwin oscillator, and a reaction with a periodic source/sink term to examine how a diffusion barrier that partitions substrates controls reaction behavior. Namely, we examine how conditions representative of a densely packed cytosol, including reduced accessible volume fraction, non-specific interactions, and buffers, impede diffusion over nanometer length-scales. We find that diffusion barriers can modulate the frequencies and amplitudes of coupled diffusion-influenced reaction networks, as well as give rise to “compartments” of decoupled reactant populations. These effects appear to be intensified in the presence of buffers localized to the diffusion barrier. These findings have strong implications for the role of the cellular environment in tuning the dynamics of signaling pathways. PMID:26342355

  18. General and victim-specific empathy: associations with actuarial risk, treatment outcome, and sexual recidivism.

    PubMed

    Brown, Sarah; Harkins, Leigh; Beech, Anthony R

    2012-10-01

    An empathy-related component has been included in most sex offender treatment programs since the 1980s; however, research linking empathy to sexual offending and/or to treatment outcome has produced mixed findings. This study examined the relationship between victim specific empathy, general empathy, and overall treatment change (determined by responses on a battery of psychometric tests) with static risk (Risk Matrix 2000 [RM 2000]) and sexual offense reconviction data in a sample of 105 offenders who completed treatment while in prison or in the community in England and Wales and followed up for an average period of more than 10 years. Victim-specific empathy improved from pretreatment to posttreatment and related to overall treatment change. A small group of offenders, whose victim empathy scores deteriorated from pretreatment to posttreatment, had higher rates of sexual recidivism compared with the rest of the sample. In contrast, neither were any reliable pretreatment to posttreatment changes noted on general empathy scores, except for an indication on the Interpersonal Reactivity Index Personal Distress Scale, nor was any relationship found to sexual recidivism. The implications of these findings are discussed in relation to treatment goals and sexual recidivism.

  19. Macroeconomic effects on mortality revealed by panel analysis with nonlinear trends.

    PubMed

    Ionides, Edward L; Wang, Zhen; Tapia Granados, José A

    2013-10-03

    Many investigations have used panel methods to study the relationships between fluctuations in economic activity and mortality. A broad consensus has emerged on the overall procyclical nature of mortality: perhaps counter-intuitively, mortality typically rises above its trend during expansions. This consensus has been tarnished by inconsistent reports on the specific age groups and mortality causes involved. We show that these inconsistencies result, in part, from the trend specifications used in previous panel models. Standard econometric panel analysis involves fitting regression models using ordinary least squares, employing standard errors which are robust to temporal autocorrelation. The model specifications include a fixed effect, and possibly a linear trend, for each time series in the panel. We propose alternative methodology based on nonlinear detrending. Applying our methodology on data for the 50 US states from 1980 to 2006, we obtain more precise and consistent results than previous studies. We find procyclical mortality in all age groups. We find clear procyclical mortality due to respiratory disease and traffic injuries. Predominantly procyclical cardiovascular disease mortality and countercyclical suicide are subject to substantial state-to-state variation. Neither cancer nor homicide have significant macroeconomic association.

  20. Macroeconomic effects on mortality revealed by panel analysis with nonlinear trends

    PubMed Central

    Ionides, Edward L.; Wang, Zhen; Tapia Granados, José A.

    2013-01-01

    Many investigations have used panel methods to study the relationships between fluctuations in economic activity and mortality. A broad consensus has emerged on the overall procyclical nature of mortality: perhaps counter-intuitively, mortality typically rises above its trend during expansions. This consensus has been tarnished by inconsistent reports on the specific age groups and mortality causes involved. We show that these inconsistencies result, in part, from the trend specifications used in previous panel models. Standard econometric panel analysis involves fitting regression models using ordinary least squares, employing standard errors which are robust to temporal autocorrelation. The model specifications include a fixed effect, and possibly a linear trend, for each time series in the panel. We propose alternative methodology based on nonlinear detrending. Applying our methodology on data for the 50 US states from 1980 to 2006, we obtain more precise and consistent results than previous studies. We find procyclical mortality in all age groups. We find clear procyclical mortality due to respiratory disease and traffic injuries. Predominantly procyclical cardiovascular disease mortality and countercyclical suicide are subject to substantial state-to-state variation. Neither cancer nor homicide have significant macroeconomic association. PMID:24587843

  1. Fatal columbid herpesvirus-1 infections in three species of Australian birds of prey.

    PubMed

    Phalen, D N; Holz, P; Rasmussen, L; Bayley, C

    2011-05-01

    We document columbid herpesvirus-1 (CoHV-1) infection in two barking owls (Ninox connivens), a powerful owl (Ninox strenua) and an Australian hobby (Falco longipennis). Antemortem signs of infection were non-specific and the birds either died soon after they were identified as ill or were found dead unexpectedly. Gross postmortem findings were also not specific. Microscopically, marked to massive splenic and hepatic necrosis with the presence of eosinophilic inclusion bodies in remaining splenocytes and hepatocytes was found in all birds. Herpesvirus virions were identified in liver sections from one of the boobook owls by electron microscopy. Using CoHV-1-specific primers and polymerase chain reaction, CoHV-1 DNA was amplified from tissue samples from all birds. A comparison of these sequences to previously reported sequences of CoHV-1 found them to be identical or to vary by a single base pair. These findings increase the number of known species of birds of prey that are susceptible to CoHV-1 infection and indicate that rock pigeons (Columbia livia) should not be included in the diet of captive Australian birds of prey. © 2011 The Authors. Australian Veterinary Journal © 2011 Australian Veterinary Association.

  2. Mammalian-specific genomic functions: Newly acquired traits generated by genomic imprinting and LTR retrotransposon-derived genes in mammals

    PubMed Central

    KANEKO-ISHINO, Tomoko; ISHINO, Fumitoshi

    2015-01-01

    Mammals, including human beings, have evolved a unique viviparous reproductive system and a highly developed central nervous system. How did these unique characteristics emerge in mammalian evolution, and what kinds of changes did occur in the mammalian genomes as evolution proceeded? A key conceptual term in approaching these issues is “mammalian-specific genomic functions”, a concept covering both mammalian-specific epigenetics and genetics. Genomic imprinting and LTR retrotransposon-derived genes are reviewed as the representative, mammalian-specific genomic functions that are essential not only for the current mammalian developmental system, but also mammalian evolution itself. First, the essential roles of genomic imprinting in mammalian development, especially related to viviparous reproduction via placental function, as well as the emergence of genomic imprinting in mammalian evolution, are discussed. Second, we introduce the novel concept of “mammalian-specific traits generated by mammalian-specific genes from LTR retrotransposons”, based on the finding that LTR retrotransposons served as a critical driving force in the mammalian evolution via generating mammalian-specific genes. PMID:26666304

  3. Mammalian-specific genomic functions: Newly acquired traits generated by genomic imprinting and LTR retrotransposon-derived genes in mammals.

    PubMed

    Kaneko-Ishino, Tomoko; Ishino, Fumitoshi

    2015-01-01

    Mammals, including human beings, have evolved a unique viviparous reproductive system and a highly developed central nervous system. How did these unique characteristics emerge in mammalian evolution, and what kinds of changes did occur in the mammalian genomes as evolution proceeded? A key conceptual term in approaching these issues is "mammalian-specific genomic functions", a concept covering both mammalian-specific epigenetics and genetics. Genomic imprinting and LTR retrotransposon-derived genes are reviewed as the representative, mammalian-specific genomic functions that are essential not only for the current mammalian developmental system, but also mammalian evolution itself. First, the essential roles of genomic imprinting in mammalian development, especially related to viviparous reproduction via placental function, as well as the emergence of genomic imprinting in mammalian evolution, are discussed. Second, we introduce the novel concept of "mammalian-specific traits generated by mammalian-specific genes from LTR retrotransposons", based on the finding that LTR retrotransposons served as a critical driving force in the mammalian evolution via generating mammalian-specific genes.

  4. Dissecting Arabidopsis Gβ Signal Transduction on the Protein Surface1[W][OA

    PubMed Central

    Jiang, Kun; Frick-Cheng, Arwen; Trusov, Yuri; Delgado-Cerezo, Magdalena; Rosenthal, David M.; Lorek, Justine; Panstruga, Ralph; Booker, Fitzgerald L.; Botella, José Ramón; Molina, Antonio; Ort, Donald R.; Jones, Alan M.

    2012-01-01

    The heterotrimeric G-protein complex provides signal amplification and target specificity. The Arabidopsis (Arabidopsis thaliana) Gβ-subunit of this complex (AGB1) interacts with and modulates the activity of target cytoplasmic proteins. This specificity resides in the structure of the interface between AGB1 and its targets. Important surface residues of AGB1, which were deduced from a comparative evolutionary approach, were mutated to dissect AGB1-dependent physiological functions. Analysis of the capacity of these mutants to complement well-established phenotypes of Gβ-null mutants revealed AGB1 residues critical for specific AGB1-mediated biological processes, including growth architecture, pathogen resistance, stomata-mediated leaf-air gas exchange, and possibly photosynthesis. These findings provide promising new avenues to direct the finely tuned engineering of crop yield and traits. PMID:22570469

  5. The placebo effect and homeopathy.

    PubMed

    Teixeira, Marcus Z; Guedes, Cristina H F F; Barreto, Patrícia V; Martins, Mílton A

    2010-04-01

    Like other forms of medicine, including Complementary and Alternative Medicine (CAM), homeopathy elicits expectations in patients. The physician-patient relationship, personal and comprehensive treatment and lack of adverse effects are elements in creating positive expectations. Other elements may be associated with negative expectations. We conducted a systematic literature review on placebo and nocebo effects in acupuncture and homeopathy using Medline. Findings on the psychophysiological and neuromediating mechanisms of the placebo-nocebo phenomenon are reviewed. Studies of these effects reveal how expectations and unconscious conditioning can be measured by imaging and EEG methods. They result in significant, non-specific therapeutic effects, which may confuse the evaluation of the specific therapeutic effects treatment, hampering selection of the simillimum. Directions for future research on non-specific therapeutic effects of homeopathy to improve clinical practice and clinical research are discussed.

  6. Contrast enema findings in patients presenting with poor functional outcome after primary repair for Hirschsprung disease.

    PubMed

    Garrett, Kevin M; Levitt, Marc A; Peña, Alberto; Kraus, Steven J

    2012-09-01

    The radiologic evaluation of Hirschsprung disease is well described in the literature. However, there is a paucity of literature describing the appearance of the neo-rectum and colon after repair, specifically describing findings in patients with poor functional outcome, which would suggest the need for reoperation. We describe findings on contrast enema and correlate them with surgical findings at reoperation in children with poor functional outcome after primary repair for Hirschsprung disease who suffer from bowel dysfunction that can manifest with either soiling or obstructive symptoms such as enterocolitis. Children were identified from our colorectal surgery database. At the time of abstract submission, 35 children had contrast enemas prior to reoperation. Additional children continue to present for evaluation. The majority of children included in the study had their primary repair performed elsewhere. The initial procedures included: Duhamel (n = 11), Soave (n = 20) or Swenson (n = 3). One child had undergone a primary Soave repair and subsequently had a Swenson-type reoperation but continued to have a poor outcome. One child's initial surgical repair could not be determined. Images were reviewed by a staff pediatric radiologist and a pediatric radiology fellow. Findings encountered on contrast enema in these children include a distal narrowed segment due to stricture or aganglionic/transitional zone segment (8), dilated/hypomotile distal segment (7), thickened presacral space due to compressing Soave cuff (11), dilated Duhamel pouch (8), active enterocolitis (3) and partially obstructing twist of the pull-through segment (1). Multiple anatomical and pathological complications exist that can lead to bowel dysfunction in children after repair of Hirschsprung disease. Little recent literature exists regarding the radiographic findings in children. We had the opportunity to review a substantial series of these children, describe the contrast enema findings in these difficult cases and correlate them with operative findings. Radiologic evaluation is key to assessing such patients; it defines the potential anatomical problem with the pull-through and facilitates surgical planning.

  7. The influence of occupation on wellbeing, as experienced by the elderly: a systematic review.

    PubMed

    Jessen-Winge, Christina; Petersen, Mille Nyboe; Morville, Anne-Le

    2018-05-01

    The objective of this review was to synthesize knowledge regarding which types of occupations the elderly perceive as important to and supporting their overall wellbeing. Being active is an important part of managing the daily challenges of advanced old age. Occupational therapy and occupational science are based on the premise that a person's occupations are intertwined with their health and are thus needed for them to experience a meaningful life and improve their wellbeing. This review, which included independently living elderly people aged 65 and over living in Europe, the USA, Canada and Australia, sought to uncover if the elderly see any specific types of occupations as enhancing their wellbeing. This review included qualitative studies with designs including, but not limited to, phenomenology, grounded theory, ethnography and action research. A three-step search strategy using Joanna Briggs Institute methodology was utilized. Both published and unpublished studies were searched. The following databases were searched for studies up to 2017: CINAHL, Nursing and Allied Health Source, Web of Science, PubMed and OpenGrey. Using the JBI Critical Appraisal Checklist for Qualitative Research, two independent reviewers assessed whether each study had the methodological quality required to be included in the review. Any disagreements were resolved through discussion with a third reviewer. The standardized JBI data extraction tool for interpretive and critical research was used to extract data from the included studies. JBI tools were used to pool the qualitative research findings. The findings were then aggregated through a process of rating according to quality, and categorized according to similarity in meaning, which generated a set of statements for each category. These categories were then subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings useful as a basis for evidence-based practice. All three of the included studies utilized qualitative interviews and followed a phenomenological approach. The studies included only participants aged 85 and over. Thirty-five findings were extracted and grouped into four categories, which were synthesized into two meta-syntheses: 1) The importance of "doing" alone - to feel good, I have to be the master of my own life; and 2) Old habits never die - a structured day is a good day. Based on the dependability and credibility of the three studies, the ranking was high (see Summary of Findings). The present review shows that two factors enhance elderly people's wellbeing: first, variation and independence in undertaking activities; second, having a choice between the occupations and a structure of activities that make up daily life. The two factors are influenced by a balance between having activities alone and with others. This review is not intended to identify specific occupations that enhance elderly people's wellbeing, but rather to indicate which types of occupations enhance the wellbeing of the elderly, and provide value and meaning to their daily lives.Both the dependability and the credibility of the studies have been rated as moderate.

  8. Antidepressants and Youth: Healing or Harmful?

    PubMed Central

    Markowitz, Sara; Cuellar, Alison

    2007-01-01

    A series of drug innovations that began in 1987, including the introduction of several Selective Serotonin Reuptake Inhibitors (SSRIs) has led to a tremendous growth in the use of antidepressants in the United States. This growth, however, has been accompanied by a growing concern about the risks of prescribing antidepressants, particularly to children. Indeed, research linking the use of antidepressant drugs to an increased risk of suicidal behaviors in youth motivated the U.S. Food and Drug Administration to direct antidepressant drug manufacturers to include warning labels about the potential dangers. This paper examines the relationship between antidepressants and suicide among youth in the USA. Using state-level data on youth suicides and age-specific prescriptions for antidepressants, we find no relationships between suicides for adolescents ages 15 to 19 and prescriptions for Selective Serotonin Reuptake Inhibitors/Serotonin-Norepinephrine Reuptake Inhibitors or tricyclic and tetracyclic antidepressants. In contrast, we find that newer generation antidepressants are associated with lower numbers of suicides for this age group. For younger children, ages 10 to 14 we find no relationship with suicides for any type of antidepressant. PMID:17374550

  9. Identifying people with type 2 diabetes and those at risk: lessons from the measure your waist (MY-WAIST) mixed-methods study in UK primary care.

    PubMed

    Aujla, Navneet; Stone, Margaret A; Taub, Nicholas; Davies, Melanie J; Khunti, Kamlesh

    2013-12-01

    This paper focuses mainly on explanations and lessons from a research-based programme for identifying undiagnosed type 2 diabetes and high risk. In addition to outlining key quantitative findings, we specifically aim to explore reasons for low uptake from the perspective of primary care staff involved. The MY-WAIST study was conducted in UK primary care and included the use of oral glucose tolerance tests (OGTTs) and waist measurement. Qualitative data from interviews with healthcare providers and records of meetings were analysed thematically. The key quantitative finding was low uptake of the assessments offered (8.6% overall, 2.6% in inner-city locations with high South Asian residency). In addition to confirming patient-reported barriers including those associated with OGTTs, qualitative findings highlighted a number of primary care provider barriers, including limited staff capacity. Interviewees suggested that those who attended were typically the 'worried well' rather than those from hard-to-reach groups. Implications discussed include the impact of low uptake on the usefulness of the quantitative data obtained, and lessons relevant to research design. Relevance to current guidance regarding early identification strategies is discussed and the importance of addressing the needs of less accessible groups is highlighted. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  10. Case Report: Congenital Erythroleukemia in a Premature Infant with Dysmorphic Features.

    PubMed

    Helin, Heidi; van der Walt, Jon; Holder, Muriel; George, Simi

    2016-01-01

    We present a case of pure erythroleukemia, diagnosed at autopsy, in a dysmorphic premature infant who died of multiorgan failure within 24 hours of birth. Dysmorphic features included facial and limb abnormalities with long philtrum, microagnathia, downturned mouth, short neck as well as abnormal and missing nails, missing distal phalanx from the second toe, and overlapping toes. Internal findings included gross hepatomegaly and patchy hemorrhages in the liver, splenomegaly, and cardiomegaly; and subdural, intracerebral, and intraventricular hemorrhages. Histology revealed infiltration of bone marrow, kidney, heart, liver, adrenal, lung, spleen, pancreas, thyroid, testis, thymus, and placenta by pure erythroleukemia. Only 6 cases of congenital erythroleukemia have been previously reported with autopsy findings similar to those of this case. The dysmorphic features, although not fitting any specific syndrome, make this case unique. Congenital erythroleukemia and possible syndromes suggested by the dysmorphic features are discussed.

  11. Aviation noise effects

    NASA Astrophysics Data System (ADS)

    Newman, J. S.; Beattie, K. R.

    1985-03-01

    This report summarizes the effects of aviation noise in many areas, ranging from human annoyance to impact on real estate values. It also synthesizes the findings of literature on several topics. Included in the literature were many original studies carried out under FAA and other Federal funding over the past two decades. Efforts have been made to present the critical findings and conclusions of pertinent research, providing, when possible, a bottom line conclusion, criterion or perspective. Issues related to aviation noise are highlighted, and current policy is presented. Specific topic addressed include: annoyance; Hearing and hearing loss; noise metrics; human response to noise; speech interference; sleep interference; non-auditory health effects of noise; effects of noise on wild and domesticated animals; low frequency acoustical energy; impulsive noise; time of day weightings; noise contours; land use compatibility; and real estate values. This document is designed for a variety of users, from the individual completely unfamiliar with aviation noise to experts in the field.

  12. Wine, women, suspiciousness and advertising.

    PubMed

    Kohn, P M; Smart, R G

    1987-03-01

    Women college students (N = 66) viewed videotapes of a soap opera episode and a rock music program, ostensibly to evaluate the appeal of such material to college women. Different versions of the videotape included zero, three or nine wine commercials. Refreshments, including white wine, were available to the subjects. Suspiciousness about the experiment was evaluated through an open-ended questionnaire, responses to which were independently content-analyzed by two scorers. Major findings were as follows: Women exposed to nine wine commercials consumed more wine than those exposed to three. Twelve women were judged suspicious about the experiment, but none showed continued specific awareness of the study's true purpose. The differential consumption patterns of women in the three-wine-commercial and nine-wine-commercial conditions were exaggerated among suspicious women. These findings, in light of previous observations, suggest opposite reactions to soft-sell versus hard-sell persuasive appeals by men and women, notably ones predisposed to be suspicious about the purpose of experiments.

  13. Health care professionals implementing a smoke-free policy at inpatient psychiatric units.

    PubMed

    Grant, Lyle G; Oliffe, John L; Johnson, Joy L; Bottorff, Joan L

    2014-12-01

    Smoke-free grounds policies (SFGPs) were introduced to inpatient psychiatric hospital settings to improve health among patients, staff, and visitors. We conducted an ethnographic study in Northern British Columbia, Canada, to describe how the implementation of SFGPs is affected by institutional cultures. Data reported here included participant observation, document review, informal discussions (n = 11), and interviews with health care professionals (HCPs; n = 19) and staff (n = 2) at two hospitals. We used iterative and inductive processes to derive thematic findings. Findings related to HCPs illustrate how local contexts and cultural factors affect SFGP implementation. These factors included individual beliefs and attitudes, the influence of group norms, leadership and consensus building, and locale-specific norms. Strong, consultative leadership, in which leaders solicited input from and long-term support of people most directly responsible for policy implementation, was key to success. © The Author(s) 2014.

  14. Trans-acting epigenetic effects of chromosomal aneuploidies: lessons from Down syndrome and mouse models

    PubMed Central

    Do, Catherine; Xing, Zhuo; Yu, Y Eugene; Tycko, Benjamin

    2017-01-01

    An important line of postgenomic research seeks to understand how genetic factors can influence epigenetic patterning. Here we review epigenetic effects of chromosomal aneuploidies, focusing on findings in Down syndrome (DS, trisomy 21). Recent work in human DS and mouse models has shown that the extra chromosome 21 acts in trans to produce epigenetic changes, including differential CpG methylation (DS-DM), in specific sets of downstream target genes, mostly on other chromosomes. Mechanistic hypotheses emerging from these data include roles of chromosome 21-linked methylation pathway genes (DNMT3L and others) and transcription factor genes (RUNX1, OLIG2, GABPA, ERG and ETS2) in shaping the patterns of DS-DM. The findings may have broader implications for trans-acting epigenetic effects of chromosomal and subchromosomal aneuploidies in other human developmental and neuropsychiatric disorders, and in cancers. PMID:27911079

  15. Primary Lateral Sclerosis

    PubMed Central

    Statland, Jeffrey M.; Barohn, Richard J.; Dimachkie, Mazen M.; Floeter, Mary Kay; Mitsumoto, Hiroshi

    2015-01-01

    Synopsis Primary lateral sclerosis (PLS) is characterized by insidious onset of progressive upper motor neuron dysfunction in the absence of clinical signs of lower motor neuron involvement. Patients experience stiffness, decreased balance and coordination, and mild weakness, and if the bulbar region is affected, difficulty speaking and swallowing, and emotional lability. The diagnosis is made based on clinical history, typical exam findings, and diagnostic testing negative for other causes of upper motor neuron dysfunction. EMG is normal, or only shows mild neurogenic findings in a few muscles, not meeting El Escorial criteria. Although no test is specific for PLS, some neurodiagnostic tests are supportive: including absent or delayed central motor conduction times; and changes in the precentral gyrus or corticospinal tracts on MRI, DTI or MR Spectroscopy. Treatment is largely supportive, and includes medications for spasticity, baclofen pump, and treatment for pseudobulbar affect. The prognosis in PLS is more benign than ALS, making this a useful diagnostic category. PMID:26515619

  16. Physics of Cell Adhesion Failure and Human Diseases

    NASA Astrophysics Data System (ADS)

    Family, Fereydoon

    Emergent phenomena in living systems, including your ability to read these lines, do not obviously follow as a consequence of the fundamental laws of physics. Understanding the physics of living systems clearly falls outside the conventional boundaries of scientific disciplines and requires a collaborative, multidisciplinary approach. Here I will discuss how theoretical and computational techniques from statistical physics can be used to make progress in explaining the physical mechanisms that underlie complex biological phenomena, including major diseases. In the specific cases of macular degeneration and cancer that we have studied recently, we find that the breakdown of the mechanical stability in the local tissue structure caused by weakening of the cell-cell adhesion plays a key role in the initiation and progression of the disease. This finding can help in the development of new therapies that would prevent or halt the initiation and progression of these diseases.

  17. Functional abdominal pain in childhood: Background studies and recent research trends

    PubMed Central

    Levy, Rona L; van Tilburg, Miranda AL

    2012-01-01

    The present review summarizes many of the major research trends investigated in the past five years regarding pediatric functional abdominal pain, and also summarizes the primary related findings from the authors’ research program. Specific areas discussed based on work within the authors’ group include familial illness patterns, genetics, traits, and mechanisms or processes related to abdominal pain. Topics covered from research published in the past five years include prevalence and cost, longitudinal follow-up, overlap with other disorders, etiology and mechanisms behind functional abdominal pain and treatment studies. It is hoped that findings from this work in abdominal pain will be interpreted as a framework for understanding the processes by which other pain phenomena and, more broadly, reactions to any physical state, can be developed and maintained in children. The present article concludes with recommendations for clinical practice and research. PMID:23248815

  18. Advancing the educational and career pathway for clinical trials nurses.

    PubMed

    Scott, Kathleen; White, Kathryn; Roydhouse, Jessica K

    2013-04-01

    Clinical trials nurses play a pivotal role in the conduct of clinical research, but the educational and career pathway for these nurses remains unclear. This article reports findings from a survey of nurses working in cancer clinical trials research in Australia. Most participants held postgraduate qualifications (42 of 61); however, clinical trials education was primarily attained through short professional development courses. Interest in pursuing trial-specific postgraduate education was high, but barriers were identified, including cost, time, and unclear benefit for career advancement. Job titles varied substantially, which is indicative of an unclear employment pathway. These findings suggest that initiatives to improve the educational and career pathway for clinical trials nurses are needed and should include the following: formal educational preparation, greater consistency in employment status, and clearer career progression. These strategies should be underpinned by broad professional recognition of the clinical trials nurse as a specialized nursing role. Copyright 2013, SLACK Incorporated.

  19. Database for vertigo.

    PubMed

    Kentala, E; Pyykkö, I; Auramo, Y; Juhola, M

    1995-03-01

    An interactive database has been developed to assist the diagnostic procedure for vertigo and to store the data. The database offers a possibility to split and reunite the collected information when needed. It contains detailed information about a patient's history, symptoms, and findings in otoneurologic, audiologic, and imaging tests. The symptoms are classified into sets of questions on vertigo (including postural instability), hearing loss and tinnitus, and provoking factors. Confounding disorders are screened. The otoneurologic tests involve saccades, smooth pursuit, posturography, and a caloric test. In addition, findings from specific antibody tests, clinical neurotologic tests, magnetic resonance imaging, brain stem audiometry, and electrocochleography are included. The input information can be applied to workups for vertigo in an expert system called ONE. The database assists its user in that the input of information is easy. If not only can be used for diagnostic purposes but is also beneficial for research, and in combination with the expert system, it provides a tutorial guide for medical students.

  20. Improving Diagnosis of Sepsis After Burn Injury Using a Portable Sepsis Alert System

    DTIC Science & Technology

    2016-10-01

    application listed milestones/target dates for important activities or phases of the project, identify these dates and show actual completion dates or the... activities ; 2) specific objectives; 3) significant results or key outcomes, including major findings, developments, or conclusions (both positive and...progresses to completion, the emphasis in reporting in this section should shift from reporting activities to reporting accomplishments. Task 1. Test the

  1. Revenues and Expenditures for Public Elementary and Secondary School Districts: School Year 2013-14 (Fiscal Year 2014). First Look. NCES 2016-303

    ERIC Educational Resources Information Center

    Cornman, Stephen Q.

    2017-01-01

    This First Look report presents data on public elementary and secondary education revenues and expenditures at the local education agency (LEA) or school district level for fiscal year (FY) 2014.1 Specifically, this report includes findings from the following types of school finance data: (1) Revenue and expenditure totals by state and the 100…

  2. Contagious Weakness in an Elderly Couple with Neurologic Emergencies

    DTIC Science & Technology

    2011-02-01

    affected, causing asphyxiation without ventilator support. Additional findings can include dry mouth , Figure 1. Home canned and processed goods in...specifically “nausea and vomiting, dysphagia, diplopia, dry mouth , and dilated and fixed pupils,” and to administer the antitoxin in consultation with...the intensive care unit ( ICU ) for observation. At that point, we were certain of botulism, given the symptoms in both patients. We contacted the

  3. Behavioral Indicators of Drug Carrying in Open Spaces

    DTIC Science & Technology

    2015-04-30

    approached by that patrol. The findings of Phase I was documented in three reports. These reports include: 1) Behavioral Indicators of Illegal and Legal ...not focus solely on persons carrying firearms or drugs because there are jurisdiction-specific legal and use-of-force elements which dictate the...to develop training for law enforcement and security personnel to utilize behavioral indicators in a safe, legal , and effective manner. Training

  4. Revenues and Expenditures for Public Elementary and Secondary School Districts: School Year 2012-13 (Fiscal Year 2013). First Look. NCES 2015-303

    ERIC Educational Resources Information Center

    Cornman, Stephen Q.

    2016-01-01

    This First Look report presents data on public elementary and secondary education revenues and expenditures at the local education agency (LEA) or school district level for fiscal year (FY) 2013. Specifically, this report includes findings from the following types of school finance data: (1) revenue and expenditure totals by state and the 100…

  5. Revenues and Expenditures for Public Elementary and Secondary School Districts: School Year 2011-12 (Fiscal Year 2012). First Look. NCES 2014-303

    ERIC Educational Resources Information Center

    Cornman, Stephen Q.

    2015-01-01

    This First Look report presents data on public elementary and secondary education revenues and expenditures at the local education agency (LEA) or school district level for fiscal year (FY) 2012.1. Specifically, this report includes findings from the following types of school finance data: (1) Revenue and expenditure totals by state and the 100…

  6. 3 CFR 13562 - Executive Order 13562 of December 27, 2010. Recruiting and Hiring Students and Recent Graduates

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... America, including sections 3301 and 3302 of title 5, United States Code, it is hereby ordered as follows... under 5 U.S.C. 3302(1), and in order to achieve a workforce that represents all segments of society as provided in 5 U.S.C. 2301(b)(1), I find that conditions of good administration (specifically, the need to...

  7. Noninvasive Assessment of Left Ventricular Assist Devices with Cardiovascular Computed Tomography and Impact on Management

    PubMed Central

    Raman, Subha V.; Sahu, Anurag; Merchant, Ali Z.; Louis, Louis B.; Firstenberg, Michael S.; Sun, Benjamin

    2009-01-01

    Background Left ventricular assist devices (LVADs) provide a bridge to recovery or heart transplantation, but require serial assessment. Echocardiographic approaches may be limited by device artifact and acoustic window. Cardiovascular computed tomography (CCT) provides noninvasive imaging of LVADs, yet no study has evaluated CCT’s impact on clinical care. We evaluated the diagnostic findings and clinical impact of CCT for noninvasive assessment of patients with LVADs. Methods CCT examinations performed between 2005 and 2008 in patients with LVADs were identified. Acquisitions were completed on the identical 64 detector-row scanner with intravenous contrast administration; electrocardiographic gating was used in patients with pulsatile devices, while peripheral pulse gating was used in patients with continuous-flow devices. Comparison was made between CCT results and 30-day outcomes, including echocardiographic and intraoperative findings. Results Thirty-two CCT examinations from 28 patients were reviewed. Indications included evaluation of low cardiac output symptoms, assessment of cannula position, low flow reading on the LVAD, and surgical planning. CCT identified critical findings in 6 patients including thrombosis and inlet cannula malposition, all confirmed intraoperatively; one case of intra-LVAD thrombus was missed by CCT. Using intraoperative findings as the gold standard, CCT’s sensitivity was 85% and specificity was 100%. Echocardiographic LVAD evaluation did not correlate with findings on CCT (kappa = −0.29, 95% CI −0.73−0.13). Conclusions This preliminary observational cohort study indicates that noninvasive imaging using CCT of LVADs is feasible and accurate. CCT warrants consideration in the initial evaluation of symptomatic patients with LVADs. PMID:19782594

  8. Correlates of low back pain in a general population sample: a multidisciplinary perspective.

    PubMed

    Roncarati, A; McMullen, W

    1988-06-01

    This study identifies correlates of low back pain in a general population sample and defines a profile of subjects with low back pain. A multidisciplinary approach was employed that required surveying and physically assessing 674 subjects on 105 variables in biographical, anatomical, strength and flexibility measurement categories. No attempt was made to select subjects from specific occupational, age, athletic, psychological and anatomical groups or subjects with specific biographical features, which may have resulted in a sample that was atypical of the general population. The results of this study based on a causal comparative ex post facto research design corroborated selected findings of previous research conducted on nongeneral population samples. These findings include relationships between low back pain and age, body type, sex, stress, smoking, selected types of physical activity, occupation and previous injuries to the neck, shoulders, back and upper legs, as well as previous episodes of low back pain. Additional correlates of low back pain that were identified and have little or controversial review in the back literature include: delayed low back pain syndrome caused by abrupt changes in running frequency, Q angle, pes cavus, leg length (right and left), trunk length, genu recurvatum and multiplane strength and flexibility limitations in the hip joints.

  9. The information needs of doctors-in-training: case study from the Cairns Library, University of Oxford.

    PubMed

    Forrest, M; Robb, M

    2000-09-01

    The objective of this study was to find out more about the information needs of doctors-in-training and to identify their preferred sources of information. The methodology included interviews with consultants and administrators, a focus group discussion with library staff and a postal questionnaire sent to 347 doctors-in-training (there was a 43% return). The shortcomings of a questionnaire primarily composed of closed questions were addressed by the inclusion of one-to-one interviews which offered the opportunity for more in-depth commentary on specific issues highlighted in the questionnaire. Results indicated the frequency with which various types of information sources were consulted and how this related to the 'ease of access' of each information source. There was also the opportunity to comment on future information needs. It was clear from the interviews as well as comments made on the questionnaire that the two most important requirements for doctors-in-training were 'more time to find and obtain information' and 'better access to information sources when and where they are needed'. The results, although not surprising, included specific suggestions that have been used for the strategic planning of the library service to deliver the best possible support to users within the current framework of evidence-based medicine.

  10. Knowledge, beliefs and barriers associated with prostate cancer prevention and screening behaviors among African-American men.

    PubMed

    Blocker, Deborah E; Romocki, LaHoma Smith; Thomas, Kamilah B; Jones, Belinda L; Jackson, Ethel Jean; Reid, LaVerne; Campbell, Marci K

    2006-08-01

    African-American men have the highest prostate cancer rates worldwide, and innovative efforts are needed to increase cancer prevention and screening behaviors among this population. Formative research was conducted to assess attitudes and behaviors linked to prostate cancer prevention activities that could be used to develop a culturally relevant intervention for an African-American church-based population. Four gender-specific focus groups were conducted with 29 men and women at two African-American churches in central North Carolina. Three primary themes emerged from the focus group discussions: culturally and gender-influenced beliefs and barriers about cancer prevention and screening; barriers related to the healthcare system: and religious influences, including the importance of spiritual beliefs and church support. These discussions revealed the importance of the black family, the positive influence of spouses/partners on promoting cancer screening and healthy behaviors, the roles of faith and church leadership, and beliefs about God's will for good health. These findings also revealed that there are still major barriers and challenges to cancer prevention among African Americans, including continued mistrust of the medical community and negative attitudes toward specific screening tests. Findings provide important insights to consider in implementing successful prostate cancer prevention interventions designed for church-based audiences.

  11. A Synthesis of the Evidence for Managing Stress at Work: A Review of the Reviews Reporting on Anxiety, Depression, and Absenteeism

    PubMed Central

    Bhui, Kamaldeep S.; Dinos, Sokratis; Stansfeld, Stephen A.; White, Peter D.

    2012-01-01

    Background. Psychosocial stressors in the workplace are a cause of anxiety and depressive illnesses, suicide and family disruption. Methods. The present review synthesizes the evidence from existing systematic reviews published between 1990 and July 2011. We assessed the effectiveness of individual, organisational and mixed interventions on two outcomes: mental health and absenteeism. Results. In total, 23 systematic reviews included 499 primary studies; there were 11 meta-analyses and 12 narrative reviews. Meta-analytic studies found a greater effect size of individual interventions on individual outcomes. Organisational interventions showed mixed evidence of benefit. Organisational programmes for physical activity showed a reduction in absenteeism. The findings from the meta-analytic reviews were consistent with the findings from the narrative reviews. Specifically, cognitive-behavioural programmes produced larger effects at the individual level compared with other interventions. Some interventions appeared to lead to deterioration in mental health and absenteeism outcomes.Gaps in the literature include studies of organisational outcomes like absenteeism, the influence of specific occupations and size of organisations, and studies of the comparative effectiveness of primary, secondary and tertiary prevention. Conclusions. Individual interventions (like CBT) improve individuals' mental health. Physical activity as an organisational intervention reduces absenteeism. Research needs to target gaps in the evidence. PMID:22496705

  12. A synthesis of the evidence for managing stress at work: a review of the reviews reporting on anxiety, depression, and absenteeism.

    PubMed

    Bhui, Kamaldeep S; Dinos, Sokratis; Stansfeld, Stephen A; White, Peter D

    2012-01-01

    Psychosocial stressors in the workplace are a cause of anxiety and depressive illnesses, suicide and family disruption. The present review synthesizes the evidence from existing systematic reviews published between 1990 and July 2011. We assessed the effectiveness of individual, organisational and mixed interventions on two outcomes: mental health and absenteeism. In total, 23 systematic reviews included 499 primary studies; there were 11 meta-analyses and 12 narrative reviews. Meta-analytic studies found a greater effect size of individual interventions on individual outcomes. Organisational interventions showed mixed evidence of benefit. Organisational programmes for physical activity showed a reduction in absenteeism. The findings from the meta-analytic reviews were consistent with the findings from the narrative reviews. Specifically, cognitive-behavioural programmes produced larger effects at the individual level compared with other interventions. Some interventions appeared to lead to deterioration in mental health and absenteeism outcomes.Gaps in the literature include studies of organisational outcomes like absenteeism, the influence of specific occupations and size of organisations, and studies of the comparative effectiveness of primary, secondary and tertiary prevention. Individual interventions (like CBT) improve individuals' mental health. Physical activity as an organisational intervention reduces absenteeism. Research needs to target gaps in the evidence.

  13. Motivations for Using MDMA (Ecstasy/Molly) among African Americans: Implications for Prevention and Harm-Reduction Programs.

    PubMed

    Rigg, Khary K

    2017-01-01

    Despite the growing popularity of MDMA (ecstasy/molly) among African Americans, their motives for using the drug are still largely unknown. The purpose of this study was to identify and describe the most salient motivations for using MDMA among this understudied population. In-depth interviews (n = 15) were conducted with a sample of African American young adults in Southwest Florida between August 2014 and November 2015. The primary motivations for using MDMA included: (1) altering the effects of marijuana and alcohol; (2) lasting longer sexually; (3) enhancing sexual pleasure; and (4) facilitating "freaky" sexual experiences. This is the first study to directly examine MDMA motivations specifically among African American drug users, and findings shed light on why some African Americans use MDMA. A better understanding of why African Americans use this drug should help to inform prevention and harm-reduction efforts. Study findings show the need for health messages that include the potential consequences of mixing MDMA with other drugs, and engaging in high-risk sexual behaviors after taking MDMA. These data contrast with motivations (e.g., introspection, self-enlightenment, getting into the music) commonly reported among groups of largely White MDMA users, suggesting that interventions tailored specifically for African American users are needed.

  14. Specific parental depression symptoms as risk markers for new-onset depression in high-risk offspring.

    PubMed

    Mars, Becky; Harold, Gordon T; Elam, Kit K; Sellers, Ruth; Owen, Michael J; Craddock, Nicholas; Thapar, Ajay K; Rice, Frances; Collishaw, Stephan; Thapar, Anita

    2013-09-01

    To disaggregate the depression construct and investigate whether specific depression symptoms in parents with a history of recurrent depression are clinical risk markers for future depression in their high-risk offspring. Our hypothesis was that parental symptoms of the type that might impact offspring would most likely be of greatest importance. Data were drawn from a longitudinal high-risk family study. Families were mainly recruited from primary care and included 337 parent-child dyads. Parents had a history of recurrent DSM-IV unipolar depression and were aged 26-55 years. Their offspring (197 female and 140 male) were aged 9-17 years. Three assessments were conducted between April 2007 and April 2011. Ninety-one percent of families (n = 305) provided full interview data at baseline and at least 1 follow-up, of which 291 were included in the primary analysis. The main outcome measure was new-onset DSM-IV mood disorder in the offspring, which was assessed using the Child and Adolescent Psychiatric Assessment. Of the 9 DSM-IV depression symptoms, parental change in appetite or weight, specifically loss of appetite or weight, most strongly predicted new-onset mood disorder (odds ratio [OR] = 4.47; 95% CI, 2.04-9.79; P < .001) and future depression symptoms in the offspring (β = 0.12; B = 0.21; 95% CI, 0.00-0.42; P = .050). The cross-generational association was not accounted for by measures of parental depression severity (total depression symptom score, episode recurrence, age at onset, and past impairment or hospitalization) or other potential confounds (parent physical health, eating disorder, or medication). Findings from this study suggest that loss of appetite or weight in parents with a history of recurrent depression is a marker of risk for depression in their offspring. The findings highlight the importance of examining depression heterogeneity. The biological and environmental mechanisms underlying this finding require investigation. © Copyright 2013 Physicians Postgraduate Press, Inc.

  15. Obstacles to implementing evidence-based practice in Belgium: a context-specific qualitative evidence synthesis including findings from different health care disciplines.

    PubMed

    Hannes, K; Goedhuys, J; Aertgeerts, B

    2012-01-01

    A number of barriers to the implementation of evidence-based practice have already been inventoried. However, little attention has been given to their context-specific nature. This qualitative evidence synthesis examines commonalities in the obstacles perceived by different groups of health care practitioners working in the Belgian health care system and sets out to discuss potential strategies to bridge some of these barriers. We actively searched for primary studies addressing our topic of interest in international and national databases (1990 to May 2008), consulted experts and screened references of retrieved studies. We opted for the meta-aggregative approach, developed by the Joanna Briggs Institute, to analyse our findings. The findings indicate that (1) evidence might have a limited role in decision-making processes; (2) aspects other than quality of care steer the evidence-based practice agenda; (3) some health care providers benefit less from evidence-based practice than others and (4) there is a lack of competences to put the evidence-based principles in practice. Belgian policy makers might consider health care system characteristics from and strategies developed or suggested by others to respond to country-specific obstacles. Examples include but are not limited to; (a) providing incentives for patient-centred care coordination and patient communication, (b) supporting practitioners interested in applying research-related activities, (c) considering direct access systems and interprofessional learning to respond to the demand for autonomous decision-making from satellite professional groups, (d) systematically involving allied health professionals in important governmental advisory boards, (e) considering pharmaceutical companies perceived as 'the enemy' an ally in filling in research gaps, (f) embedding the evaluation of evidence-based knowledge and skills in examinations (g) moving from (in)formative learning to transformative learning and (h) organizing high quality catch-up programs for those who missed out on evidence-based medicine in their curriculum.

  16. Worldwide wind/diesel hybrid power system study: Potential applications and technical issues

    NASA Astrophysics Data System (ADS)

    King, W. R.; Johnson, B. L., III

    1991-04-01

    The world market potential for wind/diesel hybrid technology is a function of the need for electric power, the availability of sufficient wind resource to support wind/diesel power, and the existence of buyers with the financial means to invest in the technology. This study includes data related to each of these three factors. This study does not address market penetration, which would require analysis of application specific wind/diesel economics. Buyer purchase criteria, which are vital to assessing market penetration, are discussed only generally. Countries were screened for a country-specific market analysis based on indicators of need and wind resource. Both developed countries and less developed countries (LDCs) were screened for wind/diesel market potential. Based on the results of the screening, ten countries showing high market potential were selected for more extensive market analyses. These analyses provide country-specific market data to guide wind/diesel technology developers in making design decisions that will lead to a competitive product. Section 4 presents the country-specific data developed for these analyses, including more extensive wind resource characterization, application-specific market opportunities, business conditions, and energy market characterizations. An attempt was made to identify the potential buyers with ability to pay for wind/diesel technology required to meet the application-specific market opportunities identified for each country. Additionally, the country-specific data are extended to corollary opportunities in countries not covered by the study. Section 2 gives recommendations for wind/diesel research based on the findings of the study.

  17. Prospective evaluation of 64 serum autoantibodies as biomarkers for early detection of colorectal cancer in a true screening setting

    PubMed Central

    Chen, Hongda; Werner, Simone; Butt, Julia; Zörnig, Inka; Knebel, Phillip; Michel, Angelika; Eichmüller, Stefan B.; Jäger, Dirk; Waterboer, Tim; Pawlita, Michael; Brenner, Hermann

    2016-01-01

    Novel blood-based screening tests are strongly desirable for early detection of colorectal cancer (CRC). We aimed to identify and evaluate autoantibodies against tumor-associated antigens as biomarkers for early detection of CRC. 380 clinically identified CRC patients and samples of participants with selected findings from a cohort of screening colonoscopy participants in 2005–2013 (N=6826) were included in this analysis. Sixty-four serum autoantibody markers were measured by multiplex bead-based serological assays. A two-step approach with selection of biomarkers in a training set, and validation of findings in a validation set, the latter exclusively including participants from the screening setting, was applied. Anti-MAGEA4 exhibited the highest sensitivity for detecting early stage CRC and advanced adenoma. Multi-marker combinations substantially increased sensitivity at the price of a moderate loss of specificity. Anti-TP53, anti-IMPDH2, anti-MDM2 and anti-MAGEA4 were consistently included in the best-performing 4-, 5-, and 6-marker combinations. This four-marker panel yielded a sensitivity of 26% (95% CI, 13–45%) for early stage CRC at a specificity of 90% (95% CI, 83–94%) in the validation set. Notably, it also detected 20% (95% CI, 13–29%) of advanced adenomas. Taken together, the identified biomarkers could contribute to the development of a useful multi-marker blood-based test for CRC early detection. PMID:26909861

  18. Parkinson's disease in Jordan: Barriers and motivators to exercise.

    PubMed

    Khalil, Hanan; Nazzal, Mohammad; Al-Sheyab, Nihaya

    2016-10-01

    Perceived barriers to engaging in exercise in people with Parkinson's disease (PD) are becoming more defined in countries such as the UK and the US. This, however, may vary by culture and environment. This study aimed to explore the perceptions of exercise and barriers that may affect participation in people with PD from Jordan. Two focus groups and seven individual interviews were conducted with people with PD. Additionally, individual interviews were conducted with two neurologists. Conversations were digitally recorded and transcribed. Transcripts were analyzed using thematic analysis and validated via researcher triangulation and peer checking. Most of the PD participants lacked previous participation in any disease-specific exercises. Several barriers were perceived by PD participants for such lack of participation. Barriers included difficulty of diagnosis, lack of informational support provided by neurologists, lack of referral to physiotherapy services, disease-specific issues, and setting-related issues. Neurologists indicated a number of barriers in counseling their PD patients on exercise including lack of time and lack of health system resources. Motivators to participate in future exercise included outcome expectations and family support. Findings of the study shed light into large areas of unmet needs of supporting exercise and physiotherapy for people with PD in developing countries as per Jordan. For better patient outcomes, findings of the study suggest that it is crucial to raise awareness among all PD-related stakeholders on the benefits of early referrals to physiotherapy and early engagement in exercise programs.

  19. Job Satisfaction, Quality of Work Life and Work Motivation in Employees with Intellectual Disability: A Systematic Review.

    PubMed

    Kocman, Andreas; Weber, Germain

    2018-01-01

    Current research on employment options for people with Intellectual Disability emphasizes the importance of employee needs and satisfaction. The study aims at systematically reviewing the literature on job satisfaction and related constructs. A systematic literature search was conducted. Studies were included if (i) they are specific to effects of work, (ii) assessed variables are related to job satisfaction, QoWL, attitudes towards work or work motivation and if (iii) studies reported intellectual disability-specific results. Twenty-three studies met the inclusion criteria. Findings were classified according to the socio-cognitive model of job satisfaction. Current literature suggests high job satisfaction in people with intellectual disability. Predictors of job satisfaction are similar to people without disabilities, albeit the importance of factors differs. Stronger consideration of well-established theories and measures from organizational psychology would enhance future research. Findings indicate that high satisfaction ratings might result from lack of control over vocational decisions. © 2016 John Wiley & Sons Ltd.

  20. A Cautionary Tale: Examining the Interplay of Culturally Specific Risk and Resilience Factors in Indigenous Communities

    PubMed Central

    Walls, Melissa L.; Whitbeck, Les; Armenta, Brian

    2016-01-01

    Efforts to build empirical evidence for the protective effects of Indigenous cultural factors on psychological health have yielded mixed findings. We examine the interplay of previously hypothesized culturally relevant risk (discrimination, historical loss) and protective (spiritual activities) factors among Indigenous people. The sample includes 569 Indigenous adolescents (M age = 17.23, SD = 0.88; 51.0% girls) and 563 Indigenous adult caregivers (M age = 44.66, SD = 9.18; 77.4% women). Our central finding was that indigenous spirituality was associated with poorer psychological outcomes across several domains (depressive symptoms, anger, anxiety, somatization and interpersonal difficulties), but observed effects were attenuated once perceived discrimination and historical losses were added to statistical models. Thus, consideration of relevant stressors drastically changed our conclusions, underscoring the uncertain dynamics through which specific Indigenous cultural factors impact mental health. Researchers should work in collaboration with Indigenous communities to improve measurement and empirical investigation of these complex constructs. PMID:28138417

  1. Roles of microRNA in the immature immune system of neonates.

    PubMed

    Yu, Hong-Ren; Huang, Lien-Hung; Li, Sung-Chou

    2018-06-13

    Neonates have an immature immune system; therefore, their immune activities are different from the activities of adult immune systems. Such differences between neonates and adults are reflected by cell population constitutions, immune responses, cytokine production, and the expression of cellular/humoral molecules, which contribute to the specific neonatal microbial susceptibility and atopic properties. MicroRNAs (miRNAs) have been discovered to modulate many aspects of immune responses. Herein, we summarize the distinct manifestations of the neonatal immune system, including cellular and non-cellular components. We also review the current findings on the modulatory effects of miRNAs on the neonatal immune system. These findings suggest that miRNAs have the potential to be useful therapeutic targets for certain infection or inflammatory conditions by modulating the neonatal immune system. In the future, we need a more comprehensive understanding in regard to miRNAs and how they modulate specific immune cells in neonates. Copyright © 2018. Published by Elsevier B.V.

  2. Long-term memory: A review and meta-analysis of studies of declarative and procedural memory in specific language impairment

    PubMed Central

    Lum, Jarrad A. G.; Conti-Ramsden, Gina

    2014-01-01

    This review examined the status of long-term memory systems in specific language impairment (SLI), in particular declarative memory and aspects of procedural memory. Studies included in the review were identified following a systematic search of the literature and findings combined using meta-analysis. This review showed individuals with SLI are poorer than age matched controls in the learning and retrieval of verbal information from the declarative memory. However, there is evidence to suggest that the problems with declarative learning and memory for verbal information in SLI might be due to difficulties with verbal working memory and language. The learning and retrieval of non-verbal information from declarative memory appears relatively intact. In relation to procedural learning and memory, evidence indicates poor implicit learning of verbal information. Findings pertaining to nonverbal information have been mixed. This review of the literature indicates there are now substantial grounds for suspecting that multiple memory systems may be implicated in the impairment. PMID:24748707

  3. Why Latinas With Breast Cancer Select Specific Informal Caregivers to Participate With Them in Psychosocial Interventions.

    PubMed

    Badger, Terry; Segrin, Chris; Swiatkowski, Paulina; McNelis, Melissa; Weihs, Karen; Lopez, Ana Maria

    2017-07-01

    The purpose of this study is to describe the reasons 88 Latinas with breast cancer selected specific supportive others to participate in an 8-week psychosocial intervention. Participants were asked one open-ended question during the baseline assessment for a larger clinical trial: "Could you tell me more about why you selected [insert name] to participate in the study with you?" A content analysis of the responses found three thematic categories: source of informational or emotional support, concern for the informal caregiver's welfare, and special characteristics or qualities of the informal caregiver. These findings reflected both the cultural value of familism, the woman's role as caregiver to the family ( marianismo), and the man's role of provider ( machismo). Findings provide support for including the supportive person identified by the patient during a health crisis rather than the provider suggesting who that should be. Psychosocial services designed and implemented through such a cultural lens are more likely to be successful.

  4. The effects of medical marijuana laws on cannabis-involved driving.

    PubMed

    Sevigny, Eric L

    2018-06-06

    This study uses data from the Fatality Analysis Reporting System and a differences-in-differences model to examine the effect of state medical marijuana laws (MMLs) on cannabis-involved driving among U.S. drivers involved in a fatal crash between 1993-2014. Findings indicate that MMLs in general have a null effect on cannabis-positive driving, as do state laws with specific supply provisions including home cultivation and unlicensed or quasi-legal dispensaries. Only in jurisdictions with state-licensed medical marijuana dispensaries did the odds of marijuana-involved driving increase significantly by 14 percent, translating into an additional 87 to 113 drivers testing positive for marijuana per year. Sensitivity analyses reveal these findings to be generally robust to alternate specifications, although an observed spillover effect consistent with elevated drugged driving enforcement in bordering states weakens a causal interpretation. Still, reasonable policy implications are drawn regarding drugged driving prevention/enforcement and regulations governing dispensary delivery services and business siting decisions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Converging evidence for control of color-word Stroop interference at the item level.

    PubMed

    Bugg, Julie M; Hutchison, Keith A

    2013-04-01

    Prior studies have shown that cognitive control is implemented at the list and context levels in the color-word Stroop task. At first blush, the finding that Stroop interference is reduced for mostly incongruent items as compared with mostly congruent items (i.e., the item-specific proportion congruence [ISPC] effect) appears to provide evidence for yet a third level of control, which modulates word reading at the item level. However, evidence to date favors the view that ISPC effects reflect the rapid prediction of high-contingency responses and not item-specific control. In Experiment 1, we first show that an ISPC effect is obtained when the relevant dimension (i.e., color) signals proportion congruency, a problematic pattern for theories based on differential response contingencies. In Experiment 2, we replicate and extend this pattern by showing that item-specific control settings transfer to new stimuli, ruling out alternative frequency-based accounts. In Experiment 3, we revert to the traditional design in which the irrelevant dimension (i.e., word) signals proportion congruency. Evidence for item-specific control, including transfer of the ISPC effect to new stimuli, is apparent when 4-item sets are employed but not when 2-item sets are employed. We attribute this pattern to the absence of high-contingency responses on incongruent trials in the 4-item set. These novel findings provide converging evidence for reactive control of color-word Stroop interference at the item level, reveal theoretically important factors that modulate reliance on item-specific control versus contingency learning, and suggest an update to the item-specific control account (Bugg, Jacoby, & Chanani, 2011).

  6. How sensitive and specific is urinalysis 'dipstick' testing for detection of hyperglycaemia and ketosis? An audit of findings from coronial autopsies.

    PubMed

    Mitchell, Rebecca; Thomas, Sunethra Devika; Langlois, Neil E I

    2013-10-01

    Biochemical analysis of glucose and ketones in the vitreous humour obtained at post-mortem examination is representative of the levels in the blood prior to death. Elevated levels can be indicative of conditions including diabetic ketoacidosis, which can be a cause for unexpected death. A rapid screening test for such conditions can be performed during the autopsy through urinalysis using test strips (urine 'dipstick' testing). The aim of this study was to assess the utility of urinalysis testing for post-mortem detection of derangements of glucose and ketone levels. The results of vitreous biochemical analysis and urinalysis were collated from 188 forensic autopsy cases. A vitreous glucose result of above 10 mmol/L was regarded as high. When this was compared to urinalysis results it was found that any urinalysis result above negative had a sensitivity of 0.83 and a specificity of 0.93. A vitreous ketone level of above 5 mmol/L was regarded as significantly elevated; a urinalysis result above negative had a sensitivity of 1, but a specificity of 0.12. Urinalysis ('dipstick' testing) for glucose has a good sensitivity and specificity for high vitreous glucose levels, which are regarded as indicative of pathological hyperglycaemia during life. It was found that urine testing for ketones either has an excellent sensitivity with low specificity or a poor sensitivity with a good specificity; however, this finding has to be viewed in the context of uncertainty of the biochemical level of significant ketosis.

  7. Screening for depression with a brief questionnaire in a primary care setting: validation of the two questions with help question (Malay version).

    PubMed

    Mohd-Sidik, Sherina; Arroll, Bruce; Goodyear-Smith, Felicity; Zain, Azhar M D

    2011-01-01

    To determine the diagnostic accuracy of the two questions with help question (TQWHQ) in the Malay language. The two questions are case-finding questions on depression, and a question on whether help is needed was added to increase the specificity of the two questions. This cross sectional validation study was conducted in a government funded primary care clinic in Malaysia. The participants included 146 consecutive women patients receiving no psychotropic drugs and who were Malay speakers. The main outcome measures were sensitivity, specificity, and likelihood ratios of the two questions and help question. The two questions showed a sensitivity of 99% (95% confidence interval 88% to 99.9%) and a specificity of 70% (62% to 78%), respectively. The likelihood ratio for a positive test was 3.3 (2.5 to 4.5) and the likelihood ratio for a negative test was 0.01 (0.00 to 0.57). The addition of the help question to the two questions increased the specificity to 95% (89% to 98%). The two qeustions on depression detected most cases of depression in this study. The questions have the advantage of brevity. The addition of the help question increased the specificity of the two questions. Based on these findings, the TQWHQ can be strongly recommended for detection of depression in government primary care clnics in Malaysia. Translation did not apear to affect the validity of the TQWHQ.

  8. Distinct Olfactory Cross-Modal Effects on the Human Motor System

    PubMed Central

    Rossi, Simone; De Capua, Alberto; Pasqualetti, Patrizio; Ulivelli, Monica; Falzarano, Vincenzo; Bartalini, Sabina; Passero, Stefano; Nuti, Daniele

    2008-01-01

    Background Converging evidence indicates that action observation and action-related sounds activate cross-modally the human motor system. Since olfaction, the most ancestral sense, may have behavioural consequences on human activities, we causally investigated by transcranial magnetic stimulation (TMS) whether food odour could additionally facilitate the human motor system during the observation of grasping objects with alimentary valence, and the degree of specificity of these effects. Methodology/Principal Findings In a repeated-measure block design, carried out on 24 healthy individuals participating to three different experiments, we show that sniffing alimentary odorants immediately increases the motor potentials evoked in hand muscles by TMS of the motor cortex. This effect was odorant-specific and was absent when subjects were presented with odorants including a potentially noxious trigeminal component. The smell-induced corticospinal facilitation of hand muscles during observation of grasping was an additive effect which superimposed to that induced by the mere observation of grasping actions for food or non-food objects. The odour-induced motor facilitation took place only in case of congruence between the sniffed odour and the observed grasped food, and specifically involved the muscle acting as prime mover for hand/fingers shaping in the observed action. Conclusions/Significance Complex olfactory cross-modal effects on the human corticospinal system are physiologically demonstrable. They are odorant-specific and, depending on the experimental context, muscle- and action-specific as well. This finding implies potential new diagnostic and rehabilitative applications. PMID:18301777

  9. Field power measurements of imaging equipment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McWhinney, Marla; Homan, Gregory; Brown, Richard

    2004-05-14

    According to the U.S. Department of Energy, electricity use by non-PC commercial office equipment is growing at an annual rate of nearly 5 percent (AEO 2003). To help address this growth in consumption, U.S. EPA periodically updates its ENERGY STAR specifications as products and markets change. This report presents background research conducted to help EPA update the ENERGY STAR specification for imaging equipment, which covers printers, fax machines, copiers, scanners, and multifunction devices (MFDs). We first estimated the market impact of the current ENERGY STAR imaging specification, finding over 90 percent of the current market complies with the specification. Wemore » then analyzed a sample of typical new imaging products, including 11 faxes, 57 printers and 19 copiers/MFD. For these devices we metered power levels in the most common modes: active/ready/sleep/off, and recorded features that would most likely affect energy consumption. Our metering indicates that for many products and speed bins, current models consume substantially less power than the current specification. We also found that for all product categories, power consumption varied most considerably across technology (i.e. inkjet vs. laser). Although inkjet printers consumed less energy than laser printers in active, ready and sleep-mode, they consumed more power on average while off, mostly due to the use of external power supplies. Based on these findings, we developed strategies for the ENERGY STAR program to achieve additional energy reductions. Finally, we present an assessment of manufacturer's ENERGY STAR labeling practices.« less

  10. Representation of action in occipito-temporal cortex.

    PubMed

    Wiggett, Alison J; Downing, Paul E

    2011-07-01

    A fundamental question for social cognitive neuroscience is how and where in the brain the identities and actions of others are represented. Here we present a replication and extension of a study by Kable and Chatterjee [Kable, J. W., & Chatterjee, A. Specificity of action representations in the lateral occipito-temporal cortex. Journal of Cognitive Neuroscience, 18, 1498-1517, 2006] examining the role of occipito-temporal cortex in these processes. We presented full-cue movies of actors performing whole-body actions and used fMRI to test for action- and identity-specific adaptation effects. We examined a series of functionally defined regions, including the extrastriate and fusiform body areas, the fusiform face area, the parahippocampal place area, the lateral occipital complex, the right posterior superior temporal sulcus, and motion-selective area hMT+. These regions were analyzed with both standard univariate measures as well as multivoxel pattern analyses. Additionally, we performed whole-brain tests for significant adaptation effects. We found significant action-specific adaptation in many areas, but no evidence for identity-specific adaptation. We argue that this finding could be explained by differences in the familiarity of the stimuli presented: The actions shown were familiar but the actors performing the actions were unfamiliar. However, in contrast to previous findings, we found that the action adaptation effect could not be conclusively tied to specific functionally defined regions. Instead, our results suggest that the adaptation to previously seen actions across identities is a widespread effect, evident across lateral and ventral occipito-temporal cortex.

  11. Co-morbid anxiety disorders in bipolar disorder and major depression: familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder.

    PubMed

    Goes, F S; McCusker, M G; Bienvenu, O J; Mackinnon, D F; Mondimore, F M; Schweizer, B; Depaulo, J R; Potash, J B

    2012-07-01

    Co-morbidity of mood and anxiety disorders is common and often associated with greater illness severity. This study investigates clinical correlates and familiality of four anxiety disorders in a large sample of bipolar disorder (BP) and major depressive disorder (MDD) pedigrees. The sample comprised 566 BP families with 1416 affected subjects and 675 MDD families with 1726 affected subjects. Clinical characteristics and familiality of panic disorder, social phobia, specific phobia and obsessive-compulsive disorder (OCD) were examined in BP and MDD pedigrees with multivariate modeling using generalized estimating equations. Co-morbidity between mood and anxiety disorders was associated with several markers of clinical severity, including earlier age of onset, greater number of depressive episodes and higher prevalence of attempted suicide, when compared with mood disorder without co-morbid anxiety. Familial aggregation was found with co-morbid panic and OCD in both BP and MDD pedigrees. Specific phobia showed familial aggregation in both MDD and BP families, although the findings in BP were just short of statistical significance after adjusting for other anxiety co-morbidities. We found no evidence for familiality of social phobia. Our findings suggest that co-morbidity of MDD and BP with specific anxiety disorders (OCD, panic disorder and specific phobia) is at least partly due to familial factors, which may be of relevance to both phenotypic and genetic studies of co-morbidity.

  12. Co-morbid anxiety disorders in bipolar disorder and major depression : familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder

    PubMed Central

    Goes, F. S.; McCusker, M. G.; Bienvenu, O. J.; MacKinnon, D. F.; Mondimore, F. M.; Schweizer, B.; DePaulo, J. R.; Potash, J. B.

    2013-01-01

    Background Co-morbidity of mood and anxiety disorders is common and often associated with greater illness severity. This study investigates clinical correlates and familiality of four anxiety disorders in a large sample of bipolar disorder (BP) and major depressive disorder (MDD) pedigrees. Method The sample comprised 566 BP families with 1416 affected subjects and 675 MDD families with 1726 affected subjects. Clinical characteristics and familiality of panic disorder, social phobia, specific phobia and obsessivecompulsive disorder (OCD] were examined in BP and MDD pedigrees with multivariate modeling using generalized estimating equations. Results Co-morbidity between mood and anxiety disorders was associated with several markers of clinical severity, including earlier age of onset, greater number of depressive episodes and higher prevalence of attempted suicide, when compared with mood disorder without co-morbid anxiety. Familial aggregation was found with co-morbid panic and OCD in both BP and MDD pedigrees. Specific phobia showed familial aggregation in both MDD and BP families, although the findings in BP were just short of statistical significance after adjusting for other anxiety co-morbidities. We found no evidence for familiality of social phobia. Conclusions Our findings suggest that co-morbidity of MDD and BP with specific anxiety disorders [OCD, panic disorder and specific phobia] is at least partly due to familial factors, which may be of relevance to both phenotypic and genetic studies of co-morbidity. PMID:22099954

  13. An examination of the specificity of motivation and executive functioning in ADHD symptom-clusters in adolescence.

    PubMed

    Lopez-Vergara, Hector I; Colder, Craig R

    2013-11-01

    Motivation and executive functioning are central to the etiology of attention-deficit/hyperactivity disorder (ADHD). Furthermore, it has been hypothesized that motivation should show specificity of association with ADHD-impulsivity/hyperactivity symptoms, whereas executive functioning should show specificity of association with ADHD-inattention symptoms. This study tests this specificity-hypothesis and extends previous research by conceptualizing motivation to include both reactivity to reward and punishment. Executive functioning was assessed using two different laboratory measures (the Wisconsin-Card-Sort and Stop-Signal Tasks) and motivation was measured using a laboratory measure of sensitivity to reward and punishment (the Point-Scoring-Reaction-Time Task). Findings suggested specificity of association between executive functioning and symptoms of inattention, and between motivation and symptoms of impulsivity/hyperactivity. However, support varied across indices of executive functioning. Results provide support for multiple component models of ADHD symptoms and extend the literature by providing a theoretically based conceptualization of motivation grounded on developmental neuroscience models of motivated behavior.

  14. Area-specific temporal control of corticospinal motor neuron differentiation by COUP-TFI

    PubMed Central

    Tomassy, Giulio Srubek; De Leonibus, Elvira; Jabaudon, Denis; Lodato, Simona; Alfano, Christian; Mele, Andrea; Macklis, Jeffrey D.; Studer, Michèle

    2010-01-01

    Transcription factors with gradients of expression in neocortical progenitors give rise to distinct motor and sensory cortical areas by controlling the area-specific differentiation of distinct neuronal subtypes. However, the molecular mechanisms underlying this area-restricted control are still unclear. Here, we show that COUP-TFI controls the timing of birth and specification of corticospinal motor neurons (CSMN) in somatosensory cortex via repression of a CSMN differentiation program. Loss of COUP-TFI function causes an area-specific premature generation of neurons with cardinal features of CSMN, which project to subcerebral structures, including the spinal cord. Concurrently, genuine CSMN differentiate imprecisely and do not project beyond the pons, together resulting in impaired skilled motor function in adult mice with cortical COUP-TFI loss-of-function. Our findings indicate that COUP-TFI exerts critical areal and temporal control over the precise differentiation of CSMN during corticogenesis, thereby enabling the area-specific functional features of motor and sensory areas to arise. PMID:20133588

  15. Distinct antimicrobial peptide expression determines host species-specific bacterial associations

    PubMed Central

    Franzenburg, Sören; Walter, Jonas; Künzel, Sven; Wang, Jun; Baines, John F.; Bosch, Thomas C. G.; Fraune, Sebastian

    2013-01-01

    Animals are colonized by coevolved bacterial communities, which contribute to the host’s health. This commensal microbiota is often highly specific to its host-species, inferring strong selective pressures on the associated microbes. Several factors, including diet, mucus composition, and the immune system have been proposed as putative determinants of host-associated bacterial communities. Here we report that species-specific antimicrobial peptides account for different bacterial communities associated with closely related species of the cnidarian Hydra. Gene family extensions for potent antimicrobial peptides, the arminins, were detected in four Hydra species, with each species possessing a unique composition and expression profile of arminins. For functional analysis, we inoculated arminin-deficient and control polyps with bacterial consortia characteristic for different Hydra species and compared their selective preferences by 454 pyrosequencing of the bacterial microbiota. In contrast to control polyps, arminin-deficient polyps displayed decreased potential to select for bacterial communities resembling their native microbiota. This finding indicates that species-specific antimicrobial peptides shape species-specific bacterial associations. PMID:24003149

  16. The diagnostic validity of musculoskeletal ultrasound in lateral epicondylalgia: a systematic review.

    PubMed

    Dones, Valentin C; Grimmer, Karen; Thoirs, Kerry; Suarez, Consuelo G; Luker, Julie

    2014-03-03

    Ultrasound is considered a reliable, widely available, non-invasive and inexpensive imaging technique for assessing soft tissue involvement in Lateral epicondylalgia. Despite the number of diagnostic studies for Lateral Epicondylalgia, there is no consensus in the current literature on the best abnormal ultrasound findings that confirm lateral epicondylalgia. Eligible studies identified by searching electronic databases, scanning reference lists of articles and chapters on ultrasound in reference books, and consultation of experts in sonography. Three reviewers (VCDIII, KP, KW) independently searched the databases using the agreed search strategy, and independently conducted all stages of article selection. Two reviewers (VCDIII, KP) then screened titles and abstracts to remove obvious irrelevance. Potentially relevant full text publications which met the inclusion criteria were reviewed by the primary investigator (VCDIII) and another reviewer (CGS). Among the 15 included diagnostic studies in this review, seven were Level II diagnostic accuracy studies for chronic lateral epicondylalgia based on the National Health and Medical Research Council Hierarchy of Evidence. Based from the pooled sensitivity of abnormal ultrasound findings with homogenous results (p > 0.05), the hypoechogenicity of the common extensor origin has the best combination of diagnostic sensitivity and specificity. It is moderately sensitive [Sensitivity: 0.64 (0.56-0.72)] and highly specific [Specificity: 0.82 (0.72-0.90)] in determining elbows with lateral epicondylalgia. Additionally, bone changes on the lateral epicondyle [Sensitivity: 0.56 (0.50-0.62)] were moderately sensitive to chronic LE. Conversely, neovascularity [Specificity: 1.00 (0.97-1.00)], calcifications [Specificity: 0.97 (0.94-0.99)] and cortical irregularities [Specificity: 0.96 (0.88-0.99)] have strong specificity for chronic lateral epicondylalgia. There is insufficient evidence supporting the use of Power Doppler Ultrasonogrophy, Real-time Sonoelastography and sonographic probe-induced tenderness in diagnosing LE. The use of Gray-scale Ultrasonography is recommended in objectively diagnosing lateral epicondylalgia. The presence of hypoechogenicity and bone changes indicates presence of a stressed common extensor origin-lateral epicondyle complex in elbows with lateral epicondylalgia. In addition to diagnosis, detection of these abnormal ultrasound findings allows localization of pathologies to tendon or bone that would assist in designing an appropriate treatment suited to patient's condition.

  17. Cell Kinetic and Histomorphometric Analysis of Microgravitational Osteopenia: PARE.03B

    NASA Technical Reports Server (NTRS)

    Roberts, W. Eugene; Garetto, Lawrence P.

    1997-01-01

    The final report includes the hypotheses and specific aims of the project as well as summaries of the experimental findings. Descriptions of several figures that are not included in the report are also presented. A list of publications that resulted from the research is also given. The three experimental summaries are entitled: (1) Pre-flight Experiment to compare 5-Bromo-2'Deoxyuridine (BrdU) Immunohistochemistry and 3H-Thymidine (3HT) Autoradiography; (2) Recovery of Osteoblast Histogenesis in Rat Periodontal Ligament following a 9-day Spaceflight (PARE.03); and (3) Analysis of Mandibular Condyles from PARE.03 Flight Experiment.

  18. Quality of life before and after cosmetic surgery.

    PubMed

    Bensoussan, Jean-Charles; Bolton, Michael A; Pi, Sarah; Powell-Hicks, Allycin L; Postolova, Anna; Razani, Bahram; Reyes, Kevin; IsHak, Waguih William

    2014-08-01

    This article reviews the literature regarding the impact of cosmetic surgery on health-related quality of life (QOL). Studies were identified through PubMed/Medline and PsycINFO searches from January 1960 to December 2011. Twenty-eight studies were included in this review, according to specific selection criteria. The procedures and tools employed in cosmetic surgery research studies were remarkably diverse, thus yielding difficulties with data analysis. However, data indicate that individuals undergoing cosmetic surgery began with lower values on aspects of QOL than control subjects, and experienced significant QOL improvement post-procedurally, an effect that appeared to plateau with time. Despite the complexity of measuring QOL in cosmetic surgery patients, most studies showed an improvement in QOL after cosmetic surgery procedures. However, this finding was clouded by measurement precision as well as heterogeneity of procedures and study populations. Future research needs to focus on refining measurement techniques, including developing cosmetic surgery-specific QOL measures.

  19. [The age-specific features of palm dermatoglyphics in the adults subjects].

    PubMed

    Teplov, K V; Bozhchenko, A P; Tolmachev, I A; Moiseenko, S A

    2016-01-01

    This article was designed to consider the congenital age-specific features of palm dermatoglyphics in the adults subjects (including the type of the papillary patterns, axial tri-radii, the termini of palmar main lines, the rudiments of palmar lines, the dermatoglyphic ridge count between the stable anatomical structures). The objective of the study was to look for the new diagnostic markers of the biological age. It included the identification of the palm prints obtained from 180 Caucasoid men and 120 women at the age varying from 16 to 80 years. The results of the mathematical and statistical analysis provided the basis for drawing up the list of 18 attributes of palm dermatoglyphics significantly (p<0.05) differing in the frequency of occurrence between the representatives of individual age groups. The methods are proposed allowing to use these findings for the expert evaluation of the age of unknown subjects.

  20. The impact of the principal in the implementation of promoting science among English language learners (P-SELL)

    NASA Astrophysics Data System (ADS)

    Kittrell, Resma

    School organizations are in a constant state of change. One of the major changes that all schools encounter is adopting new curriculum. It is important to look at the role of the principal during the implementation of a new curriculum so that we can identify specific strategies that might be useful in other areas of school change. This study focuses on the role of the principal during the adoption of a new science curriculum, Promoting Science Among English Language Learners (P-SELL), within six elementary schools. This multiple case study included teacher focus group interviews, principal interviews, and teacher and principal written surveys to identify specific roles and strategies that principals illustrated during implementation of P-SELL. The overarching themes uncovered included (a) distributive leadership, (b) clear communication, and (c) supportive conditions. These findings can be used to understand the process of change within an organization.

  1. Three dimensional single molecule localization using a phase retrieved pupilfunction

    PubMed Central

    Liu, Sheng; Kromann, Emil B.; Krueger, Wesley D.; Bewersdorf, Joerg; Lidke, Keith A.

    2013-01-01

    Localization-based superresolution imaging is dependent on finding the positions of individualfluorophores in a sample by fitting the observed single-molecule intensity pattern to the microscopepoint spread function (PSF). For three-dimensional imaging, system-specific aberrations of theoptical system can lead to inaccurate localizations when the PSF model does not account for theseaberrations. Here we describe the use of phase-retrieved pupil functions to generate a more accuratePSF and therefore more accurate 3D localizations. The complex-valued pupil function containsinformation about the system-specific aberrations and can thus be used to generate the PSF forarbitrary defocus. Further, it can be modified to include depth dependent aberrations. We describethe phase retrieval process, the method for including depth dependent aberrations, and a fastfitting algorithm using graphics processing units. The superior localization accuracy of the pupilfunction generated PSF is demonstrated with dual focal plane 3D superresolution imaging ofbiological structures. PMID:24514501

  2. Panic and phobic anxiety: associations among neuroticism, physiological hyperarousal, anxiety sensitivity, and three phobias.

    PubMed

    Longley, Susan L; Watson, David; Noyes, Russell; Yoder, Kevin

    2006-01-01

    A dimensional and psychometrically informed taxonomy of anxiety is emerging, but the specific and nonspecific dimensions of panic and phobic anxiety require greater clarification. In this study, confirmatory factor analyses of data from a sample of 438 college students were used to validate a model of panic and phobic anxiety with six content factors; multiple scales from self-report measures were indicators of each model component. The model included a nonspecific component of (1) neuroticism and two specific components of panic attack, (2) physiological hyperarousal, and (3) anxiety sensitivity. The model also included three phobia components of (4) classically defined agoraphobia, (5) social phobia, and (6) blood-injection phobia. In these data, agoraphobia correlated more strongly with both the social phobia and blood phobia components than with either the physiological hyperarousal or the anxiety sensitivity components. These findings suggest that the association between panic attacks and agoraphobia warrants greater attention.

  3. Brands matter: Major findings from the Alcohol Brand Research Among Underage Drinkers (ABRAND) project.

    PubMed

    Roberts, Sarah P; Siegel, Michael B; DeJong, William; Ross, Craig S; Naimi, Timothy; Albers, Alison; Skeer, Margie; Rosenbloom, David L; Jernigan, David H

    Alcohol research focused on underage drinkers has not comprehensively assessed the landscape of brand-level drinking behaviors among youth. This information is needed to profile youth alcohol use accurately, explore its antecedents, and develop appropriate interventions. We collected national data on the alcohol brand-level consumption of underage drinkers in the United States and then examined the association between those preferences and several factors including youth exposure to brand-specific alcohol advertising, corporate sponsorships, popular music lyrics, and social networking sites, and alcohol pricing. This paper summarizes our findings, plus the results of other published studies on alcohol branding and youth drinking. Our findings revealed several interesting facts regarding youth drinking. For example, we found that: 1) youth are not drinking the cheapest alcohol brands; 2) youth brand preferences differ from those of adult drinkers; 3) underage drinkers are not opportunistic in their alcohol consumption, but instead consume a very specific set of brands; 4) the brands that youth are heavily exposed to in magazines and television advertising correspond to the brands they most often report consuming; and 5) youth consume more of the alcohol brands to whose advertising they are most heavily exposed. The findings presented here suggests that brand-level alcohol research will provide important insight into youth drinking behaviors, the factors that contribute to youth alcohol consumption, and potential avenues for effective public health surveillance and programming.

  4. Cerebro-costo-mandibular syndrome: Clinical, radiological, and genetic findings.

    PubMed

    Tooley, Madeleine; Lynch, Danielle; Bernier, Francois; Parboosingh, Jillian; Bhoj, Elizabeth; Zackai, Elaine; Calder, Alistair; Itasaki, Nobue; Wakeling, Emma; Scott, Richard; Lees, Melissa; Clayton-Smith, Jill; Blyth, Moira; Morton, Jenny; Shears, Debbie; Kini, Usha; Homfray, Tessa; Clarke, Angus; Barnicoat, Angela; Wallis, Colin; Hewitson, Rebecca; Offiah, Amaka; Saunders, Michael; Langton-Hewer, Simon; Hilliard, Tom; Davis, Peter; Smithson, Sarah

    2016-05-01

    Cerebro-Costo-Mandibular syndrome (CCMS) is a rare autosomal dominant condition comprising branchial arch-derivative malformations with striking rib-gaps. Affected patients often have respiratory difficulties, associated with upper airway obstruction, reduced thoracic capacity, and scoliosis. We describe a series of 12 sporadic and 4 familial patients including 13 infants/children and 3 adults. Severe micrognathia and reduced numbers of ribs with gaps are consistent findings. Cleft palate, feeding difficulties, respiratory distress, tracheostomy requirement, and scoliosis are common. Additional malformations such as horseshoe kidney, hypospadias, and septal heart defect may occur. Microcephaly and significant developmental delay are present in a small minority of patients. Key radiological findings are of a narrow thorax, multiple posterior rib gaps and abnormal costo-transverse articulation. A novel finding in 2 patients is bilateral accessory ossicles arising from the hyoid bone. Recently, specific mutations in SNRPB, which encodes components of the major spliceosome, have been found to cause CCMS. These mutations cluster in an alternatively spliced regulatory exon and result in altered SNRPB expression. DNA was available from 14 patients and SNRPB mutations were identified in 12 (4 previously reported). Eleven had recurrent mutations previously described in patients with CCMS and one had a novel mutation in the alternative exon. These results confirm the specificity of SNRPB mutations in CCMS and provide further evidence for the role of spliceosomal proteins in craniofacial and thoracic development. © 2016 Wiley Periodicals, Inc.

  5. Skill learning and the evolution of social learning mechanisms.

    PubMed

    van der Post, Daniel J; Franz, Mathias; Laland, Kevin N

    2016-08-24

    Social learning is potentially advantageous, but evolutionary theory predicts that (i) its benefits may be self-limiting because social learning can lead to information parasitism, and (ii) these limitations can be mitigated via forms of selective copying. However, these findings arise from a functional approach in which learning mechanisms are not specified, and which assumes that social learning avoids the costs of asocial learning but does not produce information about the environment. Whether these findings generalize to all kinds of social learning remains to be established. Using a detailed multi-scale evolutionary model, we investigate the payoffs and information production processes of specific social learning mechanisms (including local enhancement, stimulus enhancement and observational learning) and their evolutionary consequences in the context of skill learning in foraging groups. We find that local enhancement does not benefit foraging success, but could evolve as a side-effect of grouping. In contrast, stimulus enhancement and observational learning can be beneficial across a wide range of environmental conditions because they generate opportunities for new learning outcomes. In contrast to much existing theory, we find that the functional outcomes of social learning are mechanism specific. Social learning nearly always produces information about the environment, and does not always avoid the costs of asocial learning or support information parasitism. Our study supports work emphasizing the value of incorporating mechanistic detail in functional analyses.

  6. Necrotizing fasciitis: contribution and limitations of diagnostic imaging.

    PubMed

    Malghem, Jacques; Lecouvet, Frédéric E; Omoumi, Patrick; Maldague, Baudouin E; Vande Berg, Bruno C

    2013-03-01

    Necrotizing fasciitis is a rare, rapidly spreading, deep-seated infection causing thrombosis of the blood vessels located in the fascia. Necrotizing fasciitis is a surgical emergency. The diagnosis typically relies on clinical findings of severe sepsis and intense pain, although subacute forms may be difficult to recognize. Imaging studies can help to differentiate necrotizing fasciitis from infections located more superficially (dermohypodermitis). The presence of gas within the necrotized fasciae is characteristic but may be lacking. The main finding is thickening of the deep fasciae due to fluid accumulation and reactive hyperemia, which can be visualized using computed tomography and, above all, magnetic resonance imaging (high signal on contrast-enhanced T1 images and T2 images, best seen with fat saturation). These findings lack specificity, as they can be seen in non-necrotizing fasciitis and even in non-inflammatory conditions. Signs that support a diagnosis of necrotizing fasciitis include extensive involvement of the deep intermuscular fascias (high sensitivity but low specificity), thickening to more than 3mm, and partial or complete absence on post-gadolinium images of signal enhancement of the thickened fasciae (fairly high sensitivity and specificity). Ultrasonography is not recommended in adults, as the infiltration of the hypodermis blocks ultrasound transmission. Thus, imaging studies in patients with necrotizing fasciitis may be challenging to interpret. Although imaging may help to confirm deep tissue involvement and to evaluate lesion spread, it should never delay emergency surgical treatment in patients with established necrotizing fasciitis. Copyright © 2012. Published by Elsevier SAS.

  7. Social cognition and self-other distinctions in neuropsychiatry: Insights from schizophrenia and Tourette syndrome.

    PubMed

    Eddy, Clare M

    2018-03-02

    Impairments in social cognition may reflect dysfunction of disorder specific or disorder general mechanisms. Although cross-disorder comparison may prove insightful, few studies have compared social cognition in different neuropsychiatric disorders. Parallel investigation of schizophrenia and Tourette syndrome (TS) is encouraged by similarities including the presence of problematic social behavior, echophenomena, emotional dysregulation and dopamine dysfunction. Focusing on tests of social cognition administered in both disorders, this review aims to summarize behavioral, neurophysiological and neuroimaging findings, before exploring how these may contribute to clinical symptoms. Studies investigating social cognition (imitation, emotion recognition, and understanding of beliefs or intentions) in patients with schizophrenia or TS were identified through Web of Science and PubMed searches. Although findings indicate that social cognitive deficits are more apparent in schizophrenia, adults with TS can exhibit similar task performance to patients with paranoia. In both disorders, behavioral and neuroimaging findings raise the possibility of increased internal simulation of others' actions and emotions, in combination with a relative under-application of mentalizing. More specifically, dysfunction in neurobiological substrates such as temporo-parietal junction and inferior frontal gyrus may underlie problems with self-other distinctions in both schizophrenia and TS. Difficulties in distinguishing between actions and mental states linked to the self and other may contribute to a range of psychiatric symptoms, including emotional dysregulation, paranoia, social anhedonia and socially disruptive urges. Comparing different patient populations could therefore reveal common neuro-cognitive risk factors for the development of problematic social behaviors, in addition to markers of resilience, coping strategies and potential neuro-compensation mechanisms. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Correlation between hepatobiliary scintigraphy and surgery or postmortem examination findings in dogs and cats with extrahepatic biliary obstruction, partial obstruction, or patency of the biliary system: 18 cases (1995-2004).

    PubMed

    Head, Laurie L; Daniel, Gregory B

    2005-11-15

    To evaluate the usefulness of serum biochemical variables and scintigraphic study results for differentiating between dogs and cats with complete extrahepatic biliary obstruction (EHO) and those with partial EHO or patent bile ducts. Retrospective case series. 17 dogs and 1 cat. Animals that underwent hepatobiliary scintigraphy and had either surgical or postmortem confirmation of the degree of bile duct patency were included. Scintigraphic images were evaluated and biliary tracts were classified as patent, partially obstructed but patent, or obstructed. Surgery or postmortem examination was considered the gold standard for diagnosis, and compared with those findings, sensitivity and specificity of scintigraphy were calculated. With absence of radioactivity in the intestinal tract as the diagnostic criterion for EHO, the sensitivity and specificity of scintigraphic diagnosis were both 83% when final images were acquired at 19 to 24 hours, compared with 100% and 33%, respectively, when 180 minutes was used as the cutoff time. Animals with partial biliary obstruction had less intestinal radioactivity that arrived later than that observed in animals with patent biliary tracts. Animals in which intestinal radioactivity has not been observed after the standard 3 to 4 hours should undergo additional scintigraphic imaging. Findings in animals with partial biliary obstruction include delayed arrival of radioactivity and less radioactivity in the intestine. Distinguishing between complete and partial biliary tract obstruction is important because animals with partial obstruction may respond favorably to medical management and should not be given an erroneous diagnosis of complete obstruction.

  9. Mathematics teaching experiences of elementary preservice teachers with high and low mathematics anxiety during student teaching: A multiple case study

    NASA Astrophysics Data System (ADS)

    Nisbet, Leslie Deanna

    This study investigated the teaching experiences of six elementary preservice teachers (EPTs), three with high mathematics anxiety and three with low mathematics anxiety, during their student teaching semester. The EPTs were selected from an initial pool of 121 EPTs who took the Abbreviated Mathematics Anxiety Scale. The cases were compared in a cross case analysis to highlight mathematics teaching experiences among EPTs. Data sources included EPT and researcher journal entries, interview transcripts, pre-lesson surveys, field notes, lesson plans, and artifacts of observed lessons. Data were coded using Shulman's content knowledge, Graeber's mathematics pedagogical content knowledge, and mathematics anxiety characteristics. Findings revealed both similarities and differences across EPTs as related to four major categories: (a) planning and resources used, (b) role of the cooperating teacher, (c) content knowledge, and (d) pedagogical content knowledge. All EPTs used mostly direct instruction and relied on the course textbook and their respective cooperating teacher as their primary resources for planning. Additionally, across participants, the cooperating teacher influenced EPTs' perceptions of students and teaching. Also, EPTs with high mathematics anxiety were weaker with respect to content knowledge and pedagogical content knowledge. Findings suggest a need to re-design methods courses to address improving the pedagogical content knowledge of EPTs with mathematics anxiety. Findings also suggest a need to develop content specific mathematics courses for EPTs to improve their content knowledge. Future studies could include a longitudinal study to follow highly anxious EPTs who take content specific elementary mathematics courses to observe their content knowledge and mathematics anxiety.

  10. Improving continuing medical education by enhancing interactivity: lessons from Iran

    PubMed Central

    FAGHIHI, SEYED ALIAKBAR; KHANKEH, HAMID REZA; HOSSEINI, SEYED JALIL; SOLTANI ARABSHAHI, SEYED KAMRAN; FAGHIH, ZAHRA; PARIKH, SAGAR V.; SHIRAZI, MANDANA

    2016-01-01

    Introduction Continuing Medical Education (CME) has been considered as a lifelong commitment for doctors to provide the optimal care for patients. Despite a long history of creating CME programs, outcomes are far from ideal. The present qualitative study aims to clarify the barriers affecting effectiveness of the CME programs in Iran based on the experiences of general practitioners. Methods Sixteen general practitioners were recruited to participate in in-depth interviews and field observations concerning experiences with CME. The study was performed using a qualitative content analysis method. The codes, categories and themes were explored through an inductive process in which the researchers moved from specific to general. Results The participants’ experiences identified a number of barriers, particularly insufficient interaction with the instructors; additional problems included the teachers’ use of an undifferentiated approach; unreal and abstract CME; and ignorance of the diverse reasons to participate in CME. Conclusion Based on the study results, there are multiple barriers to effective implementation of CME in Iran. The key barriers include insufficient interaction between the trainees and providers, which must be considered by other stakeholders and program designers. Such interactions would facilitate improved program design, invite more specific tailoring of the education to the participants, allow for more effective educational methods and set the stage for outcome evaluation from the learners actually applying their new knowledge in practice. Replication of these findings with another sample would improve confidence in these recommendations, but these findings are broadly consistent with findings in the educational literature on improving the efficacy of CME. PMID:27104199

  11. Pharmacogenetics of Antipsychotics

    PubMed Central

    Brandl, Eva J; Kennedy, James L; Müller, Daniel J

    2014-01-01

    Objective: During the past decades, increasing efforts have been invested in studies to unravel the influence of genetic factors on antipsychotic (AP) dosage, treatment response, and occurrence of adverse effects. These studies aimed to improve clinical care by predicting outcome of treatment with APs and thus allowing for individualized treatment strategies. We highlight most important findings obtained through both candidate gene and genome-wide association studies, including pharmacokinetic and pharmacodynamic factors. Methods: We reviewed studies on pharmacogenetics of AP response and adverse effects published on PubMed until early 2012. Owing to the high number of published studies, we focused our review on findings that have been replicated in independent studies or are supported by meta-analyses. Results: Most robust findings were reported for associations between polymorphisms of the cytochrome P450 system, the dopamine and the serotonin transmitter systems, and dosage, treatment response, and adverse effects, such as AP-induced weight gain or tardive dyskinesia. These associations were either detected for specific medications or for classes of APs. Conclusion: First promising and robust results show that pharmacogenetics bear promise for a widespread use in future clinical practice. This will likely be achieved by developing algorithms that will include many genetic variants. However, further investigation is warranted to replicate and validate previous findings, as well as to identify new genetic variants involved in AP response and for replication of existing findings. PMID:24881126

  12. Functional transferred DNA within extracellular vesicles

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cai, Jin; Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Jiangsu Province; Wu, Gengze

    Extracellular vesicles (EVs) are small membrane vesicles including exosomes and shedding vesicles that mediated a cell-to-cell communication. EVs are released from almost all cell types under both physiological and pathological conditions and incorporate nuclear and cytoplasmic molecules for intercellular delivery. Besides protein, mRNA, and microRNA of these molecules, as recent studies show, specific DNA are prominently packaged into EVs. It appears likely that some of exosomes or shedding vesicles, bearing nuclear molecules are released upon bubble-like blebs. Specific interaction of EVs with susceptible recipients performs the uptake of EVs into the target cells, discharging their cargo including nuclear and cytoplasmicmore » macromolecules into the cytosol. These findings expand the nucleic acid content of EVs to include increased levels of specific DNA. Thus, EVs contain a repertoire of genetic information available for horizontal gene transfer and potential use as blood biomarkers for cancer and atherosclerosis. In this review, the focus is on the characteristics, biological functions, and roles in diseases of DNA within EVs. - Highlights: • This review is focused on the DNA within EVs including its characteristics, biological functions, and roles in diseases. • It is clear that DNA within EVs might have important physiological and pathological roles in various diseases. • Knowledge in this area may provides us alternative methods for disease diagnosis or therapy in the future.« less

  13. Chronic fatigue in Ehlers-Danlos syndrome-Hypermobile type.

    PubMed

    Hakim, Alan; De Wandele, Inge; O'Callaghan, Chris; Pocinki, Alan; Rowe, Peter

    2017-03-01

    Chronic fatigue is an important contributor to impaired health-related quality of life in Ehlers-Danlos syndrome. There is overlap in the symptoms and findings of EDS and chronic fatigue syndrome. A proportion of those with CFS likely have EDS that has not been identified. The evaluation of chronic fatigue in EDS needs to include a careful clinical examination and laboratory testing to exclude common causes of fatigue including anemia, hypothyroidisim, and chronic infection, as well as dysfunction of major physiological or organ systems. Other problems that commonly contribute to fatigue in EDS include sleep disorders, chronic pain, deconditioning, cardiovascular autonomic dysfunction, bowel and bladder dysfunction, psychological issues, and nutritional deficiencies. While there is no specific pharmacological treatment for fatigue, many medications are effective for specific symptoms (such as headache, menstrual dysfunction, or myalgia) and for co-morbid conditions that result in fatigue, including orthostatic intolerance and insomnia. Comprehensive treatment of fatigue needs to also evaluate for biomechanical problems that are common in EDS, and usually involves skilled physical therapy and attention to methods to prevent deconditioning. In addition to managing specific symptoms, treatment of fatigue in EDS also needs to focus on maintaining function and providing social, physical, and nutritional support, as well as providing on-going medical evaluation of new problems and review of new evidence about proposed treatments. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  14. Zinc supplementation for the prevention of acute lower respiratory infection in children in developing countries: meta-analysis and meta-regression of randomized trials.

    PubMed

    Roth, Daniel E; Richard, Stephanie A; Black, Robert E

    2010-06-01

    Routine zinc supplementation is a potential intervention for the prevention of acute lower respiratory infection (ALRI) in developing countries. However, discrepant findings from recent randomized trials remain unexplained. Randomized trials of zinc supplementation in young children in developing countries were identified by a systematic literature review. Trials included in the meta-analysis met specific criteria, including participants <5 years of age, daily/weekly zinc and control supplementation for greater than 3 months, active household surveillance for respiratory morbidity and use of a case definition that included at least one sign of lower respiratory tract illness. ALRI case definitions were classified on the basis of specificity/severity. Incidence rate ratios (IRRs) were pooled by random-effects models. Meta-regression and sub-group analysis were performed to assess potential sources of between-study heterogeneity. Ten trials were eligible for inclusion (n = 49 450 children randomized). Zinc reduced the incidence of ALRI defined by specific clinical criteria [IRR 0.65, 95% confidence interval (CI) 0.52-0.82], but had no effect on lower-specificity ALRI case definitions based on caregiver report (IRR 1.01, 95% CI 0.91-1.12) or World Health Organization 'non-severe pneumonia' (0.96, 95% CI 0.86-1.08). By meta-regression, the effect of zinc was associated with ALRI case definition, but not with mean baseline age, geographic location, nutritional status or zinc dose. Routine zinc supplementation reduced the incidence of childhood ALRI defined by relatively specific clinical criteria, but the effect was null if lower specificity case definitions were applied. The choice of ALRI case definition may substantially influence inferences from community trials regarding the efficacy of preventive interventions.

  15. Deletion of Fmr1 results in sex-specific changes in behavior.

    PubMed

    Nolan, Suzanne O; Reynolds, Conner D; Smith, Gregory D; Holley, Andrew J; Escobar, Brianna; Chandler, Matthew A; Volquardsen, Megan; Jefferson, Taylor; Pandian, Ashvini; Smith, Tileena; Huebschman, Jessica; Lugo, Joaquin N

    2017-10-01

    In this study, we used a systemic Fmr1 knockout in order to investigate both genotype- and sex-specific differences across multiple measures of sociability, repetitive behaviors, activity levels, anxiety, and fear-related learning and memory. Fragile X syndrome is the most common monogenic cause of intellectual disability and autism. Few studies to date have examined sex differences in a mouse model of Fragile X syndrome, though clinical data support the idea of differences in both overall prevalence and phenotype between the sexes. Using wild-type and systemic homozygous Fmr1 knockout mice, we assessed a variety of behavioral paradigms in adult animals, including the open field test, elevated plus maze, nose-poke assay, accelerating rotarod, social partition task, three-chambered social task, and two different fear conditioning paradigms. Tests were ordered such that the most invasive tests were performed last in the sequence, and testing paradigms for similar behaviors were performed in separate cohorts to minimize testing effects. Our results indicate several sex-specific changes in Fmr1 knockout mice, including male-specific increases in activity levels, and female-specific increases in repetitive behaviors on both the nose-poke assay and motor coordination on the accelerating rotarod task. The results also indicated that Fmr1 deletion results in deficits in fear learning and memory across both sexes, and no changes in social behavior across two tasks. These findings highlight the importance of including female subjects in preclinical studies, as simply studying the impact of genetic mutations in males does not yield a complete picture of the phenotype. Further research should explore these marked phenotypic differences among the sexes. Moreover, given that treatment strategies are typically equivalent between the sexes, the results highlight a potential need for sex-specific therapeutics.

  16. Verification bias: an under-recognized source of error in assessing the efficacy of MRI of the meniscii.

    PubMed

    Richardson, Michael L; Petscavage, Jonelle M

    2011-11-01

    The sensitivity and specificity of magnetic resonance imaging (MRI) for diagnosis of meniscal tears has been studied extensively, with tears usually verified by surgery. However, surgically unverified cases are often not considered in these studies, leading to verification bias, which can falsely increase the sensitivity and decrease the specificity estimates. Our study suggests that such bias may be very common in the meniscal MRI literature, and illustrates techniques to detect and correct for such bias. PubMed was searched for articles estimating sensitivity and specificity of MRI for meniscal tears. These were assessed for verification bias, deemed potentially present if a study included any patients whose MRI findings were not surgically verified. Retrospective global sensitivity analysis (GSA) was performed when possible. Thirty-nine of the 314 studies retrieved from PubMed specifically dealt with meniscal tears. All 39 included unverified patients, and hence, potential verification bias. Only seven articles included sufficient information to perform GSA. Of these, one showed definite verification bias, two showed no bias, and four others showed bias within certain ranges of disease prevalence. Only 9 of 39 acknowledged the possibility of verification bias. Verification bias is underrecognized and potentially common in published estimates of the sensitivity and specificity of MRI for the diagnosis of meniscal tears. When possible, it should be avoided by proper study design. If unavoidable, it should be acknowledged. Investigators should tabulate unverified as well as verified data. Finally, verification bias should be estimated; if present, corrected estimates of sensitivity and specificity should be used. Our online web-based calculator makes this process relatively easy. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

  17. Air Quality uFIND: User-oriented Tool Set for Air Quality Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Hoijarvi, K.; Robinson, E. M.; Husar, R. B.; Falke, S. R.; Schultz, M. G.; Keating, T. J.

    2012-12-01

    Historically, there have been major impediments to seamless and effective data usage encountered by both data providers and users. Over the last five years, the international Air Quality (AQ) Community has worked through forums such as the Group on Earth Observations AQ Community of Practice, the ESIP AQ Working Group, and the Task Force on Hemispheric Transport of Air Pollution to converge on data format standards (e.g., netCDF), data access standards (e.g., Open Geospatial Consortium Web Coverage Services), metadata standards (e.g., ISO 19115), as well as other conventions (e.g., CF Naming Convention) in order to build an Air Quality Data Network. The centerpiece of the AQ Data Network is the web service-based tool set: user-oriented Filtering and Identification of Networked Data. The purpose of uFIND is to provide rich and powerful facilities for the user to: a) discover and choose a desired dataset by navigation through the multi-dimensional metadata space using faceted search, b) seamlessly access and browse datasets, and c) use uFINDs facilities as a web service for mashups with other AQ applications and portals. In a user-centric information system such as uFIND, the user experience is improved by metadata that includes the general fields for discovery as well as community-specific metadata to narrow the search beyond space, time and generic keyword searches. However, even with the community-specific additions, the ISO 19115 records were formed in compliance with the standard, so that other standards-based search interface could leverage this additional information. To identify the fields necessary for metadata discovery we started with the ISO 19115 Core Metadata fields and fields that were needed for a Catalog Service for the Web (CSW) Record. This fulfilled two goals - one to create valid ISO 19115 records and the other to be able to retrieve the records through a Catalog Service for the Web query. Beyond the required set of fields, the AQ Community added additional fields using a combination of keywords and ISO 19115 fields. These extensions allow discovery by measurement platform or observed phenomena. Beyond discovery metadata, the AQ records include service identification objects that allow standards-based clients, such as some brokers, to access the data found via OGC WCS or WMS data access protocols. uFIND, is one such smart client, this combination of discovery and access metadata allows the user to preview each registered dataset through spatial and temporal views; observe the data access and usage pattern and also find links to dataset-specific metadata directly in uFIND. The AQ data providers also benefit from this architecture since their data products are easier to find and re-use, enhancing the relevance and importance of their products. Finally, the earth science community at large benefits from the Service Oriented Architecture of uFIND, since it is a service itself and allows service-based interfacing with providers and users of the metadata, allowing uFIND facets to be further refined for a particular AQ application or completely repurposed for other Earth Science domains that use the same set of data access and metadata standards.

  18. Emergency management of acute abdomen in children.

    PubMed

    Balachandran, Binesh; Singhi, Sunit; Lal, Sadhna

    2013-03-01

    Acute abdomen can be defined as a medical emergency in which there is sudden and severe pain in abdomen with accompanying signs and symptoms that focus on an abdominal involvement. It accounts for about 8 % of all children attending the emergency department. The goal of emergency management is to identify and treat any life-threatening medical or surgical disease condition and relief from pain. In mild cases often the cause is gastritis or gastroenteritis, colic, constipation, pharyngo-tonsilitis, viral syndromes or acute febrile illnesses. The common surgical causes are malrotation and Volvulus (in early infancy), intussusception, acute appendicitis, and typhoid and ischemic enteritis with perforation. Lower lobe pneumonia, diabetic ketoacidosis and acute porphyria should be considered in patients with moderate-severe pain with little localizing findings in abdomen. The approach to management in ED should include, in order of priority, a rapid cardiopulmonary assessment to ensure hemodynamic stability, focused history and examination, surgical consult and radiologic examination to exclude life threatening surgical conditions, pain relief and specific diagnosis. In a sick patient the initial steps include rapid IV access and normal saline 20 ml/kg (in the presence of shock/hypovolemia), adequate analgesia, nothing per oral/IV fluids, Ryle's tube aspiration and surgical consultation. An ultrasound abdomen is the first investigation in almost all cases with moderate and severe pain with localizing abdominal findings. In patients with significant abdominal trauma or features of pancreatitis, a Contrast enhanced computerized tomography (CECT) abdomen will be a better initial modality. Continuous monitoring and repeated physical examinations should be done in all cases. Specific management varies according to the specific etiology.

  19. Gender differences in the impact of population-level alcohol policy interventions: evidence synthesis of systematic reviews.

    PubMed

    Fitzgerald, Niamh; Angus, Kathryn; Emslie, Carol; Shipton, Deborah; Bauld, Linda

    2016-10-01

    Consistent review-level evidence supports the effectiveness of population-level alcohol policies in reducing alcohol-related harms. Such policies interact with well-established social, cultural and biological differences in how men and women perceive, relate to and use alcohol, and with wider inequalities, in ways which may give rise to gender differences in policy effectiveness. This paper aimed to examine the extent to which gender-specific data and analyses were considered in, and are available from, systematic reviews of population-level alcohol policy interventions, and where possible, to conduct a narrative synthesis of relevant data. A prior systematic 'review of reviews' of population level alcohol interventions 2002-2012 was updated to May 2014, all gender-relevant data extracted, and the level and quality of gender reporting assessed. A narrative synthesis of extracted findings was conducted. Sixty-three systematic reviews, covering ten policy areas, were included. Five reviews (8%) consistently provided information on baseline participation by gender for each individual study in the review and twenty-nine (46%) reported some gender-specific information on the impact of the policies under consideration. Specific findings include evidence of possible gender differences in the impact of and exposure to alcohol marketing, and a failure to consider potential unintended consequences and harm to others in most reviews. Gender is poorly reported in systematic reviews of population-level interventions to reduce alcohol-related harm, hindering assessment of the intended and unintended effects of such policies on women and men. © 2016 Society for the Study of Addiction.

  20. A systematic review on the mental health of children and adolescents in areas of armed conflict in the Middle East.

    PubMed

    Dimitry, L

    2012-03-01

    For many decades, the Middle East has been troubled with numerous long-standing armed conflicts and wars. Children and adolescents were not spared the trauma and its consequences. Exposure to traumatic events can result in mental, behavioural and emotional problems in children and adolescents. To date, this is the first paper that aims to systematically review the literature on the mental health of children and adolescents living in areas of armed conflict in the Middle East, specifically Israel, Palestine, Lebanon and Iraq. It explores factors that mediate between exposure to armed conflict and mental, behavioural and emotional problems and places them in a cultural context. Pubmed was searched and papers were identified using specific inclusion criteria. Seventy-one eligible studies were included. The main findings are that children and adolescents living in these conflict zones are exposed to high levels of traumatic experiences. Number of conflict-related traumatic experiences correlates positively with prevalence of mental, behavioural and emotional problems. Prevalence of post-traumatic stress disorder in children and adolescents is estimated to be 5-8% in Israel, 23-70% in Palestine and 10-30% in Iraq (insufficient data for Lebanon). The main determining factors identified were level and type of exposure, age, gender, socio-economic adversity, social support and religiosity. These findings bring to light the pressing need to provide children and adolescents living in conflict areas with help. They are useful in designing new interventions to strengthen child and adolescent resilience in areas of conflict worldwide. Specific recommendations are included. © 2011 Blackwell Publishing Ltd.

  1. Association between unilateral or bilateral mastectomy and breast cancer death in patients with unilateral ductal carcinoma.

    PubMed

    Agarwal, Shailesh; Pappas, Lisa; Agarwal, Jayant

    2017-01-01

    Utilization of bilateral mastectomy for unilateral breast cancer is increasing despite cost and surgical risks with conflicting reports of survival benefit. Current studies evaluating death after bilateral mastectomy have included patients treated both with breast conservation therapy and unilateral mastectomy. In this study, we directly compared breast cancer-specific death of patients who underwent bilateral or unilateral mastectomy for unilateral breast cancer using a matched cohort analysis. This was an observational study of women diagnosed with unilateral breast cancer from 1998 through 2002, using the Surveillance, Epidemiology, and End Results (SEER) database. A 4-to-1 matched cohort of patients was selected including 14,075 patients. Mortality of the groups was compared using Cox proportional hazards models for cause-specific death. A total of 41,510 patients diagnosed with unilateral breast cancer were included. Unilateral mastectomy was performed in 93% of patients, while bilateral mastectomy was performed in the remaining 7% of patients. When 4-to-1 matching was performed, 11,260 unilateral mastectomy and 2,815 bilateral mastectomy patients were included. Patients with bilateral mastectomy did not have a significantly lower hazard of breast cancer-specific death when compared with patients with unilateral mastectomy (hazard ratio: 0.92 vs 1.00, p =0.11). Bilateral mastectomy did not provide a clinically or statistically significant breast cancer-specific mortality benefit over unilateral mastectomy based on a matched cohort analysis of a nationwide population database. These findings should be interpreted in the context of patient preference and alternative benefits of bilateral mastectomy.

  2. Association between unilateral or bilateral mastectomy and breast cancer death in patients with unilateral ductal carcinoma

    PubMed Central

    Agarwal, Shailesh; Pappas, Lisa; Agarwal, Jayant

    2017-01-01

    Background Utilization of bilateral mastectomy for unilateral breast cancer is increasing despite cost and surgical risks with conflicting reports of survival benefit. Current studies evaluating death after bilateral mastectomy have included patients treated both with breast conservation therapy and unilateral mastectomy. In this study, we directly compared breast cancer–specific death of patients who underwent bilateral or unilateral mastectomy for unilateral breast cancer using a matched cohort analysis. Methods This was an observational study of women diagnosed with unilateral breast cancer from 1998 through 2002, using the Surveillance, Epidemiology, and End Results (SEER) database. A 4-to-1 matched cohort of patients was selected including 14,075 patients. Mortality of the groups was compared using Cox proportional hazards models for cause-specific death. Results A total of 41,510 patients diagnosed with unilateral breast cancer were included. Unilateral mastectomy was performed in 93% of patients, while bilateral mastectomy was performed in the remaining 7% of patients. When 4-to-1 matching was performed, 11,260 unilateral mastectomy and 2,815 bilateral mastectomy patients were included. Patients with bilateral mastectomy did not have a significantly lower hazard of breast cancer–specific death when compared with patients with unilateral mastectomy (hazard ratio: 0.92 vs 1.00, p=0.11). Conclusion Bilateral mastectomy did not provide a clinically or statistically significant breast cancer–specific mortality benefit over unilateral mastectomy based on a matched cohort analysis of a nationwide population database. These findings should be interpreted in the context of patient preference and alternative benefits of bilateral mastectomy. PMID:29180900

  3. Prion-specific Hsp40 function: The role of the auxilin homolog Swa2

    PubMed Central

    Oliver, Emily E.; Troisi, Elizabeth M.; Hines, Justin K.

    2017-01-01

    ABSTRACT Yeast prions are protein-based genetic elements that propagate through cell populations via cytosolic transfer from mother to daughter cell. Molecular chaperone proteins including Hsp70, the Hsp40/J-protein Sis1, and Hsp104 are required for continued prion propagation, however the specific requirements of chaperone proteins differ for various prions. We recently reported that Swa2, the yeast homolog of the mammalian protein auxilin, is specifically required for the propagation of the prion [URE3].1 [URE3] propagation requires both a functional J-domain and the tetratricopeptide repeat (TPR) domain of Swa2, but does not require Swa2 clathrin binding. We concluded that the TPR domain determines the specificity of the genetic interaction between Swa2 and [URE3], and that this domain likely interacts with one or more proteins with a C-terminal EEVD motif. Here we extend that analysis to incorporate additional data that supports this hypothesis. We also present new data eliminating Hsp104 as the relevant Swa2 binding partner and discuss our findings in the context of other recent work involving Hsp90. Based on these findings, we propose a new model for Swa2's involvement in [URE3] propagation in which Swa2 and Hsp90 mediate the formation of a multi-protein complex that increases the number of sites available for Hsp104 disaggregation. PMID:28574745

  4. Specificity of Dyspraxia in Children with Autism

    PubMed Central

    MacNeil, Lindsey K.; Mostofsky, Stewart H.

    2012-01-01

    Objective To explore the specificity of impaired praxis and postural knowledge to autism by examining three samples of children, including those with autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), and typically developing (TD) children. Method Twenty-four children with ASD, 24 children with ADHD, and 24 TD children, ages 8–13, completed measures assessing basic motor control (the Physical and Neurological Exam for Subtle Signs; PANESS), praxis (performance of skilled gestures to command, with imitation, and tool use) and the ability to recognize correct hand postures necessary to perform these skilled gestures (the Postural Knowledge Test; PKT). Results Children with ASD performed significantly worse than TD children on all three assessments. In contrast, children with ADHD performed significantly worse than TD controls on PANESS but not on the praxis examination or PKT. Furthermore, children with ASD performed significantly worse than children with ADHD on both the praxis examination and PKT, but not on the PANESS. Conclusions Whereas both children with ADHD and children with ASD show impairments in basic motor control, impairments in performance and recognition of skilled motor gestures, consistent with dyspraxia, appear to be specific to autism. The findings suggest that impaired formation of perceptual-motor action models necessary to development of skilled gestures and other goal directed behavior is specific to autism; whereas, impaired basic motor control may be a more generalized finding. PMID:22288405

  5. Evolution and Expression of Tissue Globins in Ray-Finned Fishes.

    PubMed

    Gallagher, Michael D; Macqueen, Daniel J

    2017-01-01

    The globin gene family encodes oxygen-binding hemeproteins conserved across the major branches of multicellular life. The origins and evolutionary histories of complete globin repertoires have been established for many vertebrates, but there remain major knowledge gaps for ray-finned fish. Therefore, we used phylogenetic, comparative genomic and gene expression analyses to discover and characterize canonical “non-blood” globin family members (i.e., myoglobin, cytoglobin, neuroglobin, globin-X, and globin-Y) across multiple ray-finned fish lineages, revealing novel gene duplicates (paralogs) conserved from whole genome duplication (WGD) and small-scale duplication events. Our key findings were that: (1) globin-X paralogs in teleosts have been retained from the teleost-specific WGD, (2) functional paralogs of cytoglobin, neuroglobin, and globin-X, but not myoglobin, have been conserved from the salmonid-specific WGD, (3) triplicate lineage-specific myoglobin paralogs are conserved in arowanas (Osteoglossiformes), which arose by tandem duplication and diverged under positive selection, (4) globin-Y is retained in multiple early branching fish lineages that diverged before teleosts, and (5) marked variation in tissue-specific expression of globin gene repertoires exists across ray-finned fish evolution, including several previously uncharacterized sites of expression. In this respect, our data provide an interesting link between myoglobin expression and the evolution of air breathing in teleosts. Together, our findings demonstrate great-unrecognized diversity in the repertoire and expression of nonblood globins that has arisen during ray-finned fish evolution.

  6. Visual Masking in Schizophrenia: Overview and Theoretical Implications

    PubMed Central

    Green, Michael F.; Lee, Junghee; Wynn, Jonathan K.; Mathis, Kristopher I.

    2011-01-01

    Visual masking provides several key advantages for exploring the earliest stages of visual processing in schizophrenia: it allows for control over timing at the millisecond level, there are several well-supported theories of the underlying neurobiology of visual masking, and it is amenable to examination by electroencephalogram (EEG) and functional magnetic resonance imaging (fMRI). In this paper, we provide an overview of the visual masking impairment schizophrenia, including the relevant theoretical mechanisms for masking impairment. We will discuss its relationship to clinical symptoms, antipsychotic medications, diagnostic specificity, and presence in at-risk populations. As part of this overview, we will cover the neural correlates of visual masking based on recent findings from EEG and fMRI. Finally, we will suggest a possible mechanism that could explain the patterns of masking findings and other visual processing findings in schizophrenia. PMID:21606322

  7. Ophthalmic findings in a family with early-onset isolated ectopia lentis and the p.Arg62Cys mutation of the fibrillin-1 gene (FBN1).

    PubMed

    Zhao, Jun-Hong; Jin, Tian-Bo; Liu, Qing-Bo; Chen, Chao; Hu, Hai-Tao

    2013-01-01

    The purpose of this paper is to describe ophthalmic findings in a family with isolated ectopia lentis (EL) caused by a specific FBN1 mutation. Detailed family histories and clinical data were recorded for six isolated EL patients of 11 family members. The ophthalmological and systematic examinations were performed on patients and unaffected members of the investigated family. The detailed ocular examinations included visual acuity, anterior chamber depth, pupil size, lens location, optometry, central corneal thickness, keratometry, slitlamp examination, fundus examination, axial length, ocular B-ultrasound, gonioscope checking, ultrasound biomicroscopy (UBM) and intraocular pressure (IOP; Goldmann applanation tonometer). Systematic examinations included the measurement of echocardiogram, height, arm span, skull, face, jaw, tooth, breast bone, spinal column, and skin. Genomic DNA was extracted using the phenol-chloroform extraction method for all subjects, and sequencing was carried out on an ABI Prism 3730 Genetic Analyzer. A heterozygous mutation, c.184C>T (p.Arg62Cys) in exon 2 of FBN1 was identified in all affected members but was not found in any unaffected member of the family. Our study presented detailed clinical manifestations, including some novel ophthalmic findings, such as pupillary abnormality, different types of glaucoma, and progressive hyperopia. Ophthalmic findings and the p.Arg62Cys mutation of FBN1 gene were reported in a family with early-onset isolated ectopia lentis.

  8. Speech-language pathology findings in patients with mouth breathing: multidisciplinary diagnosis according to etiology.

    PubMed

    Junqueira, Patrícia; Marchesan, Irene Queiroz; de Oliveira, Luciana Regina; Ciccone, Emílio; Haddad, Leonardo; Rizzo, Maria Cândida

    2010-11-01

    The purpose of this study was to identify and compare the results of the findings from speech-language pathology evaluations for orofacial function including tongue and lip rest postures, tonus, articulation and speech, voice and language, chewing, and deglutition in children who had a history of mouth breathing. The diagnoses for mouth breathing included: allergic rhinitis, adenoidal hypertrophy, allergic rhinitis with adenoidal hypertrophy; and/or functional mouth breathing. This study was conducted with on 414 subjects of both genders, from 2 to 16-years old. A team consisting of 3 speech-language pathologists, 1 pediatrician, 1 allergist, and 1 otolaryngologist, evaluated the patients. Multidisciplinary clinical examinations were carried out (complete blood counting, X-rays, nasofibroscopy, audiometry). The two most commonly found etiologies were allergic rhinitis, followed by functional mouth breathing. Of the 414 patients in the study, 346 received a speech-language pathology evaluation. The most prevalent finding in this group of 346 subjects was the presence of orofacial myofunctional disorders. The most frequently orofacial myofunctional disorder identified in these subjects who also presented mouth breathing included: habitual open lips rest posture, low and forward tongue rest posture and lack of adequate muscle tone. There were also no statistically significant relationships identified between etiology and speech-language diagnosis. Therefore, the specific type of etiology of mouth breathing does not appear to contribute to the presence, type, or number of speech-language findings which may result from mouth breathing behavior.

  9. Parent and child distress after war exposure.

    PubMed

    Lai, Betty S; Hadi, Fawzyiah; Llabre, Maria M

    2014-09-01

    The purpose of this study was to examine multiple distress symptoms (i.e., post-traumatic stress [PTS], anxiety, depression) among parents and children exposed to the Gulf Crisis in 1990-1991. Profiles of parent distress were identified, and the relationship between parent distress and specific child distress symptoms was examined. Parents and children were assessed at one time point. Participants included 151 children (Mage = 10.62 years; 51% female) and 140 parents (Mage = 40 years; 81% female). Utilizing latent profile analysis, three parallel profiles of parent distress were identified: low distress, moderate distress, and high distress. Parent distress was a risk factor for child depression, but it was not a risk factor for child PTS or anxiety. Findings support the importance of broadening the scope of research conducted after exposure to traumatic events to include the assessment of anxiety and depression, as well as PTS, among both parents and children. Additional implications for research and clinical work are discussed. Findings support the importance of screening for multiple distress symptoms among both children and parents after war exposure. Based on our findings, clinicians may want to consider including parents in therapy for children reporting psychological distress, especially depression symptoms, after exposure to traumatic events. This study was cross-sectional. Thus, we are not able to infer direction or causality. The generalizability of our study should be interpreted with caution, as findings will need to be replicated across other populations and other cultures. © 2014 The British Psychological Society.

  10. 25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Where can I find specific policies and standards for law enforcement functions in Indian country? 12.14 Section 12.14 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards fo...

  11. Health Websites: Accessibility and Usability for American Sign Language Users

    PubMed Central

    Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R.; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

    2015-01-01

    To date, there have been efforts towards creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our paper focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users’ perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (N=32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to: 1) navigation to find the task, 2) website usability, and 3) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This paper also describes the participants’ preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users. PMID:24901350

  12. Gender Research in the National Institute on Drug Abuse National Treatment Clinical Trials Network: A Summary of Findings

    PubMed Central

    Greenfield, Shelly F.; Rosa, Carmen; Putnins, Susan I.; Green, Carla A.; Brooks, Audrey J.; Calsyn, Donald A.; Cohen, Lisa R.; Erickson, Sarah; Gordon, Susan M.; Haynes, Louise; Killeen, Therese; Miele, Gloria; Tross, Susan; Winhusen, Theresa

    2011-01-01

    Background The NIDA National Drug Abuse Treatment Clinical Trials Network (CTN) was established to foster translation of research into practice in substance abuse treatment settings. The CTN provides a unique opportunity to examine in multi-site, translational clinical trials, the outcomes of treatment interventions targeting vulnerable sub-groups of women; the comparative effectiveness of gender-specific protocols to reduce risk behaviors; and gender differences in clinical outcomes. Objectives To review gender-related findings from published CTN clinical trials and related studies from January, 2000 through March, 2010. Methods CTN studies were selected for review if they focused on treatment outcomes or services for special populations of women with substance use disorders (SUDs) including those with trauma histories, pregnancy, co-occurring eating and other psychiatric disorders and HIV risk behaviors; or implemented gender-specific protocols. Results The CTN has randomized 11,500 participants (41% women) across 200 clinics in 24 randomized clinical trials in community settings, of which 4 have been gender-specific. This paper summarizes gender-related findings from CTN clinical trials and related studies, focusing on trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors. Conclusions These published studies have expanded the evidence base regarding interventions for vulnerable groups of women with SUDs as well as gender-specific interventions to reduce HIV risk behaviors in substance using men and women. The results also underscore the complexity of accounting for gender in the design of clinical trials and analysis of results. Scientific Relevance To fully understand the relevance of gender-specific moderators and mediators of outcome, it is essential that future translational studies adopt more sophisticated approaches to understanding and measuring gender-relevant factors and plan sample sizes that are adequate to support more nuanced analytic methods. PMID:21854272

  13. Therapeutic targeting of regulatory T cells enhances tumor-specific CD8+ T cell responses in Epstein–Barr virus associated nasopharyngeal carcinoma

    PubMed Central

    Fogg, Mark; Murphy, John R.; Lorch, Jochen; Posner, Marshall; Wang, Fred

    2013-01-01

    Epstein–Barr virus (EBV) is associated with multiple malignancies including nasopharyngeal carcinoma (NPC). In nasopharynx cancer, CD8+ T cells specific for EBV Nuclear Antigen-1 (EBNA-1) and Latent Membrane Protein 2 (LMP2) are important components of anti-tumor immunity since both are consistently expressed in NPC. We have previously shown that EBNA-1-specific CD8+ T cell responses were suppressed in NPC patients compared to healthy controls. We now find that CD8+ T cell responses specific for LMP2 are also abnormal in NPC patients, and both EBNA-1- and LMP2-specific responses are suppressed by regulatory T cells (Treg). EBNA-1 and LMP2-specific CD8+ T cell responses, as well as immune control of EBV-infected cells in vitro, could be restored by the depletion of Tregs and by use of a clinically approved drug targeting Tregs. Thus, in vivo modulation of Tregs may be an effective means of enhancing these anti-tumor immune responses in NPC patients. PMID:23601786

  14. Quality specifications in postgraduate medical e-learning: an integrative literature review leading to a postgraduate medical e-learning model.

    PubMed

    De Leeuw, R A; Westerman, Michiel; Nelson, E; Ket, J C F; Scheele, F

    2016-07-08

    E-learning is driving major shifts in medical education. Prioritizing learning theories and quality models improves the success of e-learning programs. Although many e-learning quality standards are available, few are focused on postgraduate medical education. We conducted an integrative review of the current postgraduate medical e-learning literature to identify quality specifications. The literature was thematically organized into a working model. Unique quality specifications (n = 72) were consolidated and re-organized into a six-domain model that we called the Postgraduate Medical E-learning Model (Postgraduate ME Model). This model was partially based on the ISO-19796 standard, and drew on cognitive load multimedia principles. The domains of the model are preparation, software design and system specifications, communication, content, assessment, and maintenance. This review clarified the current state of postgraduate medical e-learning standards and specifications. It also synthesized these specifications into a single working model. To validate our findings, the next-steps include testing the Postgraduate ME Model in controlled e-learning settings.

  15. Is there consistency and specificity of autonomic changes during emotional episodes? Guidance from the conceptual act theory and psychophysiology

    PubMed Central

    Quigley, Karen S.; Barrett, Lisa Feldman

    2014-01-01

    The consistency and specificity of autonomic nervous system (ANS) responses during emotional episodes remains a topic of debate with relevance for emotional concordance. We present a recent model of how mental states are constructed, the Conceptual Act Theory (CAT), and then review findings from existing meta-analyses and a qualitative review along with studies using pattern classification of multivariate ANS patterns to determine if there is across-study evidence for consistency and specificity of ANS responses during emotional episodes. We conclude that there is thus far minimal evidence for ANS response consistency and specificity across studies. We then review the current understanding of the functional and anatomical features of ANS including its efferent and afferent connections with the central nervous system, which suggests the need to reformulate how we conceptualize ANS response consistency and specificity. We conclude by showing how this reformulation is consistent with the CAT, and how we suggest the model to propose when we would and would not expect to see consistency and specificity in ANS responses, and concordance more generally, during emotional episodes. PMID:24388802

  16. Disruption of striatal-enriched protein tyrosine phosphatase (STEP) function in neuropsychiatric disorders

    PubMed Central

    Karasawa, Takatoshi; Lombroso, Paul J.

    2014-01-01

    Striatal-enriched protein tyrosine phosphatase (STEP) is a brain-specific tyrosine phosphatase that plays a major role in the development of synaptic plasticity. Recent findings have implicated STEP in several psychiatric and neurological disorders, including Alzheimer’s disease, schizophrenia, fragile X syndrome, Huntington’s disease, stroke/ischemia, and stress-related psychiatric disorders. In these disorders, STEP protein expression levels and activity are dysregulated, contributing to the cognitive deficits that are present. In this review, we focus on the most recent findings on STEP, discuss how STEP expression and activity are maintained during normal cognitive function, and how disruptions in STEP activity contribute to a number of illnesses. PMID:25218562

  17. Radiographic findings in pulmonary hypertension from unresolved embolism

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Woodruff, W.W. III; Hoeck, B.E.; Chitwood, W.R. Jr.

    1985-04-01

    Pulmonary artery hypertension with chronic pulmonary embolism is an uncommon entity that is potentially treatable with pulmonary embolectomy. Although the classic radiographic features have been described, several recent investigators report a significant percentage of these patients with normal chest radiographs. In a series of 22 patients, no normal radiographs were seen. Findings included cardiomegaly (86.4%) with right-sided enlargement (68.4%), right descending pulmonary artery enlargement (54.5%), azygos vein enlargement (27.3%), mosaic oligemia (68.2%), chronic volume loss (27.3%), atelectasis and/or effusion (22.7%), and pleural thickening (13.6%). Good correlation with specific areas of diminished vascularity was seen on chest radiographs compared with pulmonarymore » angiograms.« less

  18. Effects of inflammation on social processes and implications for health.

    PubMed

    Moieni, Mona; Eisenberger, Naomi I

    2018-05-28

    Although at first glance inflammation and social behavior may appear unrelated, research points to an important role for inflammation in shaping social processes. This review summarizes findings in this field, specifically highlighting work that provides support for the idea that inflammation can lead to (1) increases in sensitivity to negative, threatening social experiences and (2) increases in sensitivity to positive, socially rewarding experiences. These diverging sensitivities in response to inflammation may depend on context and be adaptive for recuperation and recovery from illness. This review also discusses the implications of these findings for health and future research, including implications for depression, loneliness, and inflammatory disorders. © 2018 New York Academy of Sciences.

  19. Slowing Down Time: An Exploration of Personal Life Extension Desirability as it Relates to Religiosity and Specific Religious Beliefs.

    PubMed

    Ballinger, Scott; Tisdale, Theresa Clement; Sellen, David L; Martin, Loren A

    2017-02-01

    As medical technology continues increasing the possibility of living a longer life, the public's valuing of these developments must be considered. This study examines attitudes toward extending the human life span within a student population at a Christian university. Religious factors were hypothesized to affect life extension desirability. Scores on measures of willingness to defer to God's will, meaning derived from religion, positive afterlife beliefs, and intrinsic religiosity were significantly and inversely related to life extension desirability. Implications of these findings are discussed, including encouraging medical practitioners to respect decision-making processes of religious persons who may find life extension interventions undesirable.

  20. Depression Case Finding in Individuals with Dementia: A Systematic Review and Meta-Analysis.

    PubMed

    Goodarzi, Zahra S; Mele, Bria S; Roberts, Derek J; Holroyd-Leduc, Jayna

    2017-05-01

    To compare the diagnostic accuracy of depression case finding tools with a criterion standard in the outpatient setting among adults with dementia. Systematic review and meta-analysis. Studies of older outpatients with dementia. Elderly outpatients (clinic and long-term care) with dementia (N = 3,035). Prevalence of major depression and diagnostic accuracy measures including sensitivity, specificity, and likelihood ratios. From the 11,539 citations, 20 studies were included for qualitative synthesis and 15 for a meta-analysis. Tools included were the Montgomery Åsberg Depression Rating Scale, Cornell Scale for Depression in Dementia (CSDD), Geriatric Depression Scale (GDS), Center for Epidemiologic Studies Depression Scale (CES-D), Hamilton Depression Rating Scale (HDRS), Single Question, Nijmegen Observer-Rated Depression Scale, and Even Briefer Assessment Scale-Depression. The pooled prevalence of depression in individuals with dementia was 30.3% (95% CI = 22.1-38.5). The average age was 75.2 (95% CI = 71.7-78.7), and mean Mini-Mental State Examination scores ranged from 11.2 to 24. The diagnostic accuracy of the individual tools was pooled for the best-reported cutoffs and for each cutoff, if available. The CSDD had a sensitivity of 0.84 (95% CI = 0.73-0.91) and a specificity of 0.80 (95% CI = 0.65-0.90), the 30-item GDS (GDS-30) had a sensitivity of 0.62 (95% CI = 0.45-0.76) and a specificity 0.81 (95% CI = 0.75-0.85), and the HDRS had a sensitivity of 0.86 (95% CI = 0.63-0.96) and a specificity of 0.84 (95% CI = 0.76-0.90). Summary statistics for all tools across best-reported cutoffs had significant heterogeneity. There are many validated tools for the detection of depression in individuals with dementia. Tools that incorporate a physician interview with patient and collateral histories, the CSDD and HDRS, have higher sensitivities, which would ensure fewer false-negatives. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  1. Lack of Evidence of Enterotoxin Involvement in Pathogenesis of Campylobacter Diarrhea

    DTIC Science & Technology

    1992-01-01

    co/i or 1: cholerae genes encod- diarrheal disease (7, 8). but specific virulence ing enterotoxin production (29); (ii) several mechanisms are not...or watery trast to the secretory diarrhea caused by enter- stools and the absence of fever, consistent with otoxigenic E. co/i or V cholerae (21...potential of enteric host response to the toxin. Ifpresent. these find- pathogens, for many organisms, including Vibrio ings would indicate that toxinogenesis

  2. Finding Opportunities to Nudge Student Groups over the Finish Line: Examining Students' Five-Year Progress. Data Notes. Volume 7, Number 1, January-February 2012

    ERIC Educational Resources Information Center

    Clery, Sue

    2012-01-01

    Past research has revealed that students who complete coursework in a concentrated area, defined as completing three or more courses in a specific field of study, are much more likely to have successful outcomes than those who do not. Moreover, fewer than half of students included in this research, which followed students over seven years, entered…

  3. Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue Specimens for Enhanced Clinical Guidance

    DTIC Science & Technology

    2015-07-01

    describe: 1) major activities ; 2) specific objectives; 3) significant results or key outcomes, including major findings, developments, or conclusions...project progresses to completion, the emphasis in reporting in this section should shift from reporting activities to reporting accomplishments. B...high-resolution axial (depth) imaging as well. Of course, both techniques are under active development, and their properties may change sub

  4. Strategic Response to Energy-Related Security Threats in the US Department of Defense

    DTIC Science & Technology

    2014-10-15

    generation in the United States are fossil fuels . These include coal, natural gas, and oil . In some cases solar, wind, geothermal, and hydroelectric...and findings. The research addressed engagement on climate change and energy security issues by DoD across various tiers and sectors of the...on climate change and energy security issues by DoD across various tiers and sectors of the organization. Specifically, a tripartite analysis

  5. A parametric study of planform and aeroelastic effects on aerodynamic center, alpha- and q- stability derivatives. Appendix D: Procedures used to determine the mass distribution for idealized low aspect ratio two spar fighter wings

    NASA Technical Reports Server (NTRS)

    Roskam, J.; Hamler, F. R.; Reynolds, D.

    1972-01-01

    The procedures used to establish the mass matrices characteristics for the fighter type wings studied are given. A description of the procedure used to find the mass associated with a specific aerodynamic panel is presented and some examples of the application of the procedure are included.

  6. Magnetic resonance imaging findings in pediatric bilateral vocal fold dysfunction.

    PubMed

    Steiner, Joel I; Fink, A Michelle; Berkowitz, Robert G

    2013-07-01

    We studied the findings of brain magnetic resonance imaging (MRI) in infants with idiopathic congenital bilateral vocal fold dysfunction (CBVFD). We performed a retrospective investigation of a case series. We identified 26 children (14 male, 12 female) over 11 years. Three children were excluded. Thirteen patients required airway interventions, including continuous positive airway pressure (4 patients), endotracheal intubation (1), and tracheostomy (8). The findings on brain MRI were abnormal in 8 patients (35%). Tracheostomy was required in 3 patients (38%) with abnormal MRI findings, as compared with 5 of 15 patients (33%) with normal MRI findings. The MRI abnormalities involved evidence of white matter injury (2), abnormal white matter signal (1), subdural blood (3), cerebral swelling (1), and perisylvian polymicrogyria (1). The cranial ultrasound findings were abnormal in 4 of 11 patients. The MRI findings were abnormal in 2 of 7 children in whom the cranial ultrasound findings were normal, and in 2 of the 4 patients in whom the cranial ultrasound findings were abnormal. The MRI abnormalities were nonspecific; however, they may indicate unrecognized perinatal intracranial injury as being related to CBVFD. In addition, MRI may reveal an underlying structural brain anomaly. Cranial ultrasound has poor sensitivity and specificity. Hence, MRI should be considered as part of the routine assessment of neonates with CBVFD.

  7. Achieving a Healthy Zoning Policy in Baltimore: Results of a Health Impact Assessment of the TransForm Baltimore Zoning Code Rewrite

    PubMed Central

    Greiner, Amelia; Fichtenberg, Caroline M.; Feingold, Beth J.; Ellen, Jonathan M.; Jennings, Jacky M.

    2013-01-01

    Objectives The social determinants of health (SDH) include factors apart from genes and biology that affect population health. Zoning is an urban planning tool that influences neighborhood built environments. We describe the methods and results of a health impact assessment (HIA) of a rezoning effort in Baltimore, Maryland, called TransForm Baltimore. We highlight findings specific to physical activity, violent crime, and obesity. Methods We conducted a multistage HIA of TransForm Baltimore using HIA practice guidelines. Key informant interviews identified focus areas for the quantitative assessment. A literature review and a zoning code analysis evaluated potential impacts on neighborhood factors including physical activity, violent crime, and obesity. We estimated potential impacts in high- and low-poverty neighborhoods. The findings resulted in recommendations to improve the health-promoting potential of TransForm Baltimore. Results Mixed-use and transit-oriented development were key goals of TransForm Baltimore. Health impacts identified by stakeholders included walkability and healthy communities. For Baltimore residents, we estimated that (1) the percentage of people living in districts allowing mixed-use and off-premise alcohol outlets would nearly triple, (2) 18% would live in transit-oriented development zones, and (3) all residents would live in districts with new lighting and landscaping guidelines. Limiting the concentration of off-premise alcohol outlets represented an opportunity to address health promotion. Conclusions Changes to Baltimore's zoning code could improve population health including decreasing violent crime. HIAs are an important platform for applying SDH to public health practice. This HIA specifically linked municipal zoning policy with promoting healthier neighborhoods. PMID:24179284

  8. Reporting of feasibility factors in publications on integrated treatment programs for women with substance abuse issues and their children: a systematic review and analysis.

    PubMed

    Henderson, Joanna; Milligan, Karen; Niccols, Alison; Thabane, Lehana; Sword, Wendy; Smith, Ainsley; Rosenkranz, Susan

    2012-12-07

    Implementation of evidence-based practices in real-world settings is a complex process impacted by many factors, including intervention, dissemination, service provider, and organizational characteristics. Efforts to improve knowledge translation have resulted in greater attention to these factors. Researcher attention to the applicability of findings to applied settings also has increased. Much less attention, however, has been paid to intervention feasibility, an issue important to applied settings. In a systematic review of 121 documents regarding integrated treatment programs for women with substance abuse issues and their children, we examined the presence of feasibility-related information. Specifically, we analysed study descriptions for information regarding feasibility factors in six domains (intervention, practitioner, client, service delivery, organizational, and service system). On average, fewer than half of the 25 feasibility details assessed were included in the documents. Most documents included some information describing the participating clients, the services offered as part of the intervention, the location of services, and the expected length of stay or number of sessions. Only approximately half of the documents included specific information about the treatment model. Few documents indicated whether the intervention was manualized or whether the intervention was preceded by a standardized screening or assessment process. Very few provided information about the core intervention features versus the features open to local adaptation, or the staff experience or training required to deliver the intervention. As has been found in reviews of intervention studies in other fields, our findings revealed that most documents provide some client and intervention information, but few documents provided sufficient information to fully evaluate feasibility. We consider possible explanations for the paucity of feasibility information and provide suggestions for better reporting to promote diffusion of evidence-based practices.

  9. The efficacy beliefs of preservice science teachers in professional development school and traditional school settings

    NASA Astrophysics Data System (ADS)

    Newsome, Demetria Lynn

    Teachers' efficacy beliefs have been shown to correlate positively with to the successful implementation of science reform measures (National Research Council, 1996) and are context specific (Koul & Rubba, 1999). Studies on teacher efficacy in specific contexts have been conducted including the availability of resources and parent support (Tschannen-Moran & Hoy, 2002), classroom management (Emmer & Hickman, 1990; Raudenbush, Rowen, & Cheong, 1992); and institutional climate and behavior of the principal (Hoy & Woolfolk, 1993). The purpose of this study was to compare the science teaching efficacy beliefs of teacher interns prepared in professional development schools with those of student teachers prepared in traditional school settings. Other variables examined included academic level, academic major, and area of science concentration. Preservice science teacher efficacy beliefs were measured using the Science Teaching Efficacy Beliefs Instrument for Preservice Science Teachers, STEBI Form B (Enoch & Riggs, 1990) with demographic information being collected by an accompanying questionnaire. Analyses included scoring the surveys on two scales, Personal Science Teaching Efficacy Beliefs Scale and the Outcome Expectancy Scale, calculating descriptive statistics, as well as performing MANOVAS and correlations. Results indicate that preservice science teachers working in professional development schools exhibit higher personal science teaching efficacy beliefs. This finding corroborates previous studies on the efficacy beliefs of preservice teachers working in PDS schools (Long, 1996; Sandholtz & Dadlez, 2000). Results also show a strong correlation between the personal science teaching efficacy beliefs and the setting where student teaching takes place. In addition, significant differences were found in the personal science teaching efficacy beliefs between elementary education majors and science majors, science education majors, and secondary education majors. Findings of the study have implications for the design of preservice science teacher clinical experiences including providing longer, organized clinical experiences and preferential selection of preservice science teachers for PDS practicum assignments.

  10. Models of clinical reasoning with a focus on general practice: A critical review.

    PubMed

    Yazdani, Shahram; Hosseinzadeh, Mohammad; Hosseini, Fakhrolsadat

    2017-10-01

    Diagnosis lies at the heart of general practice. Every day general practitioners (GPs) visit patients with a wide variety of complaints and concerns, with often minor but sometimes serious symptoms. General practice has many features which differentiate it from specialty care setting, but during the last four decades little attention was paid to clinical reasoning in general practice. Therefore, we aimed to critically review the clinical reasoning models with a focus on the clinical reasoning in general practice or clinical reasoning of general practitioners to find out to what extent the existing models explain the clinical reasoning specially in primary care and also identity the gaps of the model for use in primary care settings. A systematic search to find models of clinical reasoning were performed. To have more precision, we excluded the studies that focused on neurobiological aspects of reasoning, reasoning in disciplines other than medicine decision making or decision analysis on treatment or management plan. All the articles and documents were first scanned to see whether they include important relevant contents or any models. The selected studies which described a model of clinical reasoning in general practitioners or with a focus on general practice were then reviewed and appraisal or critics of other authors on these models were included. The reviewed documents on the model were synthesized. Six models of clinical reasoning were identified including hypothetic-deductive model, pattern recognition, a dual process diagnostic reasoning model, pathway for clinical reasoning, an integrative model of clinical reasoning, and model of diagnostic reasoning strategies in primary care. Only one model had specifically focused on general practitioners reasoning. A Model of clinical reasoning that included specific features of general practice to better help the general practitioners with the difficulties of clinical reasoning in this setting is needed.

  11. Chemical biology based on target-selective degradation of proteins and carbohydrates using light-activatable organic molecules.

    PubMed

    Toshima, Kazunobu

    2013-05-01

    Proteins and carbohydrates play crucial roles in a wide range of biological processes, including serious diseases. The development of novel and innovative methods for selective control of specific proteins and carbohydrates functions has attracted much attention in the field of chemical biology. In this account article, the development of novel chemical tools, which can degrade target proteins and carbohydrates by irradiation with a specific wavelength of light under mild conditions without any additives, is introduced. This novel class of photochemical agents promise bright prospects for finding not only molecular-targeted bioprobes for understanding of the structure-activity relationships of proteins and carbohydrates but also novel therapeutic drugs targeting proteins and carbohydrates.

  12. Exo-reversible staging of coolers in series and in parallel

    NASA Astrophysics Data System (ADS)

    Maytal, Ben-Zion

    2017-10-01

    Serial and parallel staging of exo-reversible coolers are formulated, analyzed and compared. The parallel staging includes an extensive parameter which is the proportion of combined stages. This extensive free parameter affects the intensive factors of specific power and figure of merit. Serial staging reduces the 1st Law efficiency and parallel staging improves the 2nd Law efficiency. Comparison of a parallel with a serial staging under common cooling capacity and cooling range, shows that it is always possible to find a parallel arrangement of lower specific power and more compact. Some results are demonstrated on staging of Joule-Thomson cryocoolers (below and above the Joule-Thomson inversion temperature).

  13. Optimization of wave rotors for use as gas turbine engine topping cycles

    NASA Technical Reports Server (NTRS)

    Wilson, Jack; Paxson, Daniel E.

    1995-01-01

    Use of a wave rotor as a topping cycle for a gas turbine engine can improve specific power and reduce specific fuel consumption. Maximum improvement requires the wave rotor to be optimized for best performance at the mass flow of the engine. The optimization is a trade-off between losses due to friction and passage opening time, and rotational effects. An experimentally validated, one-dimensional CFD code, which includes these effects, has been used to calculate wave rotor performance, and find the optimum configuration. The technique is described, and results given for wave rotors sized for engines with sea level mass flows of 4, 26, and 400 lb/sec.

  14. Lectins: production and practical applications

    PubMed Central

    2010-01-01

    Lectins are proteins found in a diversity of organisms. They possess the ability to agglutinate erythrocytes with known carbohydrate specificity since they have at least one non-catalytic domain that binds reversibly to specific monosaccharides or oligosaccharides. This articles aims to review the production and practical applications of lectins. Lectins are isolated from their natural sources by chromatographic procedures or produced by recombinant DNA technology. The yields of animal lectins are usually low compared with the yields of plant lectins such as legume lectins. Lectins manifest a diversity of activities including antitumor, immunomodulatory, antifungal, HIV-1 reverse transcriptase inhibitory, and anti-insect activities, which may find practical applications. A small number of lectins demonstrate antibacterial and anti-nematode activities. PMID:20890754

  15. Correlates of stigma in adults with epilepsy: A systematic review of quantitative studies.

    PubMed

    Baker, David; Eccles, Fiona J R; Caswell, Helen L

    2018-06-01

    The aim of this review was to identify quantitative correlates, predictors, and outcomes of stigma in adults with epilepsy living in Western countries. To identify relevant literature, four academic databases (PsycINFO, CINAHL, PubMed, and Scopus) were systematically searched using key terms related to stigma and epilepsy. Thirty-three research papers reporting findings from 25 quantitative studies of correlates of stigma in epilepsy were identified. The findings suggest that stigma can be predicted by demographic, illness-related, and psychosocial factors, although associations were found to be highly culturally specific. Outcomes of stigma in people with epilepsy were replicated more consistently across cultures, and its impact was significant. Detrimental effects included both worse physical health, including less effective management of the condition, and reduced psychological well-being, including difficulties such as depression and anxiety. Educational initiatives and therapeutic interventions that aim to address stigma in people with epilepsy are recommended; however, these need to be culturally informed to ensure that they are valid and effective. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Guidelines for reporting methodological challenges and evaluating potential bias in dementia research.

    PubMed

    Weuve, Jennifer; Proust-Lima, Cécile; Power, Melinda C; Gross, Alden L; Hofer, Scott M; Thiébaut, Rodolphe; Chêne, Geneviève; Glymour, M Maria; Dufouil, Carole

    2015-09-01

    Clinical and population research on dementia and related neurologic conditions, including Alzheimer's disease, faces several unique methodological challenges. Progress to identify preventive and therapeutic strategies rests on valid and rigorous analytic approaches, but the research literature reflects little consensus on "best practices." We present findings from a large scientific working group on research methods for clinical and population studies of dementia, which identified five categories of methodological challenges as follows: (1) attrition/sample selection, including selective survival; (2) measurement, including uncertainty in diagnostic criteria, measurement error in neuropsychological assessments, and practice or retest effects; (3) specification of longitudinal models when participants are followed for months, years, or even decades; (4) time-varying measurements; and (5) high-dimensional data. We explain why each challenge is important in dementia research and how it could compromise the translation of research findings into effective prevention or care strategies. We advance a checklist of potential sources of bias that should be routinely addressed when reporting dementia research. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Undergraduate Nursing Students' Understandings of Mental Health: A Review of the Literature.

    PubMed

    Barry, Sinead; Ward, Louise

    2017-02-01

    The purpose of this literature review was to identify research and current literature surrounding nursing students' understandings of mental health. The aim is to share findings from an extensive international and national literature review exploring undergraduate nurse education specific to mental health content. Data were collected utilising a comprehensive search of electronic databases including CINAHL (EBSCO), MEDLINE, and PsycINFO 1987-(Ovid) from 2008 to 2016. The initial search terms were altered to include undergraduate, mental health, nursing, education, experience, and knowledge. Three content themes emerged which included: 1. Undergraduate nursing students' knowledge has been considered compromised due to concerns relating to the variation and inconsistencies within the comprehensive nursing curriculums representation of mental health, 2. Undergraduate nursing students knowledge of mental health is thought to be compromised due to the quality of mental health theoretical and experiential learning opportunities, and 3. Research indicates that nursing students' knowledge of mental health was influenced by their experience of undertaking mental health content. Based on these findings greater consideration of students' understandings of mental health is required.

  18. Musical hallucinations: a brief review of functional neuroimaging findings.

    PubMed

    Bernardini, Francesco; Attademo, Luigi; Blackmon, Karen; Devinsky, Orrin

    2017-10-01

    Musical hallucinations are uncommon phenomena characterized by intrusive and frequently distressful auditory musical percepts without an external source, often associated with hypoacusis, psychiatric illness, focal brain lesion, epilepsy, and intoxication/pharmacology. Their physiological basis is thought to involve diverse mechanisms, including "release" from normal sensory or inhibitory inputs as well as stimulation during seizures, or they can be produced by functional or structural disorders in diverse cortical and subcortical areas. The aim of this review is to further explore their pathophysiology, describing the functional neuroimaging findings regarding musical hallucinations. A literature search of the PubMed electronic database was conducted through to 29 December 2015. Search terms included "musical hallucinations" combined with the names of specific functional neuroimaging techniques. A total of 18 articles, all clinical case reports, providing data on 23 patients, comprised the set we reviewed. Diverse pathological processes and patient populations with musical hallucinations were included in the studies. Converging data from multiple studies suggest that the superior temporal sulcus is the most common site and that activation is the most common mechanism. Further neurobiological research is needed to clarify the pathophysiology of musical hallucinations.

  19. [Genetic mutation and clinical features of osteogenesis imperfecta type V].

    PubMed

    Guan, Shizhen; Bai, Xue; Wang, Yi; Liu, Zhigang; Ren, Xiuzhi; Zhang, Tianke; Ju, Mingyan; Li, Keqiu; Li, Guang

    2017-12-10

    To explore genetic mutations and clinical features of osteogenesis imperfecta type V. Clinical record of five patients (including one familial case) with osteogenesis imperfecta type V were retrospectively analyzed. Peripheral blood samples of the patients, one family member, as well as healthy controls were collected. Mutation of IFITM5 gene was identified by PCR amplification and Sanger sequencing. A heterozygous mutation (c.-14C>T) in the 5-UTR of the IFITM5 gene was identified in all of the patients and one mother. The clinical findings included frequent fractures and spine and/or extremities deformities, absence of dentinogenesis imperfecta, absence of hearing impairment, and blue sclera in 1 case. Radiographic findings revealed calcification of the interosseous membrane between the radius-ulna in all cases. Hyperplastic callus formation was found in 3 cases. Four had radial-head dislocation. A single heterozygous mutation c.-14C>T was found in the 5-UTR of the IFITM5 gene in 5 patients with osteogensis imperfecta type V. The patients showed specific radiological features including calcification of interosseous membrane, hyperplastic callus formation, and radial-head dislocation.

  20. Exoplanet Coronagraph Shaped Pupil Masks and Laboratory Scale Star Shade Masks: Design, Fabrication and Characterization

    NASA Technical Reports Server (NTRS)

    Balasubramanian, Kunjithapatha; White, Victor; Yee, Karl; Echternach, Pierre; Muller, Richard; Dickie, Matthew; Cady, Eric; Mejia Prada, Camilo; Ryan, Daniel; Poberezhskiy, Ilya; hide

    2015-01-01

    Star light suppression technologies to find and characterize faint exoplanets include internal coronagraph instruments as well as external star shade occulters. Currently, the NASA WFIRST-AFTA mission study includes an internal coronagraph instrument to find and characterize exoplanets. Various types of masks could be employed to suppress the host star light to about 10 -9 level contrast over a broad spectrum to enable the coronagraph mission objectives. Such masks for high contrast internal coronagraphic imaging require various fabrication technologies to meet a wide range of specifications, including precise shapes, micron scale island features, ultra-low reflectivity regions, uniformity, wave front quality, achromaticity, etc. We present the approaches employed at JPL to produce pupil plane and image plane coronagraph masks by combining electron beam, deep reactive ion etching, and black silicon technologies with illustrative examples of each, highlighting milestone accomplishments from the High Contrast Imaging Testbed (HCIT) at JPL and from the High Contrast Imaging Lab (HCIL) at Princeton University. We also present briefly the technologies applied to fabricate laboratory scale star shade masks.

  1. Exoplanet coronagraph shaped pupil masks and laboratory scale star shade masks: design, fabrication and characterization

    NASA Astrophysics Data System (ADS)

    Balasubramanian, Kunjithapatham; White, Victor; Yee, Karl; Echternach, Pierre; Muller, Richard; Dickie, Matthew; Cady, Eric; Mejia Prada, Camilo; Ryan, Daniel; Poberezhskiy, Ilya; Zhou, Hanying; Kern, Brian; Riggs, A. J.; Zimmerman, Neil T.; Sirbu, Dan; Shaklan, Stuart; Kasdin, Jeremy

    2015-09-01

    Star light suppression technologies to find and characterize faint exoplanets include internal coronagraph instruments as well as external star shade occulters. Currently, the NASA WFIRST-AFTA mission study includes an internal coronagraph instrument to find and characterize exoplanets. Various types of masks could be employed to suppress the host star light to about 10-9 level contrast over a broad spectrum to enable the coronagraph mission objectives. Such masks for high contrast internal coronagraphic imaging require various fabrication technologies to meet a wide range of specifications, including precise shapes, micron scale island features, ultra-low reflectivity regions, uniformity, wave front quality, achromaticity, etc. We present the approaches employed at JPL to produce pupil plane and image plane coronagraph masks by combining electron beam, deep reactive ion etching, and black silicon technologies with illustrative examples of each, highlighting milestone accomplishments from the High Contrast Imaging Testbed (HCIT) at JPL and from the High Contrast Imaging Lab (HCIL) at Princeton University. We also present briefly the technologies applied to fabricate laboratory scale star shade masks.

  2. PADF RF localization experiments with multi-agent caged-MAV platforms

    NASA Astrophysics Data System (ADS)

    Barber, Christopher; Gates, Miguel; Selmic, Rastko; Al-Issa, Huthaifa; Ordonez, Raul; Mitra, Atindra

    2011-06-01

    This paper provides a summary of preliminary RF direction finding results generated within an AFOSR funded testbed facility recently developed at Louisiana Tech University. This facility, denoted as the Louisiana Tech University Micro- Aerial Vehicle/Wireless Sensor Network (MAVSeN) Laboratory, has recently acquired a number of state-of-the-art MAV platforms that enable us to analyze, design, and test some of our recent results in the area of multiplatform position-adaptive direction finding (PADF) [1] [2] for localization of RF emitters in challenging embedded multipath environments. Discussions within the segmented sections of this paper include a description of the MAVSeN Laboratory and the preliminary results from the implementation of mobile platforms with the PADF algorithm. This novel approach to multi-platform RF direction finding is based on the investigation of iterative path-loss based (i.e. path loss exponent) metrics estimates that are measured across multiple platforms in order to develop a control law that robotically/intelligently positionally adapt (i.e. self-adjust) the location of each distributed/cooperative platform. The body of this paper provides a summary of our recent results on PADF and includes a discussion on state-of-the-art Sensor Mote Technologies as applied towards the development of sensor-integrated caged-MAV platform for PADF applications. Also, a discussion of recent experimental results that incorporate sample approaches to real-time singleplatform data pruning is included as part of a discussion on potential approaches to refining a basic PADF technique in order to integrate and perform distributed self-sensitivity and self-consistency analysis as part of a PADF technique with distributed robotic/intelligent features. These techniques are extracted in analytical form from a parallel study denoted as "PADF RF Localization Criteria for Multi-Model Scattering Environments". The focus here is on developing and reporting specific approaches to self-sensitivity and self-consistency within this experimental PADF framework via the exploitation of specific single-agent caged-MAV trajectories that are unique to this experiment set.

  3. Experiences of healthcare professionals of having their significant other admitted to an acute care facility: a qualitative systematic review.

    PubMed

    Sabyani, Hussamaldeen; Wiechula, Richard; Magarey, Judy; Donnelly, Frank

    2017-05-01

    Most healthcare professionals at some time will experience having a significant other admitted to an acute care hospital. The knowledge and understanding that these individuals possess because of their professional practice can potentially alter this experience. Expectations of staff and other family members (FMs) can potentially increase the burden on these health professionals. All FMs of patients should have their needs and expectations considered; however, this review specifically addresses what may be unique for healthcare professionals. To synthesize the qualitative evidence on the experiences of healthcare professionals when their significant others are admitted to an acute care hospital. The current review considered studies reporting the experiences of healthcare professionals, specifically registered nurses (RNs) and physicians. The experiences of RNs and physicians when a significant other is admitted to an acute care facility. Qualitative studies that have examined the phenomenon of interest including, but not limited to, designs such as phenomenology and grounded theory. The search strategy aimed to find both published and unpublished studies with no date restrictions. Only studies published in English were considered for inclusion in this review. Qualitative papers selected for retrieval were assessed using the standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data were extracted from the seven included papers using the standardized data extraction tool from JBI-QARI. The data were synthesized using the JBI approach to meta-synthesis by meta-aggregation using the JBI-QARI software and methods. Seven studies of moderate quality were included in the review. Forty findings were extracted and aggregated to create 10 categories, from which five synthesized findings were derived: CONCLUSION: In contrast to "lay" FMs, health professionals possess additional knowledge and understanding that alter their perceptions and expectations, and the expectations others have of them. This knowledge and understanding can be an advantage in navigating a complex health system but may also result in an additional burden such as role conflict.

  4. Association between switching antiepileptic drug products and healthcare utilization: A systematic review.

    PubMed

    Kwan, Patrick; Palmini, André

    2017-08-01

    There is ongoing concern whether switching between different antiepileptic drug (AED) products may compromise patient care. We systematically reviewed changes in healthcare utilization following AED switch. We searched MEDLINE and EMBASE databases (1980-October 2016) for studies that assessed the effect of AED switching in patients with epilepsy on outpatient visits, emergency room visits, hospitalization and hospital stay duration. A total of 14 articles met the inclusion criteria. All were retrospective studies. Four provided findings for specific AEDs only (lamotrigine, topiramate, phenytoin and divalproex), 9 presented pooled findings from multiple AEDs, and 1 study provided both specific (lamotrigine, topiramate, oxcarbazepine, and levetiracetam) and pooled findings. Three studies found an association between a switch of topiramate and an increase in healthcare utilization. Another three studies found that a brand-to-generic lamotrigine switch was not associated with an increased risk of emergently treated events (ambulance use, ER visits or hospitalization). The outcomes of the pooled AED switch studies were inconsistent; 5 studies reported an increased healthcare utilization while 5 studies did not. Studies that have examined the association between an AED switch and a change in healthcare utilization report conflicting findings. Factors that may explain these inconsistent outcomes include inter-study differences in the type of analysis undertaken (pooled vs individual AED data), the covariates used for data adjustment, and the type of switch examined. Future medical claim database studies employing a prospective design are encouraged to address these and other factors in order to enhance inter-study comparability and extrapolation of findings. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Hypertrophic lichen sclerosus sine sclerosis: clues to histopathologic diagnosis when presenting as psoriasiform lichenoid dermatitis.

    PubMed

    Weyers, Wolfgang

    2015-02-01

    The histopathologic diagnosis of lichen sclerosus (LS) is usually facilitated by a subepidermal zone of sclerosis. In the absence of sclerosis, LS mostly presents itself as a psoriasiform lichenoid dermatitis that may be difficult to distinguish from other diseases. We sought to assess histopathologic findings that allow recognition of LS in the absence of sclerosis. We studied 28 criteria in 100 biopsy specimens of LS from genital or perianal skin, including 55 cases with marked sclerosis, 16 cases with mild sclerosis confined to foci of the papillary dermis and 29 cases without sclerosis. Fifteen cases each of the early plaque stage of mycosis fungoides, lichen planus and lichen simplex chronicus were studied for comparison. Some histopathologic hallmarks of LS were seen chiefly in sclerotic lesions and, therefore, did not contribute to the diagnosis of difficult cases, such as dissolution of elastic fibers. Others were seen rarely in non-sclerotic lesions but might be helpful in individual cases, including follicular hyperkeratosis and thickening of the basement membrane. Findings that were more common and may be utilized as clues to the histopathologic diagnosis of non-sclerotic LS include tiny foci of homogenized tissue in dermal papillae, marked fibrosis with thickening of the papillary dermis, marked thickening of individual collagen fibers, lymphocytes aligned in rows between those fibers, necrotic keratinocytes, often with preserved pyknotic nuclei, in all reaches of the epidermis, including the cornified layer, clustering of necrotic keratinocytes above elongated dermal papillae and vertical columns of parakeratosis with distinct dyskeratotic parakeratotic cells. In the absence of sclerosis, histopathologic diagnosis of LS depends on findings that are less distinctive. Nonetheless, a constellation of those findings allows a specific diagnosis to be made. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

    PubMed Central

    Karppinen, Jaro; Sorensen, Joan S.; Niinimäki, Jaakko; Leboeuf-Yde, Charlotte

    2008-01-01

    The prevalence of “vertebral endplate signal changes” (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 × 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP. PMID:18787845

  7. HIV Molecular Immunology 2015

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yusim, Karina; Korber, Bette Tina; Brander, Christian

    The scope and purpose of the HIV molecular immunology database: HIV Molecular Immunology is a companion volume to HIV Sequence Compendium. This publication, the 2015 edition, is the PDF version of the web-based HIV Immunology Database (http://www.hiv.lanl.gov/ content/immunology/). The web interface for this relational database has many search options, as well as interactive tools to help immunologists design reagents and interpret their results. In the HIV Immunology Database, HIV-specific B-cell and T-cell responses are summarized and annotated. Immunological responses are divided into three parts, CTL, T helper, and antibody. Within these parts, defined epitopes are organized by protein and bindingmore » sites within each protein, moving from left to right through the coding regions spanning the HIV genome. We include human responses to natural HIV infections, as well as vaccine studies in a range of animal models and human trials. Responses that are not specifically defined, such as responses to whole proteins or monoclonal antibody responses to discontinuous epitopes, are summarized at the end of each protein section. Studies describing general HIV responses to the virus, but not to any specific protein, are included at the end of each part. The annotation includes information such as cross-reactivity, escape mutations, antibody sequence, TCR usage, functional domains that overlap with an epitope, immune response associations with rates of progression and therapy, and how specific epitopes were experimentally defined. Basic information such as HLA specificities for T-cell epitopes, isotypes of monoclonal antibodies, and epitope sequences are included whenever possible. All studies that we can find that incorporate the use of a specific monoclonal antibody are included in the entry for that antibody. A single T-cell epitope can have multiple entries, generally one entry per study. Finally, maps of all defined linear epitopes relative to the HXB2 reference proteins are provided. Alignments of CTL, helper T-cell, and antibody epitopes are available through the search interface on our web site at http:// www.hiv.lanl.gov/content/immunology.« less

  8. Red flag findings in children with headaches: Prevalence and association with emergency department neuroimaging.

    PubMed

    Tsze, Daniel S; Ochs, Julie B; Gonzalez, Ariana E; Dayan, Peter S

    2018-01-01

    Background Clinicians appear to obtain emergent neuroimaging for children with headaches based on the presence of red flag findings. However, little data exists regarding the prevalence of these findings in emergency department populations, and whether the identification of red flag findings is associated with potentially unnecessary emergency department neuroimaging. Objectives We aimed to determine the prevalence of red flag findings and their association with neuroimaging in otherwise healthy children presenting with headaches to the emergency department. Our secondary aim was to determine the prevalence of emergent intracranial abnormalities in this population. Methods A prospective cohort study of otherwise healthy children 2-17 years of age presenting to an urban pediatric emergency department with non-traumatic headaches was undertaken. Emergency department physicians completed a standardized form to document headache descriptors and characteristics, associated symptoms, and physical and neurological exam findings. Children who did not receive emergency department neuroimaging received 4-month telephone follow-up. Outcomes included emergency department neuroimaging and the presence of emergent intracranial abnormalities. Results We enrolled 224 patients; 197 (87.9%) had at least one red flag finding on history. Several red flag findings were reported by more than a third of children, including: Headache waking from sleep (34.8%); headache present with or soon after waking (39.7%); or headaches increasing in frequency, duration and severity (40%, 33.1%, and 46.3%). Thirty-three percent of children received emergency department neuroimaging. The prevalence of emergent intracranial abnormalities was 1% (95% CI 0.1, 3.6). Abnormal neurological exam, extreme pain intensity of presenting headache, vomiting, and positional symptoms were independently associated with emergency department neuroimaging. Conclusions Red flag findings are common in children presenting with headaches to the emergency department. The presence of red flag findings is associated with emergency department neuroimaging, although the risk of emergent intracranial abnormalities is low. Many children with headaches may be receiving unnecessary neuroimaging due to the high prevalence of non-specific red flag findings.

  9. Imaging discrepancies between magnetic resonance imaging and brain perfusion single-photon emission computed tomography in the diagnosis of Alzheimer's disease, and verification with amyloid positron emission tomography.

    PubMed

    Yokoyama, Shunichi; Kajiya, Yoriko; Yoshinaga, Takuma; Tani, Atsushi; Hirano, Hirofumi

    2014-06-01

    In the diagnosis of Alzheimer's disease (AD), discrepancies are often observed between magnetic resonance imaging (MRI) and brain perfusion single-photon emission computed tomography (SPECT) findings. MRI, brain perfusion SPECT, and amyloid positron emission tomography (PET) findings were compared in patients with mild cognitive impairment or early AD to clarify the discrepancies between imaging modalities. Several imaging markers were investigated, including the cortical average standardized uptake value ratio on amyloid PET, the Z-score of a voxel-based specific regional analysis system for AD on MRI, periventricular hyperintensity grade, deep white matter hyperintense signal grade, number of microbleeds, and three indicators of the easy Z-score imaging system for a specific SPECT volume-of-interest analysis. Based on the results of the regional analysis and the three indicators, we classified patients into four groups and then compared the results of amyloid PET, periventricular hyperintensity grade, deep white matter hyperintense signal grade, and the numbers of microbleeds among the groups. The amyloid deposition was the highest in the group that presented typical AD findings on both the regional analysis and the three indicators. The two groups that showed an imaging discrepancy between the regional analysis and the three indicators demonstrated intermediate amyloid deposition findings compared with the typical and atypical groups. The patients who showed hippocampal atrophy on the regional analysis and atypical AD findings using the three indicators were approximately 60% amyloid-negative. The mean periventricular hyperintensity grade was highest in the typical group. Patients showing discrepancies between MRI and SPECT demonstrated intermediate amyloid deposition findings compared with patients who showed typical or atypical findings. Strong white matter signal abnormalities on MRI in patients who presented typical AD findings provided further evidence for the involvement of vascular factors in AD. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

  10. Intimate Relationship Challenges in Early Parenthood among Lesbian, Gay, and Heterosexual Couples Adopting via the Child Welfare System

    PubMed Central

    Goldberg, Abbie E.; Kinkler, Lori A.; Moyer, April M.; Weber, Elizabeth

    2014-01-01

    Little research has examined the transition to parenthood among couples who adopt through the child welfare system. The current qualitative study of 84 individuals within 42 couples (17 lesbian, 13 gay, and 12 heterosexual), who were placed with a child via foster care three months earlier, examined perceived changes in their intimate relationship. Findings indicated that, like heterosexual biological-parent couples, some adoptive parents perceived the loss of their partner’s undivided attention as stressful to the relationship. Adoption-specific stressors were also identified, including the need to find state-approved child care to facilitate “couple time” and the legal insecurity of foster-to-adopt placements. Although our findings were similar for heterosexual, lesbian, and gay adoptive parents, same-sex couples cited some additional stressors related to their sexual minority status. Findings have implications for individual, couple, and family practitioners who work with lesbian, gay, and heterosexual adoptive parents, particularly during their transition to parenthood. PMID:25177080

  11. Diagnosis and surgical outcomes of intraparotid facial nerve schwannoma showing normal facial nerve function.

    PubMed

    Lee, D W; Byeon, H K; Chung, H P; Choi, E C; Kim, S-H; Park, Y M

    2013-07-01

    The findings of intraparotid facial nerve schwannoma (FNS) using preoperative diagnostic tools, including ultrasonography (US)-guided fine needle aspiration biopsy, computed tomography (CT) scan, and magnetic resonance imaging (MRI), were analyzed to determine if there are any useful findings that might suggest the presence of a lesion. Treatment guidelines are suggested. The medical records of 15 patients who were diagnosed with an intraparotid FNS were retrospectively analyzed. US and CT scans provide clinicians with only limited information; gadolinium enhanced T1-weighted images from MRI provide more specific findings. Tumors could be removed successfully with surgical exploration, preserving facial nerve function at the same time. Gadolinium-enhanced T1-weighted MRI showed more characteristic findings for the diagnosis of intraparotid FNS. Intraparotid FNS without facial palsy can be diagnosed with MRI preoperatively, and surgical exploration is a suitable treatment modality which can remove the tumor and preserve facial nerve function. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  12. Diagnostic yield of cystoscopy in the evaluation of recurrent urinary tract infection in women.

    PubMed

    Pagano, Matthew J; Barbalat, Yanina; Theofanides, Marissa C; Edokpolo, Leonard; James, Maxwell B; Cooper, Kimberly L

    2017-03-01

    Due to a paucity of evidence-based guidelines, anecdotal practice patterns often dictate clinical management of recurrent urinary tract infection (UTI) in women. Our aim was to identify pathologic findings of the urinary tract through cystoscopy and imaging in women with recurrent UTI, and to determine if specific risk factors are associated with a higher rate of abnormal findings. In a single-institutional cohort, cystoscopy was performed for women with recurrent UTI between 1/2010 and 7/2014. All eligible patients were included in a maintained database and those with gross or microscopic hematuria were excluded. Abdominopelvic imaging was recommended and included in study data when completed. Associations between clinical risk factors (history of renal transplant, urogynecologic surgery, or urolithiasis) and abnormal findings were analyzed by Fisher's exact test. A total of 163 women (mean age 60.6 years) were included in final analysis. Abdominopelvic imaging was available in 133 (82%) cases. Cystoscopy identified 9 (5.5%) cases of significant clinical findings. Of these only 5 (3.8%) cases were uniquely identified on cystoscopy and missed on imaging modalities. When imaging was normal, cystoscopy was also normal in 94% of cases. The examined clinical risk factors were not associated with higher risk of abnormal cystoscopy (P = 0.49) or imaging (P = 0.42). Cystoscopy performed solely for recurrent UTI is low yield in patients with normal imaging studies, but a small number of abnormal findings may be missed by foregoing this element of the patient workup. No studied risk factor was predictive of an abnormal workup. Neurourol. Urodynam. 36:692-696, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Gender differences in chemical carcinogenesis in National Toxicology Program two-year bioassays

    PubMed Central

    Kadekar, Sandeep; Peddada, Shyamal; Silins, Ilona; French, John E; Högberg, Johan; Stenius, Ulla

    2016-01-01

    Differences in cancer incidences between men and women are often explained by either differences in environmental exposures or by influences of sex hormones. However, there are few studies on intrinsic gender differences in susceptibility to chemical carcinogens. We have analyzed the National Toxicology Program (NTP) database for sex differences in rat responses to chemical carcinogens. We find that the odds that male rat bioassays were assigned a higher level of evidence than female rat bioassays was 1.69 (p<0.001). Of 278 carcinogenic chemicals in the database, 201 (72%) exhibited statistical gender differences (p = 0.05) in at least one non-reproductive organ. 130 of these 201 chemicals induced gender-specific tumors in male rats and 59 in female rats. 68 chemicals induced tumors in males but no tumors in females. Less than one third, i.e. 19 chemicals, induced tumors in females but not males. Male-specific tumors included pancreatic tumor and skin tumor, and female-specific tumors included lung tumors. For some tumor types these differences in gender susceptibility can be associated with literature data on sex hormone receptor expression. In conclusion, gender-specific tumors were common. The male dominance is in line with human data and the male susceptibility to carcinogens should be further studied. PMID:22585941

  14. ACR Appropriateness Criteria® Chronic Extremity Joint Pain-Suspected Inflammatory Arthritis.

    PubMed

    Jacobson, Jon A; Roberts, Catherine C; Bencardino, Jenny T; Appel, Marc; Arnold, Erin; Baccei, Steven J; Cassidy, R Carter; Chang, Eric Y; Fox, Michael G; Greenspan, Bennett S; Gyftopoulos, Soterios; Hochman, Mary G; Mintz, Douglas N; Newman, Joel S; Rosenberg, Zehava S; Shah, Nehal A; Small, Kirstin M; Weissman, Barbara N

    2017-05-01

    Evaluation for suspected inflammatory arthritis as a cause for chronic extremity joint pain often relies on imaging. This review first discusses the characteristic osseous and soft tissue abnormalities seen with inflammatory arthritis and how they may be imaged. It is essential that imaging results are interpreted in the context of clinical and serologic results to add specificity as there is significant overlap of imaging findings among the various types of arthritis. This review provides recommendations for imaging evaluation of specific types of inflammatory arthritis, including rheumatoid arthritis, seronegative spondyloarthropathy, gout, calcium pyrophosphate dihydrate disease (or pseudogout), and erosive osteoarthritis. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  15. Quantitative Dynamics of Chromatin Remodeling during Germ Cell Specification from Mouse Embryonic Stem Cells.

    PubMed

    Kurimoto, Kazuki; Yabuta, Yukihiro; Hayashi, Katsuhiko; Ohta, Hiroshi; Kiyonari, Hiroshi; Mitani, Tadahiro; Moritoki, Yoshinobu; Kohri, Kenjiro; Kimura, Hiroshi; Yamamoto, Takuya; Katou, Yuki; Shirahige, Katsuhiko; Saitou, Mitinori

    2015-05-07

    Germ cell specification is accompanied by epigenetic remodeling, the scale and specificity of which are unclear. Here, we quantitatively delineate chromatin dynamics during induction of mouse embryonic stem cells (ESCs) to epiblast-like cells (EpiLCs) and from there into primordial germ cell-like cells (PGCLCs), revealing large-scale reorganization of chromatin signatures including H3K27me3 and H3K9me2 patterns. EpiLCs contain abundant bivalent gene promoters characterized by low H3K27me3, indicating a state primed for differentiation. PGCLCs initially lose H3K4me3 from many bivalent genes but subsequently regain this mark with concomitant upregulation of H3K27me3, particularly at developmental regulatory genes. PGCLCs progressively lose H3K9me2, including at lamina-associated perinuclear heterochromatin, resulting in changes in nuclear architecture. T recruits H3K27ac to activate BLIMP1 and early mesodermal programs during PGCLC specification, which is followed by BLIMP1-mediated repression of a broad range of targets, possibly through recruitment and spreading of H3K27me3. These findings provide a foundation for reconstructing regulatory networks of the germline epigenome. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Types of alcoholic beverages usually consumed by students in 9th-12th grades--four states, 2005.

    PubMed

    2007-07-27

    Excessive alcohol consumption contributes to approximately 4,500 deaths among underage youths in the United States each year (e.g., from homicides, motor-vehicle crashes, and suicides) and an average of 60 years of life lost per death. However, little is known about the specific types of alcoholic beverages consumed by youths. These data are important because numerous evidence-based strategies for reducing underage drinking rates are beverage-specific, including increasing alcohol excise taxes and increasing restrictions on the distribution and sale of alcoholic beverages. To examine types of alcoholic beverages usually consumed by students in 9th-12th grades, CDC analyzed 2005 Youth Risk Behavior Survey (YRBS) data from the four state surveys that included a question on the type of alcohol consumed (Arkansas, Nebraska, New Mexico, and Wyoming). This report describes the results of that analysis, which indicated that liquor (e.g., bourbon, rum, scotch, vodka, or whiskey) was the most prevalent type of alcoholic beverage usually consumed among students in 9th-12th grades who reported current alcohol use or binge drinking. These findings suggest that considering beverage-specific alcohol consumption by youths is important when developing alcohol-control policies, specifically those related to the price and availability of particular types of alcoholic beverages.

  17. Research on treating neuropsychiatric symptoms of advanced dementia with non-pharmacological strategies, 1998–2008: a systematic literature review

    PubMed Central

    Kverno, Karan S.; Black, Betty S.; Nolan, Marie T.; Rabins, Peter V.

    2011-01-01

    Background Advanced dementia is characterized by severe cognitive and functional impairments that lead to almost total dependency in self-care. Neuropsychiatric symptoms (NPS) are common in advanced dementia, diminishing quality of life and increasing the care burden. The challenge for health care providers is to find safe and effective treatments. Non-pharmacological interventions offer the potential for safer alternatives to pharmacotherapy, but little is known about their efficacy. This review evaluates the published literature on non-pharmacological interventions for treating NPS in advanced dementia. Methods A literature search was undertaken to find non-pharmacological intervention studies published between 1998 and 2008 that measured NPS outcomes in individuals diagnosed with advanced dementia. Strict inclusion criteria initially required that all study participants have severe or very severe dementia, but this range was later broadened to include moderately severe to very severe stages. Results Out of 215 intervention studies, 21 (9.8%) specifically focused on treatments for individuals with moderately severe to very severe dementia. The studies provide limited moderate to high quality evidence for the use of sensory-focused strategies, including aroma, preferred or live music, and multi-sensory stimulation. Emotion-oriented approaches, such as simulated presence may be more effective for individuals with preserved verbal interactive capacity. Conclusions Most studies of interventions for dementia-related NPS have focused on individuals with mild to moderate cognitive impairment. Individuals with severe cognitive impairment do not necessarily respond to NPS treatments in the same manner. Future studies should be specifically designed to further explore the stage-specific efficacy of non-pharmacological therapies for patients with advanced dementia. Areas of particular need for further research include movement-based therapies, hands-on (touch) therapies, and interventions that can be provided during personal care routines. Interventions appear to work best when they are tailored to balance individual arousal patterns. PMID:19586562

  18. Research on treating neuropsychiatric symptoms of advanced dementia with non-pharmacological strategies, 1998-2008: a systematic literature review.

    PubMed

    Kverno, Karan S; Black, Betty S; Nolan, Marie T; Rabins, Peter V

    2009-10-01

    Advanced dementia is characterized by severe cognitive and functional impairments that lead to almost total dependency in self-care. Neuropsychiatric symptoms (NPS) are common in advanced dementia, diminishing quality of life and increasing the care burden. The challenge for health care providers is to find safe and effective treatments. Non-pharmacological interventions offer the potential for safer alternatives to pharmacotherapy, but little is known about their efficacy. This review evaluates the published literature on non-pharmacological interventions for treating NPS in advanced dementia. A literature search was undertaken to find non-pharmacological intervention studies published between 1998 and 2008 that measured NPS outcomes in individuals diagnosed with advanced dementia. Strict inclusion criteria initially required that all study participants have severe or very severe dementia, but this range was later broadened to include moderately severe to very severe stages. Out of 215 intervention studies, 21 (9.8%) specifically focused on treatments for individuals with moderately severe to very severe dementia. The studies provide limited moderate to high quality evidence for the use of sensory-focused strategies, including aroma, preferred or live music, and multi-sensory stimulation. Emotion-oriented approaches, such as simulated presence may be more effective for individuals with preserved verbal interactive capacity. Most studies of interventions for dementia-related NPS have focused on individuals with mild to moderate cognitive impairment. Individuals with severe cognitive impairment do not necessarily respond to NPS treatments in the same manner. Future studies should be specifically designed to further explore the stage-specific efficacy of non-pharmacological therapies for patients with advanced dementia. Areas of particular need for further research include movement-based therapies, hands-on (touch) therapies, and interventions that can be provided during personal care routines. Interventions appear to work best when they are tailored to balance individual arousal patterns.

  19. One session treatment for specific phobias in children: Comorbid anxiety disorders and treatment outcome.

    PubMed

    Ryan, Sarah M; Strege, Marlene V; Oar, Ella L; Ollendick, Thomas H

    2017-03-01

    One-Session Treatment (OST) for specific phobias has been shown to be effective in reducing phobia severity; however, the effect of different types of co-occurring anxiety disorders on OST outcomes is unknown. The present study examined (1) the effects of co-occurring generalized anxiety disorder (GAD), social anxiety disorder (SAD), or another non-targeted specific phobia (OSP) on the efficacy of OST for specific phobias, and (2) the effects of OST on these co-occurring disorders following treatment. Three groups of 18 youth (7-15 years) with a specific phobia and comorbid GAD, SAD, or OSP were matched on age, gender, and phobia type. Outcome measures included diagnostic status and severity, and clinician rated improvement. All groups demonstrated an improvement in their specific phobia following treatment. Treatment was equally effective regardless of co-occurring anxiety disorder. In addition, comorbid anxiety disorders improved following OST; however, this effect was not equal across groups. The SAD group showed poorer improvement in their comorbid disorder than the GAD group post-treatment. However, the SAD group continued to improve and this differential effect was not evident six-months following treatment. The current study sample was small, with insufficient power to detect small and medium effect sizes. Further, the sample only included a portion of individuals with primary GAD or SAD, which may have attenuated the findings. The current study demonstrated that co-occurring anxiety disorders did not interfere with phobia treatment. OST, despite targeting a single specific phobia type, significantly reduced comorbid symptomatology across multiple anxiety disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Health effects of carbon-containing particulate matter: focus on sources and recent research program results.

    PubMed

    Rohr, Annette; McDonald, Jacob

    2016-02-01

    Air pollution is a complex mixture of gas-, vapor-, and particulate-phase materials comprised of inorganic and organic species. Many of these components have been associated with adverse health effects in epidemiological and toxicological studies, including a broad spectrum of carbonaceous atmospheric components. This paper reviews recent literature on the health impacts of organic aerosols, with a focus on specific sources of organic material; it is not intended to be a comprehensive review of all the available literature. Specific emission sources reviewed include engine emissions, wood/biomass combustion emissions, biogenic emissions and secondary organic aerosol (SOA), resuspended road dust, tire and brake wear, and cooking emissions. In addition, recent findings from large toxicological and epidemiological research programs are reviewed in the context of organic PM, including SPHERES, NPACT, NERC, ACES, and TERESA. A review of the extant literature suggests that there are clear health impacts from emissions containing carbon-containing PM, but difficulty remains in apportioning responses to certain groupings of carbonaceous materials, such as organic and elemental carbon, condensed and gas phases, and primary and secondary material. More focused epidemiological and toxicological studies, including increased characterization of organic materials, would increase understanding of this issue.

  1. Pediatric bipolar disorder: validity, phenomenology, and recommendations for diagnosis

    PubMed Central

    Youngstrom, Eric A; Birmaher, Boris; Findling, Robert L

    2013-01-01

    Objective To find, review, and critically evaluate evidence pertaining to the phenomenology of pediatric bipolar disorder and its validity as a diagnosis. Methods The present qualitative review summarizes and synthesizes available evidence about the phenomenology of bipolar disorder (BD) in youths, including description of the diagnostic sensitivity and specificity of symptoms, clarification about rates of cycling and mixed states, and discussion about chronic versus episodic presentations of mood dysregulation. The validity of the diagnosis of BD in youths is also evaluated based on traditional criteria including associated demographic characteristics, family environmental features, genetic bases, longitudinal studies of youths at risk of developing BD as well as youths already manifesting symptoms on the bipolar spectrum, treatment studies and pharmacologic dissection, neurobiological findings (including morphological and functional data), and other related laboratory findings. Additional sections review impairment and quality of life, personality and temperamental correlates, the clinical utility of a bipolar diagnosis in youths, and the dimensional versus categorical distinction as it applies to mood disorder in youths. Results A schema for diagnosis of BD in youths is developed, including a review of different operational definitions of `bipolar not otherwise specified.' Principal areas of disagreement appear to include the relative role of elated versus irritable mood in assessment, and also the limits of the extent of the bipolar spectrum – when do definitions become so broad that they are no longer describing `bipolar' cases? Conclusions In spite of these areas of disagreement, considerable evidence has amassed supporting the validity of the bipolar diagnosis in children and adolescents. PMID:18199237

  2. Sonographic screening for developmental dysplasia of the hip in preterm breech infants: do current guidelines address the specific needs of premature infants?

    PubMed

    Lee, J; Spinazzola, R M; Kohn, N; Perrin, M; Milanaik, R L

    2016-07-01

    To assess the association between gestational age versus corrected age at the time of hip ultrasound with findings for developmental dysplasia of the hip (DDH) in preterm breech infants. A retrospective medical chart review was conducted to examine hip ultrasounds of 318 premature breech infants for findings associated with DDH. Positive findings for DDH occurred in 3/135 (2%) of infants <32 weeks gestational age and 17/183 (9%) of infants 32 to <37 weeks gestational age (odds ratio: 0.22, 95% CI: 0.04 to 0.79, P<0.015). No infants born <32 weeks gestational age had abnormal findings for DDH upon follow-up ultrasound. Infants <40 weeks corrected age at the time of hip ultrasound were more likely to have DDH findings compared with infants ⩾44 weeks corrected age (odds ratio: 7.83, 95% CI: 2.20 to 29.65, P<0.001). Current hip ultrasonography policies that include screening of premature breech infants may need to be revised.

  3. Primary central nervous system lymphoma in immunocompetent patients: spectrum of findings and differential characteristics.

    PubMed

    Gómez Roselló, E; Quiles Granado, A M; Laguillo Sala, G; Pedraza Gutiérrez, S

    2018-02-23

    Primary central nervous system (CNS) lymphomas are uncommon and their management differs significantly from that of other malignant tumors involving the CNS. This article explains how the imaging findings often suggest the diagnosis early. The typical findings in immunocompetent patients consist of a supratentorial intraaxial mass that enhances homogeneously. Other findings to evaluate include multifocality and incomplete ring enhancement. The differential diagnosis of primary CNS lymphomas should consider mainly other malignant tumors of the CNS such as glioblastomas or metastases. Primary CNS lymphomas tend to have less edema and less mass effect; they also tend to spare the adjacent cortex. Necrosis, hemorrhage, and calcification are uncommon in primary CNS lymphomas. Although the findings in morphologic sequences are characteristic, they are not completely specific and atypical types are sometimes encountered. Advanced imaging techniques such as diffusion or especially perfusion provide qualitative and quantitative data that play an important role in differentiating primary CNS lymphomas from other brain tumors. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. The complexity of personality: advantages of a genetically sensitive multi-group design.

    PubMed

    Hahn, Elisabeth; Spinath, Frank M; Siedler, Thomas; Wagner, Gert G; Schupp, Jürgen; Kandler, Christian

    2012-03-01

    Findings from many behavioral genetic studies utilizing the classical twin design suggest that genetic and non-shared environmental effects play a significant role in human personality traits. This study focuses on the methodological advantages of extending the sampling frame to include multiple dyads of relatives. We investigated the sensitivity of heritability estimates to the inclusion of sibling pairs, mother-child pairs and grandparent-grandchild pairs from the German Socio-Economic Panel Study in addition to a classical German twin sample consisting of monozygotic- and dizygotic twins. The resulting dataset contained 1.308 pairs, including 202 monozygotic and 147 dizygotic twin pairs, along with 419 sibling pairs, 438 mother-child dyads, and 102 grandparent-child dyads. This genetically sensitive multi-group design allowed the simultaneous testing of additive and non-additive genetic, common and specific environmental effects, including cultural transmission and twin-specific environmental influences. Using manifest and latent modeling of phenotypes (i.e., controlling for measurement error), we compare results from the extended sample with those from the twin sample alone and discuss implications for future research.

  5. Identification of stem cells from human umbilical cord blood with embryonic and hematopoietic characteristics

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhao Yong; Wang Honglan; Mazzone, Theodore

    2006-08-01

    We identified stem cells from the umbilical cord blood, designated cord blood-stem cells (CB-SC). CB-SC displayed important embryonic stem (ES) cell characteristics including expression of ES-cell-specific molecular markers including transcription factors OCT-4 and Nanog, along with stage-specific embryonic antigen (SSEA)-3 and SSEA-4. CB-SC also expressed hematopoietic cell antigens including CD9, CD45 and CD117, but were negative for CD34. CB-SC displayed very low immunogenicity as indicated by expression of a very low level of major histocompatibility complex (MHC) antigens and failure to stimulate the proliferation of allogeneic lymphocytes. CB-SC could give rise to cells with endothelial-like and neuronal-like characteristics in vitro,more » as demonstrated by expression of lineage-associated markers. Notably, CB-SC could be stimulated to differentiate into functional insulin-producing cells in vivo and eliminated hyperglycemia after transplantation into a streptozotocin-induced diabetic mouse model. These findings may have significant potential to advance stem-cell-based therapeutics.« less

  6. Table tennis dystonia.

    PubMed

    Le Floch, Anne; Vidailhet, Marie; Flamand-Rouvière, Constance; Grabli, David; Mayer, Jean-Michel; Gonce, Michel; Broussolle, Emmanuel; Roze, Emmanuel

    2010-02-15

    Focal task-specific dystonia (FTSD) occurs exclusively during a specific activity that usually involves a highly skilled movement. Classical FTSD dystonias include writer's cramp and musician's dystonia. Few cases of sport-related dystonia have been reported. We describe the first four cases of FTSD related to table tennis (TT), two involving professional international competitors. We also systematically analyzed the literature for reports of sport-related dystonia including detailed clinical descriptions. We collected a total of 13 cases of sport-related dystonia, including our four TT players. Before onset, all the patients had trained for many years, for a large number of hours per week. Practice time had frequently increased significantly in the year preceding onset. As TT is characterized by highly skilled hand/forearm movements acquired through repetitive exercises, it may carry a higher risk of FTSD than other sports. Intensive training may result in maladaptive responses and overwhelm homeostatic mechanisms that regulate cortical plasticity in vulnerable individuals. Our findings support the importance of environmental risk factors in sport-related FTSD, as also suggested in classical FTSD, and have important implications for clinical practice. (c) 2010 Movement Disorder Society.

  7. Use of Actigraphy for Assessment in Pediatric Sleep Research

    PubMed Central

    Meltzer, Lisa J.; Montgomery-Downs, Hawley E.; Insana, Salvatore P.; Walsh, Colleen M.

    2011-01-01

    The use of actigraphs, or ambulatory devices that estimate sleep-wake patterns from activity levels, has become common in pediatric research. Actigraphy provides a more objective measure than parent-report, and has gained popularity due to its ability to measure sleep-wake patterns for extended periods of time in the child’s natural environment. The purpose of this review is: (1) to provide comprehensive information on the historic and current uses of actigraphy in pediatric sleep research; (2) to review how actigraphy has been validated among pediatric populations; and (3) offer recommendations for methodological areas that should be included in all studies that utilize actigraphy, including the definition and scoring of variables commonly reported. The poor specificity to detect wake after sleep onset was consistently noted across devices and age groups, thus raising concerns about what is an “acceptable” level of specificity for actigraphy. Other notable findings from this review include the lack of standard scoring rules or variable definitions. Suggestions for the use and reporting of actigraphy in pediatric research are provided. PMID:22424706

  8. Reasons why persons living with HIV include individuals in their chosen families.

    PubMed

    Grant, Joan S; Vance, David E; Keltner, Norman L; White, Worawan; Raper, James L

    2013-01-01

    HIV influences those with the disease as well as their families and social relationships. The chosen families of persons living with HIV (PLWH) provide structure, social support, and security. Our study identified reasons why PLWH included specific individuals in their chosen families (or families of choice). This mixed-method design used a convenience sample of 150 PLWH, ages 19-68 years. Self-reported reasons for including specific individuals in their chosen families were love and acceptance (n = 135; 90.0%), support (n = 100; 66.7%), blood and family ties (n = 37; 24.7%), and commonality (n = 28; 18.7%). Demographic and personal characteristics were unrelated to these themes, supporting the conclusion that reasons for choosing family members are universal across these variables. These findings emphasize the need for health care providers to encourage the development of friendships and relationships between PLWH and those who provide love and acceptance, support, blood/familial ties, and common interests. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  9. Public views on multiple dimensions of security : nuclear waepons, terrorism, energy, and the environment : 2007.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Herron, Kerry Gale; Jenkins-Smith, Hank C.

    2008-01-01

    We analyze and compare findings from identical national surveys of the US general public on nuclear security and terrorism administered by telephone and Internet in mid-2007. Key areas of investigation include assessments of threats to US security; valuations of US nuclear weapons and nuclear deterrence; perspectives on nuclear proliferation, including the specific cases of North Korea and Iran; and support for investments in nuclear weapons capabilities. Our analysis of public views on terrorism include assessments of the current threat, progress in the struggle against terrorism, preferences for responding to terrorist attacks at different levels of assumed casualties, and support formore » domestic policies intended to reduce the threat of terrorism. Also we report findings from an Internet survey conducted in mid 2007 that investigates public views of US energy security, to include: energy supplies and reliability; energy vulnerabilities and threats, and relationships among security, costs, energy dependence, alternative sources, and research and investment priorities. We analyze public assessments of nuclear energy risks and benefits, nuclear materials management issues, and preferences for the future of nuclear energy in the US. Additionally, we investigate environmental issues as they relate to energy security, to include expected implications of global climate change, and relationships among environmental issues and potential policy options.« less

  10. The anatomy of cognitive impairment in amyotrophic lateral sclerosis: more than frontal lobe dysfunction.

    PubMed

    Tsermentseli, Stella; Leigh, P Nigel; Goldstein, Laura H

    2012-02-01

    Cognitive and behavioural impairments accompanying amyotrophic lateral sclerosis (ALS) have been reported since the early 20th century. Typically, these changes can be associated with a dysexecutive syndrome or manifest as a frontotemporal dementia (FTD). Although the nature of specific frontotemporal dysfunction in ALS remains to be refined, as with the clinical presentation, there is likely to be significant heterogeneity. This article will review the current state of knowledge regarding the neuropathological and neuroanatomical basis for cognitive dysfunction in ALS. Neuropathological findings suggest that ALS does not selectively affect the frontotemporal network but rather is part of a broad clinico-pathological spectrum now known as TAR-DNA binding protein (TDP)-43 proteinopathies. Functional neuroimaging has supported neuropsychological findings of frontotemporal dysfunction but has also implied the involvement of somatosensory areas. Structural neuroimaging has not been able to establish a specific hypothesis of extra-motor cortical atrophy beyond the combination of various frontal, temporal and limbic areas. The finding of reduction in the integrity of white matter in the frontal, temporal and parietal lobes including long association fibers suggests that subcortical involvement may underlie both cognitive and functional changes in ALS. Future perspectives for further investigations are highlighted. Copyright © 2011 Elsevier Srl. All rights reserved.

  11. Challenging the Pathophysiologic Connection between Subdural Hematoma, Retinal Hemorrhage and Shaken Baby Syndrome

    PubMed Central

    Gabaeff, Steven C.

    2011-01-01

    Child abuse experts use diagnostic findings of subdural hematoma and retinal hemorrhages as near-pathognomonic findings to diagnose shaken baby syndrome. This article reviews the origin of this link and casts serious doubt on the specificity of the pathophysiologic connection. The forces required to cause brain injury were derived from an experiment of high velocity impacts on monkeys, that generated forces far above those which might occur with a shaking mechanism. These forces, if present, would invariably cause neck trauma, which is conspicuously absent in most babies allegedly injured by shaking. Subdural hematoma may also be the result of common birth trauma, complicated by prenatal vitamin D deficiency, which also contributes to the appearance of long bone fractures commonly associated with child abuse. Retinal hemorrhage is a non-specific finding that occurs with many causes of increased intracranial pressure, including infection and hypoxic brain injury. The evidence challenging these connections should prompt emergency physicians and others who care for children to consider a broad differential diagnosis before settling on occult shaking as the de-facto cause. While childhood non-accidental trauma is certainly a serious problem, the wide exposure of this information may have the potential to exonerate some innocent care-givers who have been convicted, or may be accused, of child abuse. PMID:21691518

  12. The clinical application of research utilization: amphotericin B.

    PubMed

    Reedy, A M; Shivnan, J C; Hanson, J L; Haisfield, M E; Gregory, R E

    1994-05-01

    To describe the first application of the research utilization process by clinical nurses using the Stetler-Marram Model of Research Utilization to the practice of amphotericin B administration; to share the findings; and to discuss issues encountered in the process and their solutions. Published articles identified through computerized literature searches, published abstracts and books, personal communication with one author, and an informal survey of other cancer centers' amphotericin B infusion practices; research articles were selected for review if studies included settings and patient populations similar to those of the authors and if they used experimental designs. Studies were reviewed for scientific merit and clinical applicability according to the Stetler-Marram model; findings were used to develop a specific nursing protocol for infusion times of amphotericin B based on clinical criteria. The Stetler-Marram model helped staff nurses decide how to apply research findings to practice, although using it was difficult and required mentorship. A research base exists for amphotericin B administration time but not for test doses or premedications to prevent or minimize side effects. Staff nurses can use the Stetler-Marram model but need resources and support from individuals, committees, and administration. A specific protocol representing a practice change was implemented and may be applicable to other settings.

  13. Diagnosis of Pediatric Foreign Body Ingestion: Clinical Presentation, Physical Examination, and Radiologic Findings.

    PubMed

    Sink, Jacquelyn R; Kitsko, Dennis J; Mehta, Deepak K; Georg, Matthew W; Simons, Jeffrey P

    2016-04-01

    (1) To describe clinical and radiologic findings in patients with esophageal foreign bodies. (2) To examine the sensitivity and specificity of history, physical examination, and radiologic studies in children with suspected foreign body ingestion. A retrospective cohort study was performed evaluating all children who underwent esophagoscopy for suspected foreign body ingestion at our institution from 2006 to 2013. Five hundred forty-three patients were included (54% male). Average age was 4.7 years (SD = 4.1 years). Foreign bodies were identified on esophagoscopy in 497 cases (92%). Ingestion was witnessed in 23% of cases. Most common presenting symptoms were choking/gagging (49%), vomiting (47%), and dysphagia/odynophagia (42%). Most patients with foreign bodies had a normal exam (76%). Most foreign bodies were radiopaque (83%). In 59% of patients with normal chest radiographs, a foreign body was present. Sensitivity and specificity of 1 or more findings on history, physical examination, and imaging were 99% and 0%, 21% and 76%, and 83% and 100%, respectively. Most patients with esophageal foreign bodies are symptomatic. Although many patients will have a normal physical examination, an abnormal exam should increase suspicion for a foreign body. Most esophageal foreign bodies are radiopaque, but a normal chest radiograph cannot rule out a foreign body. © The Author(s) 2015.

  14. Cognitive Predictors of Verbal Memory in a Mixed Clinical Pediatric Sample

    PubMed Central

    Jordan, Lizabeth L.; Tyner, Callie E.; Heaton, Shelley C.

    2013-01-01

    Verbal memory problems, along with other cognitive difficulties, are common in children diagnosed with neurological and/or psychological disorders. Historically, these “memory problems” have been poorly characterized and often present with a heterogeneous pattern of performance across memory processes, even within a specific diagnostic group. The current study examined archival neuropsychological data from a large mixed clinical pediatric sample in order to understand whether functioning in other cognitive areas (i.e., verbal knowledge, attention, working memory, executive functioning) may explain some of the performance variability seen across verbal memory tasks of the Children’s Memory Scale (CMS). Multivariate analyses revealed that among the cognitive functions examined, only verbal knowledge explained a significant amount of variance in overall verbal memory performance. Further univariate analyses examining the component processes of verbal memory indicated that verbal knowledge is specifically related to encoding, but not the retention or retrieval stages. Future research is needed to replicate these findings in other clinical samples, to examine whether verbal knowledge predicts performance on other verbal memory tasks and to explore whether these findings also hold true for visual memory tasks. Successful replication of the current study findings would indicate that interventions targeting verbal encoding deficits should include efforts to improve verbal knowledge. PMID:25379253

  15. Empirical research on international environmental migration: a systematic review.

    PubMed

    Obokata, Reiko; Veronis, Luisa; McLeman, Robert

    2014-01-01

    This paper presents the findings of a systematic review of scholarly publications that report empirical findings from studies of environmentally-related international migration. There exists a small, but growing accumulation of empirical studies that consider environmentally-linked migration that spans international borders. These studies provide useful evidence for scholars and policymakers in understanding how environmental factors interact with political, economic and social factors to influence migration behavior and outcomes that are specific to international movements of people, in highlighting promising future research directions, and in raising important considerations for international policymaking. Our review identifies countries of migrant origin and destination that have so far been the subject of empirical research, the environmental factors believed to have influenced these migrations, the interactions of environmental and non-environmental factors as well as the role of context in influencing migration behavior, and the types of methods used by researchers. In reporting our findings, we identify the strengths and challenges associated with the main empirical approaches, highlight significant gaps and future opportunities for empirical work, and contribute to advancing understanding of environmental influences on international migration more generally. Specifically, we propose an exploratory framework to take into account the role of context in shaping environmental migration across borders, including the dynamic and complex interactions between environmental and non-environmental factors at a range of scales.

  16. Lessons Learned From Methodological Validation Research in E-Epidemiology.

    PubMed

    Kesse-Guyot, Emmanuelle; Assmann, Karen; Andreeva, Valentina; Castetbon, Katia; Méjean, Caroline; Touvier, Mathilde; Salanave, Benoît; Deschamps, Valérie; Péneau, Sandrine; Fezeu, Léopold; Julia, Chantal; Allès, Benjamin; Galan, Pilar; Hercberg, Serge

    2016-10-18

    Traditional epidemiological research methods exhibit limitations leading to high logistics, human, and financial burden. The continued development of innovative digital tools has the potential to overcome many of the existing methodological issues. Nonetheless, Web-based studies remain relatively uncommon, partly due to persistent concerns about validity and generalizability. The objective of this viewpoint is to summarize findings from methodological studies carried out in the NutriNet-Santé study, a French Web-based cohort study. On the basis of the previous findings from the NutriNet-Santé e-cohort (>150,000 participants are currently included), we synthesized e-epidemiological knowledge on sample representativeness, advantageous recruitment strategies, and data quality. Overall, the reported findings support the usefulness of Web-based studies in overcoming common methodological deficiencies in epidemiological research, in particular with regard to data quality (eg, the concordance for body mass index [BMI] classification was 93%), reduced social desirability bias, and access to a wide range of participant profiles, including the hard-to-reach subgroups such as young (12.30% [15,118/122,912], <25 years) and old people (6.60% [8112/122,912], ≥65 years), unemployed or homemaker (12.60% [15,487/122,912]), and low educated (38.50% [47,312/122,912]) people. However, some selection bias remained (78.00% (95,871/122,912) of the participants were women, and 61.50% (75,590/122,912) had postsecondary education), which is an inherent aspect of cohort study inclusion; other specific types of bias may also have occurred. Given the rapidly growing access to the Internet across social strata, the recruitment of participants with diverse socioeconomic profiles and health risk exposures was highly feasible. Continued efforts concerning the identification of specific biases in e-cohorts and the collection of comprehensive and valid data are still needed. This summary of methodological findings from the NutriNet-Santé cohort may help researchers in the development of the next generation of high-quality Web-based epidemiological studies.

  17. Reduced Specificity of Personal Goals and Explanations for Goal Attainment in Major Depression

    PubMed Central

    Dickson, Joanne M.; Moberly, Nicholas J.

    2013-01-01

    Objectives Overgeneralization has been investigated across many domains of cognitive functioning in major depression, including the imagination of future events. However, it is unknown whether this phenomenon extends to representations of personal goals, which are important in structuring long-term behaviour and providing meaning in life. Furthermore, it is not clear whether depressed individuals provide less specific explanations for and against goal attainment. Method Clinically depressed individuals and controls generated personally important approach and avoidance goals, and then generated explanations why they would and would not achieve these goals. Goals and causal explanations were subsequently coded as either specific or general. Results Compared to controls, depressed individuals did not generate significantly fewer goals or causal explanations for or against goal attainment. However, compared to controls, depressed individuals generated less specific goals, less specific explanations for approach (but not avoidance) goal attainment, and less specific explanations for goal nonattainment. Significance Our results suggest that motivational deficits in depression may stem partly from a reduction in the specificity of personal goal representations and related cognitions that support goal-directed behaviour. Importantly, the findings have the potential to inform the ongoing development of psychotherapeutic approaches in the treatment of depression. PMID:23691238

  18. CR softcopy display presets based on optimum visualization of specific findings

    NASA Astrophysics Data System (ADS)

    Andriole, Katherine P.; Gould, Robert G.; Webb, W. R.

    1999-07-01

    The purpose of this research is to assess the utility of providing presets for computed radiography (CR) softcopy display, based not on the window/level settings, but on image processing applied to the image based on optimization for visualization of specific findings, pathologies, etc. Clinical chest images are acquired using an Agfa ADC 70 CR scanner, and transferred over the PACS network to an image processing station which has the capability to perform multiscale contrast equalization. The optimal image processing settings per finding are developed in conjunction with a thoracic radiologist by manipulating the multiscale image contrast amplification algorithm parameters. Softcopy display of images processed with finding-specific settings are compared with the standard default image presentation for fifty cases of each category. Comparison is scored using a five point scale with positive one and two denoting the standard presentation is preferred over the finding-specific presets, negative one and two denoting the finding-specific preset is preferred over the standard presentation, and zero denoting no difference. Presets have been developed for pneumothorax and clinical cases are currently being collected in preparation for formal clinical trials. Subjective assessments indicate a preference for the optimized-preset presentation of images over the standard default, particularly by inexperienced radiology residents and referring clinicians.

  19. Relationships between Premonitory Urge and Anxiety in Youth with Chronic Tic Disorders.

    PubMed

    Rozenman, Michelle; Johnson, Olivia E; Chang, Susanna W; Woods, Douglas W; Walkup, John T; Wilhelm, Sabine; Peterson, Alan; Scahill, Lawrence; Piacentini, John

    2015-07-01

    Tourette's Disorder and other chronic tic disorders are common neurodevelopmental conditions. One characteristic of tic disorders is the premonitory urge, an aversive or unpleasant sensory phenomenon that may precede tics. Initial examination of premonitory urge in pediatric tic disorders suggests that awareness and experience of sensations preceding tics may be related to anxiety and OCD. However, it may be possible that specific anxiety-related symptoms, such as anxious physiologic arousal, are particularly relevant to the experience of premonitory urge. The current study examines relationships between tic-related premonitory urge and anxiety-related symptom clusters in treatment-seeking youths with a primary diagnoses of Tourette's or other chronic tic disorder. The sample consisted of 124 youth, ages 9 to 17, who participated in the multi-site Comprehensive Behavioral Intervention for Tics randomized controlled trial (CBIT; Piacentini et al., 2010). Specific anxiety-related subtypes, including generalized worry, separation, social, and panic/somatic symptoms, as well as severity of obsessions and compulsions, were assessed as potential correlates of premonitory urge. Findings indicated that age, global tic-related impairment, and specific panic/somatic symptoms accounted for a substantial proportion of variance in youth report of premonitory urge. These findings provide information about the characteristics of premonitory urge in pediatric tic disorders, and have implications for the treatment of pediatric tic syndromes.

  20. Psychophysiological and self-reported reactivity associated with social anxiety and public speaking fear symptoms: Effects of fear versus distress.

    PubMed

    Panayiotou, Georgia; Karekla, Maria; Georgiou, Dora; Constantinou, Elena; Paraskeva-Siamata, Michaela

    2017-09-01

    This study examines psychophysiological and subjective reactivity to anxiety-provoking situations in relation to social anxiety and public speaking fear. We hypothesized that social anxiety symptoms would be associated with similar reactivity across types of imaginary anxiety scenes and not specifically to social anxiety-related scenes. This would be attributed to co-existing depression symptoms. Public speaking fear was expected to be associated with more circumscribed reactivity to survival-threat scenes, due to its association with fearfulness. Community participants imagined standardized anxiety situations, including social anxiety and animal fear scenes, while their physiological reactivity and self-reported emotions were assessed. Findings supported that social anxiety was associated with undifferentiated physiological reactivity across anxiety-provoking situations, except with regards to skin conductance level, which was higher during social anxiety imagery. Public speaking fear was associated with increased reactivity to animal phobia and panic scenes. Covariance analyses indicated that the lack of response specificity associated with social anxiety could be attributed to depression levels, while the specificity associated with public speaking fear could be explained by fearfulness. Findings highlight the need to assess not only primary anxiety symptoms but also depression and fearfulness, which likely predict discrepant reactions of individuals to anxiogenic situations. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  1. Environmental factors that distinguish between clinical and healthy samples with childhood experiences of abuse and neglect.

    PubMed

    Infurna, Maria Rita; Giannone, Francesca; Guarnaccia, Cinzia; Lo Cascio, Maria; Parzer, Peter; Kaess, Michael

    2015-01-01

    Childhood maltreatment is associated with a wide range of problems in adulthood. However, specific environmental factors (either positive or negative) influence mental health outcomes in maltreated children. The present study investigated the effect of environmental factors by comparing a group of clinical participants with experiences of abuse/neglect with a healthy group with similar patterns of experiences. Environmental factors selected were: separation from parents, financial hardship, parental psychiatric disorders, and low social involvement. The study included 55 mixed clinical participants and 23 healthy participants. All participants were investigated using the Childhood Experience of Care and Abuse (CECA) interview. The two groups were specifically matched with regard to patterns of childhood maltreatment. The findings indicated that psychopathological outcome was associated with a greater presence of negative environmental factors (p < 0.001). In particular, lack of social support seemed to be the only one predictor (OR = 27.86). This study is the first to investigate the influence of specific environmental factors in two groups with similar childhood experiences of abuse/neglect but different mental health outcomes. These findings suggest that efforts should be made to incorporate both familial and external sources of social support in promoting mental health for maltreated children. © 2015 S. Karger AG, Basel.

  2. A systematic review of the nature of support for breast-feeding adolescent mothers.

    PubMed

    Hall Moran, Victoria; Edwards, Janet; Dykes, Fiona; Downe, Soo

    2007-06-01

    to review the evidence on the nature of support for breast-feeding adolescent mothers. a systematic review of relevant English-language papers was conducted using an a-priori search strategy. Agreement on final inclusion was reached by consensus across the team. The findings were tabulated and described narratively and thematically. of 209 studies identified, seven fitted the inclusion criteria. The papers included in this review varied in design, quality and focus. Five types of support were identified: emotional, esteem, instrumental, informational and network. The participants in the included studies seemed to find the emotional, esteem and network components of support most helpful. Support from the participants' mothers seemed to be particularly powerful. The provision of continuity of support from an expert individual who is skilled in both lactation support and working with adolescents was also highly valued by breast-feeding adolescents. There was also evidence to suggest that targeted breast-feeding educational programmes, specifically designed for the adolescent learner, may be successful in improving breast-feeding initiation and continuation rates in this population. However, a question still arises about which elements of the complex package on offer were most effective. the studies included in the review are diverse. Although the support provided by known and trusted individuals emerges as important to the adolescents, further research is required on the specific nature of that support and the person best placed to provide it. The acceptability and feasibility of other aspects of support and modes of provision also requires additional exploration. Further qualitative and feasibility studies are therefore warranted in order to inform future randomised-controlled interventions trials.

  3. Incidental Finding of Cryptococcus on Prostate Biopsy for Prostate Adenocarcinoma Following Cardiac Transplant: Case Report and Review of the Literature.

    PubMed

    Shah, Sujal I; Bui, Hai; Velasco, Nelson; Rungta, Shilpa

    2017-11-06

    BACKGROUND Cryptococcus is the third most common invasive fungal organism in immunocompromised patients, including transplant patients, and usually involves the central nervous system and lungs, with a median time to infection of 25 months. We report a case of Cryptococcus of the prostate gland, found as an incidental finding on prostate biopsy for prostate adenocarcinoma, four months following cardiac transplantation. CASE REPORT A 62-year-old male African-American who had a cardiac transplant four months previously, underwent a six-core prostate biopsy for a two-year history of increasing prostate-specific antigen (PSA) levels, and a recent history of non-specific urinary tract symptoms. A prostatic adenocarcinoma, Gleason grade 4+4=8, was diagnosed on histopathology, and 'foamy' cells were seen in the biopsies. Histochemical stains, including Grocott methenamine silver (GMS), and periodic acid-Schiff (PAS) showed abundant round and oval 5-7 µm diameter fungal elements; mucicarmine highlighted the fungal polysaccharide capsule, diagnostic for Cryptococcus. Cryptococcal antigen detection was made by the latex agglutination test and cultures. We reviewed the literature and found 70 published cases (from 1946-2008) of Cryptococcus of the prostate gland, with only one previous case presenting five years following cardiac transplantation. CONCLUSIONS Fungal infections of the prostate are rare, and occur mainly in immunocompromised patients. We present a unique case of prostatic Cryptococcus found incidentally at four months following cardiac transplantation. This case report highlights the need to consider atypical fungal infection as a differential diagnosis for prostatitis in immunosuppressed patients, including transplant patients.

  4. Prader-Willi syndrome and atypical submicroscopic 15q11-q13 deletions with or without imprinting defects.

    PubMed

    Hassan, Maaz; Butler, Merlin G

    2016-11-01

    We report a 20 year follow up on a Caucasian female, now 26 years of age, with Prader-Willi syndrome (PWS) harboring an atypical 15q11-q13 submicroscopic deletion of 100-200 kb in size first detected in 1996 involving the imprinting center, SNRPN gene and surrounding region. PWS is a rare complex disorder caused by the loss of paternally expressed genes in the 15q11-q13 region. With high resolution chromosomal microarray and methylation - specific MLPA analysis, we updated the genetic findings on our patient and found a 209,819bp deletion including the SNURF-SNRPN gene complex which includes the imprinting center and the SNORD116 region. We compared with four other similarly reported individuals in the literature with atypical submicroscopic deletions within this region but without imprinting center involvement to better characterize the specific genetic lesions causing PWS clinical findings. Clinically, our patient met the diagnostic criteria of PWS including infantile hypotonia, a poor suck with feeding difficulties, global developmental delays and later food foraging, childhood obesity, small hands and skin picking. Small atypical deletions of comparable sizes were seen in the 15q11-q13 region in all five cases and similar behavioral/physical characteristics were found despite an imprinting defect in our patient. These results further support an overlapping critical deletion region involving the non-coding snoRNA SNORD116 in common in the five individuals playing a key role in contributing to the PWS phenotype. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Initial Development and Validation of the Mexican Intercultural Competence Scale

    PubMed Central

    Torres, Lucas

    2013-01-01

    The current project sought to develop the Mexican Intercultural Competence Scale (MICS), which assesses group-specific skills and attributes that facilitate effective cultural interactions, among adults of Mexican descent. Study 1 involved an Exploratory Factor Analysis (N = 184) that identified five factors including Ambition/Perseverance, Networking, the Traditional Latino Culture, Family Relationships, and Communication. In Study 2, a Confirmatory Factor Analysis provided evidence for the 5-factor model for adults of Mexican origin living in the Midwest (N = 341) region of the U.S. The general findings are discussed in terms of a competence-based formulation of cultural adaptation and include theoretical and clinical implications. PMID:24058890

  6. Initial Development and Validation of the Mexican Intercultural Competence Scale.

    PubMed

    Torres, Lucas

    2013-01-01

    The current project sought to develop the Mexican Intercultural Competence Scale (MICS), which assesses group-specific skills and attributes that facilitate effective cultural interactions, among adults of Mexican descent. Study 1 involved an Exploratory Factor Analysis ( N = 184) that identified five factors including Ambition/Perseverance, Networking, the Traditional Latino Culture, Family Relationships, and Communication. In Study 2, a Confirmatory Factor Analysis provided evidence for the 5-factor model for adults of Mexican origin living in the Midwest ( N = 341) region of the U.S. The general findings are discussed in terms of a competence-based formulation of cultural adaptation and include theoretical and clinical implications.

  7. Deflagration Rates and Molecular Bonding Trends of Statically Compressed Secondary Explosives

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zaug, J M; Foltz, M F; Hart, E

    2010-03-09

    We discuss our measurements of the chemical reaction propagation rate as a function of pressure. Materials investigated have included CL-20, HMX, TATB, and RDX crystalline powders, LX-04, Comp B, and nitromethane. The anomalous correspondence between crystal structure, including in some instances isostructural phase transitions, on pressure-dependant RPRs of TATB, HMX, Nitromethane, CL-20, and PETN have been elucidated using micro-IR and -Raman spectroscopies. Here we specifically highlight pressure-dependent physicochemical mechanisms affecting the deflagration rate of nitromethane and epsilon-CL-20. We find that pressure induced splitting of symmetric stretch NO{sub 2} vibrations can signal the onset of increasingly more rapid combustion reactions.

  8. Long-term and chronic homelessness in homeless women and women with children.

    PubMed

    Zlotnick, Cheryl; Tam, Tammy; Bradley, Kimberly

    2010-09-01

    The Chronic Homelessness initiative has directed millions of federal dollars to services for single "unaccompanied homeless" individuals, specifically excluding women living with their children. Using a data set with a nationally representative sample of homeless adults, we calculated the prevalence rates and profiles of long-term homelessness in homeless women (n = 849). With the exception of the criterion of being a single "unaccompanied individual," many women, including women with children, met the criteria for chronic homelessness including having a disability of mental health or substance abuse problems. Our findings suggest that the federal definition of chronic homelessness needs to be revised.

  9. Factors Associated With Volunteering Among Racial/Ethnic Groups: Findings From the California Health Interview Survey.

    PubMed

    Johnson, Kimberly J; Lee, S Hannah

    2017-06-01

    The present study investigated how volunteering was influenced by individual resources and social capital among four racial/ethnic groups of adults aged 50 and older. The data came from the California Health Interview Survey, a statewide sample that includes non-Hispanic Whites ( n = 18,927), non-Hispanic Asians ( n = 2,428), non-Hispanic Blacks ( n = 1,265), and Hispanics ( n = 3,799). Logistic regression models of volunteering were estimated to explore the effects of human and social capital within and across the racial/ethnic groups. Compared to Whites, racial/ethnic minority adults volunteered less. Although education was a significant predictor of volunteering across all groups, the findings indicated group-specific factors related to human and social capital. Results showed similarities and differences associated with volunteer participation among diverse racial/ethnic groups. The findings underscore the importance of understanding ways of creating inclusive opportunities for civic engagement among an increasingly diverse population.

  10. Strategies for application of scientific findings in prevention.

    PubMed

    Wei, S H

    1995-07-01

    Dental research in the last 50 years has accomplished numerous significant advances in preventive dentistry, particularly in the area of research in fluorides, periodontal diseases, restorative dentistry, and dental materials, as well as craniofacial development and molecular biology. The transfer of scientific knowledge to clinical practitioners requires additional effort. It is the responsibility of the scientific communities to transfer the fruits of their findings to society through publications, conferences, media, and the press. Specific programs that the International Association for Dental Research (IADR) has developed to transmit science to the profession and the public have included science transfer seminars, the Visiting Lecture Program, and hands-on workshops. The IADR Strategic Plan also has a major outreach goal. In addition, the Federation Dentaire Internationale (FDI) and the World Health Organization (WHO) have initiated plans to celebrate World Health Day and the Year of Oral Health in 1994. These are important strategies for the application of scientific findings in prevention.

  11. Acetyl-coenzyme A synthetase 2 is a nuclear protein required for replicative longevity in Saccharomyces cerevisiae

    PubMed Central

    Falcón, Alaric A.; Chen, Shaoping; Wood, Michael S.

    2013-01-01

    Acs2p is one of two acetyl-coenzyme A synthetases in Saccharomyces cerevisiae. We have prepared and characterized a monoclonal antibody specific for Acs2p and find that Acs2p is localized primarily to the nucleus, including the nucleolus, with a minor amount in the cytosol. We find that Acs2p is required for replicative longevity: an acs2Δ strain has a reduced replicative life span compared to wild-type and acs1Δ strains. Furthermore, replicatively aged acs2Δ cells contain elevated levels of extrachromosomal rDNA circles, and silencing at the rDNA locus is impaired in an acs2Δ strain. These findings indicate that Acs2p-mediated synthesis of acetyl-CoA in the nucleus functions to promote rDNA silencing and replicative longevity in yeast. PMID:19618123

  12. “Don’t Think Paralysis Takes Away Your Womanhood”: Sexual Intimacy After Spinal Cord Injury

    PubMed Central

    Dillaway, Heather; Lysack, Cathy L.

    2015-01-01

    Sexuality and intimacy are important components of health and well-being. Issues surrounding sexuality and intimacy are equally important for men and women living with physical disabilities, including spinal cord injury (SCI). Yet, women’s sexuality after SCI remains largely unexamined. This article presents the findings from an in-depth qualitative investigation of the sexual and reproductive health experiences of 20 women with SCI in or around Detroit, MI. Findings echo existing literature documenting the sexual consequences of life after SCI and suggest new areas of inquiry important for better addressing sexual concerns across the lifespan. Specifically, findings suggest a need to consider the variable effects of SCI on sexual intimacy in relation to a person’s developmental trajectory, the appropriate timing of sexual education, the need to expand conceptualizations of sexual intimacy, and the ways SCI may affect sexuality in later life. PMID:26122683

  13. Can Smartphones and Privacy Coexist Assessing Technologies and Regulations Protecting Personal Data on Android and iOS Devices

    DTIC Science & Technology

    2016-01-01

    does not find any critically private information. To What Extent Do Apps Use Cryptography or Transmit Nonessential Private Data? In a third experiment... cryptography and private data. Specifically, we analyzed 50 banking apps on both iOS and Android to understand how well these apps use cryptography . First...RAND’s Engineering and Applied Sciences Department. His research expertise includes applied cryptography and technology policy. Zev Winkelman is a

  14. Identifying Neurofibromin Specific Regulatory Nodes for Therapeutic Targeting in NF1

    DTIC Science & Technology

    2017-10-01

    neurofibromin depends on the adapter protein SPRED1, to function, and we are utilizing the latest technical innovations including CRISPR technology... CRISPR technology to find genes that regulate neurofibromin SPRED function. Keywords Neurofibromin, Spred1, Spred2, EGFR, mutant EGFR(L858R), Ras...Establish good NF1 and Spred1/2 knockdown protocols for indicated cell lines NF1-Null and Spred1-Null HEK 293T cells have been generated using CRISPR /Cas9

  15. Targeting Tim-1 to Circumvent Immune Tolerance in Prostate Cancer

    DTIC Science & Technology

    2012-09-01

    findings that SIM2 is selectively expressed in PCa, that human HLA- A2.1–restricted SIM2 epitopes induce specific T cells in vivo, and that anti -SIM2...TAA, would include a vaccine in conjunction with biologic agents that are known to simultaneously augment antigen presentation by DCs and inhibit...such agents is the agonist antibody that targets TIM-1, a receptor expressed on lymphocytes and dendritic cells that enhances cytotoxic lymphocyte

  16. [The emergence of positive occupational health psychology].

    PubMed

    Bakker, Arnold B; Rodríguez-Muñoz, Alfredo; Derks, Daantje

    2012-02-01

    The aim of this paper is to provide an overview of the emerging concept of Positive Occupational Health Psychology (POHP). We discuss the usefulness of focusing on positive constructs in order to understand the path to health and well-being at work. We describe research findings on several POHP topics, including engagement, psychological capital, and job crafting. Additionally, we review the first positive interventions in this field and conclude by identifying some specific questions for future research.

  17. Peers and adolescent smoking.

    PubMed

    Kobus, Kimberly

    2003-05-01

    There is a considerable body of empirical research that has identified adolescent peer relationships as a primary factor involved in adolescent cigarette smoking. Despite this large research base, many questions remain unanswered about the mechanisms by which peers affect youths' smoking behavior. Understanding these processes of influence is key to the development of prevention and intervention programs designed to address adolescent smoking as a significant public health concern. In this paper, theoretical frameworks and empirical findings are reviewed critically which inform the current state of knowledge regarding peer influences on teenage smoking. Specifically, social learning theory, primary socialization theory, social identity theory and social network theory are discussed. Empirical findings regarding peer influence and selection, as well as multiple reference points in adolescent friendships, including best friendships, romantic relationships, peer groups and social crowds, are also reviewed. Review of this work reveals the contribution that peers have in adolescents' use of tobacco, in some cases promoting use, and in other cases deterring it. This review also suggests that peer influences on smoking are more subtle than commonly thought and need to be examined more carefully, including consideration of larger social contexts, e.g. the family, neighborhood, and media. Recommendations for future investigations are made, as well as suggestions for specific methodological approaches that offer promise for advancing our knowledge of the contribution of peers on adolescent tobacco use.

  18. Action Video Game Training for Healthy Adults: A Meta-Analytic Study

    PubMed Central

    Wang, Ping; Liu, Han-Hui; Zhu, Xing-Ting; Meng, Tian; Li, Hui-Jie; Zuo, Xi-Nian

    2016-01-01

    Action video game (AVG) has attracted increasing attention from both the public and from researchers. More and more studies found video game training improved a variety of cognitive functions. However, it remains controversial whether healthy adults can benefit from AVG training, and whether young and older adults benefit similarly from AVG training. In the present study, we aimed to quantitatively assess the AVG training effect on the cognitive ability of adults and to compare the training effects on young and older adults by conducting a meta-analysis on previous findings. We systematically searched video game training studies published between January 1986 and July 2015. Twenty studies were included in the present meta-analysis, for a total of 313 participants included in the training group and 323 participants in the control group. The results demonstrate that healthy adults achieve moderate benefit from AVG training in overall cognitive ability and moderate to small benefit in specific cognitive domains. In contrast, young adults gain more benefits from AVG training than older adults in both overall cognition and specific cognitive domains. Age, education, and some methodological factors, such as the session duration, session number, total training duration, and control group type, modulated the training effects. These meta-analytic findings provide evidence that AVG training may serve as an efficient way to improve the cognitive performance of healthy adults. We also discussed several directions for future AVG training studies. PMID:27378996

  19. Action Video Game Training for Healthy Adults: A Meta-Analytic Study.

    PubMed

    Wang, Ping; Liu, Han-Hui; Zhu, Xing-Ting; Meng, Tian; Li, Hui-Jie; Zuo, Xi-Nian

    2016-01-01

    Action video game (AVG) has attracted increasing attention from both the public and from researchers. More and more studies found video game training improved a variety of cognitive functions. However, it remains controversial whether healthy adults can benefit from AVG training, and whether young and older adults benefit similarly from AVG training. In the present study, we aimed to quantitatively assess the AVG training effect on the cognitive ability of adults and to compare the training effects on young and older adults by conducting a meta-analysis on previous findings. We systematically searched video game training studies published between January 1986 and July 2015. Twenty studies were included in the present meta-analysis, for a total of 313 participants included in the training group and 323 participants in the control group. The results demonstrate that healthy adults achieve moderate benefit from AVG training in overall cognitive ability and moderate to small benefit in specific cognitive domains. In contrast, young adults gain more benefits from AVG training than older adults in both overall cognition and specific cognitive domains. Age, education, and some methodological factors, such as the session duration, session number, total training duration, and control group type, modulated the training effects. These meta-analytic findings provide evidence that AVG training may serve as an efficient way to improve the cognitive performance of healthy adults. We also discussed several directions for future AVG training studies.

  20. A systematic review of validated methods for identifying anaphylaxis, including anaphylactic shock and angioneurotic edema, using administrative and claims data.

    PubMed

    Schneider, Gary; Kachroo, Sumesh; Jones, Natalie; Crean, Sheila; Rotella, Philip; Avetisyan, Ruzan; Reynolds, Matthew W

    2012-01-01

    The Food and Drug Administration's Mini-Sentinel pilot program initially aims to conduct active surveillance to refine safety signals that emerge for marketed medical products. A key facet of this surveillance is to develop and understand the validity of algorithms for identifying health outcomes of interest from administrative and claims data. This article summarizes the process and findings of the algorithm review of anaphylaxis. PubMed and Iowa Drug Information Service searches were conducted to identify citations applicable to the anaphylaxis health outcome of interest. Level 1 abstract reviews and Level 2 full-text reviews were conducted to find articles using administrative and claims data to identify anaphylaxis and including validation estimates of the coding algorithms. Our search revealed limited literature focusing on anaphylaxis that provided administrative and claims data-based algorithms and validation estimates. Only four studies identified via literature searches provided validated algorithms; however, two additional studies were identified by Mini-Sentinel collaborators and were incorporated. The International Classification of Diseases, Ninth Revision, codes varied, as did the positive predictive value, depending on the cohort characteristics and the specific codes used to identify anaphylaxis. Research needs to be conducted on designing validation studies to test anaphylaxis algorithms and estimating their predictive power, sensitivity, and specificity. Copyright © 2012 John Wiley & Sons, Ltd.

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