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Sample records for early presentation systematic

  1. A systematic review of barriers to early presentation and diagnosis with breast cancer among black women

    Science.gov (United States)

    Jones, Claire EL; Maben, Jill; Jack, Ruth H; Davies, Elizabeth A; Forbes, Lindsay JL; Lucas, Grace; Ream, Emma

    2014-01-01

    Objective To explore barriers to early presentation and diagnosis with breast cancer among black women. Design Systematic review. Methods We searched multiple bibliographic databases (January 1991–February 2013) for primary research, published in English, conducted in developed countries and investigating barriers to early presentation and diagnosis with symptomatic breast cancer among black women (≥18 years). Studies were excluded if they did not report separate findings by ethnic group or gender, only reported differences in time to presentation/diagnosis, or reported on interventions and barriers to cancer screening. We followed Cochrane and PRISMA guidance to identify relevant research. Findings were integrated through thematic synthesis. Designs of quantitative studies made meta-analysis impossible. Results We identified 18 studies (6183 participants). Delay was multifactorial, individual and complex. Factors contributing to delay included: poor symptom and risk factor knowledge; fear of detecting breast abnormality; fear of cancer treatments; fear of partner abandonment; embarrassment disclosing symptoms to healthcare professionals; taboo and stigmatism. Presentation appears quicker following disclosure. Influence of fatalism and religiosity on delay is unclear from evidence in these studies. We compared older studies (≥10 years) with newer ones (<10 years) to determine changes over time. In older studies, delaying factors included: inaccessibility of healthcare services; competing priorities and concerns about partner abandonment. Partner abandonment was studied in older studies but not in newer ones. Comparisons of healthy women and cancer populations revealed differences between how people perceive they would behave, and actually behave, on finding breast abnormality. Conclusions Strategies to improve early presentation and diagnosis with breast cancer among black women need to address symptom recognition and interpretation of risk, as well as

  2. Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings.

    Science.gov (United States)

    French, Michael T; Homer, Jenny; Gumus, Gulcin; Hickling, Lucas

    2016-10-01

    To conduct a systematic literature review of selected major provisions of the Affordable Care Act (ACA) pertaining to expanded health insurance coverage. We present and synthesize research findings from the last 5 years regarding both the immediate and long-term effects of the ACA. We conclude with a summary and offer a research agenda for future studies. We identified relevant articles from peer-reviewed scholarly journals by performing a comprehensive search of major electronic databases. We also identified reports in the "gray literature" disseminated by government agencies and other organizations. Overall, research shows that the ACA has substantially decreased the number of uninsured individuals through the dependent coverage provision, Medicaid expansion, health insurance exchanges, availability of subsidies, and other policy changes. Affordability of health insurance continues to be a concern for many people and disparities persist by geography, race/ethnicity, and income. Early evidence also indicates improvements in access to and affordability of health care. All of these changes are certain to ultimately impact state and federal budgets. The ACA will either directly or indirectly affect almost all Americans. As new and comprehensive data become available, more rigorous evaluations will provide further insights as to whether the ACA has been successful in achieving its goals. © Health Research and Educational Trust.

  3. Perceiving the present: systematization of illusions or illusion of systematization?

    Science.gov (United States)

    Briscoe, Robert E

    2010-11-01

    Mark Changizi et al. (2008) claim that it is possible systematically to organize more than 50 kinds of illusions in a 7 × 4 matrix of 28 classes. This systematization, they further maintain, can be explained by the operation of a single visual processing latency correction mechanism that they call "perceiving the present" (PTP). This brief report raises some concerns about the way a number of illusions are classified by the proposed systematization. It also poses two general problems-one empirical and one conceptual-for the PTP approach.

  4. Breast cancer. Present perspective of early diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Brunner, S.

    1987-01-01

    The Third International Copenhagen Symposium on Detection of Breast Cancer afforded a further opportunity for scientists from all over the world to come together and present important papers concerning breast cancer and early diagnosis procedures. The symposium was an opportunity to learn from extensive screening procedures carried out at outstanding centers in the United States, Sweden, the Netherlands, and England. Furthermore, the symposium dealt with new modalities such as ultra-sonography, magnification techniques, and magnetic resonance; and significant contributions concerning self-examination, fine needle aspiration biopsy, and radiation risks were presented. A whole section was also dedicated to the highly important cooperation between radiologist, surgeon, and pathologist.

  5. Clinical presentation of childhood leukaemia : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Clarke, Rachel T; Van den Bruel, Ann; Bankhead, Clare; Mitchell, Christopher D; Phillips, Bob; Thompson, Matthew J

    2016-01-01

    OBJECTIVE: Leukaemia is the most common cancer of childhood, accounting for a third of cases. In order to assist clinicians in its early detection, we systematically reviewed all existing data on its clinical presentation and estimated the frequency of signs and symptoms presenting at or prior to di

  6. Acute Pancreatitis as the Initial Presentation of Systematic Lupus Erythematosus

    OpenAIRE

    Yi Jia; Arleen Ortiz; Richard Mccallum; Hasan Salameh; Pedro Serrato

    2014-01-01

    Systematic lupus erythematosus (SLE) is a multisystem disease, including the gastrointestinal system in about half of SLE patients. As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE. Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

  7. Acute Pancreatitis as the Initial Presentation of Systematic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Yi Jia

    2014-01-01

    Full Text Available Systematic lupus erythematosus (SLE is a multisystem disease, including the gastrointestinal system in about half of SLE patients. As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE. Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

  8. Acute pancreatitis as the initial presentation of systematic lupus erythematosus.

    Science.gov (United States)

    Jia, Yi; Ortiz, Arleen; Mccallum, Richard; Salameh, Hasan; Serrato, Pedro

    2014-01-01

    Systematic lupus erythematosus (SLE) is a multisystem disease, including the gastrointestinal system in about half of SLE patients. As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE. Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

  9. Varied presentations of early congenital syphilis.

    Science.gov (United States)

    Basu, Sriparna; Kumar, Ashok

    2013-06-01

    In spite of availability of cost-effective preventive measures and treatment, a resurgence of congenital syphilis has currently been noted. During the past 4 years, we came across five low birth weight neonates with unusual symptoms, which subsequently proved to be manifestations of early congenital syphilis. All the mothers had apparently uneventful antenatal period. No investigation was done during pregnancy. They were unaware about their disease and were found to be positive for syphilis by Venereal Disease Research Laboratory Test and fluorescent treponemal antibody (absorbed) IgM test only after childbirth. Screening for other congenital infections was negative. All the neonates were positive for Venereal Disease Research Laboratory Test. They were treated with intravenous crystalline penicillin G for 10 days. Recovery was uneventful. We reemphasize the importance of raising public awareness, routine antenatal screening and treatment for all pregnant mothers to avoid such a potentially treatable condition.

  10. Breast cancer. Present perspective of early diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Bruenner, S.; Langfeldt, B. (eds.)

    1987-01-01

    This book contains outstanding papers presented at the 3rd International Copenhagen Symposium on Detection of Breast Cancer, 1985. The Symposium was an opportunity to learn from extensive screening procedures carried out at outstanding centers in the United States, Sweden, the Netherlands, and England. Furthermore, the symposium dealt with new modalities such as ultrasonography, magnification techniques, and magnetic resonance; and very important contributions concerning self-examination, fine needle aspiration biopsy, and radiation risks were presented. A whole section was also dedicated to the highly important cooperation between radiologist, surgeon, and pathologist. With 59 figs., 43 tabs.

  11. Growth monitoring as an early detection tool: a systematic review

    NARCIS (Netherlands)

    Scherdel, P.; Dunkel, L.; Dommelen, P. van; Goulet, O.; Salaün, J.F.; Brauner, R.; Heude, B.; Chalumeau, M.

    2016-01-01

    Growth monitoring of apparently healthy children aims at early detection of serious underlying disorders. However, existing growth-monitoring practices are mainly based on suboptimal methods, which can result in delayed diagnosis of severe diseases and inappropriate referrals. We did a systematic re

  12. Data Analysis for ARRA Early Fuel Cell Market Demonstrations (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Kurtz, J.; Wipke, K.; Sprik, S.; Ramsden, T.

    2010-05-01

    Presentation about ARRA Early Fuel Cell Market Demonstrations, including an overview of the ARRE Fuel Cell Project, the National Renewable Energy Laboratory's data analysis objectives, deployment composite data products, and planned analyses.

  13. Early Onset Marfan Syndrome: Atypical Clinical Presentation of Two Cases

    Directory of Open Access Journals (Sweden)

    Ozyurt Abdullah

    2015-06-01

    Full Text Available Early onset Marfan Syndrome (eoMFS is a rare, severe form of Marfan Syndrome (MFS. The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system.

  14. A systematic review of the effects of early intervention on motor development

    NARCIS (Netherlands)

    Blauw-Hospers, CH; Hadders-Algra, M

    2005-01-01

    We present a systematic review on the effect of early intervention, starting between birth and a corrected age of 18 months, on motor development in infants at high risk for, or with, developmental motor disorders. Thirty-four studies fulfilled the selection criteria. Seventeen studies were performe

  15. CERN receives early 50th anniversary present from Swiss Confederation

    CERN Multimedia

    2003-01-01

    "Swiss President Pascal Couchepin announced Wednesday 4 June an early 50th birthday present from the Swiss Confederation to CERN. Switzerland has decided to offer the laboratory the 'Palais de l'Equilibre', a landmark building designed by Geneva architects for Switzerland's 2002 national exhibition" (1/2 page).

  16. Systematic analysis of pleiotropy in C. elegans early embryogenesis.

    Directory of Open Access Journals (Sweden)

    Lihua Zou

    2008-02-01

    Full Text Available Pleiotropy refers to the phenomenon in which a single gene controls several distinct, and seemingly unrelated, phenotypic effects. We use C. elegans early embryogenesis as a model to conduct systematic studies of pleiotropy. We analyze high-throughput RNA interference (RNAi data from C. elegans and identify "phenotypic signatures", which are sets of cellular defects indicative of certain biological functions. By matching phenotypic profiles to our identified signatures, we assign genes with complex phenotypic profiles to multiple functional classes. Overall, we observe that pleiotropy occurs extensively among genes involved in early embryogenesis, and a small proportion of these genes are highly pleiotropic. We hypothesize that genes involved in early embryogenesis are organized into partially overlapping functional modules, and that pleiotropic genes represent "connectors" between these modules. In support of this hypothesis, we find that highly pleiotropic genes tend to reside in central positions in protein-protein interaction networks, suggesting that pleiotropic genes act as connecting points between different protein complexes or pathways.

  17. Early Mycoplasma pneumoniae infection presenting as multiple pulmonary masses: an unusual presentation in a child

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Edward; Altes, Talissa; Anupindi, Sudha A. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2008-04-15

    Mycoplasma pneumoniae is a major cause of community-acquired pneumonia. Because most children are not imaged prior to onset of clinical symptoms, the appearance of early Mycoplasma infection has not been extensively studied. We present the case of an 11-year-old boy with large pulmonary masses incidentally detected during spine MRI evaluation for scoliosis. Eight days later, the patient developed acute respiratory symptoms, and the masses seen previously had evolved into a diffuse bronchiolitis. Diagnostic testing identified Mycoplasma pneumoniae as the likely etiology. We briefly review chest CT findings of infection by Mycoplasma and compare them to this unusual presentation of Mycoplasma pneumonia with subclinical imaging findings. (orig.)

  18. Stomatal Blue Light Response Is Present in Early Vascular Plants.

    Science.gov (United States)

    Doi, Michio; Kitagawa, Yuki; Shimazaki, Ken-ichiro

    2015-10-01

    Light is a major environmental factor required for stomatal opening. Blue light (BL) induces stomatal opening in higher plants as a signal under the photosynthetic active radiation. The stomatal BL response is not present in the fern species of Polypodiopsida. The acquisition of a stomatal BL response might provide competitive advantages in both the uptake of CO2 and prevention of water loss with the ability to rapidly open and close stomata. We surveyed the stomatal opening in response to strong red light (RL) and weak BL under the RL with gas exchange technique in a diverse selection of plant species from euphyllophytes, including spermatophytes and monilophytes, to lycophytes. We showed the presence of RL-induced stomatal opening in most of these species and found that the BL responses operated in all euphyllophytes except Polypodiopsida. We also confirmed that the stomatal opening in lycophytes, the early vascular plants, is driven by plasma membrane proton-translocating adenosine triphosphatase and K(+) accumulation in guard cells, which is the same mechanism operating in stomata of angiosperms. These results suggest that the early vascular plants respond to both RL and BL and actively regulate stomatal aperture. We also found three plant species that absolutely require BL for both stomatal opening and photosynthetic CO2 fixation, including a gymnosperm, C. revoluta, and the ferns Equisetum hyemale and Psilotum nudum.

  19. Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis.

    Science.gov (United States)

    Molina-Sócola, F E; López-Herrero, F; Medina-Tapia, A; Rueda-Rueda, T; Contreras-Díaz, M; Sánchez-Vicente, J L

    2016-12-07

    A 36 year-old male with a recent HIV diagnosis, presented with loss of vision of his left eye. Ophthalmoscopy revealed a unilateral yellowish placoid lesion in the macula. After fluorescein angiography, optical coherence tomography, optical coherence tomography angiography, syphilis serology, and cerebrospinal fluid results, he was diagnosed with neurosyphilis and syphilitic posterior placoid chorioretinitis. Acute syphilitic posterior placoid chorioretinitis is a rare ocular manifestation of syphilis. All patients with characteristic clinical and angiographic findings of acute syphilitic posterior placoid chorioretinitis should be tested for a neurosyphilis and human immunodeficiency virus co-infection. Early treatment with intravenous penicillin is usually effective with good visual results. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Cosmic Acceleration in the Early and Present Universe

    Science.gov (United States)

    Yamaguchi, Masahide

    Cosmic accelerations in the early and present Universe play essentially important roles to determine the evolution, structure, and destiny of the Universe. Therefore, to identify the origins of cosmic accelerations is one of the most ultimate goals of cosmology. In this award talk for the C. N. Yang Award, I introduced my achievements on this mystery. First of all, we gave a natural mechanism to cause chaotic inflation, which is the most natural inflation model but had never been realized in the context of realistic particle physics for almost twenty years. We introduced a Nambu-Goldstone-like shift symmetry, which is now recognized as a key feature to control the Planck-scale physics, and solved the long standing difficulties to realize chaotic inflation. Second, we found a generic relation (now called Suyama-Yamaguchi inequality) between higher order correlations of the curvature perturbations, which is quite useful to identify what fields are actually responsible for the origin of primordial fluctuation. Finally, we mention our proposal (now called k-essence) for the present cosmic acceleration.

  1. Early presentation of gait impairment in Wolfram Syndrome

    Directory of Open Access Journals (Sweden)

    Pickett Kristen A

    2012-12-01

    associated with WFS, and may be a reflection of early cerebellar and/or brainstem abnormalities. Effective patient-centered treatment paradigms could benefit from a more complete understanding of the progression of motor and other neurological symptom presentation in individuals with WFS.

  2. Early motor developmental milestones and schizophrenia: A systematic review and meta-analysis.

    Science.gov (United States)

    Filatova, S; Koivumaa-Honkanen, H; Hirvonen, N; Freeman, A; Ivandic, I; Hurtig, T; Khandaker, G M; Jones, P B; Moilanen, K; Miettunen, J

    2017-01-25

    The neurodevelopmental hypothesis of schizophrenia proposes that impaired brain development is a cause of the illness. Early motor developmental milestones, such as learning to walk, are predictors of later schizophrenia but studies have not been systematically reviewed. The aim of the present systematic review and meta-analysis was to explore the association between early motor developmental milestones and the risk of adult schizophrenia. In addition, we updated a systematic review on motor function and risk of schizophrenia. The PubMed, PsycINFO and Scopus databases were searched for original research articles published up to July 2015. Motor milestones were measured between ages 0 and 13years. Random effect meta-analysis calculated effect estimates (Hedges' g) for the association between individual motor milestones and schizophrenia risk. An electronic database and selected articles reference list search identified 5990 articles after removing duplicates. Sixty-nine full text articles were assessed for eligibility of which six were included in the review. Five studies provided sufficient data for meta-analyses. The following motor milestones were significantly associated with adult schizophrenia risk: walking unsupported (g=0.46; 95% CI 0.27-0.64; pmotor milestones in childhood and can contribute to the identification of individuals at risk of psychosis.

  3. Gene-environment interactions in psychopathology throughout early childhood: a systematic review.

    Science.gov (United States)

    Pinto, Raquel Q; Soares, Isabel; Carvalho-Correia, Eduarda; Mesquita, Ana R

    2015-12-01

    Up to 20% of children and adolescents worldwide suffer from mental health problems. Epidemiological studies have shown that some of these problems are already present at an early age. The recognition that psychopathology is a result of an interaction between individual experiences and genetic characteristics has led to an increase in the number of studies using a gene-environment approach (G×E). However, to date, there has been no systematic review of G×E studies on psychopathology in the first 6 years of life. Following a literature search and a selection process, 14 studies were identified and most (n=12) of the studies found at least one significant G×E effect. This review provides a systematic characterization of the published G×E studies, providing insights into the neurobiological and environmental determinants involved in the etiology of children's psychopathology.

  4. Birth weight, early life weight gain and age at menarche: a systematic review of longitudinal studies.

    Science.gov (United States)

    Juul, F; Chang, V W; Brar, P; Parekh, N

    2017-11-01

    Adiposity in pre- and postnatal life may influence menarcheal age. Existing evidence is primarily cross-sectional, failing to address temporality, for which the role of adiposity in early life remains unclear. The current study sought to systematically review longitudinal studies evaluating the associations between birth weight and infant/childhood weight status/weight gain in relation to menarcheal age. PubMed, EMBASE, Web of Science, Global Health (Ovid) and CINAHL were systematically searched. Selected studies were limited to English-language articles presenting multi-variable analyses. Seventeen studies reporting risk estimates for birth weight (n = 3), infant/childhood weight gain/weight status (n = 4) or both (n = 10), in relation to menarcheal age were included. Lower vs. higher birth weight was associated with earlier menarche in nine studies and later menarche in one study, while three studies reported a null association. Greater BMI or weight gain over time and greater childhood weight were significantly associated with earlier menarche in nine of nine and six of seven studies, respectively. Studies suggested that lower birth weight and higher body weight and weight gain in infancy and childhood may increase the risk of early menarche. The pre- and postnatal period may thus be an opportune time for weight control interventions to prevent early menarche, and its subsequent consequences. © 2017 World Obesity Federation.

  5. Factors predicting persistence of early wheezing through childhood and adolescence: a systematic review of the literature

    Science.gov (United States)

    Rodríguez-Martínez, Carlos E; Sossa-Briceño, Monica P; Castro-Rodriguez, Jose A

    2017-01-01

    Background For the early identification of persistent asthma symptoms among young children with recurrent wheezing, it would be helpful to identify all available studies that have identified at least one factor for predicting the persistence of early wheezing. The objective of the present study was to perform a systematic review of all studies that have identified factors that predict the persistence of symptoms among young patients with recurring wheezing. Methods A systematic review of relevant studies was conducted through searching in MEDLINE, EMBASE, CINHAL, and SCOPUS databases up to June 2016. Studies that identified predictors of persistence of wheezing illness among young children with recurrent wheezing were retrieved. Two independent reviewers screened the literature and extracted relevant data. Results The literature search returned 649 references, 619 of which were excluded due to their irrelevance. Five additional studies were identified from reference lists, and 35 studies were finally included in the review. Among all the identified predictors, the most frequently identified ones were the following: family asthma or atopy; personal history of atopic diseases; allergic sensitization early in life; and frequency, clinical pattern, or severity of wheezing/symptoms. Conclusion Parental asthma (especially maternal), parental allergy, eczema, allergic rhinitis, persistent wheezing, wheeze without colds, exercise-induced wheeze, severe wheezing episodes, allergic sensitization (especially polysensitization), eosinophils (blood or eosinophil cationic protein in nasal sample), and fraction of exhaled nitric oxide were risk factors predicting persistence of early wheezing through school age. All of them are included in conventional algorithms, for example, Asthma Predictive Index and its modifications, for predicting future asthma. PMID:28392707

  6. Systematic Review of Early Intensive Behavioral Interventions for Children with Autism

    Science.gov (United States)

    Howlin, Patricia; Magiati, Iliana; Charman, Tony

    2009-01-01

    Recent reviews highlight limitations in the evidence base for early interventions for children with autism. We conducted a systematic review of controlled studies of early intensive behavioral interventions (EIBI) for young children with autism. Eleven studies met inclusion criteria (including two randomized controlled trials). At group level,…

  7. Minimal Z' models present bounds and early LHC reach

    CERN Document Server

    Salvioni, Ennio; Zwirner, Fabio

    2009-01-01

    We consider `minimal' Z' models, whose phenomenology is controlled by only three parameters beyond the Standard Model ones: the Z' mass and two effective coupling constants. They encompass many popular models motivated by grand unification, as well as many arising in other theoretical contexts. This parameterization takes also into account both mass and kinetic mixing effects, which we show to be sizable in some cases. After discussing the interplay between the bounds from electroweak precision tests and recent direct searches at the Tevatron, we extend our analysis to estimate the early LHC discovery potential. We consider a center-of-mass energy from 7 towards 10 TeV and an integrated luminosity from 50 to several hundred pb^-1, taking all existing bounds into account. We find that the LHC will start exploring virgin land in parameter space for M_Z' around 700 GeV, with lower masses still excluded by the Tevatron and higher masses still excluded by electroweak precision tests. Increasing the energy up to 10...

  8. Early reproductive developmental anatomy in Decaisnea (Lardizabalaceae) and its systematic implications.

    Science.gov (United States)

    Wang, Hua-Feng; Friedman, Cynthia Ross; Zhu, Zhi-Xin; Qin, Hai-Ning

    2009-11-01

    Decaisnea insignis, known as 'dead man's fingers' (Lardizabalaceae), is widely distributed in China and the Himalayan foothill countries. This economically important plant, which is the only species in the genus, has not been the subject of any embryological studies aside from one brief, older paper that lacks micrographs. Data on Decaisnea are also important because its systematic position has been unstable since the genus was established in 1855. Therefore, the objectives of this study were: (a) to use modern microscopy to document early reproductive anatomical development in Decaisnea; and (b) to compare qualitatively these early embryological characters with allied taxa in a systematic context. Decaisnea insignis floral buds and inflorescences were regularly collected from Shaanxi Province, China and prepared for light microscopy. The embryological characters studied were qualitatively compared with those of allied taxa via a thorough examination of the existing literature. Early reproductive anatomy in Decaisnea was documented and novel revelations made. It was discovered that the pollen is shed when three-celled (not two-celled, as previously reported), and that endosperm formation is nuclear (not cellular or helobial, as previously reported). These two newly revealed embryological characters are not found in any other members of Lardizabalaceae. Furthermore, neither are persistent antipodal cells, which we confirmed to be present in Decaisnea. Decaisnea and other Lardizabalaceae characteristically have tetrasporangiate anthers, a secretory tapetum, simultaneous microsporocyte cytokinesis, primarily bitegmic, crassinucellate ovules, and a Polygonum type embryo sac. However, in the family, persistent antipodals, nuclear endosperm, and pollen shed at the three-celled stage are only found in Decaisnea. These embryological data prompted the suggestion that Decaisnea needs elevation above the level of genus.

  9. Clinical zinc deficiency as early presentation of Wilson disease.

    Science.gov (United States)

    Van Biervliet, Stephanie; Küry, Sébastien; De Bruyne, Ruth; Vanakker, Olivier M; Schmitt, Sébastien; Vande Velde, Saskia; Blouin, Eric; Bézieau, Stéphane

    2015-04-01

    Wilson disease is a rare autosomal recessive disorder of the copper metabolism caused by homozygous or compound heterozygous mutations in the ATP-ase Cu(2+) transporting polypeptide (ATP7B) gene. The copper accumulation in different organs leads to the suspicion of Wilson disease. We describe a child with clinical zinc deficiency as presenting symptom of Wilson disease, which was confirmed by 2 mutations within the ATP7B gene and an increased copper excretion.

  10. Periodontitis as an early presentation of HIV infection.

    OpenAIRE

    Tenenbaum, H C; Mock, D; Simor, A E

    1991-01-01

    OBJECTIVE: To determine whether the presence of rapidly progressive periodontitis (RPP) in people at high risk for acquired immunodeficiency syndrome (AIDS) may be the first symptom of previously unrecognized human immunodeficiency virus (HIV) infection. DESIGN: Case series. SETTING: Dental clinic. PATIENTS: Twenty patients who presented or were referred to the dental clinic over 6 months for the treatment of unexplained RPP and were at high risk for AIDS. OUTCOME MEASURES: Diagnosis of HIV i...

  11. Routes for early enteral nutrition after esophagectomy : A systematic review

    NARCIS (Netherlands)

    Weijs, Teus J; Berkelmans, Gijs H K; Nieuwenhuijzen, Grard A P; Ruurda, Jelle P; Hillegersberg, Richard V; Soeters, Peter B; Luyer, Misha D P

    2015-01-01

    BACKGROUND: Early enteral feeding following surgery can be given orally, via a jejunostomy or via a nasojejunal tube. However, the best feeding route following esophagectomy is unclear. OBJECTIVES: To determine the best route for enteral nutrition following esophagectomy regarding anastomotic leakag

  12. Routes for early enteral nutrition after esophagectomy : A systematic review

    NARCIS (Netherlands)

    Weijs, Teus J; Berkelmans, Gijs H K; Nieuwenhuijzen, Grard A P; Ruurda, Jelle P|info:eu-repo/dai/nl/257561021; Hillegersberg, Richard V|info:eu-repo/dai/nl/110706242; Soeters, Peter B; Luyer, Misha D P

    2015-01-01

    BACKGROUND: Early enteral feeding following surgery can be given orally, via a jejunostomy or via a nasojejunal tube. However, the best feeding route following esophagectomy is unclear. OBJECTIVES: To determine the best route for enteral nutrition following esophagectomy regarding anastomotic leakag

  13. Early Disk dynamics Inferred from Isotope Systematics of Individual Chrondules

    DEFF Research Database (Denmark)

    Bollard, Jean Francois André

    to different reservoirs. Lastly, a reduced abundance of 26Al relative to 27Al in inner Solar System objects implies that asteroid accretion must have occurred very early in the Solar System’s formation, to allow melting and differentiation driven by 26Al decay. With respect to our Pb-Pb chondrule chronology...

  14. Early Disk dynamics Inferred from Isotope Systematics of Individual Chrondules

    DEFF Research Database (Denmark)

    Bollard, Jean Francois André

    to different reservoirs. Lastly, a reduced abundance of 26Al relative to 27Al in inner Solar System objects implies that asteroid accretion must have occurred very early in the Solar System’s formation, to allow melting and differentiation driven by 26Al decay. With respect to our Pb-Pb chondrule chronology...

  15. A systematic review of the clinical presentation, treatment and relapse characteristics of human Plasmodium ovale malaria.

    Science.gov (United States)

    Groger, Mirjam; Fischer, Hannah S; Veletzky, Luzia; Lalremruata, Albert; Ramharter, Michael

    2017-03-11

    Despite increased efforts to control and ultimately eradicate human malaria, Plasmodium ovale malaria is for the most part outside the focus of research or public health programmes. Importantly, the understanding of P. ovale-nowadays regarded as the two distinct species P. ovale wallikeri and P. ovale curtisi-largely stems from case reports and case series lacking study designs providing high quality evidence. Consecutively, there is a lack of systematic evaluation of the clinical presentation, appropriate treatment and relapse characteristics of P. ovale malaria. The aim of this systematic review is to provide a systematic appraisal of the current evidence for severe manifestations, relapse characteristics and treatment options for human P. ovale malaria. This systematic review was performed according to the PRISMA guidelines and registered in the international prospective register for systematic reviews (PROSPERO 2016:CRD42016039214). P. ovale mono-infection was a strict inclusion criterion. Of 3454 articles identified by the literature search, 33 articles published between 1922 and 2015 met the inclusion criteria. These articles did not include randomized controlled trials. Five prospective uncontrolled clinical trials were performed on a total of 58 participants. P. ovale was sensitive to all tested drugs within the follow-up periods and on interpretable in vitro assays. Since its first description in 1922, only 18 relapsing cases of P. ovale with a total of 28 relapse events were identified in the scientific literature. There was however no molecular evidence for a causal relationship between dormant liver stages and subsequent relapses. A total of 22 severe cases of P. ovale malaria were published out of which five were fatal. Additionally, two cases of congenital P. ovale malaria were reported. Current knowledge of P. ovale malaria is based on small trials with minor impact, case reports and clinical observations. This systematic review highlights that P

  16. Psychiatric presentations heralding Hashimoto's encephalopathy: A systematic review and analysis of cases reported in literature

    Directory of Open Access Journals (Sweden)

    Vikas Menon

    2017-01-01

    Full Text Available Hashimoto's encephalopathy (HE may often present initially with psychiatric symptoms. These presentations are often variable in clinical aspects, and there has been no systematic analysis of the numerous psychiatric presentations heralding an eventual diagnosis of HE which will guide clinicians to make a correct diagnosis of HE. This systematic review was done to analyze the demographic characteristics, symptom typology, and clinical and treatment variables associated with such forerunner presentations. Electronic databases such as PubMed, ScienceDirect, and Google Scholar databases were searched to identify potential case reports that described initial psychiatric presentations of HE in English language peer-reviewed journals. The generated articles were evaluated and relevant data were extracted using a structured tool. We identified a total of forty articles that described 46 cases. More than half of the total samples (54.4% were above the age of 50 years at presentation. The most common psychiatric diagnosis heralding HE was acute psychosis (26.1% followed by depressive disorders (23.9%. Dementia (10.9% and schizophrenia (2.2% were uncommon presentations. Antithyroid peroxidase antibodies were elevated in all patients but not antithyroglobulin antibodies. Preexisting hypothyroidism was absent in majority of cases (60.9%. Steroid doses initiated were 500–1000 mg of intravenous methylprednisolone for majority (52.1% of patients while oral steroid maintenance was required for a significant minority (39.1%. Psychiatric manifestations of HE may be heterogeneous and require a high index of clinical suspicion, especially in older adults. A range of clinical and treatment variables may assist clinicians in making a faster diagnosis and instituting prompt and effective management.

  17. Psychiatric Presentations Heralding Hashimoto's Encephalopathy: A Systematic Review and Analysis of Cases Reported in Literature

    Science.gov (United States)

    Menon, Vikas; Subramanian, Karthick; Thamizh, Jaiganesh Selvapandian

    2017-01-01

    Hashimoto's encephalopathy (HE) may often present initially with psychiatric symptoms. These presentations are often variable in clinical aspects, and there has been no systematic analysis of the numerous psychiatric presentations heralding an eventual diagnosis of HE which will guide clinicians to make a correct diagnosis of HE. This systematic review was done to analyze the demographic characteristics, symptom typology, and clinical and treatment variables associated with such forerunner presentations. Electronic databases such as PubMed, ScienceDirect, and Google Scholar databases were searched to identify potential case reports that described initial psychiatric presentations of HE in English language peer-reviewed journals. The generated articles were evaluated and relevant data were extracted using a structured tool. We identified a total of forty articles that described 46 cases. More than half of the total samples (54.4%) were above the age of 50 years at presentation. The most common psychiatric diagnosis heralding HE was acute psychosis (26.1%) followed by depressive disorders (23.9%). Dementia (10.9%) and schizophrenia (2.2%) were uncommon presentations. Antithyroid peroxidase antibodies were elevated in all patients but not antithyroglobulin antibodies. Preexisting hypothyroidism was absent in majority of cases (60.9%). Steroid doses initiated were 500–1000 mg of intravenous methylprednisolone for majority (52.1%) of patients while oral steroid maintenance was required for a significant minority (39.1%). Psychiatric manifestations of HE may be heterogeneous and require a high index of clinical suspicion, especially in older adults. A range of clinical and treatment variables may assist clinicians in making a faster diagnosis and instituting prompt and effective management. PMID:28479803

  18. Misspecifications of stimulus presentation durations in experimental psychology: a systematic review of the psychophysics literature.

    Directory of Open Access Journals (Sweden)

    Tobias Elze

    Full Text Available BACKGROUND: In visual psychophysics, precise display timing, particularly for brief stimulus presentations, is often required. The aim of this study was to systematically review the commonly applied methods for the computation of stimulus durations in psychophysical experiments and to contrast them with the true luminance signals of stimuli on computer displays. METHODOLOGY/PRINCIPAL FINDINGS: In a first step, we systematically scanned the citation index Web of Science for studies with experiments with stimulus presentations for brief durations. Articles which appeared between 2003 and 2009 in three different journals were taken into account if they contained experiments with stimuli presented for less than 50 milliseconds. The 79 articles that matched these criteria were reviewed for their method of calculating stimulus durations. For those 75 studies where the method was either given or could be inferred, stimulus durations were calculated by the sum of frames (SOF method. In a second step, we describe the luminance signal properties of the two monitor technologies which were used in the reviewed studies, namely cathode ray tube (CRT and liquid crystal display (LCD monitors. We show that SOF is inappropriate for brief stimulus presentations on both of these technologies. In extreme cases, SOF specifications and true stimulus durations are even unrelated. Furthermore, the luminance signals of the two monitor technologies are so fundamentally different that the duration of briefly presented stimuli cannot be calculated by a single method for both technologies. Statistics over stimulus durations given in the reviewed studies are discussed with respect to different duration calculation methods. CONCLUSIONS/SIGNIFICANCE: The SOF method for duration specification which was clearly dominating in the reviewed studies leads to serious misspecifications particularly for brief stimulus presentations. We strongly discourage its use for brief stimulus

  19. Misspecifications of stimulus presentation durations in experimental psychology: a systematic review of the psychophysics literature.

    Science.gov (United States)

    Elze, Tobias

    2010-09-29

    In visual psychophysics, precise display timing, particularly for brief stimulus presentations, is often required. The aim of this study was to systematically review the commonly applied methods for the computation of stimulus durations in psychophysical experiments and to contrast them with the true luminance signals of stimuli on computer displays. In a first step, we systematically scanned the citation index Web of Science for studies with experiments with stimulus presentations for brief durations. Articles which appeared between 2003 and 2009 in three different journals were taken into account if they contained experiments with stimuli presented for less than 50 milliseconds. The 79 articles that matched these criteria were reviewed for their method of calculating stimulus durations. For those 75 studies where the method was either given or could be inferred, stimulus durations were calculated by the sum of frames (SOF) method. In a second step, we describe the luminance signal properties of the two monitor technologies which were used in the reviewed studies, namely cathode ray tube (CRT) and liquid crystal display (LCD) monitors. We show that SOF is inappropriate for brief stimulus presentations on both of these technologies. In extreme cases, SOF specifications and true stimulus durations are even unrelated. Furthermore, the luminance signals of the two monitor technologies are so fundamentally different that the duration of briefly presented stimuli cannot be calculated by a single method for both technologies. Statistics over stimulus durations given in the reviewed studies are discussed with respect to different duration calculation methods. The SOF method for duration specification which was clearly dominating in the reviewed studies leads to serious misspecifications particularly for brief stimulus presentations. We strongly discourage its use for brief stimulus presentations on CRT and LCD monitors.

  20. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

    Directory of Open Access Journals (Sweden)

    Ilana Shavit

    2014-12-01

    Full Text Available Objectives: The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods: We performed literature investigation through MEDLINE (PubMed electronic database and manual search through dental journals to find articles concerning inferior alveolar nerve injury following implant placement. The search was restricted to English language articles published during the last 10 years, from December 2004 to March 2014. Results: In total, we found 33 articles related to the topic, of which 27 were excluded due to incompatibility with established inclusion criteria. Six articles were eventually chosen to be suitable. The studies presented diagnostic methods of inferior alveolar nerve sensory deficit, and we carried out an assessment of the proportion of patients diagnosed within different time intervals from the time the injury occurred. Conclusions: Various diagnostic methods have been developed throughout the years for dealing with 1 quite frequent complication in the implantology field - inferior alveolar nerve injury. Concurrently, the importance of early diagnosis and treatment was proved repeatedly. According to the results of the data analysis, a relatively high percentage of the practitioners successfully accomplished this target and achieved good treatment outcomes.

  1. PA01.02. Effect of Shodhana Karma in early Psoriasis– A case study presentation

    OpenAIRE

    2013-01-01

    Purpose: To show the effect of holistic Ayurvedic Treatment in a critical disease like psoriasis in early stage. Method: A patient of known case of psoriasis (not more than 2 yrs) given systematic Ayurvedic Shodhana Karma every 3 yrs. Result: After shodhana Karma, patient got both Subjective & objective relief from Symptoms for a long duration than modern medicines. Conclusion: Pure Ayurvedic Traditional treatment can give relief from symptoms of psoriasis for a longer time without any side e...

  2. Methodological developments in searching for studies for systematic reviews: past, present and future?

    Science.gov (United States)

    Lefebvre, Carol; Glanville, Julie; Wieland, L Susan; Coles, Bernadette; Weightman, Alison L

    2013-09-25

    The Cochrane Collaboration was established in 1993, following the opening of the UK Cochrane Centre in 1992, at a time when searching for studies for inclusion in systematic reviews was not well-developed. Review authors largely conducted their own searches or depended on medical librarians, who often possessed limited awareness and experience of systematic reviews. Guidance on the conduct and reporting of searches was limited. When work began to identify reports of randomized controlled trials (RCTs) for inclusion in Cochrane Reviews in 1992, there were only approximately 20,000 reports indexed as RCTs in MEDLINE and none indexed as RCTs in Embase. No search filters had been developed with the aim of identifying all RCTs in MEDLINE or other major databases. This presented The Cochrane Collaboration with a considerable challenge in identifying relevant studies.Over time, the number of studies indexed as RCTs in the major databases has grown considerably and the Cochrane Central Register of Controlled Trials (CENTRAL) has become the best single source of published controlled trials, with approximately 700,000 records, including records identified by the Collaboration from Embase and MEDLINE. Search filters for various study types, including systematic reviews and the Cochrane Highly Sensitive Search Strategies for RCTs, have been developed. There have been considerable advances in the evidence base for methodological aspects of information retrieval. The Cochrane Handbook for Systematic Reviews of Interventions now provides detailed guidance on the conduct and reporting of searches. Initiatives across The Cochrane Collaboration to improve the quality inter alia of information retrieval include: the recently introduced Methodological Expectations for Cochrane Intervention Reviews (MECIR) programme, which stipulates 'mandatory' and 'highly desirable' standards for various aspects of review conduct and reporting including searching, the development of Standard Training

  3. Interventions employing mobile technology for overweight and obesity: an early systematic review of randomized controlled trials

    Science.gov (United States)

    Bacigalupo, R; Cudd, P; Littlewood, C; Bissell, P; Hawley, M S; Buckley Woods, H

    2013-01-01

    Summary Obesity is a global epidemic with major healthcare implications and costs. Mobile technologies are potential interventions to promote weight loss. An early systematic review of this rapidly growing area of research was conducted. Electronic databases were searched for articles published between January 1998 and October 2011. Data sources included Medline, Embase and the Cochrane Central Register of Controlled Trials. Ongoing research was searched for using clinical trials databases and registers. Out of 174 articles retrieved, 21 met the inclusion criteria of randomized controlled trials (RCTs) on mobile technology interventions facilitating weight loss in overweight and obese adults with any other comparator. A narrative synthesis was undertaken. Seven articles were included and appraised using the Cochrane risk of bias tool: four presented a low risk of bias and three presented a high risk of bias. There is consistent strong evidence across the included multiple high-quality RCTs that weight loss occurs in the short-term because of mobile technology interventions, with moderate evidence for the medium-term. Recommendations for improving the reporting and quality of future trials are made including reporting weight loss in percent to meet clinical standards, and including features such as long-term follow-up, cost-effectiveness and patient acceptability. PMID:23167478

  4. The effect of early in-hospital medication review on health outcomes: a systematic review

    Science.gov (United States)

    Hohl, Corinne M; Wickham, Maeve E; Sobolev, Boris; Perry, Jeff J; Sivilotti, Marco L A; Garrison, Scott; Lang, Eddy; Brasher, Penny; Doyle-Waters, Mary M; Brar, Baljeet; Rowe, Brian H; Lexchin, Joel; Holland, Richard

    2015-01-01

    Aims Adverse drug events are an important cause of emergency department visits, unplanned admissions and prolonged hospital stays. Our objective was to synthesize the evidence on the effect of early in-hospital pharmacist-led medication review on patient-oriented outcomes based on observed data. Methods We systematically searched eight bibliographic reference databases, electronic grey literature, medical journals, conference proceedings, trial registries and bibliographies of relevant papers. We included studies that employed random or quasi-random methods to allocate subjects to pharmacist-led medication review or control. Medication review had to include, at a minimum, obtaining a best possible medication history and reviewing medications for appropriateness and adverse drug events. The intervention had to be initiated within 24 h of emergency department presentation or 72 h of admission. We extracted data in duplicate and pooled outcomes from clinically homogeneous studies of the same design using random effects meta-analysis. Results We retrieved 4549 titles of which seven were included, reporting the outcomes of 3292 patients. We pooled data from studies of the same design, and found no significant differences in length of hospital admission (weighted mean difference [WMD] –0.04 days, 95% confidence interval [CI] –1.63, 1.55), mortality (odds ratio [OR] 1.09, 95% CI 0.69, 1.72), readmissions (OR 1.15, 95% CI 0.81, 1.63) or emergency department revisits at 3 months (OR 0.60, 95% CI 0.27, 1.32). Two large studies reporting reductions in readmissions could not be included in our pooled estimates due to differences in study design. Conclusions Wide confidence intervals suggest that additional research is likely to influence the effect size estimates and clarify the effect of medication review on patient-oriented outcomes. This systematic review failed to identify an effect of pharmacist-led medication review on health outcomes. PMID:25581134

  5. A systematic approach for identifying and presenting mechanistic evidence in human health assessments

    Science.gov (United States)

    Kushman, Mary E.; Kraft, Andrew D.; Guyton, Kathryn Z.; Chiu, Weihsueh A.; Makris, Susan L.; Rusyn, Ivan

    2013-01-01

    Clear documentation of literature search and presentation methodologies can improve transparency in chemical hazard assessments. We sought to improve clarity for the scientific support for cancer mechanisms of action using a systematic approach to literature retrieval, selection, and presentation of studies. The general question was “What are the mechanisms by which a chemical may cause carcinogenicity in the target tissue?” Di(2-ethylhexyl)phthalate was used as a case study chemical with a complex database of >3,000 publications. Relevant mechanistic events were identified from published reviews. The PubMed search strategy included relevant synonyms and wildcards for DEHP and its metabolites, mechanistic events, and species of interest. Tiered exclusion/inclusion criteria for study pertinence were defined, and applied to the retrieved literature. Manual curation was conducted for mechanistic events with large literature databases. Literature trees documented identification and selection of the literature evidence. The selected studies were summarized in evidence tables accompanied by succinct narratives. Primary publications were deposited into the Health and Environmental Research Online (http://hero.epa.gov/) database and identified by pertinence criteria and key terms to permit organized retrieval. This approach contributes to human health assessment by effectively managing a large volume of literature, improving transparency, and facilitating subsequent synthesis of information across studies. PMID:23959061

  6. Psychotherapeutic benefits of compassion-focused therapy: an early systematic review

    OpenAIRE

    Leaviss, J.; Uttley, L.

    2014-01-01

    Background. Compassion-focused therapy (CFT) is a relatively novel form of psychotherapy that was developed for people who have mental health problems primarily linked to high shame and self-criticism. The aim of this early systematic review was to draw together the current research evidence of the effectiveness of CFT as a psychotherapeutic intervention, and to provide recommendations that may inform the development of further trials.\\ud \\ud Method. A comprehensive search of electronic datab...

  7. Inferior Alveolar Nerve Injuries Following Implant Placement - Importance of Early Diagnosis and Treatment: a Systematic Review

    OpenAIRE

    Ilana Shavit; Gintaras Juodzbalys

    2014-01-01

    ABSTRACT Objectives The purpose of this article is to systematically review diagnostic procedures and risk factors associated with inferior alveolar nerve injury following implant placement, to identify the time interval between inferior alveolar nerve injury and its diagnosis after surgical dental implant placement and compare between outcomes of early and delayed diagnosis and treatment given based on case series recorded throughout a period of 10 years. Material and Methods We performed li...

  8. Correction of nonvertex presentation with moxibustion: a systematic review and metaanalysis.

    Science.gov (United States)

    Vas, Jorge; Aranda, Jose Manuel; Nishishinya, Betina; Mendez, Camila; Martin, M Angeles; Pons, Joana; Liu, Jian Ping; Wang, Chun Yong; Perea-Milla, Emilio

    2009-09-01

    We searched systematically for randomized controlled trials, comparing moxibustion with a nonmoxibustion control group or other methods such as external cephalic version, postural methods, and acupuncture in databases, both Western and Chinese, up to June 2007. Six studies, with 1087 subjects and a high degree of heterogeneity, compared moxibustion vs observation or postural methods and reported a rate of cephalic version among the moxibustion group of 72.5% vs 53.2% in the control group (relative risk, 1.36; 95% confidence interval, 1.17-1.58); the number needed to treat was 5 (95% confidence interval, 4-7). In terms of safety, no significant differences were found in the comparison of moxibustion with other techniques. Moxibustion at acupuncture point BL67 has been shown to produce a positive effect, whether used alone or in combination with acupuncture or postural measures, in comparison with observation or postural methods alone, for the correction of nonvertex presentation, although these results should be viewed with caution, given the considerable heterogeneity found among studies.

  9. Early Hebrew education and its significance for present-day educational theory and practice

    Directory of Open Access Journals (Sweden)

    S. Schoeman

    1997-01-01

    Full Text Available Early Hebrew education and its significance for present-day educational theory and practice The history of education in antiquity is not without relevance to present-day educational theory and practice. The focus in this article is on the early Hebrews and their education. A study of early Hebrew education may in itself not provide solutions to current educational problems, but it may be useful in offering new perspectives, encouragement and suggestions for a juture South African educational dispensation.

  10. Evidence of Nervous System Sensitization in Commonly Presenting and Persistent Painful Tendinopathies : A Systematic Review

    NARCIS (Netherlands)

    Plinsinga, Melanie L.; Brink, Michel S.; Vicenzino, Bill; Van Wilgen, C. Paul

    2015-01-01

    STUDY DESIGN: Systematic review. OBJECTIVES: To elucidate if there is sensitization of the nervous system in those with persistent rotator cuff (shoulder), lateral elbow, patellar, and Achilles tendinopathies. BACKGROUND: Tendinopathy can be difficult to treat, and persistent intractable pain and

  11. Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis in a Setting With No Systematic Screening in Pregnancy.

    Science.gov (United States)

    Stajner, Tijana; Bobic, Branko; Klun, Ivana; Nikolic, Aleksandra; Srbljanovic, Jelena; Uzelac, Aleksandra; Rajnpreht, Irena; Djurkovic-Djakovic, Olgica

    2016-03-01

    To determine the risk of congenital toxoplasmosis (CT) and provide early (pre- or postnatal) identification of cases of CT in the absence of systematic screening in pregnancy.I n the presented cross-sectional study, serological criteria were used to date Toxoplasma gondii infection versus conception in 80 pregnant women with fetal abnormalities or referred to as suspected of acute infection, and in 16 women after delivery of symptomatic neonates. A combination of serological, molecular (qPCR), and biological (bioassay) methods was used for prenatal and/or postnatal diagnosis of CT. Most (77.5%) pregnant women were examined in advanced pregnancy. Of all the examined seropositive women (n = 90), infection could not be ruled out to have occurred during pregnancy in 93.3%, of which the majority (69%) was dated to the periconceptual period. CT was diagnosed in 25 cases, of which 17 prenatally and 8 postnatally. Molecular diagnosis proved superior, but the diagnosis of CT based on bioassay in 7 instances and by Western blot in 2 neonates shows that other methods remain indispensable. In the absence of systematic screening in pregnancy, maternal infection is often diagnosed late, or even only when fetal/neonatal infection is suspected. In such situations, use of a complex algorithm involving a combination of serological, biological, and molecular methods allows for prenatal and/or early postnatal diagnosis of CT, but lacks the preventive capacity provided by early maternal treatment.

  12. Neural Correlates of Word Recognition: A Systematic Comparison of Natural Reading and Rapid Serial Visual Presentation.

    Science.gov (United States)

    Kornrumpf, Benthe; Niefind, Florian; Sommer, Werner; Dimigen, Olaf

    2016-09-01

    Neural correlates of word recognition are commonly studied with (rapid) serial visual presentation (RSVP), a condition that eliminates three fundamental properties of natural reading: parafoveal preprocessing, saccade execution, and the fast changes in attentional processing load occurring from fixation to fixation. We combined eye-tracking and EEG to systematically investigate the impact of all three factors on brain-electric activity during reading. Participants read lists of words either actively with eye movements (eliciting fixation-related potentials) or maintained fixation while the text moved passively through foveal vision at a matched pace (RSVP-with-flankers paradigm, eliciting ERPs). The preview of the upcoming word was manipulated by changing the number of parafoveally visible letters. Processing load was varied by presenting words of varying lexical frequency. We found that all three factors have strong interactive effects on the brain's responses to words: Once a word was fixated, occipitotemporal N1 amplitude decreased monotonically with the amount of parafoveal information available during the preceding fixation; hence, the N1 component was markedly attenuated under reading conditions with preview. Importantly, this preview effect was substantially larger during active reading (with saccades) than during passive RSVP with flankers, suggesting that the execution of eye movements facilitates word recognition by increasing parafoveal preprocessing. Lastly, we found that the N1 component elicited by a word also reflects the lexical processing load imposed by the previously inspected word. Together, these results demonstrate that, under more natural conditions, words are recognized in a spatiotemporally distributed and interdependent manner across multiple eye fixations, a process that is mediated by active motor behavior.

  13. Physical Activity and Early Rehabilitation in Hospitalized Elderly Medical Patients: Systematic Review of Randomized Clinical Trials.

    Science.gov (United States)

    Martínez-Velilla, N; Cadore, L; Casas-Herrero, Á; Idoate-Saralegui, F; Izquierdo, M

    2016-01-01

    To critically review the effect of interventions incorporating exercise and early rehabilitation (physical therapy, occupational therapy, and physical activity) in the functional outcomes (i.e., active daily living tests, such as Barthel Index Scores, Timed-up-and go, mobility tests), and feasibility in hospitalized elderly medical patients. Systematic review of the literature. A literature search was conducted using the following databases and medical resources from 1966 to January 2014: PubMed (Medline), PEDro, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews, Google Scholar, ClinicalTrials.gov, Clinical Evidence, SportsDiscus, EMBASE and UptoDate. Studies must have mentioned the effects of early rehabilitation on the above mentioned functional outcomes and feasibility. Data on the mortality, economic profile and average stay were also described. From the 6564 manuscripts potentially related to exercise performance in hospitalized elderly patients, the review focused on 1086, and 17 articles were ultimately included. Regarding functional outcomes after discharge, four studies observed significant improvement in functional outcomes following early rehabilitation, even up to twelve months after discharge. Eight studies directly or indirectly assessed the economic impact of exercise intervention. Five of them did not show any increase in costs, while three concluded that the intervention was cost effective. No adverse effect related with the interventions were mentioned. The introduction of an exercise program for hospitalized elderly patients may be feasible, and may not increase costs. Importantly, early rehabilitation may also improve the functional and healthcare.

  14. Clinical presentations and outcomes of Takotsubo syndrome in the setting of subarachnoid hemorrhage: A systematic review and meta-analysis.

    Science.gov (United States)

    Elgendy, Akram Y; Elgendy, Islam Y; Mansoor, Hend; Mahmoud, Ahmed N

    2016-11-16

    Evidence remains inconsistent regarding the incidence and prognosis of Takotsubo syndrome in the setting of subarachnoid hemorrhage. Thus, we aimed to evaluate the clinical presentation and in-hospital mortality of these patients. A systematic review of the electronic databases was conducted for studies involving patients with spontaneous subarachnoid hemorrhage and concomitant findings of classical Takotsubo syndrome on transthoracic echocardiogram. A meta-analysis was conducted for the primary outcome of in-hospital mortality using the Mantel-Haenszel method for fixed effects and the DerSimonian and Laird method for random effects, with 95% confidence interval and a p-value Takotsubo syndrome, representing 4.4% of the subarachnoid hemorrhage total population. The overall incidence of in-hospital mortality was 30% in the patients who developed Takotsubo syndrome. Meta-analysis illustrated a significant increase in the odds of in-hospital mortality for the Takotsubo syndrome patients by fixed effects model (odds ratio 2.6, 95% confidence interval 1.16-5.85, p=0.02, I(2)=39%), with a trend towards increased risk of in-hospital mortality by random effects model (odds ratio 3.00, 95% confidence interval 0.90-9.77, p = 0.07). The incidence of Takotsubo syndrome in patients with spontaneous subarachnoid hemorrhage seems to be high with a trend towards higher risk of in-hospital mortality in those patients. Thus, patients presenting with subarachnoid hemorrhage might benefit from a comprehensive cardiac evaluation upon presentation for early detection and proper triage of this high-risk population. © The European Society of Cardiology 2016.

  15. A systematic review of the long-term outcome of early onset schizophrenia

    DEFF Research Database (Denmark)

    Clemmensen, Lars; Vernal, Ditte Lammers; Steinhausen, Hans-Christoph

    2012-01-01

    of onset in these studies was 10 years, small to moderate for more unfavourable outcomes in males, and small to large for worse outcomes in studies including patients diagnosed before 1970. CONCLUSIONS: In contrast to the adult manifestation, the early manifestation of schizophrenia in childhood......ABSTRACT: BACKGROUND: The current review analyzes the long-term outcome and prognosis of early onset schizophrenia based on previously published studies onset schizophrenia based on previously published studies in 1980. METHODS: A systematic search of articles published in the English......-language literature after 1980 identified a total of 21 studies, which included 716 patients who were either suffering from early onset schizophrenia (EOS) or both EOS and other psychotic disorders (MIX). The authors of the current review scored the outcome as either "good," "moderate," or "poor." The mean age...

  16. Early changes in somatosensory function in spinal pain: a systematic review and meta-analysis.

    Science.gov (United States)

    Marcuzzi, Anna; Dean, Catherine M; Wrigley, Paul J; Hush, Julia M

    2015-02-01

    Alterations in sensory processing have been demonstrated in chronic low back and neck pain. However, it has not been yet systematically summarized how early these changes occur in spinal pain. This systematic review examines the available literature measuring somatosensory function in acute (<6 weeks) and subacute (6-12 weeks) spinal pain. The protocol for this review has been registered on the International Prospective Register of Systematic Reviews (PROSPERO). An electronic search of 4 databases was conducted to retrieve studies assessing somatosensory function by quantitative sensory testing in adults with spinal pain of up to 12 weeks duration. Two reviewers independently screened the studies and assessed the risk of bias. Studies were grouped according to spinal pain condition (whiplash injury, idiopathic neck pain, and nonspecific low back pain), and, where possible, meta-analyses were performed for comparable results. Fifteen studies were included. Sources of bias included lack of assessor blinding, unclear sampling methods, and lack of control for confounders. We found that: (1) there is consistent evidence for thermal and widespread mechanical pain hypersensitivity in the acute stage of whiplash, (2) there is no evidence for pain hypersensitivity in the acute and subacute stage of idiopathic neck pain, although the body of evidence is small, and (3) hyperalgesia and spinal cord hyperexcitability have been detected in early stages of nonspecific low back pain, although evidence about widespread effects are conflicting. Future longitudinal research using multiple sensory modalities and standardized testing may reveal the involvement of somatosensory changes in the development and maintenance of chronic pain.

  17. Building the Evidence Base of Blood-Based Biomarkers for Early Detection of Cancer: A Rapid Systematic Mapping Review

    Directory of Open Access Journals (Sweden)

    Lesley Uttley

    2016-08-01

    Interpretation: This study is the first to systematically and comprehensively map blood biomarkers for early detection of cancer. Use of this rapid systematic mapping approach found a broad range of relevant biomarkers allowing an evidence-based approach to identification of promising biomarkers for development of a blood-based cancer screening test in the general population.

  18. Barriers to early presentation and diagnosis of breast cancer among African women living in sub-Saharan Africa

    Science.gov (United States)

    Akuoko, Cynthia Pomaa; Armah, Ernestina; Sarpong, Theresa; Quansah, Dan Yedu; Amankwaa, Isaac

    2017-01-01

    Background Breast cancer (BC) has been described as the leading cause of cancer deaths among women especially in the developing world including sub Saharan Africa (SSA). Delayed presentation and late diagnosis at health facilities are parts of the contributing factors of high BC mortality in Africa. This review aimed to appraise the contributing factors to delayed breast cancer presentation and diagnosis among SSA women. Methods Five databases encompassing medical and social sciences were systematically searched using predefined search terms linked with breast cancer presentation and diagnosis and sub Saharan Africa. Reference lists of relevant papers were also hand searched. Quality of quantitative and qualitative articles were assessed using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Critical Appraisal Skills Programme (CASP) quality appraisal checklist. Thematic analysis was used to synthesize the qualitative studies to integrate findings. Results Fourteen (14) quantitative studies, two (2) qualitative studies and one (1) mixed method study merited inclusion for analysis. This review identified low knowledge of breast cancer among SSA women. This review also found lack of awareness of early detection treatment, poor perception of BC, socio-cultural factors such as belief, traditions and fear as factors impacting African women’s health seeking behavior in relation to breast cancer. Conclusion Improving African women’s knowledge and understanding will improve behaviors related to breast cancer and facilitate early presentation and detection and enhance proper management and treatment of breast cancer. PMID:28192444

  19. A systematic review and meta-analysis of Hirschsprung's disease presenting after childhood.

    LENUS (Irish Health Repository)

    Doodnath, Reshma

    2012-02-01

    BACKGROUND: Hirschsprung\\'s disease (HD) is characterised by an absence of ganglion cells in the distal bowel, beginning at the internal sphincter and extending proximally to varying distances. It is usually diagnosed in the newborn period, with usual presentation of delayed passage of meconium and abdominal distension, with or without bilious vomiting. HD in adults is rare and is thus often undiagnosed or misdiagnosed. The purpose of this meta-analysis was to review the presentation, treatment and clinical outcome of HD presenting after childhood. METHODS: A systematic review and meta-analysis of all cases of HD presenting after childhood in the English literature was performed from 1950 to 2009. Detailed information regarding demographics, clinical presentation and methods of diagnosis, surgical procedure, complications and the outcome at time of follow up was recorded. RESULTS: There were 490 cases of HD presenting after childhood in the English literature, 341 (69.5%) males, 129 (26.4%) females and 20 (4.1%) cases where gender was not specified. As much as 390 (79.6%) were confined to the rectum, 60 (12.3%) had recto-sigmoid disease, 4 (0.8%) had disease extending to the descending colon and there were 2 (0.4%) cases that extended to the transverse colon and 2 (0.4%) cases of total colonic disease. The extent of disease was not specified in the remaining 32 (6.5%) cases. A total of 49 (10%) patients had the Swenson procedure, 231 (47.2%) patients had the Duhamel procedure, 40 (8.2%) patients had the Soave procedure, 45 (9.2%) patients had a myectomy only, 3 (0.6%) patients had a myectomy combined with colectomy, 14 (2.9%) patients had a myectomy combined with anterior resection. As much as 26 (5.3%) patients had a lower anterior resection (LAR), 28 (5.7%) patients had LAR combined with colectomy, 10 (2%) patients had a colectomy, 1 (0.2%) patient had an anopexy and 4 (0.9%) patients had a colostomy only. A total of 13 (2.7%) patients refused surgery and

  20. Presentation

    Directory of Open Access Journals (Sweden)

    Eduardo Vicente

    2013-06-01

    effectivities more than a number of fixed essential characteristics. Luiz Artur Ferrareto (UFRGS, undertaking a theoretical proposal for categorizing radio content in four different levels of planning (segment, form, programming and content itself tries to “compare and contrast the practices of Brazilian commercial broadcasting companies to those used on the radio in the United States, a reference market for our national entrepreneurs”. Madalena Oliveira (University of Minho focuses on the current stage of communication researches in Portugal reflecting on the challenges for studying a culture based on listening in times of looking. Marko Ala-Fossi, (University of Tampere beginning with the statement that “radio evolution greatly depends not only on the cultural context of a country but also on the whole social, political, economic development of societies” gives us a projection on radio development around the world for the next decades. Closing the dossier, Rafael Duarte Oliveira Venancio (UFU assuming radio as language by definition and not as a device understands it as a section and an operating model in such language as it intersects the world. Another six articles, not enrolled in the dossier, round the edition off. Fernando de Tacca debates the category of “photocine” recurring to three recent Spanish productions. Gustavo Souza investigates the possibility of identifying a point of view in documentary movies while establishing a debate that joins the materialities of image and sound with the subjectivity resulting from interpretation. Vinicius Bandeira develops on the special duplicity present in the movies between what is and what is not subsumed by the camera. Neide Jallageas proposes the study of visual communication design from the first modelings, attempting especially to the radical propositions from the early XXth century avant-garde movement. Gilson Schwartz debates on the impact from the distribution of videogames as hegemonic cultural practice in

  1. A systematic scoping review of speech and language therapists' public health practice for early language development.

    Science.gov (United States)

    Smith, Clare; Williams, Emma; Bryan, Karen

    2017-07-01

    There have been calls for speech and language therapists (SLTs) to work within a public-health framework to support language development. Innovative practice is reported, but the range of services remains unknown. Furthermore, the potential impact of public health practice in speech and language therapy on early child development is also currently unknown. A new method in SLT research, systematic scoping reviews enable greater breadth of focus than traditional systematic reviews when identifying innovative practice. To report scope and critically appraise evidence of family-focused health-promotion practice for early language development in this area. Using the Cochrane Public Health Group scoping review framework, data from reports of health-promotion practice with families of children aged 0-3 years were extracted and critically appraised on service delivery, information, reach and evaluation. Group-based service delivery was the most popular form of service delivery. There were limited reports on the information given in services and on their reach. Questionnaires were the most popular reported evaluation method. Quality of evaluations was poor due to lack of replicability and experimental control in the studies reported. This method of systematic review has highlighted the scope of health-promotion practice in speech and language therapy and also demonstrated the lack of evidence for its effectiveness on child language development. It is argued that systematic scoping reviews are valuable for scoping innovative practice in areas where either there is a lack of robust evidence or there is a high level of heterogeneity in practice or evaluation. To support clinician appraisal of available evidence, recommendations are given for development of questionnaire appraisal and for categorization of evidence levels on summary databases. © 2016 Royal College of Speech and Language Therapists.

  2. Evidence of Nervous System Sensitization in Commonly Presenting and Persistent Painful Tendinopathies : A Systematic Review

    NARCIS (Netherlands)

    Plinsinga, Melanie L.; Brink, Michel S.; Vicenzino, Bill; Van Wilgen, C. Paul

    2015-01-01

    STUDY DESIGN: Systematic review. OBJECTIVES: To elucidate if there is sensitization of the nervous system in those with persistent rotator cuff (shoulder), lateral elbow, patellar, and Achilles tendinopathies. BACKGROUND: Tendinopathy can be difficult to treat, and persistent intractable pain and dy

  3. Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression

    Science.gov (United States)

    Walton, Catherine; Kerr, Mike

    2016-01-01

    Background: The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and…

  4. Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression

    Science.gov (United States)

    Walton, Catherine; Kerr, Mike

    2016-01-01

    Background: The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and…

  5. Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy.

    Science.gov (United States)

    Gjeorgjievski, Mihajlo; Cappell, Mitchell S

    2016-02-08

    To describe the pathophysiology, clinical presentation, natural history, and therapy of portal hypertensive gastropathy (PHG) based on a systematic literature review. Computerized search of the literature was performed via PubMed using the following medical subject headings or keywords: "portal" and "gastropathy"; or "portal" and "hypertensive"; or "congestive" and "gastropathy"; or "congestive" and "gastroenteropathy". The following criteria were applied for study inclusion: Publication in peer-reviewed journals, and publication since 1980. Articles were independently evaluated by each author and selected for inclusion by consensus after discussion based on the following criteria: Well-designed, prospective trials; recent studies; large study populations; and study emphasis on PHG. PHG is diagnosed by characteristic endoscopic findings of small polygonal areas of variable erythema surrounded by a pale, reticular border in a mosaic pattern in the gastric fundus/body in a patient with cirrhotic or non-cirrhotic portal hypertension. Histologic findings include capillary and venule dilatation, congestion, and tortuosity, without vascular fibrin thrombi or inflammatory cells in gastric submucosa. PHG is differentiated from gastric antral vascular ectasia by a different endoscopic appearance. The etiology of PHG is inadequately understood. Portal hypertension is necessary but insufficient to develop PHG because many patients have portal hypertension without PHG. PHG increases in frequency with more severe portal hypertension, advanced liver disease, longer liver disease duration, presence of esophageal varices, and endoscopic variceal obliteration. PHG pathogenesis is related to a hyperdynamic circulation, induced by portal hypertension, characterized by increased intrahepatic resistance to flow, increased splanchnic flow, increased total gastric flow, and most likely decreased gastric mucosal flow. Gastric mucosa in PHG shows increased susceptibility to gastrotoxic

  6. Portal hypertensive gastropathy: A systematic review of the pathophysiology, clinical presentation, natural history and therapy

    Science.gov (United States)

    Gjeorgjievski, Mihajlo; Cappell, Mitchell S

    2016-01-01

    AIM: To describe the pathophysiology, clinical presentation, natural history, and therapy of portal hypertensive gastropathy (PHG) based on a systematic literature review. METHODS: Computerized search of the literature was performed via PubMed using the following medical subject headings or keywords: “portal” and “gastropathy”; or “portal” and “hypertensive”; or “congestive” and “gastropathy”; or “congestive” and “gastroenteropathy”. The following criteria were applied for study inclusion: Publication in peer-reviewed journals, and publication since 1980. Articles were independently evaluated by each author and selected for inclusion by consensus after discussion based on the following criteria: Well-designed, prospective trials; recent studies; large study populations; and study emphasis on PHG. RESULTS: PHG is diagnosed by characteristic endoscopic findings of small polygonal areas of variable erythema surrounded by a pale, reticular border in a mosaic pattern in the gastric fundus/body in a patient with cirrhotic or non-cirrhotic portal hypertension. Histologic findings include capillary and venule dilatation, congestion, and tortuosity, without vascular fibrin thrombi or inflammatory cells in gastric submucosa. PHG is differentiated from gastric antral vascular ectasia by a different endoscopic appearance. The etiology of PHG is inadequately understood. Portal hypertension is necessary but insufficient to develop PHG because many patients have portal hypertension without PHG. PHG increases in frequency with more severe portal hypertension, advanced liver disease, longer liver disease duration, presence of esophageal varices, and endoscopic variceal obliteration. PHG pathogenesis is related to a hyperdynamic circulation, induced by portal hypertension, characterized by increased intrahepatic resistance to flow, increased splanchnic flow, increased total gastric flow, and most likely decreased gastric mucosal flow. Gastric mucosa

  7. Portal hypertensive gastropathy: A systematic review of thepathophysiology, clinical presentation, natural history andtherapy

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    AIM To describe the pathophysiology, clinical presentation,natural history, and therapy of portal hypertensivegastropathy (PHG) based on a systematic literaturereview.METHODS: Computerized search of the literature wasperformed via PubMed using the following medicalsubject headings or keywords: "portal" and "gastropathy";or "portal" and "hypertensive"; or "congestive"and "gastropathy"; or "congestive" and "gastroenteropathy".The following criteria were applied for studyinclusion: Publication in peer-reviewed journals, andpublication since 1980. Articles were independentlyevaluated by each author and selected for inclusionby consensus after discussion based on the followingcriteria: Well-designed, prospective trials; recent studies;large study populations; and study emphasis on PHG.RESULTS: PHG is diagnosed by characteristic endoscopicfindings of small polygonal areas of variableerythema surrounded by a pale, reticular border in amosaic pattern in the gastric fundus/body in a patientwith cirrhotic or non-cirrhotic portal hypertension. Histologicfindings include capillary and venule dilatation,congestion, and tortuosity, without vascular fibrinthrombi or inflammatory cells in gastric submucosa.PHG is differentiated from gastric antral vascular ectasiaby a different endoscopic appearance. The etiology ofPHG is inadequately understood. Portal hypertensionis necessary but insufficient to develop PHG becausemany patients have portal hypertension without PHG.PHG increases in frequency with more severe portalhypertension, advanced liver disease, longer liver diseaseduration, presence of esophageal varices, and endoscopicvariceal obliteration. PHG pathogenesis is related to ahyperdynamic circulation, induced by portal hypertension,characterized by increased intrahepatic resistance toflow, increased splanchnic flow, increased total gastricflow, and most likely decreased gastric mucosal flow.Gastric mucosa in PHG shows increased

  8. Preventing Posttraumatic Stress Related to Sexual Assault Through Early Intervention: A Systematic Review.

    Science.gov (United States)

    Dworkin, Emily R; Schumacher, Julie A

    2016-09-28

    Sexual assault survivors come into contact with a variety of community responders after assault, and these interactions may play an important role in mitigating distress. Given theoretical understandings of the importance of early experiences in the development of posttraumatic stress (PTS), early contact with formal systems (e.g., health care, criminal justice, social services) and informal responders (e.g., friends, family) might be particularly important in preventing PTS. However, the effectiveness of these early interventions is unclear. Understanding the key elements of early interventions, both formal and informal, that successfully prevent the development of PTS could help to improve community responses to sexual assault and ultimately promote survivor well-being. In this systematic review, we investigate the types of experiences with responders in the early aftermath of assault that are associated with PTS, the duration of effects on PTS, and the role of the timing of these responses in the development of PTS. Findings indicate that responder contact alone is not typically associated with significant differences in PTS, and there is insufficient evidence to indicate that the timing of seeking help is associated with PTS, but the quality of services provided and perceptions of interactions with certain responders appear to be associated with PTS. Although many effects were short-lived, interventions that were perceived positively may be associated with lower PTS up to a year postassault. These findings support the importance of offering best practice interventions that are perceived positively, rather than simply encouraging survivors to seek help.

  9. Presentation

    Directory of Open Access Journals (Sweden)

    Nicanor Lopes

    2010-11-01

    Full Text Available The Journal Caminhando debuts with a new editorial format: eachmagazine will have a Dossier.In 2010 Christianity celebrated the centenary of Edinburgh. TheWorld Missionary Conference in Edinburgh in 1910 is regarded by manyas missiological watershed in the missionary and ecumenical movement.So the Faculty of Theology of the Methodist Church (FATEO decidedto organize a Wesleyan Week discussing the issue of mission. For anevent of this magnitude FATEO invited the Rev. Dr. Wesley Ariarajah,Methodist pastor and teacher of Sri Lanka with extensive experience inpastoral ministry in local churches and professor of History of Religionsand the New Testament at the Theological College of Lanka, maintainedby the Protestant Churches in Sri Lanka. In 1981 he was invited to jointhe World Council of Churches, where he presided for over ten years theCouncil of Interreligious Dialogue. From 1992 he served as Deputy GeneralSecretary of the WCC.The following texts are not the speeches of the Rev. Dr. WesleyAriarajah, for they will be published separately. Nevertheless, the journaldialogs with the celebrations of the centenary of Edinburgh, parting formthe intriguing theme: "Mission in the 21st century in Brazil". After all, howis it that mission takes place among us in personal, church, and communityactivities?Within the Dossier, as common to the journal, the textos are organizedas follows: Bible, Theology / History and Pastoral Care. Other items thatdo not fit within the Dossier, but, do articulate mission, can be found inthe section Declarations and Documents and Book Reviews.The authors of the Dossier have important considerations in buildinga contemporary missiological concept considering Brazilian reality.Anderson de Oliveira, in the Bible-Section, presents a significantexegeses of Matthew 26.6-13. What does it mean when Jesus is quotedwith the words: "For the poor always ye have with you, but me ye havenot always." Is this declaration challenging the gospels

  10. Mood and anxiety disorders as early manifestations of medical illness: a systematic review.

    Science.gov (United States)

    Cosci, Fiammetta; Fava, Giovanni A; Sonino, Nicoletta

    2015-01-01

    Affective disturbances involving alterations of mood, anxiety and irritability may be early symptoms of medical illnesses. The aim of this paper was to provide a systematic review of the literature with qualitative data synthesis. MEDLINE, PsycINFO, EMBASE, Cochrane, and ISI Web of Science were systematically searched from inception to February 2014. Search terms were 'prodrome/early symptom', combined using the Boolean 'AND' operator with 'anxiety/depression/mania/hypomania/irritability/irritable mood/hostility', combined with the Boolean 'AND' operator with 'medical illness/medical disorder'. PRISMA guidelines were followed. A total of 21 studies met the inclusion criteria and were analyzed. Depression was found to be the most common affective prodrome of medical disorders and was consistently reported in Cushing's syndrome, hypothyroidism, hyperparathyroidism, pancreatic and lung cancer, myocardial infarction, Wilson's disease, and AIDS. Mania, anxiety and irritability were less frequent. Physicians may not pursue medical workup of cases that appear to be psychiatric in nature. They should be alerted that disturbances in mood, anxiety and irritability may antedate the appearance of a medical disorder.

  11. Presentation of Two Cases with Early Extracranial Metastases from Glioblastoma and Review of the Literature

    DEFF Research Database (Denmark)

    Johansen, Maria Dinche; Rochat, Per; Law, Ian

    2016-01-01

    close to the straight sinus and this might be an explanation to the early and extensive metastases. Case 2 presents a 60-year-old man with liver metastasis found at autopsy, and, in this case, it is more difficult to find an explanation. This patient had two spontaneous intracerebral bleeding incidents...

  12. Radiofrequency ablation versus resection for Barcelona clinic liver cancer very early/early stage hepatocellular carcinoma: a systematic review

    Directory of Open Access Journals (Sweden)

    He ZX

    2016-02-01

    : 0.60–0.98, P=0.04; and RR =0.70, 95% CI: 0.52–0.94, P=0.02, respectively. Ten studies involving 2,501 patients were identified that compared radiofrequency ablation (n=1,476 to liver resection (n=1,025 for single BCLC early HCC. In these ten studies, the rates of 3-year OS, 5-year OS, 3-year DFS, and 5-year DFS were also significantly lower in the radiofrequency ablation group than in the liver resection group (RR =0.93, 95% CI: 0.88–0.98, P=0.003; RR =0.84, 95% CI: 0.75–0.94, P=0.002; RR =0.72, 95% CI: 0.58–0.89, P=0.002; and RR =0.47, 95% CI: 0.33–0.67, P<0.0001, respectively.Conclusion: The long-term survival outcomes for patients with single BCLC very early/early stage HCC appear to be superior after liver resection compared to radiofrequency ablation. Keywords: radiofrequency ablation, liver resection, hepatocellular carcinoma, systematic review 

  13. Identification of early cancerous lesion of esophagus with endoscopic images by hyperspectral image technique (Conference Presentation)

    Science.gov (United States)

    Huang, Shih-Wei; Chen, Shih-Hua; Chen, Weichung; Wu, I.-Chen; Wu, Ming Tsang; Kuo, Chie-Tong; Wang, Hsiang-Chen

    2016-03-01

    This study presents a method to identify early esophageal cancer within endoscope using hyperspectral imaging technology. The research samples are three kinds of endoscopic images including white light endoscopic, chromoendoscopic, and narrow-band endoscopic images with different stages of pathological changes (normal, dysplasia, dysplasia - esophageal cancer, and esophageal cancer). Research is divided into two parts: first, we analysis the reflectance spectra of endoscopic images with different stages to know the spectral responses by pathological changes. Second, we identified early cancerous lesion of esophagus by principal component analysis (PCA) of the reflectance spectra of endoscopic images. The results of this study show that the identification of early cancerous lesion is possible achieve from three kinds of images. In which the spectral characteristics of NBI endoscopy images of a gray area than those without the existence of the problem the first two, and the trend is very clear. Therefore, if simply to reflect differences in the degree of spectral identification, chromoendoscopic images are suitable samples. The best identification of early esophageal cancer is using the NBI endoscopic images. Based on the results, the use of hyperspectral imaging technology in the early endoscopic esophageal cancer lesion image recognition helps clinicians quickly diagnose. We hope for the future to have a relatively large amount of endoscopic image by establishing a hyperspectral imaging database system developed in this study, so the clinician can take this repository more efficiently preliminary diagnosis.

  14. Achievement Gap in Reading Is Present as Early as First Grade and Persists through Adolescence.

    Science.gov (United States)

    Ferrer, Emilio; Shaywitz, Bennett A; Holahan, John M; Marchione, Karen E; Michaels, Reissa; Shaywitz, Sally E

    2015-11-01

    To determine if differences between dyslexic and typical readers in their reading scores and verbal IQ are evident as early as first grade and whether the trajectory of these differences increases or decreases from childhood to adolescence. The subjects were the 414 participants comprising the Connecticut Longitudinal Study, a sample survey cohort, assessed yearly from 1st to 12th grade on measures of reading and IQ. Statistical analysis employed longitudinal models based on growth curves and multiple groups. As early as first grade, compared with typical readers, dyslexic readers had lower reading scores and verbal IQ, and their trajectories over time never converge with those of typical readers. These data demonstrate that such differences are not so much a function of increasing disparities over time but instead because of differences already present in first grade between typical and dyslexic readers. The achievement gap between typical and dyslexic readers is evident as early as first grade, and this gap persists into adolescence. These findings provide strong evidence and impetus for early identification of and intervention for young children at risk for dyslexia. Implementing effective reading programs as early as kindergarten or even preschool offers the potential to close the achievement gap. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Presenting the model of risk, disability and hard-to-reach families to inform early intervention services.

    Science.gov (United States)

    Phoenix, Michelle; Rosenbaum, Peter

    2017-09-29

    Several concepts - risk, resilience, disability and hard-to-reach families in early intervention services - are talked and written about in many ways. Family Stress Theory can be usefully applied to explore these issues systematically. The relationship between risk and disability is complex, and the role of resilience is not fully understood. The idea of "hard-to-reach families" is not well defined, thus presenting challenges to service providers and policy makers. Reflection: This paper presents the Model of Risk, Disability and Hard-to-Reach Families and uses the model to: (1) define the groups of high risk families and families of children with disabilities and explore the concept of resilience within these groups; (2) describe services offered to these groups; and (3) reflect on service use and so-called "hard-to-reach families". Each section includes suggested applications for service providers that may inform the work done with young children and their families who experience risk or disability. Service providers can apply the Model of Risk, Disability and Hard-to-Reach Families to consider each family's unique strengths and challenges, and use those individual elements to influence service recommendations and anticipate service use. Implications for rehabilitation The concepts of risk, resilience, and hard-to-reach families are poorly defined in the literatures, but have important implications with respect to early childhood intervention services. Family Stress Theory can help to identify high-risk families and account for family resilience It is important for clinicians, researchers and policy makers to consider the relationship between disability and risk with respect to services offered to families and the potential barriers to service use. Clinicians and policy makers have a role in promoting accessible early childhood services.

  16. Early infant male circumcision: Systematic review, risk-benefit analysis, and progress in policy

    Science.gov (United States)

    Morris, Brian J; Kennedy, Sean E; Wodak, Alex D; Mindel, Adrian; Golovsky, David; Schrieber, Leslie; Lumbers, Eugenie R; Handelsman, David J; Ziegler, John B

    2017-01-01

    AIM To determine whether recent evidence-based United States policies on male circumcision (MC) apply to comparable Anglophone countries, Australia and New Zealand. METHODS Articles in 2005 through 2015 were retrieved from PubMed using the keyword “circumcision” together with 36 relevant subtopics. A further PubMed search was performed for articles published in 2016. Searches of the EMBASE and Cochrane databases did not yield additional citable articles. Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further. The most relevant and representative of the topic were included. Bibliographies were examined to retrieve further key references. Randomized controlled trials, recent high quality systematic reviews or meta-analyses (level 1++ or 1+ evidence) were prioritized for inclusion. A risk-benefit analysis of articles rated for quality was performed. For efficiency and reliability, recent randomized controlled trials, meta-analyses, high quality systematic reviews and large well-designed studies were used if available. Internet searches were conducted for other relevant information, including policies and Australian data on claims under Medicare for MC. RESULTS Evidence-based policy statements by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) support infant and later age male circumcision (MC) as a desirable public health measure. Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria. Together, these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects, phimosis that causes difficult and painful erections and “ballooning” during urination, inflammatory skin conditions, inferior penile hygiene, candidiasis, various sexually transmissible

  17. Presentation

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Freire Vieira

    2013-12-01

    Full Text Available This dossier focuses on one of the essential debate topics today about the territorial dimension of the new development strategies concerned with the worsening of the global socioecological crisis, that is: the challenges related to the activation and integration in networks of localized agri-food systems. For its composition, some contributions presented and debated during the VI International Conference on Localized Agri-food System - The LAFS facing the opportunities and challenges of the new global context have been gathered. The event took place in the city of Florianópolis, from May 21th to 25th of 2013. The event was promoted by the Federal University of Santa Catarina (UFSC and by the Center for the International Cooperation on Agricultural Research for Development (CIRAD. Besides UFSC and CIRAD, EPAGRI, State University of Santa Catarina (UDESC, as well as research institutes and universities from other states (UFMG, IEA/SP, UFS, UFRGS and Mexican and Argentinian partners from the RED SIAL Latino Americana also participated in the organization of lectures, discussion tables and workshops.

  18. Presentation

    Directory of Open Access Journals (Sweden)

    Helmut Renders

    2008-10-01

    Full Text Available We present to our esteemed readers the second edition of our journal for 2008. We have chosen the theme “The life and work of Prof. Dr. Jürgen Moltmann” as its special emphasis. It is our way to pay homage to J. Moltmann in the year the Universidade Metodista de São Paulo awards him an honorary Doctor Honoris Causa degree. Sincethe seventies, Moltmann and Latin America have been in dialog. In his emblematic work “A Theology of Liberation”, Gustavo Gutiérrez, the Catholic, discussed with Moltmann, the Reformed, the relationship between eschatology and history (GUTIÉRREZ, Gustavo.Teologia da Libertação. 5ª edição. Petrópolis, RJ: Vozes, 1985, p. 27, 137-139. A dialog held in the premises of IMS, which nowadays is called UMESP, has produced the little book “Passion for life” (MOLTMANN, Jürgen. Paixão pela vida. São Paulo, SP: ASTE - Associaçãode Seminários Teológicos Evangélicos, 1978.In the following years, the wide theological work of J. Moltmann went all the way from debates to congresses and has conquered the classrooms. Most probably, J. Moltmann is nowadays the most widely read European author in Brazilian theological seminaries. Thisrecognition can only be held in unison and the wide response to our request for articles confirms the huge repercussion that Moltmann’s work has been having up to today in Brazil. The ecumenical theologian J. Moltmann is ecumenically read. We believe that thisway we may be better equipped to answer to anyone who asks us for the reason there is hope in us. We have organized the articles on J. Moltmann’s theology according to the original publication date of the books dealt with in each essay. We also communicate that some articles which were originally requested for this edition of the journal will be published in the journal Estudos de Regilião in May 2009.As it is usual with the journal Caminhando, we have, besides this thematic emphasis, yet other contributions in the areas of

  19. Insight on the anatomy, systematic relationships, and age of the Early Cretaceous ankylopollexian dinosaur Dakotadon lakotaensis.

    Science.gov (United States)

    Boyd, Clint A; Pagnac, Darrin C

    2015-01-01

    Knowledge regarding the early evolution within the dinosaurian clade Ankylopollexia drastically increased over the past two decades, in part because of an increase in described taxa from the Early Cretaceous of North America. These advances motivated the recent completion of extensive preparation and conservation work on the holotype and only known specimen of Dakotadon lakotaensis, a basal ankylopollexian from the Lakota Formation of South Dakota. That specimen (SDSM 8656) preserves a partial skull, lower jaws, a single dorsal vertebra, and two caudal vertebrae. That new preparation work exposed several bones not included in the original description and revealed that other bones were previously misidentified. The presence of extensive deformation in areas of the skull is also noted that influenced inaccuracies in prior descriptions and reconstructions of this taxon. In addition to providing an extensive re-description of D. lakotaensis, this study reviews previously proposed diagnoses for this taxon, identifies two autapomorphies, and provides an extensive differential diagnosis. Dakotadon lakotaensis is distinct from the only other ankylopollexian taxon known from the Lakota Formation, Osmakasaurus depressus, in the presence of two prominent, anteroposteriorly oriented ridges on the ventral surfaces of the caudal vertebrae, the only overlapping material preserved between these taxa. The systematic relationships of D. lakotaensis are evaluated using both the parsimony and posterior probability optimality criteria, with both sets of analyses recovering D. lakotaensis as a non-hadrosauriform ankylopollexian that is more closely related to taxa from the Early Cretaceous (e.g., Iguanacolossus, Hippodraco, and Theiophytalia) than to more basally situated taxa from the Jurassic (e.g., Camptosaurus, Uteodon). This taxonomic work is supplemented by field work that relocated the type locality, confirming its provenance from unit L2 (lower Fuson Member equivalent) of the

  20. Insight on the anatomy, systematic relationships, and age of the Early Cretaceous ankylopollexian dinosaur Dakotadon lakotaensis

    Directory of Open Access Journals (Sweden)

    Clint A. Boyd

    2015-09-01

    Full Text Available Knowledge regarding the early evolution within the dinosaurian clade Ankylopollexia drastically increased over the past two decades, in part because of an increase in described taxa from the Early Cretaceous of North America. These advances motivated the recent completion of extensive preparation and conservation work on the holotype and only known specimen of Dakotadon lakotaensis, a basal ankylopollexian from the Lakota Formation of South Dakota. That specimen (SDSM 8656 preserves a partial skull, lower jaws, a single dorsal vertebra, and two caudal vertebrae. That new preparation work exposed several bones not included in the original description and revealed that other bones were previously misidentified. The presence of extensive deformation in areas of the skull is also noted that influenced inaccuracies in prior descriptions and reconstructions of this taxon. In addition to providing an extensive re-description of D. lakotaensis, this study reviews previously proposed diagnoses for this taxon, identifies two autapomorphies, and provides an extensive differential diagnosis. Dakotadon lakotaensis is distinct from the only other ankylopollexian taxon known from the Lakota Formation, Osmakasaurus depressus, in the presence of two prominent, anteroposteriorly oriented ridges on the ventral surfaces of the caudal vertebrae, the only overlapping material preserved between these taxa. The systematic relationships of D. lakotaensis are evaluated using both the parsimony and posterior probability optimality criteria, with both sets of analyses recovering D. lakotaensis as a non-hadrosauriform ankylopollexian that is more closely related to taxa from the Early Cretaceous (e.g., Iguanacolossus, Hippodraco, and Theiophytalia than to more basally situated taxa from the Jurassic (e.g., Camptosaurus, Uteodon. This taxonomic work is supplemented by field work that relocated the type locality, confirming its provenance from unit L2 (lower Fuson Member

  1. A systematic review of infliximab in the treatment of early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Sophie Martin Du Pan

    2007-11-01

    Full Text Available Sophie Martin Du Pan, Cem Gabay, Axel FinckhDivision of Rheumatology, Department of Internal Medicine, University of GenevaBackground: Several health authorities have recently revised the indication of infliximab (IFX to include the treatment of early rheumatoid arthritis (RA. The aim of this systematic review of the literature was to appraise the efficacy, safety, and cost-effectiveness of early therapy with IFX.Methods: We identified published clinical trials from 1966 to May 2006. We included randomized clinical trials (RCTs in RA with disease duration of less than 3 years comparing the treatment of methotrexate-IFX (MTX-IFX with methotrexate-placebo (MTX-placebo.Results: A total of 8 studies met inclusion criteria. Three studies reported redundant data regarding the vdH Sharp Score. Out of the 5 remaining studies, 4 analyzed structural joint destruction (vdH Sharp Score and demonstrated a significant reduction in radiographic damage progression in favor of the combination of MTX-IFX compared with MTX-placebo (–4.1 vdH Sharp Score units (95% CI: 3.5; 4.6. Three studies also displayed a benefit of MTX-IFX on functional outcomes of RA (HAQ score and disease activity measures (DAS, ACR response criteria, although less markedly.Conclusions: Although data might be skewed because of only 2 existing large studies with concordant data, results from RCTs demonstrate improved efficacy of the combination MTXIFX compared with MTX-placebo in early RA. However, many early RA patients probably do not require the addition of IFX to achieve a satisfying clinical and radiological course. So far, no evidence has established the superiority of MTX-IFX over MTX-prednisone or other combinations of traditional disease-modifying anti-rheumatic agents.Keywords: rheumatoid arthritis, antirheumatic agents, infliximab

  2. Early life arsenic exposure, infant and child growth, and morbidity: a systematic review.

    Science.gov (United States)

    Rahman, Anisur; Granberg, Caroline; Persson, Lars-Åke

    2017-09-14

    Epidemiological studies have suggested a negative association between early life arsenic exposure and fetal size at birth, and subsequently with child morbidity and growth. However, our understanding of the relationship between arsenic exposure and morbidity and growth is limited. This paper aims to systematically review original human studies with an analytical epidemiological study design that have assessed arsenic exposure in fetal life or early childhood and evaluated the association with one or several of the following outcomes: fetal growth, birth weight or other birth anthropometry, infant and child growth, infectious disease morbidity in infancy and early childhood. A literature search was conducted in PubMed, TOXLINE, Web of Science, SciFinder and Scopus databases filtered for human studies. Based on the predefined eligibility criteria, two authors independently evaluated the studies. A total of 707 studies with morbidity outcomes were identified, of which six studies were eligible and included in this review. For the growth outcomes, a total of 2959 studies were found and nine fulfilled the criteria and were included in the review. A majority of the papers (10/15) emanated from Bangladesh, three from the USA, one from Romania and one from Canada. All included studies on arsenic exposure and morbidity showed an increased risk of respiratory tract infections and diarrhea. The findings in the studies of arsenic exposure and fetal, infant, and child growth were heterogeneous. Arsenic exposure was not associated with fetal growth. There was limited evidence of negative associations between arsenic exposures and birth weight and growth during early childhood. More studies from arsenic-affected low- and middle-income countries are needed to support the generalizability of study findings.

  3. Association between perceived present working conditions and demands versus attitude to early retirement among construction workers.

    Science.gov (United States)

    Jebens, Einar; Medbø, Jon I; Knutsen, Oddvar; Mamen, Asgeir; Veiersted, Kaj Bo

    2014-01-01

    Early retirement is an increasing problem in the construction industry. There is limited information about causes leading employees to leave working life early. We have compared construction workers present situation with their perception of future demands at work to avoid early retirement. All 87 employees in a medium-sized Norwegian construction company participated in the study. All were men and answered questionnaires on health and pain, work ability, mechanical exposure, psychosocial conditions, and demands regarding future working conditions. Most workers showed good work ability, irrespective of age. Many reported high levels of mechanical exposure at work. The level of musculoskeletal pain was higher in the middle-aged (30-50 year old) age groups and seniors aged over 50 years than among the youngest workers less than 30 years of age. All workers reported that good health was important for continued working. Most workers stated that future work must not be too physically demanding. Many workers reported relatively low job satisfaction; consequently an interesting job was rated as important for continuing work. Good social conditions were a high priority. According to the examined construction workers, good health and reduced levels of mechanical exposure at work are essential to avoid early retirement.

  4. Malignant Transformation Rate in Patients Presenting Oral Epithelial Dysplasia: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jaffer A. Shariff

    2015-01-01

    Full Text Available Objective. To perform a systematic review and meta-analysis on studies that assess malignant transformation rates (MTR of oral epithelial dysplasia. Materials and Methods. This review was planned and conducted in accordance with the meta-analysis of observational studies in epidemiology (MOOSE guidelines. PubMed, EMBASE, Google Scholar, and Cochrane databases were screened to identify observational studies. Quality assessments were completed by two reviewers independently using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Pooled-malignant transformation rate (MTR in person years, subgroup, sensitivity, and publication bias analysis were calculated using STATA 13.0 and Comprehensive Meta-Analysis software. Results. Sixteen observational cohort studies were identified with a total of 3708 participants from Asia, North America, and Europe. Analysis showed a MTR of 10.5% (pooled-MTR: 10.5, 95% CI: 3.7 to 17.3; fixed effect model, I2=0.0%; Q-value = 2.389; p>0.05 among patients with histologically confirmed oral epithelia dysplasia undergoing long-term follow-up. Higher MTR in person year were seen among the sever dysplastic cases (pooled-MTR: 14.4%, 95% CI: 5.3% to 23.5%, studies published in Europe (pooled-MTR: 12.6%, 95% CI: 8.0% to 24.3%, and retrospective studies (pooled-MTR: 11.0%, 95% CI: 2.2% to 19.9%. Conclusion. These studies show that oral epithelial dysplasia has a significant high rate of transformation to cancer.

  5. Systematic review of physical activity and cognitive development in early childhood.

    Science.gov (United States)

    Carson, Valerie; Hunter, Stephen; Kuzik, Nicholas; Wiebe, Sandra A; Spence, John C; Friedman, Alinda; Tremblay, Mark S; Slater, Linda; Hinkley, Trina

    2016-07-01

    To comprehensively review all observational and experimental studies examining the relationship between physical activity and cognitive development during early childhood (birth to 5 years). Systematic review. Electronic databases were searched in July, 2014. No study design, date, or language limits were imposed on the search. Included studies had to be published, peer reviewed articles that satisfied the a priori determined population (apparently healthy children aged birth to 5 years), intervention (duration, intensity, frequency, or patterns of physical activity), comparator (various durations, intensity, or patterns of physical activity), and outcome (cognitive development) study criteria. Study quality and risk of bias were assessed in December 2014. A total of seven studies, representing 414 participants from five different countries met the inclusion criteria, including two observational and five experimental studies. Six studies found increased or higher duration/frequency of physical activity had statistically significant (pcognitive development outcome, including 67% of the outcomes assessed in the executive function domain and 60% in the language domain. No study found that increased or higher duration/frequency of physical activity had statistically significant detrimental effects on cognitive development. Six of the seven studies were rated weak quality with a high risk of bias. This review provides some preliminary evidence that physical activity may have beneficial effects on cognitive development during early childhood. Given the shortage of the information and the weak quality of available evidence, future research is needed to strengthen the evidence base in this area. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. Systematic review with meta-analysis: early infant feeding and coeliac disease--update 2015.

    Science.gov (United States)

    Szajewska, H; Shamir, R; Chmielewska, A; Pieścik-Lech, M; Auricchio, R; Ivarsson, A; Kolacek, S; Koletzko, S; Korponay-Szabo, I; Mearin, M L; Ribes-Koninckx, C; Troncone, R

    2015-06-01

    New evidence emerged on early feeding practices and the risk of coeliac disease. To systematically update evidence on these practices to find out whether there is a need to revise current recommendations. MEDLINE, EMBASE and the Cochrane Library were searched from July 2012 (end of last search) to February 2015 for studies of any design that assessed the effect of gluten consumption and breastfeeding on the development of coeliac disease and/or coeliac disease-related autoimmunity. We identified 21 publications, including two, new, large, randomised controlled trials performed in high-risk infants. Exclusive or any breastfeeding, as well as breastfeeding at the time of gluten introduction, did not reduce the risk of developing coeliac disease during childhood. For infants at high risk of developing coeliac disease, gluten introduction at 4 months of age in very small amounts, or at 6 or 12 months of age, resulted in similar rates of coeliac disease diagnosis in early childhood. Later gluten introduction was associated with later development of coeliac specific autoimmunity and coeliac disease during childhood, but not total risk reduction. Observational studies indicate that consumption of a higher amount of gluten at weaning may increase the risk for coeliac disease development. Infant feeding practices (breastfeeding, time of gluten introduction) have no effect on the risk of developing coeliac disease during childhood (at least at specific timeframes evaluated in the included studies), necessitating an update of current European recommendations. © 2015 John Wiley & Sons Ltd.

  7. Mobile screening units for the early detection of cancer: a systematic review.

    Science.gov (United States)

    Greenwald, Zoë R; El-Zein, Mariam; Bouten, Sheila; Ensha, Heydar; Vazquez, Fabiana L; Franco, Eduardo L

    2017-10-04

    Mobile Screening Units (MSUs) provide cancer screening services outside of fixed clinical sites, thereby increasing access to early detection services. We conducted a systematic review of the performance of MSUs for the early detection of cancer. Databases (MEDLINE, EMBASE, Cochrane Library, WHO Global Health Library, Web of Science, PsycINFO) were searched up to July 2015. Studies describing screening for breast, cervical and colon cancer using MSUs were included. Data was collected for operational aspects including the performance of exams, screening tests used, and outcomes of case-detection. Of 268 identified studies, 78 were included. Studies investigated screening for cancers including breast (n=55), cervical (n=12), colon (n=1) and multiphasic screening for multiple cancers (n=10). The median number of screening exams performed per intervention was 1767 (interquartile range 5656-38,233). Programs operated in 20 countries, mostly in North America (36%) and Europe (36%). 52% served mixed rural/urban regions, while 35% and 13% served rural or urban regions, respectfully. MSUs have served to expand access to screening in diverse contexts. Further research on the implementation of MSUs in low-resource settings and health economic research on cost-effectiveness of MSUs compared with fixed clinics to inform policymakers is needed. Copyright ©2017, American Association for Cancer Research.

  8. Comprehensive geriatric assessment for older women with early breast cancer – a systematic review of literature

    Directory of Open Access Journals (Sweden)

    Parks Ruth M

    2012-05-01

    Full Text Available Abstract Background The Comprehensive Geriatric Assessment (CGA is an analytical tool increasingly implemented in clinical practice. Breast cancer is primarily a disease of older people; however, most evidence-based research is aimed at younger patients. Methods A systematic review of literature was carried out to assess the use of CGA in older breast cancer patients for clinical decision making. The PubMed, Embase and Cochrane databases were searched. Results A total of nine useful full text article results were found. Only five of these were exclusively concerned with early breast cancer; thus, studies involving a variety of cancer types, stages and treatments were accepted, as long as they included early breast cancer.The results comprised a series of low sources of evidence. However, all results shared a common theme: the CGA has a use in determining patient suitability for different types of cancer treatment and subsequently maximizing the patient’s quality of life. Conclusions There is not yet sufficient high level evidence to instate CGA guidelines as a mandatory practice in the management of breast cancer, due to the heterogeneity of available studies. More studies need to be conducted to cement current work on the benefits of the CGA. An area of particular interest is with regard to treatment options, especially surgery and chemotherapy, and identifying patients who may be suitable for these treatments.

  9. Do Family Interventions Improve Outcomes in Early Psychosis? A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Claxton, Melanie; Onwumere, Juliana; Fornells-Ambrojo, Miriam

    2017-01-01

    Family interventions for psychosis (FIp) are effective in reducing service user relapse and carer distress in people with schizophrenia-spectrum conditions. Several treatment and best practice guidelines recommend FIp for all people with schizophrenia. However, outcome findings in relation to early psychosis groups have been inconsistent. The current paper reports a systematic review and meta-analyses of articles that evaluated FIp in early psychosis with a clearly defined comparison group. A combination of electronic database searches (using PsychINFO, Medline, and CENTRAL), citation searches and hand searches of key journals and reviews was conducted. Peer-reviewed articles published in English from database inception to June 2016 were included. Methodological quality was assessed using the Effective Public Health Practice Project Quality Assessment Tool (EPHPP). Seventeen papers from 14 studies met inclusion criteria for review, the overall quality of which was moderate. Meta-analytic synthesis showed that FIp improved service user functioning and reduced the likelihood of relapse by the end of treatment. Psychotic symptoms were significantly reduced in the FIp group at follow up, but this was not evident at end of treatment. In terms of FIp target mechanisms, carers receiving FIp were more likely to shift from high to low expressed emotion and less likely to report patient focused criticism or engage in conflict communication than carers randomized to standard care. Carer burden and well-being were improved by the end of treatment but gains were not sustained at follow up. FIp had no impact on carer emotional over-involvement. The findings indicate that FIp is an effective intervention for early psychosis service users and their relatives. However, further research is required to establish which key therapeutic components of FIp are most effective for whom, in addition to understanding the mechanisms by which FIp might affect positive change.

  10. Hereditary angioedema presenting as irritable bowel syndrome: a case of early closure

    Directory of Open Access Journals (Sweden)

    Karim M. Benrajab

    2015-10-01

    Full Text Available Abdominal pain is one of the most common reasons for outpatient and emergency department visits. We present one such case of early closure in a 32-year-old male with recurrent abdominal pain who was diagnosed with irritable bowel syndrome (IBS. Family history was suspicious for hereditary angioedema (HAE. The HAE workup came back positive, and the patient was started on prophylactic therapy, which led to an improvement in symptoms and quality of life. The purpose of this case is to create awareness among physicians to test for HAE in patients diagnosed with IBS who, based on their history or physical examination, have clinical suspicion for HAE.

  11. Significance of (sub) clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy : a systematic review

    NARCIS (Netherlands)

    van den Boogaard, Emmy; Vissenberg, Rosa; Land, Jolande A.; van Wely, Madelon; van der Post, Joris A. M.; Goddijn, Mariette; Bisschop, Peter H.

    2011-01-01

    BACKGROUND: Thyroid dysfunction and thyroid autoimmunity are prevalent among women of reproductive age and are associated with adverse pregnancy outcomes. Preconception or early pregnancy screening for thyroid dysfunction has been proposed but is not widely accepted. We conducted a systematic review

  12. Feasibility and Effectiveness of Very Early Intervention for Infants At-Risk for Autism Spectrum Disorder: A Systematic Review

    Science.gov (United States)

    Bradshaw, Jessica; Steiner, Amanda Mossman; Gengoux, Grace; Koegel, Lynn Kern

    2015-01-01

    Early detection methods for autism spectrum disorder (ASD) in infancy are rapidly advancing, yet the development of interventions for infants under two years with or at-risk for ASD remains limited. In order to guide research and practice, this paper systematically reviewed studies investigating interventions for infants under 24 months with or…

  13. Literacy and Language Outcomes of Comprehensive and Developmental-Constructivist Approaches to Early Childhood Education: A Systematic Review

    Science.gov (United States)

    Chambers, Bette; Cheung, Alan C. K.; Slavin, Robert E.

    2016-01-01

    This systematic review of research on early childhood programs seeks to identify effective approaches capable of improving literacy and language outcomes for preschoolers. It applies consistent standards to determine the strength of evidence supporting a variety of approaches, which fell into two main categories: "comprehensive…

  14. Significance of (sub) clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy : a systematic review

    NARCIS (Netherlands)

    van den Boogaard, Emmy; Vissenberg, Rosa; Land, Jolande A.; van Wely, Madelon; van der Post, Joris A. M.; Goddijn, Mariette; Bisschop, Peter H.

    2011-01-01

    BACKGROUND: Thyroid dysfunction and thyroid autoimmunity are prevalent among women of reproductive age and are associated with adverse pregnancy outcomes. Preconception or early pregnancy screening for thyroid dysfunction has been proposed but is not widely accepted. We conducted a systematic review

  15. Options for early breast cancer follow-up in primary and secondary care - a systematic review

    Directory of Open Access Journals (Sweden)

    Taggart Frances

    2012-06-01

    Full Text Available Abstract Background Both incidence of breast cancer and survival have increased in recent years and there is a need to review follow up strategies. This study aims to assess the evidence for benefits of follow-up in different settings for women who have had treatment for early breast cancer. Method A systematic review to identify key criteria for follow up and then address research questions. Key criteria were: 1 Risk of second breast cancer over time - incidence compared to general population. 2 Incidence and method of detection of local recurrence and second ipsi and contra-lateral breast cancer. 3 Level 1–4 evidence of the benefits of hospital or alternative setting follow-up for survival and well-being. Data sources to identify criteria were MEDLINE, EMBASE, AMED, CINAHL, PSYCHINFO, ZETOC, Health Management Information Consortium, Science Direct. For the systematic review to address research questions searches were performed using MEDLINE (2011. Studies included were population studies using cancer registry data for incidence of new cancers, cohort studies with long term follow up for recurrence and detection of new primaries and RCTs not restricted to special populations for trials of alternative follow up and lifestyle interventions. Results Women who have had breast cancer have an increased risk of a second primary breast cancer for at least 20 years compared to the general population. Mammographically detected local recurrences or those detected by women themselves gave better survival than those detected by clinical examination. Follow up in alternative settings to the specialist clinic is acceptable to women but trials are underpowered for survival. Conclusions Long term support, surveillance mammography and fast access to medical treatment at point of need may be better than hospital based surveillance limited to five years but further large, randomised controlled trials are needed.

  16. Paediatric early warning systems for detecting and responding to clinical deterioration in children: a systematic review

    Science.gov (United States)

    Lambert, Veronica; Matthews, Anne; MacDonell, Rachel; Fitzsimons, John

    2017-01-01

    Objective To systematically review the available evidence on paediatric early warning systems (PEWS) for use in acute paediatric healthcare settings for the detection of, and timely response to, clinical deterioration in children. Method The electronic databases PubMed, MEDLINE, CINAHL, EMBASE and Cochrane were searched systematically from inception up to August 2016. Eligible studies had to refer to PEWS, inclusive of rapid response systems and teams. Outcomes had to be specific to the identification of and/or response to clinical deterioration in children (including neonates) in paediatric hospital settings (including emergency departments). 2 review authors independently completed the screening and selection process, the quality appraisal of the retrieved evidence and data extraction; with a third reviewer resolving any discrepancies, as required. Results were narratively synthesised. Results From a total screening of 2742 papers, 90 papers, of varied designs, were identified as eligible for inclusion in the review. Findings revealed that PEWS are extensively used internationally in paediatric inpatient hospital settings. However, robust empirical evidence on which PEWS is most effective was limited. The studies examined did however highlight some evidence of positive directional trends in improving clinical and process-based outcomes for clinically deteriorating children. Favourable outcomes were also identified for enhanced multidisciplinary team work, communication and confidence in recognising, reporting and making decisions about child clinical deterioration. Conclusions Despite many studies reporting on the complexity and multifaceted nature of PEWS, no evidence was sourced which examined PEWS as a complex healthcare intervention. Future research needs to investigate PEWS as a complex multifaceted sociotechnical system that is embedded in a wider safety culture influenced by many organisational and human factors. PEWS should be embraced as a part of a

  17. [The early postoperative rehabilitation of the patients presenting with cholelithiasis and experiencing psychoemotional stress].

    Science.gov (United States)

    Poddubnaia, O A; Marsheva, S I

    2013-01-01

    Early postoperative rehabilitation of the patients presenting with cholelithiasis and experiencing psychoemotional stress is designed to restore the function of bile secretion, enhance their adaptive capabilities, and normalize the psychovegetative status for the purpose of preventing further progress of the disease and reducing the risk of the development of post-cholecystectomy syndrome. The inclusion of drinking mineral water, magnetic laser therapy, and UHF therapy in the combined rehabilitative treatment of such patients results in the appreciable enhancement of all functional abilities of the body manifest as the significant improvement and normalization of clinical and laboratory characteristics (elimination of clinical symptoms of the disease, improvement of general and biochemycal parameters of peripheral blood). Simultaneously, the adaptive capabilities and the psychovegetative status of the patients improved as apparent from the increased lymphocyte count, normalization of the Kerdo and Hildebrandt indices and indices of stress level, decreased psychoemotional stress, enhancement of physical functioning characteristics. Taken together, these changes account for the high effectiveness of the above procedures of early postoperative rehabilitation of the patients presenting with cholelithiasisand experiencing psychoemotional stress (94.7%).

  18. Cryptococcus meningitis in an immunocompetent teenage boy presented early with diplopia

    Science.gov (United States)

    Muslikhan, Yanti; Hitam, Wan Hazabbah Wan; Ishak, Siti Raihan; Mohtar, Ibrahim; Takaran, John

    2010-01-01

    AIM To report a case of cryptococcus meningitis in an immunocompetent teenager that presented early with diplopia and bilateral poor vision. METHODS A case report RESULTS A 17-year-old boy presented with blurring of vision in both eyes and diplopia for 3 weeks. It was associated with severe throbbing headaches, nausea and vomiting. He was also having low grade fever. On physical examination he was afebrile with no sign of meningism. His vision was 6/15 in both eyes with constricted visual field. Anterior segment was normal in both eyes. Extraocular muscles movement showed bilateral sixth nerve palsies. Fundoscopy revealed bilateral hyperaemic and slightly elevated optic disc. CT scan of the brain was normal with no evidence of intracranial mass or abnormal ventricles. Lumbar puncture revealed high opening pressure >300mmH2O. Cerebrospinal fluid (CSF) microscopically and culture showed presence of cryptococcus neoformans. This case was combinedly managed with neuro-medical team. Patient was started on intravenous Amphotericin B and fluconazole. His neurological symptoms recovered after a week. His vision was improved to 6/6 in both eyes with recovery of peripheral visual field. The diplopia improved with recovery of sixth nerve palsies in both eyes. Unfortunately, patient developed nosocomial lower respiratory tract infection and was treated for the problem. CONCLUSION This case highlights the indolent nature of cryptococcus meningitis and the fact that the overt signs of meningism may not be present even in immunocompetent person. Diplopia may be one of the early presentations of meningitis patient. PMID:22553527

  19. Peripherally presented emotional scenes: a spatiotemporal analysis of early ERP responses.

    Science.gov (United States)

    Rigoulot, Simon; Delplanque, Sylvain; Despretz, Pascal; Defoort-Dhellemmes, Sabine; Honoré, Jacques; Sequeira, Henrique

    2008-06-01

    Recent findings from event-related potentials (ERPs) studies provided strong evidence that centrally presented emotional pictures could be used to assess affective processing. Moreover, several studies showed that emotionally charged stimuli may automatically attract attention even if these are not consciously identified. Indeed, such perceptive conditions can be compared to those typical of the peripheral vision, particularly known to have low spatial resolution capacities. The aim of the present study was to characterize at behavioral and neural levels the impact of emotional visual scenes presented in peripheral vision. Eighteen participants were asked to categorize neutral and unpleasant pictures presented at central (0 degrees ) and peripheral eccentricities (-30 and +30 degrees ) while ERPs were recorded from 63 electrodes. ERPs were analysed by means of spatio-temporal principal component analyses (PCA) in order to evaluate influences of the emotional content on ERP components for each spatial position (central vs. peripheral). Main results highlight that affective modulation of early ERP components exists for both centrally and peripherally presented pictures. These findings suggest that, for far peripheral eccentricities as for central vision, the brain engages specific resources to process emotional information.

  20. Early orthodontic treatment for Class III malocclusion: A systematic review and meta-analysis.

    Science.gov (United States)

    Woon, See Choong; Thiruvenkatachari, Badri

    2017-01-01

    Class III malocclusion affects between 5% and 15% of our population. The 2 most common dilemmas surrounding Class III treatment are the timing of treatment and the type of appliance. A number of appliances have been used to correct a Class III skeletal discrepancy, but there is little evidence available on their effectiveness in the long term. Similarly, early treatment of Class III malocclusion has been practiced with increasing interest. However, there has been no solid evidence on the benefits in the long term. The aim of this systematic review was to evaluate the effectiveness of orthodontic/orthopedic methods used in the early treatment of Class III malocclusion in the short and long terms. Several sources were used to identify all relevant studies independently of language. The Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase (Ovid), and MEDLINE (Ovid) were searched to June 2016. The selection criteria included randomized controlled trials (RCTs) and prospective controlled clinical trials (CCTs) of children between the ages of 7 and 12 years on early treatment with any type of orthodontic/orthopedic appliance compared with another appliance to correct Class III malocclusion or with an untreated control group. The primary outcome measure was correction of reverse overjet, and the secondary outcomes included skeletal changes, soft tissue changes, quality of life, patient compliance, adverse effect, Peer Assessment Rating score, and treatment time. The search results were screened for inclusion, and the data extracted by 2 independent authors. The data were analyzed using software (version 5.1, Review Manager; The Nordic Cochrane Centre, The Cochrane Collaboration; Copenhagen, Denmark). The mean differences with 95% confidence intervals were expressed for the continuous data. Random effects were carried out with high levels of clinical or statistical heterogeneity and fixed affects when the heterogeneity was low

  1. Reconsideration of the systematics of the Early Pleistocene Cervavitus (Cervidae, Artiodactyla, Mammalia

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    Dong, W.

    2011-12-01

    Full Text Available Cervavitus were usually found from the Late Miocene and Pliocene deposits in East Europe, Middle Asia and North China, but they were found recently in many Early Pleistocene localities in southern China. The latter resulted in the discussion of their systematic status between Cervavitus and Cervus. Here we show the Early Pleistocene forms from southern China are morphometrically more similar to northern China Cervavitus species, and the cladistic analysis shows that the southern China forms are closer to classic Cervavitus species than Cervus and that also proves their systematic status in Cervavitus rather than in Cervus. Cervavitus originated in Moldovan forests of East Europe in the late Vallesian (MN10 from a brachyodont and holometacarpal ancestor with two/three-tined antlers and Palaeomeryx fold and evolved into C. novorossiae. It dispersed into West Europe forests in the earliest Turolian and further west to France in the Ruscinian. It dispersed into northern China forests in the early Turolian and represented by C. shanxius. The great quantity of C. shanxius specimens with brachyodont teeth and complete lateral metacarpals implies the arid Loess Plateau of today was a humid forested region in the Late Miocene. C. shanxius migrated southwards in the Plio-Pleistocene probably due to the drying environment in northern China with uplifting of Himalayas and evolved into C. ultimus and C. fenqii, which survived in southern China until the Early Pleistocene (MNQ18.La revisión sistemática de Cervivatus sugiere que deriva del principal clado de los cérvidos posteriores a los muntiacinos, e implica que Procervulinae, Dicrocerinae y la primeras formas de Munticiacinae serían holometacarpales, como también lo es Cervivatus, originario en los bosques de Moldavia (Europa del Este durante el Vallesiense final (MN 10, a partir de un antecesor braquiodonto y holometacarpal, con astas con dos o tres candiles y pliegue paleomerícido, y que da lugar a

  2. History, Present, and Progress of Frontotemporal Dementia in China: A Systematic Review

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    Ru-Jing Ren

    2012-01-01

    Full Text Available We aim to provide an overview of clinical and demographical features and neuropathological research on frontotemporal dementia (FTD from China over the past decade. We reviewed the demographic features, clinical presentations, and neuropathology of the FTD-spectrum disorders from the 49 cases in China published since 1998. On the basis of these findings, we retrospect the history and speculate on future progress in terms of FTD in China. We found that most published papers comprise case reports with a few retrospective studies with small sample sizes. Behavior variant FTD (bvFTD was the most common diagnostic subtype, of which 35% were associated with amyotrophic lateral sclerosis or Parkinsonian syndrome. More than 47% patients with FTD had age onset before 65. There were no differences in age of onset and sex distribution between diagnostic subtypes. The spectrum of neuropathological diagnosis of bvFTD was frontotemporal lobe degeneration (FTLD with tau protein or ubiquitin-immunopositive inclusions, and FTLD without intracellular inclusions. Median survival in bvFTD was 14 years. This paper provides an overview of the current status and pointers for future research directions of FTD in China.

  3. Takotsubo cardiomyopathy systematic review: Pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy.

    Science.gov (United States)

    Ono, Ryohei; Falcão, L Menezes

    2016-04-15

    Takotsubo cardiomyopathy (TTC) is characterized by transient left ventricular apical ballooning with the absence of coronary occlusion, which typically occurs in older women after emotional or physical stress. The pathophysiology of TTC is not well established, though several possible causes such as catecholamine cardiotoxicity, metabolic disturbance, coronary microvascular impairment and multivessel epicardial coronary artery spasm have been proposed. A number of diagnostic criteria have been suggested in the world and not unified as single, but the most common accepted one is Mayo Clinic proposed criteria. Since the clinical presentation of TTC is usually similar to acute coronary syndrome, differential diagnosis is essential to exclude other diseases and also for its treatment. Imaging modality including echocardiogram, angio CT and cardiac MRI, and lab tests for catecholamine, troponin T, creatine kinase MB and B-type natriuretic peptide can be useful to differentiate TTC from other diseases. Prognosis is generally favorable and in-hospital mortality is from 0% to within 10%. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Facial emotion identification in early-onset and first-episode psychosis: a systematic review with meta-analysis.

    Science.gov (United States)

    Barkl, Sophie J; Lah, Suncica; Harris, Anthony W F; Williams, Leanne M

    2014-10-01

    Patients with chronic schizophrenia are characterized by deficits in identifying facial expressions of emotion, and these deficits relate to impaired social and occupational function. It is not yet known if these deficits are trait-like and present at the onset of psychosis, preceding a subsequent diagnosis of schizophrenia. Our objective was to systematically review and analyze the extant literature to assess if there is a consistent profile of emotion identification problems in early-onset and first-episode psychosis. We conducted a systematic review and meta-analysis of 12 peer-reviewed studies of facial emotion identification in early-onset and first-episode psychosis, published between 1980 and March 2013. We examined the average mean difference between patients and controls on measures of facial emotion identification. Findings suggest that patients with early-onset and first-episode psychosis have impairment in identifying facial expressions of biologically salient emotion. Across the 12 studies, the onset of psychosis was distinguished by a generalized effect of significantly poorer accuracy for identifying facial expressions of emotion than healthy controls, and this difference had a substantial effect size (d=-0.88, N=378, 95% CI=-1.42 to -0.32). Within this general effect some emotions were also harder for patients to identify than others, with the magnitude of impairment found to be (i) large for disgust, fear and surprise, and (ii) medium for sadness, and happiness. No between groups mean differences were found for anger or neutral facial expressions. Deficits in facial emotion identification are evident at first onset of a psychotic episode. The findings suggest that, over and above a generalized deficit in identifying facial emotion, patients may find some emotions harder to identifying than others. This reflects findings with chronic schizophrenia populations and suggests that emotion identification impairment represents a trait susceptibility

  5. Early Pregnancy Biomarkers in Pre-Eclampsia: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Pensée Wu

    2015-09-01

    Full Text Available Pre-eclampsia (PE complicates 2%–8% of all pregnancies and is an important cause of perinatal morbidity and mortality worldwide. In order to reduce these complications and to develop possible treatment modalities, it is important to identify women at risk of developing PE. The use of biomarkers in early pregnancy would allow appropriate stratification into high and low risk pregnancies for the purpose of defining surveillance in pregnancy and to administer interventions. We used formal methods for a systematic review and meta-analyses to assess the accuracy of all biomarkers that have been evaluated so far during the first and early second trimester of pregnancy to predict PE. We found low predictive values using individual biomarkers which included a disintegrin and metalloprotease 12 (ADAM-12, inhibin-A, pregnancy associated plasma protein A (PAPP-A, placental growth factor (PlGF and placental protein 13 (PP-13. The pooled sensitivity of all single biomarkers was 0.40 (95% CI 0.39–0.41 at a false positive rate of 10%. The area under the Summary of Receiver Operating Characteristics Curve (SROC was 0.786 (SE 0.02. When a combination model was used, the predictive value improved to an area under the SROC of 0.893 (SE 0.03. In conclusion, although there are multiple potential biomarkers for PE their efficacy has been inconsistent and comparisons are difficult because of heterogeneity between different studies. Therefore, there is an urgent need for high quality, large-scale multicentre research in biomarkers for PE so that the best predictive marker(s can be identified in order to improve the management of women destined to develop PE.

  6. A systematic variation of the stellar initial mass function in early-type galaxies

    CERN Document Server

    Cappellari, Michele; Alatalo, Katherine; Blitz, Leo; Bois, Maxime; Bournaud, Frederic; Bureau, M; Crocker, Alison F; Davies, Roger L; Davis, Timothy A; de Zeeuw, P T; Duc, Pierre-Alain; Emsellem, Eric; Khochfar, Sadegh; Krajnovic, Davor; Kuntschner, Harald; Lablanche, Pierre-Yves; Morganti, Raffaella; Naab, Thorsten; Oosterloo, Tom; Sarzi, Marc; Scott, Nicholas; Serra, Paolo; Weijmans, Anne-Marie; Young, Lisa M

    2012-01-01

    Much of our knowledge of galaxies comes from analysing the radiation emitted by their stars. It depends on the stellar initial mass function (IMF) describing the distribution of stellar masses when the population formed. Consequently knowledge of the IMF is critical to virtually every aspect of galaxy evolution. More than half a century after the first IMF determination, no consensus has emerged on whether it is universal in different galaxies. Previous studies indicated that the IMF and the dark matter fraction in galaxy centres cannot be both universal, but they could not break the degeneracy between the two effects. Only recently indications were found that massive elliptical galaxies may not have the same IMF as our Milky Way. Here we report unambiguous evidence for a strong systematic variation of the IMF in early-type galaxies as a function of their stellar mass-to-light ratio, producing differences up to a factor of three in mass. This was inferred from detailed dynamical models of the two-dimensional ...

  7. Systematic variations of central mass density slopes in early-type galaxies

    CERN Document Server

    Tortora, C; Napolitano, N R; Romanowsky, A J; Ferreras, I; de Carvalho, R R

    2014-01-01

    We study the total density distribution in the central regions (~ 1 effective radius, $R_e$) of early-type galaxies (ETGs), using data from SPIDER and $\\rm ATLAS^{3D}$. Our analysis extends the range of galaxy stellar mass ($M_{\\star}$) probed by gravitational lensing, down to ~ $10^{10}\\, \\rm M_{\\odot}$. We model each galaxy with two components (dark matter halo + stars), exploring different assumptions for the dark matter (DM) halo profile (i.e. NFW, NFW-contracted, and Burkert profiles), and leaving stellar mass-to-light ($M_{\\star}/L$) ratios as free fitting parameters to the data. For all plausible halo models, the best-fitting $M_{\\star}/L$, normalized to that for a Chabrier IMF, increases systematically with galaxy size and mass. For an NFW profile, the slope of the total mass profile is non-universal, independently of several ingredients in the modeling (e.g., halo contraction, anisotropy, and rotation velocity in ETGs). For the most massive ($M_{\\star}$ ~ $10^{11.5} \\, M_{\\odot}$) or largest ($R_{\\rm...

  8. Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review.

    Science.gov (United States)

    Hammarberg, K; Fisher, J R W; Wynter, K H

    2008-01-01

    It is known that infertility affects emotional well-being, satisfaction with life and self-esteem and that failed assisted reproductive technology (ART) treatment is associated with diminished life satisfaction, reduced self-confidence and substantial psychological distress. Investigations of whether these persist when treatment results in a pregnancy and live birth have been undertaken. A systematic search for English-language research articles on psychological and social aspects of pregnancy, childbirth and the first post-partum year after ART conception. Of 466 retrieved papers, 46 met inclusion criteria. These reported data from 28 studies. There is consistent evidence that marital satisfaction, emotional well-being and self-regard in pregnancy, attachment to the fetus and parent-infant relationship in ART groups are similar to comparison groups. Anxiety about the survival of the fetus and early parenting difficulties appear to be higher and post-natal self-confidence lower. Evidence about adjustment to pregnancy and parenthood and the experience of childbirth is inconclusive and reports of parental perceptions of infant temperament and behaviour are contradictory. Between-study methodological differences may explain the lack of consistency in findings of the influence of infertility and ART on some aspects of the transition to parenthood. Overall, this body of evidence is best described as emergent. It is possible that in pregnancy after ART, parenthood might be idealized and this might then hinder adjustment and the development of a confident parental identity.

  9. The use and application of assistive technology to promote literacy in early childhood: a systematic review.

    Science.gov (United States)

    Burne, Brian; Knafelc, Valerie; Melonis, Maureen; Heyn, Patricia C

    2011-01-01

    The Individuals with Disabilities Act was implemented in 1975 to assure that all children aged 0-21 years old have access and the right to an equal education. However, young children with disabilities continue to need additional support to meet the reading readiness standards as outlined in The No Child Left Behind legislation (2004). Although all children benefit from readiness skills, it is essential for children with special needs. With the technology boom of the past decade, assistive technology (AT) has been used increasingly to enhance emerging literacy skills. In order to identify current trends in the use of AT as a means to enhance emergent literacy skills in young children with disabilities, a systematic review of the literature was undertaken. The findings from this review support the scarcity of empirical research demonstrating the benefit of AT to promote emergent literacy with young children with disabilities. We also found a need for evidence supporting education approaches for the proper use of AT in early childhood literacy as well as little family knowledge regarding the implementation and instructional use of AT.

  10. Effect of early intervention in infants at very high risk of cerebral palsy: a systematic review.

    Science.gov (United States)

    Hadders-Algra, Mijna; Boxum, Anke G; Hielkema, Tjitske; Hamer, Elisa G

    2017-03-01

    First, to systematically review the evidence on the effect of intervention applied during the first postnatal year in infants with or at very high risk of cerebral palsy (CP) on child and family outcome. Second, to assess whether type and dosing of intervention modify the effect of intervention. Relevant literature was identified by searching the PubMed, Embase, and CINAHL databases. Selection criteria included infants younger than 12 months corrected age with or at very high risk of CP. Methodological quality including risk of bias was scrutinized. Thirteen papers met the inclusion criteria. Seven studies with moderate to high methodological quality were analysed in detail; they evaluated neurodevelopmental treatment only (n=2), multisensory stimulation (n=1), developmental stimulation (n=2), and multifaceted interventions consisting of a mix of developmental stimulation, support of parent-infant interaction, and neurodevelopmental treatment (n=2). The heterogeneity precluded conclusions. Yet, two suggestions emerged: (1) dosing may be critical for effectiveness; (2) multifaceted intervention may offer best opportunities for child and family. The literature on early intervention in very high-risk infants with sufficient methodological quality is limited, heterogeneous, and provides weak evidence on the effect. More studies are urgently needed. Suggestions for future research are provided. © 2016 Mac Keith Press.

  11. Stomatal Blue Light Response Is Present in Early Vascular Plants1[OPEN

    Science.gov (United States)

    Doi, Michio; Kitagawa, Yuki; Shimazaki, Ken-ichiro

    2015-01-01

    Light is a major environmental factor required for stomatal opening. Blue light (BL) induces stomatal opening in higher plants as a signal under the photosynthetic active radiation. The stomatal BL response is not present in the fern species of Polypodiopsida. The acquisition of a stomatal BL response might provide competitive advantages in both the uptake of CO2 and prevention of water loss with the ability to rapidly open and close stomata. We surveyed the stomatal opening in response to strong red light (RL) and weak BL under the RL with gas exchange technique in a diverse selection of plant species from euphyllophytes, including spermatophytes and monilophytes, to lycophytes. We showed the presence of RL-induced stomatal opening in most of these species and found that the BL responses operated in all euphyllophytes except Polypodiopsida. We also confirmed that the stomatal opening in lycophytes, the early vascular plants, is driven by plasma membrane proton-translocating adenosine triphosphatase and K+ accumulation in guard cells, which is the same mechanism operating in stomata of angiosperms. These results suggest that the early vascular plants respond to both RL and BL and actively regulate stomatal aperture. We also found three plant species that absolutely require BL for both stomatal opening and photosynthetic CO2 fixation, including a gymnosperm, C. revoluta, and the ferns Equisetum hyemale and Psilotum nudum. PMID:26307440

  12. Early detection of diabetic kidney disease: Present limitations and future perspectives

    Institute of Scientific and Technical Information of China (English)

    Chih-Hung; Lin; Yi-Cheng; Chang; Lee-Ming; Chuang

    2016-01-01

    Diabetic kidney disease(DKD) is one of the most common diabetic complications, as well as the leading cause of chronic kidney disease and end-stage renal disease around the world. To prevent the dreadful consequence, development of new assays for diagnostic of DKD has always been the priority in the research field of diabetic complications. At present, urinary albumin-to-creatinine ratio and estimated glomerular filtration rate(eG FR) are the standard methods for assessing glomerular damage and renal function changes in clinical practice. However, due to diverse tissue involvement in different individuals, the so-called "non-albuminuric renal impairment" is not uncommon, especially in patients with type 2 diabetes. On the other hand, the precision of creatinine-based GFR estimates is limited in hyperfiltration status. These facts make albuminuria and eG FR less reliable indicators for early-stage DKD. In recent years, considerable progress has been made in the understanding of the pathogenesis of DKD, along with the elucidation of its genetic profiles and phenotypic expression of different molecules. With the help of ever-evolving technologies, it has gradually become plausible to apply the thriving information in clinical practice. The strength and weakness of several novel biomarkers, genomic, proteomic and metabolomic signatures in assisting the early diagnosis of DKD will be discussed in this article.

  13. Clinical presentation and early care relationships in 'poor-me' and 'bad-me' paranoia.

    Science.gov (United States)

    Morris, Emma; Milner, Philip; Trower, Peter; Peters, Emmanuelle

    2011-06-01

    OBJECTIVE. To test the proposal that 'poor-me' (PM) and 'bad-me' (BM) paranoia can be differentiated in terms of (1) current emotional experience and presence of grandiose delusions and (2) early caregiving and threats to self-construction. METHOD. Participants experiencing persecutory delusions were separated into PM (N= 21) and BM (N= 15) groups on the basis of perceived deservedness of the persecution. The groups were compared on measures examining grandiose delusions, shame and depression, parental care, and threats of alienation and insecurity. RESULTS. As predicted, BM patients scored higher on shame and depression, and lower on grandiose delusions, than PM patients. BM patients reported higher levels of parental overprotection, but PM patients were not characterized by neglect, and the groups did not differ in type of threat to self-construction. Conclusion. The two paranoia types were differentiated on symptomatic and emotional presentation, but predicted differences in early relationships and self-construction were not fully supported.

  14. Early presentation of de novo high grade glioma with epileptic seizures: electroclinical and neuroimaging findings.

    Science.gov (United States)

    Rossi, Rosario; Figus, Andrea; Corraine, Simona

    2010-10-01

    We report the clinical, EEG and neuroradiologic findings from three adult patients who developed new-onset seizure disorders as early clinical manifestations of de novo high grade glioma. The malignancies could not be recognised at the time of the first epileptic seizure because of minimal non-specific brain abnormalities, which showed no signs of necrosis or significant contrast enhancement on computed tomography and magnetic resonance imaging. Focal EEG abnormalities were recorded in all cases and appeared consistent with the neuroradiologic findings. The patients regained normal neurological status after the first seizure but rapidly developed space-occupying necrotic lesions. Two patients underwent surgery and received histological diagnoses of the tumours. Another patient was finally diagnosed with a malignant glioma based on the neuroradiologic picture and rapid progression of the cerebral lesion. It should be noted that in adult patients, new-onset epileptic seizures might reveal the presence of malignant gliomas at a very early stage in the tumour formation process. This report indicates that typical anatomoradiologic features of de novo high grade glioma, such as necrosis and rim-contrast enhancement, could be absent at the time of the first epileptic seizure but become clear within a short period after clinical presentation.

  15. Understanding Factors that Shape Gender Attitudes in Early Adolescence Globally: A Mixed-Methods Systematic Review.

    Science.gov (United States)

    Kågesten, Anna; Gibbs, Susannah; Blum, Robert Wm; Moreau, Caroline; Chandra-Mouli, Venkatraman; Herbert, Ann; Amin, Avni

    2016-01-01

    Early adolescence (ages 10-14) is a period of increased expectations for boys and girls to adhere to socially constructed and often stereotypical norms that perpetuate gender inequalities. The endorsement of such gender norms is closely linked to poor adolescent sexual and reproductive and other health-related outcomes yet little is known about the factors that influence young adolescents' personal gender attitudes. To explore factors that shape gender attitudes in early adolescence across different cultural settings globally. A mixed-methods systematic review was conducted of the peer-reviewed literature in 12 databases from 1984-2014. Four reviewers screened the titles and abstracts of articles and reviewed full text articles in duplicate. Data extraction and quality assessments were conducted using standardized templates by study design. Thematic analysis was used to synthesize quantitative and qualitative data organized by the social-ecological framework (individual, interpersonal and community/societal-level factors influencing gender attitudes). Eighty-two studies (46 quantitative, 31 qualitative, 5 mixed-methods) spanning 29 countries were included. Ninety percent of studies were from North America or Western Europe. The review findings indicate that young adolescents, across cultural settings, commonly express stereotypical or inequitable gender attitudes, and such attitudes appear to vary by individual sociodemographic characteristics (sex, race/ethnicity and immigration, social class, and age). Findings highlight that interpersonal influences (family and peers) are central influences on young adolescents' construction of gender attitudes, and these gender socialization processes differ for boys and girls. The role of community factors (e.g. media) is less clear though there is some evidence that schools may reinforce stereotypical gender attitudes among young adolescents. The findings from this review suggest that young adolescents in different cultural

  16. Understanding Factors that Shape Gender Attitudes in Early Adolescence Globally: A Mixed-Methods Systematic Review.

    Directory of Open Access Journals (Sweden)

    Anna Kågesten

    Full Text Available Early adolescence (ages 10-14 is a period of increased expectations for boys and girls to adhere to socially constructed and often stereotypical norms that perpetuate gender inequalities. The endorsement of such gender norms is closely linked to poor adolescent sexual and reproductive and other health-related outcomes yet little is known about the factors that influence young adolescents' personal gender attitudes.To explore factors that shape gender attitudes in early adolescence across different cultural settings globally.A mixed-methods systematic review was conducted of the peer-reviewed literature in 12 databases from 1984-2014. Four reviewers screened the titles and abstracts of articles and reviewed full text articles in duplicate. Data extraction and quality assessments were conducted using standardized templates by study design. Thematic analysis was used to synthesize quantitative and qualitative data organized by the social-ecological framework (individual, interpersonal and community/societal-level factors influencing gender attitudes.Eighty-two studies (46 quantitative, 31 qualitative, 5 mixed-methods spanning 29 countries were included. Ninety percent of studies were from North America or Western Europe. The review findings indicate that young adolescents, across cultural settings, commonly express stereotypical or inequitable gender attitudes, and such attitudes appear to vary by individual sociodemographic characteristics (sex, race/ethnicity and immigration, social class, and age. Findings highlight that interpersonal influences (family and peers are central influences on young adolescents' construction of gender attitudes, and these gender socialization processes differ for boys and girls. The role of community factors (e.g. media is less clear though there is some evidence that schools may reinforce stereotypical gender attitudes among young adolescents.The findings from this review suggest that young adolescents in different

  17. A systematic review of the long-term outcome of early onset schizophrenia

    Directory of Open Access Journals (Sweden)

    Clemmensen Lars

    2012-09-01

    Full Text Available Abstract Background The current review analyzes the long-term outcome and prognosis of early onset schizophrenia based on previously published studies in 1980. Methods A systematic search of articles published in the English-language literature after 1980 identified a total of 21 studies, which included 716 patients who were either suffering from early onset schizophrenia (EOS or both EOS and other psychotic disorders (MIX. The authors of the current review scored the outcome as either “good,” “moderate,” or “poor.” The mean age of onset in these studies was Results In general, the outcome in studies with EOS is worse than the outcome in MIX studies. Only 15.4% of the patients in EOS studies versus 19.6% of the patients in MIX studies experienced a “good” outcome. In contrast, 24.5% of the patients in EOS studies versus 33.6% in MIX studies experienced a “moderate” outcome, and 60.1% in EOS studies versus 46.8% in MIX studies experienced a “poor” outcome. The authors identified various significant effects on outcome. In EOS, the findings were significantly affected by sample attrition, indicating that in studies with a high dropout rate, fewer patients experienced a “moderate” outcome, and more patients experienced a “poor” outcome; however, the effect sizes were small. Furthermore, the effects were also small and more favourable for specific functioning measures, as opposed to more global measures, small to moderate in terms of worse outcomes for follow-up periods >10 years, small to moderate for more unfavourable outcomes in males, and small to large for worse outcomes in studies including patients diagnosed before 1970. Conclusions In contrast to the adult manifestation, the early manifestation of schizophrenia in childhood and adolescence still carries a particularly poor prognosis. According to these aggregated data analyses, longer follow-up periods, male sex, and patients having been diagnosed before 1970

  18. Understanding Factors that Shape Gender Attitudes in Early Adolescence Globally: A Mixed-Methods Systematic Review

    Science.gov (United States)

    Gibbs, Susannah; Blum, Robert Wm; Moreau, Caroline; Chandra-Mouli, Venkatraman; Herbert, Ann; Amin, Avni

    2016-01-01

    Background Early adolescence (ages 10–14) is a period of increased expectations for boys and girls to adhere to socially constructed and often stereotypical norms that perpetuate gender inequalities. The endorsement of such gender norms is closely linked to poor adolescent sexual and reproductive and other health-related outcomes yet little is known about the factors that influence young adolescents’ personal gender attitudes. Objectives To explore factors that shape gender attitudes in early adolescence across different cultural settings globally. Methods A mixed-methods systematic review was conducted of the peer-reviewed literature in 12 databases from 1984–2014. Four reviewers screened the titles and abstracts of articles and reviewed full text articles in duplicate. Data extraction and quality assessments were conducted using standardized templates by study design. Thematic analysis was used to synthesize quantitative and qualitative data organized by the social-ecological framework (individual, interpersonal and community/societal-level factors influencing gender attitudes). Results Eighty-two studies (46 quantitative, 31 qualitative, 5 mixed-methods) spanning 29 countries were included. Ninety percent of studies were from North America or Western Europe. The review findings indicate that young adolescents, across cultural settings, commonly express stereotypical or inequitable gender attitudes, and such attitudes appear to vary by individual sociodemographic characteristics (sex, race/ethnicity and immigration, social class, and age). Findings highlight that interpersonal influences (family and peers) are central influences on young adolescents’ construction of gender attitudes, and these gender socialization processes differ for boys and girls. The role of community factors (e.g. media) is less clear though there is some evidence that schools may reinforce stereotypical gender attitudes among young adolescents. Conclusions The findings from this

  19. Different Association of Human Papillomavirus 16 Variants with Early and Late Presentation of Cervical Cancer

    Science.gov (United States)

    Alfaro, Ana; Juárez-Torres, Eligia; Medina-Martínez, Ingrid; Mateos-Guerrero, Norma; Bautista-Huerta, Maura; Román-Bassaure, Edgar; Villegas-Sepúlveda, Nicolás; Berumen, Jaime

    2016-01-01

    The median age of cervical cancer (CC) presentation coincides with the mean age of menopause presentation (49 years) in Mexico. Here, we investigated the association between different HPV16 variants and early (≤ 49 years) or delayed (≥ 50 years) CC presentation. We conducted a case-case study that included 462 CCs, 386 squamous cell carcinomas (SCC), 63 adenocarcinomas (ACC), and 13 additional cell types. Variants were identified by PCR and DNA sequencing. The risk conferred by each variant for developing CC earlier than 50 years was analyzed using a univariate logistic regression model considering old-aged patients (≥ 50 years) and non-HPV16 cases as the reference variables. Overall, the frequency of HPV16 was 50.9%, and the only identified variants were the European A1/2 (31.2%) and the Asian-American D2 (10.8%), and D3 (8.9%). D2 was mainly associated with ≤ 49-year-old patients (15.9%); A1/2 was uniformly distributed between the two age groups (~31%), whereas D3 increased with age to a frequency of 11.8% in the older group. Only the D2 variant conferred a 3.3-fold increase in the risk of developing CC before 50 years of age (OR = 3.3, 95% CI = 1.7–6.6, p < 0.001) in relation with non-HPV16 cases. Remarkably, this risk was higher for ACC (OR = 6.0, 95% CI = 1.1–33, p < 0.05) than for SCC (OR = 2.8, 95% CI = 1.3–5.9, p < 0.01). Interestingly, when analyzing only the HPV16-positive CC, D2 increases (OR = 2.5, 95% CI = 1.2–5, p < 0.05) and D3 decreases (OR = 0.45, 95% CI 0.2–0.9, p < 0.05) the risk to develop CC before 50 years old in relation with A1/2 variant. These results indicated that D2 variant is associated with early and D3 with delayed CC presentation, whereas A1/2 variant was uniformly distributed between the two age groups. PMID:28036379

  20. Different Association of Human Papillomavirus 16 Variants with Early and Late Presentation of Cervical Cancer.

    Science.gov (United States)

    Alfaro, Ana; Juárez-Torres, Eligia; Medina-Martínez, Ingrid; Mateos-Guerrero, Norma; Bautista-Huerta, Maura; Román-Bassaure, Edgar; Villegas-Sepúlveda, Nicolás; Berumen, Jaime

    2016-01-01

    The median age of cervical cancer (CC) presentation coincides with the mean age of menopause presentation (49 years) in Mexico. Here, we investigated the association between different HPV16 variants and early (≤ 49 years) or delayed (≥ 50 years) CC presentation. We conducted a case-case study that included 462 CCs, 386 squamous cell carcinomas (SCC), 63 adenocarcinomas (ACC), and 13 additional cell types. Variants were identified by PCR and DNA sequencing. The risk conferred by each variant for developing CC earlier than 50 years was analyzed using a univariate logistic regression model considering old-aged patients (≥ 50 years) and non-HPV16 cases as the reference variables. Overall, the frequency of HPV16 was 50.9%, and the only identified variants were the European A1/2 (31.2%) and the Asian-American D2 (10.8%), and D3 (8.9%). D2 was mainly associated with ≤ 49-year-old patients (15.9%); A1/2 was uniformly distributed between the two age groups (~31%), whereas D3 increased with age to a frequency of 11.8% in the older group. Only the D2 variant conferred a 3.3-fold increase in the risk of developing CC before 50 years of age (OR = 3.3, 95% CI = 1.7-6.6, p < 0.001) in relation with non-HPV16 cases. Remarkably, this risk was higher for ACC (OR = 6.0, 95% CI = 1.1-33, p < 0.05) than for SCC (OR = 2.8, 95% CI = 1.3-5.9, p < 0.01). Interestingly, when analyzing only the HPV16-positive CC, D2 increases (OR = 2.5, 95% CI = 1.2-5, p < 0.05) and D3 decreases (OR = 0.45, 95% CI 0.2-0.9, p < 0.05) the risk to develop CC before 50 years old in relation with A1/2 variant. These results indicated that D2 variant is associated with early and D3 with delayed CC presentation, whereas A1/2 variant was uniformly distributed between the two age groups.

  1. Moxibustion for the Correction of Nonvertex Presentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Qin-hong Zhang

    2013-01-01

    Full Text Available Objectives. This study aims to assess the effectiveness and safety of moxibustion for the correction of nonvertex presentation. Methods. Records without language restrictions were searched up to February 2013 for randomized controlled trials (RCTs comparing moxibustion with other therapies in women with a singleton nonvertex presentation. Cochrane risk of bias criteria were used to assess the methodological quality of the trials. Results. Seven of 392 potentially relevant studies met the inclusion criteria. When moxibustion was compared with other interventions, a meta-analysis revealed a significant difference in favor of moxibustion on the correction of nonvertex presentation at delivery (risk ratio (RR 1.29, 95% confidence interval (CI 1.12 to 1.49, and I2=0. The same findings applied to the cephalic presentation after cessation of treatment (RR 1.36, 95% CI 1.08 to 1.71, and I2=80%. A subgroup analysis that excluded two trials with a high risk of bias also indicated favorable effects (RR 1.63, 95% CI 1.42 to 1.86, and I2=0%. With respect to safety, moxibustion resulted in decreased use of oxytocin. Conclusion. Our systematic review and meta-analysis suggested that moxibustion may be an effective treatment for the correction of nonvertex presentation. Moreover, moxibustion might reduce the need for oxytocin.

  2. Exercise for health for early postmenopausal women: a systematic review of randomised controlled trials.

    Science.gov (United States)

    Asikainen, Tuula-Maria; Kukkonen-Harjula, Katriina; Miilunpalo, Seppo

    2004-01-01

    Women who pass menopause face many changes that may lead to loss of health-related fitness (HRF), especially if sedentary. Many exercise recommendations are also relevant for early postmenopausal women; however, these may not meet their specific needs because the recommendations are based mainly on studies on men. We conducted a systematic review for randomised, controlled exercise trials on postmenopausal women (aged 50 to 65 years) on components of HRF. HRF consists of morphological fitness (body composition and bone strength), musculoskeletal fitness (muscle strength and endurance, flexibility), motor fitness (postural control), cardiorespiratory fitness (maximal aerobic power, blood pressure) and metabolic fitness (lipid and carbohydrate metabolism). The outcome variables chosen were: bodyweight; proportion of body fat of total bodyweight (F%); bone mineral density (BMD); bone mineral content (BMC); various tests on muscle performance, flexibility, balance and coordination; maximal oxygen consumption (V-dotO(2max)); resting blood pressure (BP); total cholesterol (TC); high-density lipoprotein-cholesterol; low-density lipoprotein-cholesterol; triglycerides; blood glucose and insulin. The feasibility of the exercise programme was assessed from drop-out, attendance and injury rates. Twenty-eight randomised controlled trials with 2646 participants were assessed. In total, 18 studies reported on the effects of exercise on bodyweight and F%, 16 on BMD or BMC, 11 on muscular strength or endurance, five on flexibility, six on balance or coordination, 18 on V-dotO(2max), seven on BP, nine on lipids and two studies on glucose an one on insulin. Based on these studies, early postmenopausal women could benefit from 30 minutes of daily moderate walking in one to three bouts combined with a resistance training programme twice a week. For a sedentary person, walking is feasible and can be incorporated into everyday life. A feasible way to start resistance training is to

  3. Interventions to Reduce Harm from Smoking with Families in Infancy and Early Childhood: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Nicola Brown

    2015-03-01

    Full Text Available Exposure to adult smoking can have deleterious effects on children. Interventions that assist families with smoking cessation/reduction and environmental tobacco smoke (ETS avoidance can improve child health outcomes and reduce the risk of smoking initiation. The purpose of this review was to describe the state of the science of interventions with families to promote smoke-free home environments for infants and young children, including parent smoking reduction and cessation interventions, ETS reduction, and anti-smoking socialisation interventions, using the socio-ecological framework as a guide. A systematic review of peer-reviewed articles identified from journal databases from 2000 to 2014 was undertaken. Of 921 articles identified, 28 were included in the review. Considerable heterogeneity characterised target populations, intervention types, complexity and intensity, precluding meta-analysis. Few studies used socio-ecological approaches, such as family theories or concepts. Studies in early parenthood (child age newborn to one year tended to focus on parent smoking cessation, where studies of families with children aged 1–5 years were more likely to target household SHSe reduction. Results suggest that interventions for reduction in ETS may be more successful than for smoking cessation and relapse prevention in families of children aged less than 5 years. There is a need for a range of interventions to support families in creating a smoke free home environment that are both tailored and targeted to specific populations. Interventions that target the social and psychodynamics of the family should be considered further, particularly in reaching vulnerable populations. Consideration is also required for approaches to interventions that may further stigmatise families containing smokers. Further research is required to identify successful elements of interventions and the contexts in which they are most effective.

  4. Systematic variations of central mass density slopes in early-type galaxies

    Science.gov (United States)

    Tortora, C.; La Barbera, F.; Napolitano, N. R.; Romanowsky, A. J.; Ferreras, I.; de Carvalho, R. R.

    2014-11-01

    We study the total density distribution in the central regions (≲1 effective radius, Re) of early-type galaxies (ETGs), using data from SPIDER and ATLAS3D. Our analysis extends the range of galaxy stellar mass (M⋆) probed by gravitational lensing, down to ˜ 1010 M⊙. We model each galaxy with two components (dark matter halo + stars), exploring different assumptions for the dark matter halo profile (i.e. NFW, NFW-contracted, and Burkert profiles), and leaving stellar mass-to-light (M⋆/L) ratios as free fitting parameters to the data. For all plausible halo models, the best-fitting M⋆/L, normalized to that for a Chabrier initial mass function, increases systematically with galaxy size and mass. For an NFW profile, the slope of the total mass profile is non-universal, independently of several ingredients in the modelling (e.g. halo contraction, anisotropy, and rotation velocity in ETGs). For the most massive (M⋆ ˜ 1011.5 M⊙) or largest (Re˜ 15 kpc) ETGs, the profile is isothermal in the central regions (˜ Re/2), while for the low-mass (M⋆ ˜ 1010.2 M⊙) or smallest (Re˜ 0.5 kpc) systems, the profile is steeper than isothermal, with slopes similar to those for a constant-M/L profile. For a steeper concentration-mass relation than that expected from simulations, the correlation of density slope with galaxy mass tends to flatten, while correlations with Re and velocity dispersions are more robust. Our results clearly point to a `non-homology' in the total mass distribution of ETGs, which simulations of galaxy formation suggest may be related to a varying role of dissipation with galaxy mass.

  5. SADI-S WITH RIGHT GASTRIC ARTERY LIGATION: TECHNICAL SYSTEMATIZATION AND EARLY RESULTS

    Science.gov (United States)

    GEBELLI, Jordi Pujol; de GORDEJUELA, Amador Garcia Ruiz; RAMOS, Almino Cardoso; NORA, Mario; PEREIRA, Ana Marta; CAMPOS, Josemberg Marins; RAMOS, Manoela Galvão; BASTOS, Eduardo Lemos de Souza; MARCHESINI, João Batista

    2016-01-01

    ABSTRACT Background: Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance. Aim: To explain the technical aspects and the benefits of the SADI-S with right gastric artery ligation as an effective simplification from the original duodenal switch. Methods: Were included all patients undergoing this procedure from the November 2014 to May 2016, describing and analysing aspects of this technique, the systematization and early complications associated with the procedure. Results: A series of 67 patients were operated; 46 were women (68.7%); mean age of the group was 44 years old (33-56); and an average BMI of 53.5 kg/m2 (50-63.5). Surgical time was 115 min (80-180). A total of five patients (7.5%) had any complication and two (2.9%) had to be reoperated. There were two patients with leak, one at the duodenal stump and other at the esophagogastric angle. There was no mortality. Patients stayed at the hospital a median of 2.5 days (1-25). Conclusions: SADI-S with right gastric artery ligation is a safe procedure with few preliminary complications. The technical variations introduced to the classical duodenal switch are reproducible and may allow this procedure to be more popular. All the complications in this series were not related to the ligation of the right gastric artery. PMID:27683784

  6. Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review.

    Science.gov (United States)

    Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

    2016-02-09

    This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Early prehospital phase of a major incident. Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. CRD42013004473. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Accepted standards on how to give a Medical Research Presentation: a systematic review of expert opinion papers.

    Science.gov (United States)

    Blome, Christine; Sondermann, Hanno; Augustin, Matthias

    2017-01-01

    Background: This systematic review aimed to extract recommendations from expert opinion articles on how to give a medical research presentation on a scientific conference and to determine whether the experts agree on what makes an effective or poor presentation. Methods: Presentation-related terms were searched within article titles listed in PubMed, restricting the search to English-language articles published from January 1975 to July 2015. Recommendations were extracted from the articles, grouped by content, and analyzed for frequency. Ninety-one articles were included. Among 679 different recommendations, 29 were given in more than 20% of articles each. The five most frequent recommendations were to keep slides simple, adjust the talk to the audience, rehearse, not read the talk from slides or a manuscript, and make eye contact. Results: No article gave advice that was the complete opposite of the 29 most frequent recommendations with the exception of whether a light or dark background should be used for slides. Conclusions: Researchers should comply with these widely accepted standards to be perceived as effective presenters.

  8. Accepted standards on how to give a Medical Research Presentation: a systematic review of expert opinion papers

    Directory of Open Access Journals (Sweden)

    Blome, Christine

    2017-02-01

    Full Text Available Background: This systematic review aimed to extract recommendations from expert opinion articles on how to give a medical research presentation on a scientific conference and to determine whether the experts agree on what makes an effective or poor presentation. Methods: Presentation-related terms were searched within article titles listed in PubMed, restricting the search to English-language articles published from January 1975 to July 2015. Recommendations were extracted from the articles, grouped by content, and analyzed for frequency. Ninety-one articles were included. Among 679 different recommendations, 29 were given in more than 20% of articles each. The five most frequent recommendations were to keep slides simple, adjust the talk to the audience, rehearse, not read the talk from slides or a manuscript, and make eye contact. Results: No article gave advice that was the complete opposite of the 29 most frequent recommendations with the exception of whether a light or dark background should be used for slides. Conclusions: Researchers should comply with these widely accepted standards to be perceived as effective presenters.

  9. Treatment and Prevention of (Early) Osteoarthritis Using Articular Cartilage Repair—Fact or Fiction? A Systematic Review

    Science.gov (United States)

    de Windt, Tommy S.; Vonk, Lucienne A.; Brittberg, Mats

    2013-01-01

    Early osteoarthritis (OA) is increasingly being recognized in patients who wish to remain active while not accepting the limitations of conservative treatment or joint replacement. The aim of this systematic review was to evaluate the existing evidence for treatment of patients with early OA using articular cartilage repair techniques. A systematic search was performed in EMBASE, MEDLINE, and the Cochrane collaboration. Articles were screened for relevance and appraised for quality. Nine articles of generally low methodological quality (mean Coleman score 58) including a total of 502 patients (mean age range = 36-57 years) could be included. In the reports, both radiological and clinical criteria for early OA were applied. Of all patients included in this review, 75% were treated with autologous chondrocyte implantation. Good short-term clinical outcome up to 9 years was shown. Failure rates varied from 8% to 27.3%. The conversion to total knee arthroplasty rate was 2.5% to 6.5%. Although a (randomized controlled) trial in this patient category with long-term follow-up is needed, the literature suggests autologous chondrocyte implantation could provide good short- to mid-term clinical outcome and delay the need for total knee arthroplasty. The use of standardized criteria for early OA and implementation of (randomized) trials with long-term follow-up may allow for further expansion of the research field in articular cartilage repair to the challenging population with (early) OA. PMID:26069664

  10. The effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance: A systematic review.

    Science.gov (United States)

    Saab, Mohamad M; McCarthy, Bridie; Andrews, Tom; Savage, Eileen; Drummond, Frances J; Walshe, Nuala; Forde, Mary; Breen, Dorothy; Henn, Patrick; Drennan, Jonathan; Hegarty, Josephine

    2017-04-25

    This review aims to determine the effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance. Early Warning Systems support timely identification of clinical deterioration and prevention of avoidable deaths. Several educational programmes have been designed to help nurses recognize and manage deteriorating patients. Little is known as to the effectiveness of these programmes. Systematic review. Academic Search Complete, CINAHL, MEDLINE, PsycINFO, PsycARTICLES, Psychology and Behavioral Science Collection, SocINDEX and the UK & Ireland Reference Centre, EMBASE, the Turning Research Into Practice database, the Cochrane Central Register of Controlled Trials (CENTRAL) and Grey Literature sources were searched between October and November 2015. This is a quantitative systematic review using Cochrane methods. Studies published between January 2011 - November 2015 in English were sought. The risk of bias, level of evidence and the quality of evidence per outcome were assessed. Eleven articles with 10 studies were included. Nine studies addressed clinical performance, four addressed knowledge and two addressed confidence. Knowledge, vital signs recording and Early Warning Score calculation were improved in the short term. Two interventions had no effect on nurses' response to clinical deterioration and use of communication tools. This review highlights the importance of measuring outcomes using standardized tools and valid and reliable instruments. Using longitudinal designs, researchers are encouraged to investigate the effect of Early Warning Systems educational programmes. These can include interactive e-learning, on-site interdisciplinary Early Warning Scoring systems training sessions and simulated scenarios. © 2017 John Wiley & Sons Ltd.

  11. Off-hour presentation and outcomes in patients with acute ischemic stroke: a systematic review and meta-analysis.

    Science.gov (United States)

    Sorita, Atsushi; Ahmed, Adil; Starr, Stephanie R; Thompson, Kristine M; Reed, Darcy A; Dabrh, Abd Moain Abu; Prokop, Larry; Kent, David M; Shah, Nilay D; Murad, Mohammad Hassan; Ting, Henry H

    2014-04-01

    Studies have suggested that patients with acute ischemic stroke who present to the hospital during off-hours (weekends and nights) may or may not have worse clinical outcomes compared to patients who present during regular hours. We searched Medline In-Process & Other Non-Indexed Citations, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus through August 2013, and included any study that evaluated the association between time of patient presentation to a healthcare facility and mortality or modified Rankin Scale in acute ischemic stroke. Quality of studies was assessed with the Newcastle-Ottawa Scale. A random-effect meta-analysis model was applied. Heterogeneity was assessed using the Q statistic and I(2). A priori subgroup analyses were used to explain observed heterogeneity. A total of 21 cohort studies (23 cohorts) with fair quality enrolling 1,421,914 patients were included. Off-hour presentation for patients with acute ischemic stroke was associated with significantly higher short-term mortality (OR, 1.11, 95% CI 1.06-1.17). Presenting at accredited stroke centers (OR 1.04, 95% CI 0.98-1.11) and countries in North America (OR 1.05, 95% CI 1.01-1.09) were associated with smaller increase in mortality during off-hours. The results were not significantly different between adjusted (OR, 1.11, 95% CI 1.05-1.16) and unadjusted (OR, 1.13, 95% CI 0.95-1.35) outcomes. The proportion of patients with modified Rankin Scale at discharge ≥ 2-3 was higher in patients presenting during off-hours (OR, 1.14, 95% CI 1.06-1.22). The evidence suggests that patients with acute ischemic stroke presenting during off-hours have higher short-term mortality and greater disability at discharge. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  12. Annual Research Review: Attachment Disorders in Early Childhood--Clinical Presentation, Causes, Correlates, and Treatment

    Science.gov (United States)

    Zeanah, Charles H.; Gleason, Mary Margaret

    2015-01-01

    Background: Though noted in the clinical literature for more than 50 years, attachment disorders have been studied systematically only recently. In part because of the ubiquity of attachments in humans, determining when aberrant behavior is best explained as an attachment disorder as opposed to insecure attachment has led to some confusion. In…

  13. Early epidermoid carcinoma. A case presentation Carcinoma epidermoide primitivo. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Julian Viera Llanes

    2009-12-01

    Full Text Available The early epidermoid carcinoma is considered the strangest breast tumor with an incidence that only represents from 0,04 to 0,075 % out of all malignant tumors of the breast. It is a variety of the metaplastic carcinoma constituted by pavement keratinizing cells with an inconstant presence of fusocellular sarcomatoid elements, that reach great volume and frequently present as cystic tumours that may be confused with a breast abscess. This is the case of a 41 year-old white female from Cienfuegos municipality, Cuba, who presented to the provincial Mastology consultation because of a two month follow up of a 5 cm tumor in the right outer upper quadrant of her breast. Surgical removal of the tumor was performed and the result of the biopsy revealed a little differentiated epidermoid carcinoma. At present the patient has no metastasis and receives treatment at the outpatient. Its unusual presentation has led this case to be published. El carcinoma epidermoide primitivo es considerado el tumor más raro de la mama, con una incidencia que representa solo del 0,04 al 0,075 % de todos los tumores malignos de mama. Es una variedad de carcinoma metaplásico constituido por células pavimentosas queratinizantes, con presencia inconstante de elementos fusocelulares sarcomatoides, estos alcanzan grandes volúmenes y se presentan frecuentemente como tumoraciones quísticas que pueden confundirse con un absceso mamario. El caso que se presenta es una paciente femenina de 41 años de edad, de color de piel blanca, residente en el municipio de Cienfuegos que acudió a la consulta de Mastología de la provincia por presentar una tumoración de 5 cms. en el cuadrante superior externo de la mama derecha, de dos meses de evolución. Se realizó exèresis de la tumoración y se recibió informe de la biopsia con el resultado de carcinoma epidermoide poco diferenciado. Actualmente la paciente es seguida por consulta y está libre de metástasis. Por lo inusual del

  14. Low income/socio-economic status in early childhood and physical health in later childhood/adolescence: a systematic review.

    Science.gov (United States)

    Spencer, Nick; Thanh, Tu Mai; Louise, Séguin

    2013-04-01

    To systematically review the literature on the relationship between early childhood low income/socioeconomic status (SES) and physical health in later childhood/adolescence, to identify gaps in the literature and to suggest new avenues for research. A systematic search of electronic databases from their start date to November 2011 was conducted to identify prospective longitudinal studies in industrialized countries with a measure of low income/SES in the first 5 years of life and physical health outcomes in later childhood or adolescence. STROBE criteria were used to assess study quality. Risk estimates were expressed as odds ratios with 95 % confidence intervals where possible. Heterogeneity of studies precluded meta-analysis. Nine studies fulfilled the inclusion criteria. Significant associations of early childhood low income/SES with activity-limiting illness, parent-reported poor health status, acute and recurrent infections, increasing BMI percentile and hospitalization were reported. Results for parent-reported asthma were less consistent: there was a significant association with low income/SES in early childhood in 2 studies but null findings in 3 others. This systematic review of the association of early childhood low income/SES with physical health status in later childhood and adolescence shows that, in contrast to the extensive literature on the impact of poor childhood social circumstances on adult health, the evidence base is limited. The literature points to some associations of early low income/SES with later poor health status, but many key research questions remain unanswered. Implications for further research are considered.

  15. Moxibustion and other acupuncture point stimulation methods to treat breech presentation: a systematic review of clinical trials

    Directory of Open Access Journals (Sweden)

    Zhang Huirui

    2009-02-01

    Full Text Available Abstract Background Moxibustion, acupuncture and other acupoint stimulations are commonly used for the correction of breech presentation. This systematic review aims to evaluate the efficacy and safety of moxibustion and other acupoint stimulations to treat breech presentation. Methods We included randomized controlled trials (RCTs and controlled clinical trials (CCTs on moxibustion, acupuncture or any other acupoint stimulating methods for breech presentation in pregnant women. All searches in PubMed, the Cochrane Library (2008 Issue 2, China National Knowledge Information (CNKI, Chinese Scientific Journal Database (VIP and WanFang Database ended in July 2008. Two authors extracted and analyzed the data independently. Results Ten RCTs involving 2090 participants and seven CCTs involving 1409 participants were included in the present study. Meta-analysis showed significant differences between moxibustion and no treatment (RR 1.35, 95% CI 1.20 to 1.51; 3 RCTs. Comparison between moxibustion and knee-chest position did not show significant differences (RR 1.30, 95% CI 0.95 to 1.79; 3 RCTs. Moxibustion plus other therapeutic methods showed significant beneficial effects (RR 1.36, 95% CI 1.21 to 1.54; 2 RCTs. Laser stimulation was more effective than assuming the knee-chest position plus pelvis rotating. Moxibustion was more effective than no treatment (RR 1.29, 95% CI 1.17 to 1.42; 2 CCTs but was not more effective than the knee-chest position treatment (RR 1.22, 95% CI 1.11 to 1.34; 2 CCTs. Laser stimulation at Zhiyin (BL67 was more effective than the knee-chest position treatment (RR 1.30, 95% CI 1.10 to 1.54; 2 CCTs,. Conclusion Moxibustion, acupuncture and laser acupoint stimulation tend to be effective in the correction of breech presentation.

  16. Promoting the early detection of cancer: a systematic review of community pharmacy-based education and screening interventions.

    Science.gov (United States)

    Lindsey, Laura; Husband, Andy; Nazar, Hamde; Todd, Adam

    2015-10-01

    Given that the burden of cancer is set to increase globally, strategies are needed to improve the early detection of cancer. As such, increasing focus is now placed on promoting the early detection of cancer through education and screening interventions. One healthcare setting that has significant potential in delivering these approaches is the community pharmacy. This study aimed to systematically review the literature to identify and assess the current evidence for the role of community pharmacies in delivering early cancer detection initiatives. A systematic literature search of four databases was undertaken (Medline, Embase, CINAHL, PsycINFO) from inception to June 2015 to identify peer-reviewed intervention studies. A total of 3711 articles were identified from the search, of which twelve were included in the review. The studies focused on a range of different cancers and showed it is feasible to recruit patients to education and screening interventions within a community pharmacy setting. However, the interventions were poorly described in the literature. There is significant potential for community pharmacy to deliver education and screening-based interventions to promote the early detection of cancer, but more evidence is needed to ascertain how interventions delivered in this setting impact on patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Models and (some) Searches for CPT Violation: From Early Universe to the Present Era

    Science.gov (United States)

    Mavromatos, Nick E.

    2017-07-01

    In the talk, I review theoretical models, inspired by quantum gravity, that may violate CPT symmetry. The amount of violation today (which is constrained severely by a plethora of experiments that I will not describe due to lack of space) need not be the same with the one that occurred in the Early Universe,. In certain models, one can obtain a precise temperature dependence of CPT violating effects, which is such that these effects are significant during the radiation era of the Universe, but are damped quickly so that they do not to affect nucleosynthesis and are negligible in the present epoch (that is, beyond experimental detection with the current experimental sensitivity). The CPT Violation (CPTV) in these models may arise from special properties of the background over which the fields of the model are propagating upon and be responsible for the generation of a matter-antimatter asymmetry, where any CP violation effects could only assist in the creation of the asymmetry, the dominant effect being CPTV. However, there are cases, where the CPTV arises as a consequence of an ill-defined CPT operator due to decoherence as a result of quantum gravity environmental degrees of freedom, inaccessible to a low-energy observer. I also discuss briefly the current-era phenomenology of some of the above models; in particular, for the ones involving decoherence-induced CPT violation, I argue that entangled states of neutral mesons (Kaons or B-systems) can provide smoking-gun sensitive tests or even falsify some of these models. If CPT is ill-defined one may also encounter violations of the spin-statistics theorem, with possible consequences for the Pauli Exclusion Principle.

  18. Effect of early or delayed treatment upon healing of mandibular fractures: a systematic literature review

    DEFF Research Database (Denmark)

    Hermund, Niels Ulrich; Hillerup, Søren; Kofod, Thomas

    2008-01-01

    The possible relation between treatment delay and healing complications in mandibular fracture treatment (excluding condylar fractures) was reviewed systematically. Twenty-two studies were identified. No randomized studies focused on the effect of immediate or delayed treatment. The main focus...

  19. Imperfect past and present progressive: beak color reflects early-life and adult exposure to antigen.

    Science.gov (United States)

    Merrill, Loren; Naylor, Madeleine F; Grindstaff, Jennifer L

    2016-01-01

    Secondary sexual traits may convey information about individual condition. We assessed the capacity for immune challenge with lipopolysaccharide (LPS) or keyhole limpet hemocyanin (KLH) during the prenatal and early postnatal stages to impact beak color development and expression in captive zebra finches. In addition, we tested whether adult immune challenge impacted beak color, and if early-life experience was influential. Immune challenge with KLH early in life slowed development of red beak coloration, and males challenged with KLH as nestlings had reduced red coloration as adults. Following adult KLH challenge, males exhibited a decline in beak redness. Birds challenged with KLH during development produced more anti-KLH antibodies after adult challenge. There was a significant interaction between young treatment and anti-KLH antibody production; for males not challenged with KLH early in life, individuals that mounted a weaker antibody response lost more red coloration after challenge than males mounting a stronger antibody response. Based on models of avian vision, these differences in beak coloration should be detectable to the finches. In contrast to previous studies, we found no effect of early-life or adult challenge with LPS on any aspects of beak coloration. These results provide evidence that beak color reflects developmental and current conditions, and that the signal is linked to critical physiological processes.

  20. Urticaria as the initial presentation of early stage Bronchioloalveolar carcinoma: a case report

    Institute of Scientific and Technical Information of China (English)

    HU Hui-hui; YING Ke-jing; WU Xiao-hong; CHAI Ying

    2012-01-01

    Bronchioloalveolar carcinoma is a subtype of the lung adenocarcinoma.Early stage bronchioloalveolar carcinoma is usually asymptomatic,especially in the peripheral lung.Rarely,urticaria has been described occurring with lung cancer,usually small-cell lung cancer,but no case has been reported of the bronchioloalveolar carcinoma yet.We report here a unique and initial urticaria on a patient,lasting for 6 months,who finally was diagnosed as early stage bronchioloalveolar carcinoma (T1aNOMo).After treatment of surgery,the symptom of urticaria disappeared and did not recur.Therefore,we consider that utricaria is a oossibly clinical manifestation in early stage bronchioloalveolar carcinoma.

  1. Impact of leukapheresis on early death rate in adult acute myeloid leukemia presenting with hyperleukocytosis.

    Science.gov (United States)

    Bug, Gesine; Anargyrou, Konstantinos; Tonn, Torsten; Bialleck, Heike; Seifried, Erhard; Hoelzer, Dieter; Ottmann, Oliver G

    2007-10-01

    Patients with acute myeloid leukemia (AML) with hyperleukocytosis of at least 100 x 10(9) per L are at high risk of early death due to pulmonary or cerebral leukostasis. Although the efficacy of leukapheresis in terms of prompt cytoreduction is generally accepted, published data regarding the clinical value of immediate therapeutic leukapheresis are limited and conflicting. To determine whether leukapheresis has a favorable impact on early mortality, the clinical course of 53 newly diagnosed patients with AML and hyperleukocytosis admitted between 1995 and 2005 was analyzed retrospectively. Before August 2001, 28 patients received chemotherapy without leukoreduction (Cohort A). Thereafter, all AML patients with hyperleukocytosis were scheduled to receive leukapheresis, which was performed in 25 patients (Cohort B). There were no procedure-related adverse events. By Day 21 of therapy, 13 of 53 patients had died, resulting in an overall early death rate of 25 percent. In a multivariate logistic regression model, patients in Cohort B had a significantly lower risk of early death than patients in Cohort A (16% vs. 32%, respectively; p = 0.015). Dyspnea (p = 0.005), elevated creatinine (p = 0.028), and higher lactate dehydrogenase serum levels (p = 0.021) were independent risk factors for early death. With a median follow-up of 24.2 months, the overall survival was similar in both cohorts (Cohort A, 7.5; Cohort B, 6.5 months). Thus, leukapheresis had no impact on patients' long-term survivals. Our experience suggests that AML patients with hyperleukocytosis receiving leukapheresis had a significantly lower risk for early death by Day 21 than patients treated without leukapheresis. We therefore have adopted leukapheresis as a standard procedure in our department.

  2. Intervention-Driven Assessment Practices in Early Childhood/Early Intervention: Measuring What Is Possible Rather than What Is Present

    Science.gov (United States)

    VanDerHeyden, Amanda M.

    2005-01-01

    Comments on an article by Marisa G. Macy, Diane D. Bricker, and Jane K. Squires. This commentary presents a distinction between curriculum-based assessment (CBA) and curriculum-based measurement (CBM). CBA has been linked to a mastery measurement model whereas; CBM has been linked to a general outcome measurement model. The primary difference…

  3. Early Diagnosis of Autism Spectrum Disorder: Stability and Change in Clinical Diagnosis and Symptom Presentation

    Science.gov (United States)

    Guthrie, Whitney; Swineford, Lauren B.; Nottke, Charly; Wetherby, Amy M.

    2013-01-01

    Background: Although a diagnosis of autism spectrum disorder (ASD) appears to be stable in children as young as age three, few studies have explored stability of a diagnosis in younger children. Predictive value of diagnostic tools for toddlers and patterns of symptom change are important considerations for clinicians making early diagnoses. Most…

  4. Early Diagnosis of Autism Spectrum Disorder: Stability and Change in Clinical Diagnosis and Symptom Presentation

    Science.gov (United States)

    Guthrie, Whitney; Swineford, Lauren B.; Nottke, Charly; Wetherby, Amy M.

    2013-01-01

    Background: Although a diagnosis of autism spectrum disorder (ASD) appears to be stable in children as young as age three, few studies have explored stability of a diagnosis in younger children. Predictive value of diagnostic tools for toddlers and patterns of symptom change are important considerations for clinicians making early diagnoses. Most…

  5. Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Castro-Avila, Ana Cristina; Serón, Pamela; Fan, Eddy; Gaete, Mónica; Mickan, Sharon

    2015-01-01

    Critically ill survivors may have functional impairments even five years after hospital discharge. To date there are four systematic reviews suggesting a beneficial impact for mobilisation in mechanically ventilated and intensive care unit (ICU) patients, however there is limited information about the influence of timing, frequency and duration of sessions. Earlier mobilisation during ICU stay may lead to greater benefits. This study aims to determine the effect of early rehabilitation for functional status in ICU/high-dependency unit (HDU) patients. Systematic review and meta-analysis. MEDLINE, EMBASE, CINALH, PEDro, Cochrane Library, AMED, ISI web of science, Scielo, LILACS and several clinical trial registries were searched for randomised and non-randomised clinical trials of rehabilitation compared to usual care in adult patients admitted to an ICU/HDU. Results were screened by two independent reviewers. Primary outcome was functional status. Secondary outcomes were walking ability, muscle strength, quality of life, and healthcare utilisation. Data extraction and methodological quality assessment using the PEDro scale was performed by primary reviewer and checked by two other reviewers. The authors of relevant studies were contacted to obtain missing data. 5733 records were screened. Seven articles were included in the narrative synthesis and six in the meta-analysis. Early rehabilitation had no significant effect on functional status, muscle strength, quality of life, or healthcare utilisation. However, early rehabilitation led to significantly more patients walking without assistance at hospital discharge (risk ratio 1.42; 95% CI 1.17-1.72). There was a non-significant effect favouring intervention for walking distance and incidence of ICU-acquired weakness. Early rehabilitation during ICU stay was not associated with improvements in functional status, muscle strength, quality of life or healthcare utilisation outcomes, although it seems to improve walking

  6. Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Ana Cristina Castro-Avila

    Full Text Available Critically ill survivors may have functional impairments even five years after hospital discharge. To date there are four systematic reviews suggesting a beneficial impact for mobilisation in mechanically ventilated and intensive care unit (ICU patients, however there is limited information about the influence of timing, frequency and duration of sessions. Earlier mobilisation during ICU stay may lead to greater benefits. This study aims to determine the effect of early rehabilitation for functional status in ICU/high-dependency unit (HDU patients.Systematic review and meta-analysis. MEDLINE, EMBASE, CINALH, PEDro, Cochrane Library, AMED, ISI web of science, Scielo, LILACS and several clinical trial registries were searched for randomised and non-randomised clinical trials of rehabilitation compared to usual care in adult patients admitted to an ICU/HDU. Results were screened by two independent reviewers. Primary outcome was functional status. Secondary outcomes were walking ability, muscle strength, quality of life, and healthcare utilisation. Data extraction and methodological quality assessment using the PEDro scale was performed by primary reviewer and checked by two other reviewers. The authors of relevant studies were contacted to obtain missing data.5733 records were screened. Seven articles were included in the narrative synthesis and six in the meta-analysis. Early rehabilitation had no significant effect on functional status, muscle strength, quality of life, or healthcare utilisation. However, early rehabilitation led to significantly more patients walking without assistance at hospital discharge (risk ratio 1.42; 95% CI 1.17-1.72. There was a non-significant effect favouring intervention for walking distance and incidence of ICU-acquired weakness.Early rehabilitation during ICU stay was not associated with improvements in functional status, muscle strength, quality of life or healthcare utilisation outcomes, although it seems to

  7. Studies of volatiles and organic materials in early terrestrial and present-day outer solar system environments

    Science.gov (United States)

    Sagan, Carl; Thompson, W. Reid; Chyba, Christopher F.; Khare, B. N.

    1991-01-01

    A review and partial summary of projects within several areas of research generally involving the origin, distribution, chemistry, and spectral/dielectric properties of volatiles and organic materials in the outer solar system and early terrestrial environments are presented. The major topics covered include: (1) impact delivery of volatiles and organic compounds to the early terrestrial planets; (2) optical constants measurements; (3) spectral classification, chemical processes, and distribution of materials; and (4) radar properties of ice, hydrocarbons, and organic heteropolymers.

  8. Early pain after laparoscopic inguinal hernia repair. A qualitative systematic review

    DEFF Research Database (Denmark)

    Tolver, M A; Rosenberg, J; Bisgaard, T

    2012-01-01

    Early post-operative pain after laparoscopic groin hernia repair may, as in other laparoscopic operations, have its own individual pain pattern and patient-related predictors of early pain. The purpose of this review was to characterise pain within the first post-operative week after transabdomin...... pre-peritoneal repair (TAPP) and total extraperitoneal repair (TEP), and to identify patient-related predictors of early pain....

  9. Early Intensive Behavioral Intervention (EIBI) for Young Children with Autism Spectrum Disorders (ASD): A Systematic Review. Campbell Systematic Reviews 2014:9

    Science.gov (United States)

    Reichow, Brian; Barton, Erin E.; Boyd, Brian A.; Hume, Kara

    2014-01-01

    Background: The rising prevalence of autism spectrum disorders (ASD) increases the need for evidence-based behavioral treatments to lessen the impact of symptoms on children's functioning. At present, there are no curative or psychopharmacological therapies to effectively treat all symptoms of the disorder. Early intensive behavioral intervention…

  10. Thermonuclear propaganda: presentations of nuclear strategy in the early atomic age

    OpenAIRE

    Harrington, Brian M.

    2014-01-01

    Approved for public release; distribution is unlimited As the image of the thermonuclear apocalypse loomed over the early years of the Cold War and technological advancements brought the possibility of such a fate closer to reality, the U.S.-Soviet conflict became increasingly a battle for hearts and minds—on the home front as well as among allied populations. However, public diplomacy in a democracy is more complicated than a public relations campaign, for actions often trump words, parti...

  11. PRESENTATION OF A MODIFIED METHOD OF VESTIBULOPLASTY WITH AN EARLY PROSTHETIC LOADING.

    Directory of Open Access Journals (Sweden)

    Desislava Konstantinova

    2015-11-01

    Full Text Available Experience reveals that preliminary surgical correction is quite often expedient in mounting dentures for edentulous jaws. The purpose of the investigation is to introduce a method of vestibuloplasty for edentulous jaws by which the dentures are better held in place and retained. The use of xenoderm grafts with early insertion of the prostheses subsequent to surgical manipulation shows excellent results. Materials and methods: Patients were divided into two groups - with the first group the prosthesis was made prior to surgery and placed on the 7th day after removal of sutures. With the second group the prostheses were made following a complete healing of soft tissue, i.e. 1 month after surgery. With both groups xenoderm grafts were applied to cover the open wound surface area. Results: The post-operative period for both groups of patients proceeded normally and without complications. For the group with early prosthetic loading due to the method of vestibuloplasty it was possible to maintain the depth of the vestibule. Conclusions: The method proposed by the authors using xenoderm grafts and early loading on the newly-formed vestibule has proved a success and implies further in-depth application with larger group of patients.

  12. Early prediction of a benign course of multiple sclerosis on clinical grounds : a systematic review

    NARCIS (Netherlands)

    Ramsaransing, G; Maurits, N; Zwanikken, C; De Keyser, J

    2001-01-01

    Background. There is growing consensus that neurologists should consider disease-modifying therapies early in multiple sclerosis (MS). However there is a subgroup with a natural benign course, in which treatment could be postponed. We sought to determine the frequency of benign MS and early clinical

  13. Effect of early intervention in infants at very high risk of cerebral palsy : A systematic review

    NARCIS (Netherlands)

    Hadders-Algra, Mijna; Boxum, Anke G.; Hielkema, Tjitske; Hamer, Elisa G.

    2017-01-01

    AIM First, to systematically review the evidence on the effect of intervention applied during the first postnatal year in infants with or at very high risk of cerebral palsy (CP) on child and family outcome. Second, to assess whether type and dosing of intervention modify the effect of intervention.

  14. Effect of early intervention in infants at very high risk of cerebral palsy: a systematic review

    NARCIS (Netherlands)

    Hadders-Algra, M.; Boxum, A.G.; Hielkema, T.; Hamer, E.G.

    2017-01-01

    AIM: First, to systematically review the evidence on the effect of intervention applied during the first postnatal year in infants with or at very high risk of cerebral palsy (CP) on child and family outcome. Second, to assess whether type and dosing of intervention modify the effect of intervention

  15. Clean Energy Finance: Challenges and Opportunities of Early-Stage Energy Investing (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Heap, D.; Pless, J.; Aieta, N.

    2013-12-01

    Characterized by a changing landscape and new opportunities, today's increasingly complex energy decision space will need innovative financing and investment models to appropriately assess risk and profitability. This report provides an overview of the current state of clean energy finance across the entire spectrum but with a focus on early stage investing, and it includes insights from investors across all investment classes. Further, this report aims to provide a roadmap with the mechanisms, limitations, and considerations involved in making successful investments by identifying risks, challenges, and opportunities in the clean energy sector.

  16. A systematic review of early rehabilitation methods following a rupture of the Achilles tendon.

    Science.gov (United States)

    Kearney, Rebecca S; McGuinness, Katie R; Achten, Juul; Costa, Matthew L

    2012-03-01

    Rupture of the Achilles tendon is a debilitating injury. Advances have led to the development of immediate weight bearing rehabilitation. A range of early rehabilitation methods exist, but further research is required into this new area. The first stage in the investigation of a complex intervention is to identify its defining components. The aim of this review was to systemically identify and summarise, from clinical studies, the individual components that define immediate weight bearing rehabilitation protocols for the treatment of acute Achilles tendon rupture's. The electronic databases MEDLINE, EMBASE, CINAHL, AMED and the register of current controlled trials were searched up to March 2010. All study designs and languages were included. Two independent reviewers used pre-defined inclusion and exclusion criteria to identify all eligible articles. Eligible articles were summarised and critically reviewed, using the extension of the CONSORT statement for non-pharmacological interventions. Two hundred and fifteen articles were screened, nine were included. These studies, presented the results of 424 patients; 236 who had surgery and 188 who were managed non-operatively. There were a range of rehabilitation protocols that were defined by four components. These components consisted of the degree of maintained plantarflexion, whether daily range of movement exercises were permitted, the type of orthotic and for how long it was worn. The efficacy of different immediate weight bearing rehabilitation protocols following an acute rupture of the Achilles tendon remains unclear. Further research is required to evaluate the identified components to optimise rehabilitation. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  17. Social marketing approaches to nutrition and physical activity interventions in early care and education centres: a systematic review.

    Science.gov (United States)

    Luecking, C T; Hennink-Kaminski, H; Ihekweazu, C; Vaughn, A; Mazzucca, S; Ward, D S

    2017-09-29

    Social marketing is a promising planning approach for influencing voluntary lifestyle behaviours, but its application to nutrition and physical activity interventions in the early care and education setting remains unknown. PubMed, ISI Web of Science, PsycInfo and the Cumulative Index of Nursing and Allied Health were systematically searched to identify interventions targeting nutrition and/or physical activity behaviours of children enrolled in early care centres between 1994 and 2016. Content analysis methods were used to capture information reflecting eight social marketing benchmark criteria. The review included 135 articles representing 77 interventions. Two interventions incorporated all eight benchmark criteria, but the majority included fewer than four. Each intervention included behaviour and methods mix criteria, and more than half identified audience segments. Only one-third of interventions incorporated customer orientation, theory, exchange and insight. Only six interventions addressed competing behaviours. We did not find statistical significance for the effectiveness of interventions on child-level diet, physical activity or anthropometric outcomes based on the number of benchmark criteria used. This review highlights opportunities to apply social marketing to obesity prevention interventions in early care centres. Social marketing could be an important strategy for early childhood obesity prevention efforts, and future research investigations into its effects are warranted. © 2017 World Obesity Federation.

  18. Early versus late surgical intervention or medical management for infective endocarditis: a systematic review and meta-analysis.

    Science.gov (United States)

    Anantha Narayanan, Mahesh; Mahfood Haddad, Toufik; Kalil, Andre C; Kanmanthareddy, Arun; Suri, Rakesh M; Mansour, George; Destache, Christopher J; Baskaran, Janani; Mooss, Aryan N; Wichman, Tammy; Morrow, Lee; Vivekanandan, Renuga

    2016-06-15

    Infective endocarditis is associated with high morbidity and mortality and optimal timing for surgical intervention is unclear. We performed a systematic review and meta-analysis to compare early surgical intervention with conservative therapy in patients with infective endocarditis. PubMed, Cochrane, EMBASE, CINAHL and Google-scholar databases were searched from January 1960 to April 2015. Randomised controlled trials, retrospective cohorts and prospective observational studies comparing outcomes between early surgery at 20 days or less and conservative management for infective endocarditis were analysed. A total of 21 studies were included. OR of all-cause mortality for early surgery was 0.61 (95% CI 0.50 to 0.74, pendocarditis between the overall unmatched cohorts. The results of our meta-analysis suggest that early surgical intervention is associated with significantly lower risk of mortality in patients with infective endocarditis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Response to "Discussion on the systematic position of the Early Cambrian priapulomorph worms"

    Institute of Scientific and Technical Information of China (English)

    HAN Jian; HU Shixue

    2006-01-01

    @@ Due to the combination of complex states of preservation and taphonomies in Chengjiang fossils, Huang et al.[1] expressed different opinions to those of Han et al.[2] on the morphology and systematic position of the fossil priapulomorph worms (Priapulomorpha) based on their additional materials. These diverse opinions are critical in any investigation of the diversity of the Introverta in the Cambrian explosion. However, some of their ideas need to be discussed in further detail.

  20. Inorganic arsenic and respiratory health, from early life exposure to sex-specific effects: A systematic review.

    Science.gov (United States)

    Sanchez, Tiffany R; Perzanowski, Matthew; Graziano, Joseph H

    2016-05-01

    This systematic review synthesizes the diverse body of epidemiologic research accrued on inorganic arsenic exposure and respiratory health effects. Twenty-nine articles were identified that examined the relationship between inorganic arsenic exposure and respiratory outcomes (i.e. lung function, symptoms, acute respiratory infections, chronic non-malignant lung diseases, and non-malignant lung disease mortality). There was strong evidence of a general association between arsenic and non-malignant respiratory illness, including consistent evidence on lung function impairment, acute respiratory tract infections, respiratory symptoms, and non-malignant lung disease mortality. Overall, early life exposure (i.e. in utero and/or early-childhood) had a marked effect throughout the lifespan. This review also identified some research gaps, including limited evidence at lower levels of exposure (water arsenic arsenic and any single non-malignant respiratory disease or pathological process. Common limitations, including potential publication bias; non-comparability of outcome measures across included articles; incomplete exposure histories; and limited confounder control attenuated the cumulative strength of the evidence as it relates to US populations. This systematic review provides a comprehensive assessment of the epidemiologic evidence and should be used to guide future research on arsenic's detrimental effects on respiratory health.

  1. An early career researcher's perspective on presenting flood risk research to the media

    Science.gov (United States)

    Slater, Louise

    2017-04-01

    My research lies at the intersection of three disciplines: hydrology, climatology, and geomorphology, and focusses on understanding the drivers of changing flood hazards to improve flood projections. Because flooding has major impacts on people's lives, and flood losses are projected to continue to increase in future decades, attribution studies are readily picked up by the press. As an Early Career Researcher, I will share my own experiences in communicating flood-related research results (through university press releases, Twitter, blog posts, and interviews), and what I have learnt about the types of strategies that can be followed to increase research dissemination/outreach, and the "Attention Score" of individual papers. In terms of interacting with the media, I will also share some suggestions regarding the types of questions that often arise, as well as awareness strategies to avoid potential pitfalls, misunderstandings or misinterpretations.

  2. Early brain injury and subarachnoid hemorrhage: Where are we at present?

    Directory of Open Access Journals (Sweden)

    Tumul Chowdhury

    2013-01-01

    Full Text Available The current era has adopted many new innovations in nearly every aspect of management of subarachnoid hemorrhage (SAH; however, the neurological outcome has still not changed significantly. These major therapeutic advances mainly addressed the two most important sequels of the SAH-vasospasm and re-bleed. Thus, there is a possibility of some different pathophysiological mechanism that would be responsible for causing poor outcome in these patients. In this article, we have tried to compile the current role of this different yet potentially treatable pathophysiological mechanism in post-SAH patients. The main pathophysiological mechanism for the development of early brain injury (EBI is the apoptotic pathways. The macro-mechanism includes increased intracranial pressure, disruption of the blood-brain barrier, and finally global ischemia. Most of the treatment strategies are still in the experimental phase. Although the role of EBI following SAH is now well established, the treatment modalities for human patients are yet to be testified.

  3. Towards early in vivo photoacoustic malaria diagnosis with 10,000-fold sensitivity improvement (Conference Presentation)

    Science.gov (United States)

    Carey, Kai A.; Menyaev, Yulian A.; Nedosekin, Dmitry A.; Sarimollaoglu, Mustafa; Galanzha, Ekaterina I.; Stumhofer, Jason S.; Zharov, Vladimir P.

    2017-03-01

    Roughly 0.6 million people die each year from malaria due to lack of early diagnosis and well-timed treatment. Our previous study demonstrated great potential of in vivo photoacoustic (PA) flow cytometry (PAFC) for early diagnosis of deadly diseases with focus on cancer and thromboembolic complications. Here we demonstrate potential of advanced PAFC platforms using new laser, ultrasound transducer array and recording system to detect infected red blood cells (iRBCs) with malaria-associated pigment hemozoin which has a higher PA contrast than blood background. Mature parasites of human infecting species such as P. falciparum characteristically sequester mature iRBCs in the capillary bed and display synchrony in their reproductive cycle. To address this issue prior to clinical application, new PAFC platform was verified in a pre-clinical study using new animal models. Specifically, we used P. chabaudi (a rodent malaria species that mimics the characteristics of the most virulent human counterpart) to estimate the detection sensitivity with immature ring-stage parasites in peripheral blood, compared PA signals from the differing species, and examined the relationship between PA signal amplitudes and level of blood oxygenation. Based on previous successful trials on melanoma patients with melanin as an intrinsic PA marker, which has similar absorption as hemozoin, we believe that after additional malaria-related clinical trials, PAFC with a small 1064 nm laser and wearable a cost-effective, easy-to-use, watch-like, safe PA probe will provide malaria diagnosis in humans at parasitemia levels 10e4 -times lower than the current gold standard of diagnosis, the Giemsa-stained blood smear. It can reduce malaria-related mortality by well-timed treatment, especially in children in malaria-endemic countries.

  4. Optical mapping of conduction in early embryonic quail hearts with light-sheet microscopy (Conference Presentation)

    Science.gov (United States)

    Ma, Pei; Gu, Shi; Wang, Yves T.; Jenkins, Michael W.; Rollins, Andrew M.

    2016-03-01

    Optical mapping (OM) using fluorescent voltage-sensitive dyes (VSD) to measure membrane potential is currently the most effective method for electrophysiology studies in early embryonic hearts due to its noninvasiveness and large field-of-view. Conventional OM acquires bright-field images, collecting signals that are integrated in depth and projected onto a 2D plane, not capturing the 3D structure of the sample. Early embryonic hearts, especially at looping stages, have a complicated, tubular geometry. Therefore, conventional OM cannot provide a full picture of the electrical conduction circumferentially around the heart, and may result in incomplete and inaccurate measurements. Here, we demonstrate OM of Hamburger and Hamilton stage 14 embryonic quail hearts using a new commercially-available VSD, Fluovolt, and depth sectioning using a custom built light-sheet microscopy system. Axial and lateral resolution of the system is 14µm and 8µm respectively. For OM imaging, the field-of-view was set to 900µm×900µm to cover the entire heart. 2D over time OM image sets at multiple cross-sections through the looping-stage heart were recorded. The shapes of both atrial and ventricular action potentials acquired were consistent with previous reports using conventional VSD (di-4-ANNEPS). With Fluovolt, signal-to-noise ratio (SNR) is improved significantly by a factor of 2-10 (compared with di-4-ANNEPS) enabling light-sheet OM, which intrinsically has lower SNR due to smaller sampling volumes. Electrophysiologic parameters are rate dependent. Optical pacing was successfully integrated into the system to ensure heart rate consistency. This will also enable accurately gated reconstruction of full four dimensional conduction maps and 3D conduction velocity measurements.

  5. The Clinical Utility and Diagnostic Performance of MRI for Identification of Early and Advanced Knee Osteoarthritis: A Systematic Review

    Science.gov (United States)

    Quatman, Carmen E.; Hettrich, Carolyn M.; Schmitt, Laura C.; Spindler, Kurt P.

    2013-01-01

    Background Current diagnostic strategies for detection of structural articular cartilage abnormalities, the earliest structural signs of osteoarthritis, often do not capture the condition until it is too far advanced for the most potential benefit of non-invasive interventions. Purpose Systematically review the literature relative to the following questions: (1) Is MRI a valid, sensitive, specific, accurate and reliable instrument to identify knee articular cartilage abnormalities compared to arthroscopy? (2) Is MRI a sensitive tool that can be utilized to identify early cartilage degeneration? Study Design Systematic Review Methods A systematic search was performed in November 2010 using PubMed MEDLINE (from 1966), CINAHL (from 1982), SPORTDiscus (from 1985), and SCOPUS (from 1996) databases. Results Fourteen level I and 13 level II studies were identified that met inclusion criteria and provided information related to diagnostic performance of MRI compared to arthroscopic evaluation. The diagnostic performance of MRI demonstrated a large range of sensitivities, specificities, and accuracies. The sensitivity for identifying articular cartilage abnormalities in the knee joint was reported between 26–96%. Specificity and accuracy was reported between 50–100% and 49–94%, respectively. The sensitivity, specificity, and accuracy for identifying early osteoarthritis were reported between 0–86%, 48–95%, and 5–94%, respectively. As a result of inconsistencies between imaging techniques and methodological shortcomings of many of the studies, a meta-analysis was not performed and it was difficult to fully synthesize the information to state firm conclusions about the diagnostic performance of MRI. Conclusions There is evidence in some MRI protocols that MRI is a relatively valid, sensitive, specific, accurate, and reliable clinical tool for identifying articular cartilage degeneration. Due to heterogeneity of MRI sequences it is not possible to make definitive

  6. Systematic review of the use of dried blood spots for monitoring HIV viral load and for early infant diagnosis.

    Directory of Open Access Journals (Sweden)

    Pieter W Smit

    Full Text Available BACKGROUND: Dried blood spots (DBS have been used as alternative specimens to plasma to increase access to HIV viral load (VL monitoring and early infant diagnosis (EID in remote settings. We systematically reviewed evidence on the performance of DBS compared to plasma for VL monitoring and EID. METHODS AND FINDINGS: Thirteen peer reviewed HIV VL publications and five HIV EID papers were included. Depending on the technology and the viral load distribution in the study population, the percentage of DBS samples that are within 0.5 log of VL in plasma ranged from 52-100%. Because the input sample volume is much smaller in a blood spot, there is a risk of false negatives with DBS. Sensitivity of DBS VL was found to be 78-100% compared to plasma at VL below 1000 copies/ml, but this increased to 100% at a threshold of 5000 copies/ml. Unlike a plasma VL test which measures only cell free HIV RNA, a DBS VL also measures proviral DNA as well as cell-associated RNA, potentially leading to false positive results when using DBS. The systematic review showed that specificity was close to 100% at DBS VL above 5000 copies/ml, and this threshold would be the most reliable for predicting true virologic failure using DBS. For early infant diagnosis, DBS has a sensitivity of 100% compared to fresh whole blood or plasma in all studies. CONCLUSIONS: Although limited data are available for EID, DBS offer a highly sensitive and specific sampling strategy to make viral load monitoring and early infant diagnosis more accessible in remote settings. A standardized approach for sampling, storing, and processing DBS samples would be essential to allow successful implementation. TRIAL REGISTRATION: PROSPERO Registration #: CRD42013003621.

  7. Systematic Review of the Use of Dried Blood Spots for Monitoring HIV Viral Load and for Early Infant Diagnosis

    Science.gov (United States)

    Smit, Pieter W.; Sollis, Kimberly A.; Fiscus, Susan; Ford, Nathan; Vitoria, Marco; Essajee, Shaffiq; Barnett, David; Cheng, Ben; Crowe, Suzanne M.; Denny, Thomas; Landay, Alan; Stevens, Wendy; Habiyambere, Vincent; Perriens, Joseph H.; Peeling, Rosanna W.

    2014-01-01

    Background Dried blood spots (DBS) have been used as alternative specimens to plasma to increase access to HIV viral load (VL) monitoring and early infant diagnosis (EID) in remote settings. We systematically reviewed evidence on the performance of DBS compared to plasma for VL monitoring and EID. Methods and Findings Thirteen peer reviewed HIV VL publications and five HIV EID papers were included. Depending on the technology and the viral load distribution in the study population, the percentage of DBS samples that are within 0.5 log of VL in plasma ranged from 52–100%. Because the input sample volume is much smaller in a blood spot, there is a risk of false negatives with DBS. Sensitivity of DBS VL was found to be 78–100% compared to plasma at VL below 1000 copies/ml, but this increased to 100% at a threshold of 5000 copies/ml. Unlike a plasma VL test which measures only cell free HIV RNA, a DBS VL also measures proviral DNA as well as cell-associated RNA, potentially leading to false positive results when using DBS. The systematic review showed that specificity was close to 100% at DBS VL above 5000 copies/ml, and this threshold would be the most reliable for predicting true virologic failure using DBS. For early infant diagnosis, DBS has a sensitivity of 100% compared to fresh whole blood or plasma in all studies. Conclusions Although limited data are available for EID, DBS offer a highly sensitive and specific sampling strategy to make viral load monitoring and early infant diagnosis more accessible in remote settings. A standardized approach for sampling, storing, and processing DBS samples would be essential to allow successful implementation. Trial Registration PROSPERO Registration #: CRD42013003621. PMID:24603442

  8. Early enteral and parenteral nutritional support after hepatectomy in patients with hepatic carcinoma: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Gao LB

    2015-03-01

    Full Text Available Lin-Ben Gao,1* He Tian,2* Xing-Guang Wang,3 Xiao-Fei Yu,4 Yan Guan,2 Ming-Lu Chen,5 Jian Zhang6 1Department of Respiratory Medicine, Haiyang People’s Hospital, Haiyang, 2Department of Oncology, Shandong Province Tumor Hospital, Jinnan, 3Department of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinnan, 4Department of Emergency, Haiyang People’s Hospital, Haiyang, 5Department of Nuclear Radiology, Shandong Province Tumor Hospital, Jinnan, 6Department of Gastroenterology, Haiyang People’s Hospital, Haiyang, People’s Republic of China *These two authors contributed equally to this work Background: This study sought to conduct a systematic review providing a comparative analysis of enteral nutrition (EN and parenteral nutrition (PN after hepatectomy. Methods: PubMed, Embase, and the China National Knowledge Infrastructure databases were searched for publications describing randomized controlled trials that compared early EN and PN after hepatectomy. The time period for this search was from January 1990 to December 2013. In accordance with the inclusion criteria of this study, two researchers independently screened the retrieved literature, extracted data, and assessed methodological quality. A meta-analysis of the included publications was then performed using RevMan 5.2 software. Results: The meta-analysis results indicated statistically significant differences between the group that received EN and the group that received PN during the early stages after hepatectomy with respect to average total bilirubin and alanine aminotransferase levels after nutrition, prealbumin levels, incidence of diarrhea and abdominal bloating, time to flatus, and average cost of nutrition. To varying degrees, better results were observed in the EN group than in the PN group for these metrics. Conclusion: During the early stages after hepatectomy, EN has obvious advantages relative to PN; thus, EN merits more widespread promotion

  9. Early diagnosis of rheumatic diseases: an evaluation of the present situation and proposed changes.

    Science.gov (United States)

    Kwiatkowska, Brygida; Raciborski, Filip; Kłak, Anna; Maślińska, Maria; Gryglewicz, Jerzy

    2015-01-01

    Musculoskeletal pain is a very common complaint, affecting 30-40% of the European population. It is estimated that approximately 400,000 Poles suffer from inflammatory rheumatic diseases, such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis, and a vast majority of those affected are working-age individuals. Patients with suspected arthritis require prompt diagnosis and treatment, as any delays may result in irreversible joint destruction and disability. Currently in Poland, the lag time between the onset of symptoms and diagnosis is, on average, as much as 35 weeks. In this paper, we review the current state of specialist rheumatology care in Poland and propose a reorganised care model that includes early diagnosis of inflammatory arthritis. The main goal we wish to achieve with our reorganised model is to enhance access to outpatient specialist rheumatology care for patients with suspected arthritis. We believe that our model should make it possible to considerably reduce the lag time between GP referral and the diagnosis and treatment by a rheumatologist to as little as 3 to 4 weeks. This article provides a proposal of changes that would achieve this goal and is a summary of the report published by the Institute of Rheumatology in September 2014.

  10. Breast MRI in clinically and mammographically occult breast cancer presenting with an axillary metastasis: a systematic review

    OpenAIRE

    Bresser, J; De Vos, B.; van der Ent, F.; Hulsewé, K.

    2010-01-01

    Abstract Background Axillary metastatic lymphadenopathy with no primary tumour identified in the breast on physical examination, mammography or ultrasound is referred to as occult breast cancer. The goal of this systematic review is to give an overview of the value and additional considerations of using breast MRI in occult breast cancer. Methods The databases of Pubmed, Embase, CINAHL and the Cochrane library were searched for studies addressing th...

  11. Mood disorder as an early presentation of epidermoid of quadrigeminal cistern

    Directory of Open Access Journals (Sweden)

    Sujita Kumar Kar

    2017-01-01

    Full Text Available Intracranial epidermoids are space-occupying lesions of rare variant. Although cerebropontine angle and parasellar region are common sites of occurrence, it has been reported in various other parts of the intracranial cavity. Headache and features of increased intracranial tension are the common clinical manifestation. Report of psychiatric symptoms as the initial presentation of epidermoid is not known in literature except a single case report, which describes mutism to be the manifestation of intracranial epidermoid. We present here the case of a young male, who presented with long depressive episode persisting for 3 years with subsequent switch to mania, which persisted for more than 3 years. An episode of unconsciousness warranted neuroimaging, which revealed a large epidermoid of the quadrigeminal cistern. Surgical resection of the epidermoid was done. Persisting mood symptoms had responded to mood stabilizer and antipsychotic treatment.

  12. Mood Disorder as an Early Presentation of Epidermoid of Quadrigeminal Cistern.

    Science.gov (United States)

    Kar, Sujita Kumar; Das, Kuntal Kanti; Jaiswal, Awadhesh Kumar; Jaiswal, Sushila

    2017-01-01

    Intracranial epidermoids are space-occupying lesions of rare variant. Although cerebropontine angle and parasellar region are common sites of occurrence, it has been reported in various other parts of the intracranial cavity. Headache and features of increased intracranial tension are the common clinical manifestation. Report of psychiatric symptoms as the initial presentation of epidermoid is not known in literature except a single case report, which describes mutism to be the manifestation of intracranial epidermoid. We present here the case of a young male, who presented with long depressive episode persisting for 3 years with subsequent switch to mania, which persisted for more than 3 years. An episode of unconsciousness warranted neuroimaging, which revealed a large epidermoid of the quadrigeminal cistern. Surgical resection of the epidermoid was done. Persisting mood symptoms had responded to mood stabilizer and antipsychotic treatment.

  13. Infective endocarditis: Clinical presentation, etiology, and early predictors of in-hospital case fatality.

    Science.gov (United States)

    Pilmis, B; Mizrahi, A; Laincer, A; Couzigou, C; El Helali, N; Nguyen Van, J-C; Abassade, P; Cador, R; Le Monnier, A

    2016-02-01

    We aimed to assess the clinical presentation, microbial etiology and outcome of patients presenting with infective endocarditis (IE). We conducted a four-year retrospective study including all patients presenting with IE. We included 121 patients in the study. The median age was 74.8years. Most patients had native valve IE (57%). Staphylococcus aureus accounted for 24.8% of all IE. Surgery was indicated for 70 patients (57.9%) but actually performed in only 55 (44.7%). Factors associated with surgery were younger age (P=0.002) and prosthetic valve IE (P=0.001). Risk factors associated with in-hospital mortality were diabetes mellitus (OR=3.17), chronic renal insufficiency (OR=6.62), and surgical indication (OR=3.49). Mortality of patients who underwent surgery was one sixth of that of patients with surgical indication who did not have the surgery (P<0.001). Copyright © 2016. Published by Elsevier SAS.

  14. The Past and the Present in the Early Novels of Hanns-Josef Ortheil

    Directory of Open Access Journals (Sweden)

    Ernestine Schlant

    1994-06-01

    Full Text Available Hanns-Josef Ortheil's early novels Fermer , 1979 and Hecke , 1983 have male protagonists who search for self-identity in the West Germany of the 1980s. In the process, they discover that they are profoundly influenced by the lives and experiences of their parents, particularly as these lives were shaped during and by the Hitler regime. In Fermer , the 19-year old protagonist rebels against this society by going AWOL. Yet in his geographical flight and intellectual analyses he realizes his deep emotional bonds with the expectations and behavior of the parent generation. Recognition of these bonds is only the first step on a Iong and painful road toward personally independent and politically responsible adulthood. An exploration of the key concepts of order and Geborgenheit (being protected reveals the deep-seated ambiguities in the postwar mentality of the parent generation as it is trying to instill these sentiments in their successors. The 30-year old protagonist of Hecke pieces together his mother's traumatized life during and after the Hitler regime in order to understand her emotionally stultifying hold on him. He comes to understand the manipulative power of her suffering and realizes that he must shed the burden of her displaced needs if he hopes to attain a conscious, mature self-identity. The use and the manipulation of language and its silences are the prime target of the narrator's efforts to penetrate the "protective hedges" of untold stories. Both novels conclude with the protagonists' intellectual insights into their psychological and socially conditioned make-up, but they do not—yet—carry these insights into action.

  15. The Need for More Effective Father Involvement in Early Autism Intervention: A Systematic Review and Recommendations

    Science.gov (United States)

    Flippin, Michelle; Crais, Elizabeth R.

    2011-01-01

    Fathers of children with autism spectrum disorders (ASD) are underrepresented in both early intervention and research. However, fathers have unique interaction styles that make important contributions to the language and symbolic play development of typically developing children. Fathers may make similar contributions to the development of their…

  16. Early Prediction of Outcome of Activities of Daily Living After Stroke A Systematic Review

    NARCIS (Netherlands)

    Veerbeek, Janne M.; Kwakkel, Gert; van Wegen, Erwin E. H.; Ket, Johannes C. F.; Heymans, Martijn W.

    Background and Purpose-Knowledge about robust and unbiased factors that predict outcome of activities of daily living (ADL) is paramount in stroke management. This review investigates the methodological quality of prognostic studies in the early poststroke phase for final ADL to identify variables

  17. Obesity Prevention Interventions in Early Childhood Education and Care Settings with Parental Involvement: A Systematic Review

    Science.gov (United States)

    Morris, Heather; Skouteris, Helen; Edwards, Susan; Rutherford, Leonie

    2015-01-01

    Partnering early childhood education and care (ECEC) and the home together may be more effective in combating obesogenic risk factors in preschool children. Thus, an evaluation of ECEC obesity prevention interventions with a parental component was conducted, exploring parental engagement and its effect on obesity and healthy lifestyle outcomes. A…

  18. Obesity Prevention Interventions in Early Childhood Education and Care Settings with Parental Involvement: A Systematic Review

    Science.gov (United States)

    Morris, Heather; Skouteris, Helen; Edwards, Susan; Rutherford, Leonie

    2015-01-01

    Partnering early childhood education and care (ECEC) and the home together may be more effective in combating obesogenic risk factors in preschool children. Thus, an evaluation of ECEC obesity prevention interventions with a parental component was conducted, exploring parental engagement and its effect on obesity and healthy lifestyle outcomes. A…

  19. Early Prediction of Outcome of Activities of Daily Living After Stroke A Systematic Review

    NARCIS (Netherlands)

    Veerbeek, Janne M.; Kwakkel, Gert; van Wegen, Erwin E. H.; Ket, Johannes C. F.; Heymans, Martijn W.

    2011-01-01

    Background and Purpose-Knowledge about robust and unbiased factors that predict outcome of activities of daily living (ADL) is paramount in stroke management. This review investigates the methodological quality of prognostic studies in the early poststroke phase for final ADL to identify variables t

  20. Early surgical intervention and its impact on patients presenting with necrotizing soft tissue infections: A single academic center experience

    Directory of Open Access Journals (Sweden)

    George J Hadeed

    2016-01-01

    Full Text Available Objectives: Early diagnosis and emergent surgical debridement of necrotizing soft tissue infections (NSTIs remains the cornerstone of care. We aimed to study the effect of early surgery on patients' outcomes and, in particular, on hospital length of stay (LOS and Intensive Care Unit (ICU LOS. Materials and Methods: Over a 6-year period (January 2003 through December 2008, we analyzed the records of patients with NSTIs. We divided patients into two groups based on the time of surgery (i.e., the interval from being diagnosed and surgical intervention: Early (<6 h and late (≥6 h intervention groups. For these two groups, we compared baseline demographic characteristics, symptoms, and outcomes. For our statistical analysis, we used the Student's t-test and Pearson Chi-square (χ2 test. To evaluate the clinical predictors of early diagnosis of NSTIs, we performed multivariate logistic regression analysis. Results: In the study population (n = 87; 62% males and 38% females, age, gender, wound locations, and comorbidities were comparable in the two groups. Except for higher proportion of crepitus, the clinical presentations showed no significant differences between the two groups. There were significantly shorter hospital LOS and ICU LOS in the early than late intervention group. The overall mortality rate in our study patients with NSTIs was 12.5%, but early intervention group had a mortality of 7.5%, but this did not reach statistical significance. Conclusions: Our findings show that early surgery, within the first 6 h after being diagnosed, improves in-hospital outcomes in patients with NSTIs.

  1. A Systematic Literature Review and Meta-Regression Analysis on Early-Life Energy Restriction and Cancer Risk in Humans

    Science.gov (United States)

    Elands, Rachel J. J.; Simons, Colinda C. J. M.; van Dongen, Martien; Schouten, Leo J.; Verhage, Bas A. J.; van den Brandt, Piet A.; Weijenberg, Matty P.

    2016-01-01

    Background In animal models, long-term moderate energy restriction (ER) is reported to decelerate carcinogenesis, whereas the effect of severe ER is inconsistent. The impact of early-life ER on cancer risk has never been reviewed systematically and quantitatively based on observational studies in humans. Objective We conducted a systematic review of observational studies and a meta-(regression) analysis on cohort studies to clarify the association between early-life ER and organ site-specific cancer risk. Methods PubMed and EMBASE (1982 –August 2015) were searched for observational studies. Summary relative risks (RRs) were estimated using a random effects model when available ≥3 studies. Results Twenty-four studies were included. Eleven publications, emanating from seven prospective cohort studies and some reporting on multiple cancer endpoints, met the inclusion criteria for quantitative analysis. Women exposed to early-life ER (ranging from 220–1660 kcal/day) had a higher breast cancer risk than those not exposed (RRRE all ages = 1.28, 95% CI: 1.05–1.56; RRRE for 10–20 years of age = 1.21, 95% CI: 1.09–1.34). Men exposed to early-life ER (ranging from 220–800kcal/day) had a higher prostate cancer risk than those not exposed (RRRE = 1.16, 95% CI: 1.03–1.30). Summary relative risks were not computed for colorectal cancer, because of heterogeneity, and for stomach-, pancreas-, ovarian-, and respiratory cancer because there were <3 available studies. Longer duration of exposure to ER, after adjustment for severity, was positively associated with overall cancer risk in women (p = 0.02). Ecological studies suggest that less severe ER is generally associated with a reduced risk of cancer. Conclusions Early-life transient severe ER seems to be associated with increased cancer risk in the breast (particularly ER exposure at adolescent age) and prostate. The duration, rather than severity of exposure to ER, seems to positively influence relative risk

  2. Development of the hematopoietic system and disorders of hematopoiesis that present during infancy and early childhood.

    Science.gov (United States)

    Fernández, Karen S; de Alarcón, Pedro A

    2013-12-01

    This article reviews the ontogeny of hematopoiesis (embryonic/fetal/newborn phases) and its regulation and provides examples of the disorders of hematopoiesis that present in the newborn or infant and their pathophysiology. Many of these disorders are discussed in depth in other articles of this issue.

  3. Huntington Disease: A Case Study of Early Onset Presenting as Depression

    Science.gov (United States)

    Duesterhus, Pia; Schimmelmann, Benno Graf; Wittkugel, Oliver; Schulte-Markwort, Michael

    2004-01-01

    Huntington disease is a dominantly inherited, neurodegenerative disease characterized by choreiform movement disturbances and dementia, usually with adult onset. The rare juvenile-onset Huntington disease differs from the adult phenotype. A case presenting twice, at age 10 with all the signs of a major depression and age 14 with mutism and…

  4. Local anaesthetic infiltration for the rubber band ligation of early symptomatic haemorrhoids: a systematic review and meta-analysis.

    Science.gov (United States)

    Sajid, M S; Bhatti, M I; Caswell, J; Sains, P; Baig, M K

    2015-03-01

    The objective of this article is to systematically analyse the randomized, controlled trials evaluating the effectiveness of local anaesthetic infiltration prior to the rubber band ligation of early symptomatic haemorrhoids. Published randomized, controlled trials comparing the use of local anaesthetic (LA) versus no-local anaesthetic (NLA) for the rubber band ligation of early symptomatic haemorrhoids were analysed using RevMan®, and the combined outcomes were expressed as odds ratios (OR) and standardized mean difference (SMD). Four randomized, controlled trials evaluating 387 patients were retrieved from the standard electronic databases. The risk of treatment failure (OR 0.44; 95% CI 0.07, 2.79; z = 0.87; p = 0.39) and post-procedure complications (OR 0.48; 95% CI 0.08, 2.76; z = 0.83; p = 0.41) was similar between two techniques. However, the post-procedure pain score (SMD -5.19; 95% CI -9.08, -1.30; z = 2.62; p rubber band ligation of haemorrhoids under local anaesthetic injection. The use of LA appears to have clinically measurable advantages over NLA in the rubber band ligation of early symptomatic haemorrhoids to lessen post-procedure pain.

  5. Early metastasis to anterior abdominal wall following radical cystectomy: A rare presentation.

    Science.gov (United States)

    Sawant, Ajit; Bansal, Sumit; Pawar, Prakash; Kasat, Gaurav

    2016-01-01

    Abdominal wall metastasis from urothelial cancer is extremely rare and very few such cases have been reported in the literature. As such the treatment protocols are not so well defined. We present an interesting case of a 65-year-old male patient, known case of chronic kidney disease, who presented with a large, fungating infraumbilical mass 8 months postradical cystectomy. The mass involved full thickness anterior abdominal wall and small bowel including the ileal conduit. Wide excision of the mass along with adhered bowel loops and partial excision of the ileal conduit with right ureteric reimplant was performed. The large defect in the anterior abdominal wall was closed using a mesh (permanent with a bioresorbable coating inside) and myocutaneous thigh flap. The histopathological examination of the excised mass was consistent with secondary from the urothelial tumor.

  6. Early metastasis to anterior abdominal wall following radical cystectomy: A rare presentation

    Directory of Open Access Journals (Sweden)

    Ajit Sawant

    2016-01-01

    Full Text Available Abdominal wall metastasis from urothelial cancer is extremely rare and very few such cases have been reported in the literature. As such the treatment protocols are not so well defined. We present an interesting case of a 65-year-old male patient, known case of chronic kidney disease, who presented with a large, fungating infraumbilical mass 8 months postradical cystectomy. The mass involved full thickness anterior abdominal wall and small bowel including the ileal conduit. Wide excision of the mass along with adhered bowel loops and partial excision of the ileal conduit with right ureteric reimplant was performed. The large defect in the anterior abdominal wall was closed using a mesh (permanent with a bioresorbable coating inside and myocutaneous thigh flap. The histopathological examination of the excised mass was consistent with secondary from the urothelial tumor.

  7. Early nasogastric enteral nutrition for severe acute pancreatitis: A systematic review

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To evaluate the effectiveness and safety of early nasogastric enteral nutrition (NGEN) for patients with severe acute pancreatitis (SAP).METHODS: We searched Cochrane Central Register of Controlled Trials (Issue 2, 2006), Pub-Medline (1966-2006), and references from relevant articles. We included randomized controlled trials (RCTs) only, which reported the mortality of SAP patients at least. Two reviewers assessed the quality of each trial and collected data independently. The Cochrane Collaboration's RevMan 4.2.9 software was used for statistical analysis.RESULTS: Three RCTs were included, involving 131 patients. The baselines of each trial were comparable.Meta-analysis showed no significant differences in mortality rate of SAP patients between nasogastric and conventional routes (RR = 0.76, 95% CI = 0.37 and 1.55, P = 0.45), and in other outcomes, including time of hospital stay (weighted mean difference = -5.87,95% CI = -20.58 and 8.84, P = 0.43), complication rate of infection (RR = 1.41, 95% CI = 0.62 and 3.23, P =0.41) or multiple organ deficiency syndrome (RR = 0.97,95% CI = 0.27 and 3.47, P = 0.97), rate of admission to ICU (RR = 1.00, 95% CI = 0.48 and 2.09, P = 0.99) or conversion to surgery (RR = 0.66, 95% CI = 0.12 and 3.69, P = 0.64), as well as recurrence of re-feeding pain and adverse events associated with nutrition.CONCLUSION: Early NGEN is a breakthrough in the management of SAP. Based on current studies, early NGEN appears effective and safe. Since the available evidence is poor in quantity, it is hard to make an accurate evaluation of the role of early NGEN in SAP.Before recommendation to clinical practice, further high qualified, large scale, randomized controlled trials are needed.

  8. Diagnosis, prognosis and classification of early arthritis: results of a systematic review informing the 2016 update of the EULAR recommendations for the management of early arthritis

    Science.gov (United States)

    Hua, Charlotte; Daien, Claire I; Combe, Bernard; Landewe, Robert

    2017-01-01

    Objective To update the evidence pertaining to the diagnosis, prognosis and classification of patients with early arthritis (EA), and to inform the 2016 European League Against Rheumatism (EULAR) recommendations for the management of patients with EA. Methods MEDLINE, EMBASE and Cochrane databases were searched up to October 2015. The first part of the systematic literature review (SLR) involved a search for studies investigating the recognition and referral of EA. The second part involved a search for studies to identify the place of laboratory and imaging tests in establishing a diagnosis and a prognosis in patients with EA. Results Regarding the issue of referral of patients with EA (1643 hits), 4 studies were included. These studies were in support of early referral for patients with EA. Regarding the issue of diagnosis and prognosis of patients with EA (11 435 hits), 88 studies were included, evaluating mainly the value of rheumatoid factor (RF) and anticitrullinated-peptide antibodies (ACPAs). Sensitivity of these antibodies for a RA diagnosis in patients with EA was moderate (40–80%). Specificity was higher, notably for ACPAs (frequently >80%). ACPAs also showed better prognostic performance than RF (negative predictive values around 80%). We confirmed that structural damage on baseline X-rays is predictive of further radiographic progression in patients with EA. Regarding other imaging modalities, data are sparse. Conclusions This SLR highlights the importance of early referral for patients with EA and confirms that RF and mainly ACPAs as well as a search for structural X-rays changes may help in the diagnosis and prognosis of patients with EA. PMID:28155923

  9. Non-pharmacological and pharmacological interventions in patients with early arthritis: a systematic literature review informing the 2016 update of EULAR recommendations for the management of early arthritis.

    Science.gov (United States)

    Daien, Claire Immediato; Hua, Charlotte; Combe, Bernard; Landewe, Robert

    2017-01-01

    To perform a systematic literature review (SLR) on pharmacological and non-pharmacological treatments, in order to inform the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis (EA). The expert committee defined research questions concerning non-pharmacological interventions, patient information and education, non-steroidal anti-inflammatory drug, glucocorticoid (GC) and disease-modifying antirheumatic drugs (DMARDs) use, as well as on disease monitoring. The SLR included articles published after the last EULAR SLR until November 2015 found in the MEDLINE, EMBASE and Cochrane databases and abstracts from the 2014 and 2015 American College of Rheumatology and EULAR conferences. Exercise programmes may improve pain and physical function in patients with EA. Patients with EA treated within the first 3 months of symptoms have better clinical and radiological outcomes than those treated beyond 3 months. The clinical and radiological efficacy of GCs is confirmed, with similar efficacy of oral and parenteral administrations. Long-term data raise concerns regarding cardiovascular safety when using GCs. Step-up DMARD therapy is as effective as intensive DMARD therapy 'ab initio' for the long-term outcome of EA. Short-term superiority of intensive therapy with bDMARDs is not maintained on withdrawal of bDMARD. Patients with early psoriatic arthritis have better skin and joint outcomes when tight control is used compared to standard care. The findings confirm the beneficial effect of exercise programmes and the importance of early drug therapy and tight control. They support the use of methotrexate and GCs as first-line drugs, although the long-term use of GCs raises safety concerns.

  10. Non-pharmacological and pharmacological interventions in patients with early arthritis: a systematic literature review informing the 2016 update of EULAR recommendations for the management of early arthritis

    Science.gov (United States)

    DAIEN, Claire Immediato; HUA, Charlotte; COMBE, Bernard; LANDEWE, Robert

    2017-01-01

    Objective To perform a systematic literature review (SLR) on pharmacological and non-pharmacological treatments, in order to inform the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis (EA). Methods The expert committee defined research questions concerning non-pharmacological interventions, patient information and education, non-steroidal anti-inflammatory drug, glucocorticoid (GC) and disease-modifying antirheumatic drugs (DMARDs) use, as well as on disease monitoring. The SLR included articles published after the last EULAR SLR until November 2015 found in the MEDLINE, EMBASE and Cochrane databases and abstracts from the 2014 and 2015 American College of Rheumatology and EULAR conferences. Results Exercise programmes may improve pain and physical function in patients with EA. Patients with EA treated within the first 3 months of symptoms have better clinical and radiological outcomes than those treated beyond 3 months. The clinical and radiological efficacy of GCs is confirmed, with similar efficacy of oral and parenteral administrations. Long-term data raise concerns regarding cardiovascular safety when using GCs. Step-up DMARD therapy is as effective as intensive DMARD therapy ‘ab initio’ for the long-term outcome of EA. Short-term superiority of intensive therapy with bDMARDs is not maintained on withdrawal of bDMARD. Patients with early psoriatic arthritis have better skin and joint outcomes when tight control is used compared to standard care. Conclusions The findings confirm the beneficial effect of exercise programmes and the importance of early drug therapy and tight control. They support the use of methotrexate and GCs as first-line drugs, although the long-term use of GCs raises safety concerns.

  11. A late-diagnosed phenylketonuria case presenting with autism spectrum disorder in early childhood.

    Science.gov (United States)

    Mazlum, Betül; Anlar, Banu; Kalkanoğlu-Sivri, H Serap; Karlı-Oğuz, Kader; Özusta, Şeniz; Ünal, Fatih

    2016-01-01

    Phenylketonuria is one of the most prevalent autosomal recessive hereditary disorders in Turkey. If untreated, it results in severe brain damage and can also be associated with autism in certain patients. We present a three-year old boy who exhibited the symptoms of autism and was subsequently diagnosed with phenylketonuria. This case illustrates that because the majority of autism cases are idiopathic, an occasional patient with a metabolic disorder might be overlooked especially in the era of newborn screening. We also discuss the possible pathogenetic processes leading to autistic symptoms in phenylketonuria, and wish to draw attention to the possibility of cases missed in the screening program because of less than 100% coverage or insufficient food intake before blood sampling. Clinicians should keep in mind the possibility of treatable disorders in children with autism even when such disorders appear unlikely.

  12. [The relationship between the effectiveness and specific features of the early postoperative rehabilitation of the patients presenting with cholelithiasis].

    Science.gov (United States)

    Poddubnaya, O A; Marsheva, S I

    2015-01-01

    The objective of the early postoperative rehabilitation of the patients presenting with cholelithiasis is to prevent the further progression of the disease and reduce the risk of development of post-cholecystectomy disorders. The combined treatment including the use of low-mineralized mineral waters, magnetic, laser, and EHF-therapy makes it possible to significantly improve the parameters of interest due to the marked improve mentor normalization of the clinical and laboratory characteristics, the increase of adaptive capabilities, and the correction of the psycho-emotional and vegetative status of the patients. Taken together, the peculiarities of the combined rehabilitative treatment of the patients with cholelithiasis during the early postoperative period account for its high clinical effectiveness amounting to 94.7%. The results of the study give reason to recommend the application of the proposed technology for the rehabilitative treatment of the patients presenting with cholelithiasis.

  13. Essentiality of early diagnosis of molar incisor hypomineralization in children and review of its clinical presentation, etiology and management.

    Science.gov (United States)

    Garg, Nishita; Jain, Abhay Kumar; Saha, Sonali; Singh, Jaspal

    2012-09-01

    Molar incisor hypomineralization (MIH) is a common developmental condition resulting in enamel defects in first permanent molars and permanent incisors. It presents at eruption of these teeth. One to four molars, and often also the incisors, could be affected. Since first recognized, the condition has been puzzling and interpreted as a distinct phenomenon unlike other enamel disturbances. Early diagnosis is essential since, rapid breakdown of tooth structure may occur, giving rise to acute symptoms and complicated treatment. The purpose of this article is to review MIH and illustrate its diagnosis and clinical management in young children. How to cite this article: Garg N, Jain AK, Saha S, Singh J. Essentiality of Early Diagnosis of Molar Incisor Hypomineralization in Children and Review of its Clinical Presentation, Etiology and Management. Int J Clin Pediatr Dent 2012;5(3):190-196.

  14. Early risk and protective factors for problem gambling: A systematic review and meta-analysis of longitudinal studies.

    Science.gov (United States)

    Dowling, N A; Merkouris, S S; Greenwood, C J; Oldenhof, E; Toumbourou, J W; Youssef, G J

    2017-02-01

    This systematic review aimed to identify early risk and protective factors (in childhood, adolescence or young adulthood) longitudinally associated with the subsequent development of gambling problems. A systematic search of peer-reviewed and grey literature from 1990 to 2015 identified 15 studies published in 23 articles. Meta-analyses quantified the effect size of 13 individual risk factors (alcohol use frequency, antisocial behaviours, depression, male gender, cannabis use, illicit drug use, impulsivity, number of gambling activities, problem gambling severity, sensation seeking, tobacco use, violence, undercontrolled temperament), one relationship risk factor (peer antisocial behaviours), one community risk factor (poor academic performance), one individual protective factor (socio-economic status) and two relationship protective factors (parent supervision, social problems). Effect sizes were on average small to medium and sensitivity analyses revealed that the results were generally robust to the quality of methodological approaches of the included articles. These findings highlight the need for global prevention efforts that reduce risk factors and screen young people with high-risk profiles. There is insufficient investigation of protective factors to adequately guide prevention initiatives. Future longitudinal research is required to identify additional risk and protective factors associated with problem gambling, particularly within the relationship, community, and societal levels of the socio-ecological model. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Early Caffeine Use in Very Low Birth Weight Infants and Neonatal Outcomes: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Park, Hye Won; Lim, Gina; Chung, Sung-Hoon; Chung, Sochung; Kim, Kyo Sun; Kim, Soo-Nyung

    2015-12-01

    The use of caffeine citrate for treatment of apnea in very low birth weight infants showed short-term and long-term benefits. A systematic review and meta-analysis of the literature was undertaken to document the effect providing caffeine early (0-2 days of life) compared to providing caffeine late (≥3 days of life) in very low birth weight infants on several neonatal outcomes, including bronchopulmonary dysplasia (BPD). We searched MEDLINE, the EMBASE database, the Cochrane Library, and KoreaMed for this meta-analysis. The quality of the included studies was assessed using the Newcastle-Ottawa Scale and Jadad's scale. Studies were included if they examined the effect of the early use of caffeine compared with the late use of caffeine. Two reviewers screened the candidate articles and extracted the data from the full-text of all of the included studies. We included a total of 59,136 participants (range 58,997-59,136; variable in one study) from a total of 5 studies. The risk of death (odds ratio [OR], 0.902; 95% confidence interval [CI], 0.828 to 0.983; P=0.019), bronchopulmonary dysplasia (BPD) (OR, 0.507; 95% CI, 0.396 to 0.648; Pcaffeine group. Early caffeine use was not associated with a risk of necrotizing enterocolitis (NEC) and NEC requiring surgery. This meta-analysis suggests that early caffeine use has beneficial effects on neonatal outcomes, including mortality and BPD, without increasing the risk of NEC.

  16. Acute lymphoblastic leukemia in early childhood as the presenting sign of ataxia-telangiectasia variant.

    Science.gov (United States)

    Bielorai, Bella; Fisher, Tamar; Waldman, Dalia; Lerenthal, Yaniv; Nissenkorn, Andreea; Tohami, Tali; Marek, Dina; Amariglio, Ninette; Toren, Amos

    2013-09-01

    Ataxia-telangiectasia (A-T), an autosomal recessive disorder is characterized by progressive neurodegeneration, immunodeficiency, sensitivity to ionizing radiation, and predisposition to cancer, especially to lymphoid malignancies. A-T variant is characterized by a milder clinical phenotype and is caused by missense or leaky splice site mutations that produce residual ataxia telangiectasia mutated (ATM) kinase activity. Lymphoid malignancy can precede the diagnosis of A-T, particularly in young children with mild neurological symptoms. We studied a consanguineous family with four A-T variant patients, three of them developed T-ALL at a young age before the diagnosis of A-T was established. ATM mutation analysis detected two new missense mutations both within exon 12: c.1514T>C and c.1547T>C. All four patients are homozygous for the two mutations, while their parents are heterozygous for the mutations. ATM protein level was low in all patients and the response to the radiomimetic agent, neocarzinostatin, was reduced. Leukemic presentation in a young age in three members of consanguineous family led to the identification of a new missense mutation in the ATM gene. The diagnosis of A-T or A-T variant should be considered in children with neurological abnormalities who develop T-ALL at a young age.

  17. Improved heuristics for early melanoma detection using multimode hyperspectral dermoscopy (Conference Presentation)

    Science.gov (United States)

    Vasefi, Fartash; MacKinnon, Nicholas B.; Booth, Nicholas; Farkas, Daniel L.

    2017-02-01

    Purpose: To determine the performance of a multimode dermoscopy system (SkinSpect) designed to quantify and 3-D map in vivo melanin and hemoglobin concentrations in skin and its melanoma scoring system, and compare the results accuracy with SIAscopy, and histopathology. Methods: A multimode imaging dermoscope is presented that combines polarization, fluorescence and hyperspectral imaging to accurately map the distribution of skin melanin, collagen and hemoglobin in pigmented lesions. We combine two depth-sensitive techniques: polarization, and hyperspectral imaging, to determine the spatial distribution of melanin and hemoglobin oxygenation in a skin lesion. By quantifying melanin absorption in pigmented areas, we can also more accurately estimate fluorescence emission distribution mainly from skin collagen. Results and discussion: We compared in vivo features of melanocytic lesions (N = 10) extracted by non-invasive SkinSpect and SIMSYS-MoleMate SIAscope, and correlate them to pathology report. Melanin distribution at different depths as well as hemodynamics including abnormal vascularity we detected will be discussed. We will adapt SkinSpect scoring with ABCDE (asymmetry , border, color, diameter, evolution) and seven point dermatologic checklist including: (1) atypical pigment network, (2) blue-whitish veil, (3) atypical vascular pattern, (4) irregular streaks, (5) irregular pigmentation, (6) irregular dots and globules, (7) regression structures estimated by dermatologist. Conclusion: Distinctive, diagnostic features seen by SkinSpect in melanoma vs. normal pigmented lesions will be compared by SIAscopy and results from histopathology.

  18. Role of fluoride varnish in preventing early childhood caries: A systematic review.

    Science.gov (United States)

    Mishra, Poulami; Fareed, Nusrath; Battur, Hemant; Khanagar, Sanjeev; Bhat, Manohar A; Palaniswamy, Jagan

    2017-01-01

    Early childhood caries is a public health problem that continues to affect babies and preschool children worldwide. This untreated caries process results in progressive destruction of the crowns of the teeth, often accompanied by severe pain and suffering, affecting the quality of life. Fluoride varnish which is one of the most important materials to prevent ECC is easy to apply and well tolerated by children. This study aimed to evaluate the scientific evidence regardingthe role of fluoride varnish in preventing early childhood caries. Records were searched from various databases such as PubMed/Medline, Cochrane, and EMBASE. Articles published over the past 36 years (1979-2015) were identified using the key search terms. A total of 190 records were identified by title/abstracts/full text articles and were retrieved. Potentially relevant reports identified from the reference lists of relevant studies, review articles and chapters were hand-searched, which yielded an additional 10 articles. The main outcome of our investigation was prevention of early childhood caries following application of fluoride varnish and unavoidable fluoride exposure. Out of 190 articles originally identified, 30 records were considered potentially eligible and sought for further assessment. 17 articles met the inclusion criteria and these studies were assessed independently for methodology and performance. Analysis of literature revealed that basically two concentrations of fluoride varnishes have been used: 1% and 5%, with a caries preventive fraction ranges of 6.4-30% and 5-63%, respectively. The results showed that fluoride varnishes have been used at concentrations of 1% and 5% in the prevention of ECC. The preventive fraction was influenced by the frequency of application, the duration of study and sample size. The evidence level of the studies was of moderate to limited value.

  19. Barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia: a qualitative multicentre study.

    Science.gov (United States)

    Lim, Jennifer N W; Potrata, Barbara; Simonella, Leonardo; Ng, Celene W Q; Aw, Tar-Ching; Dahlui, Maznah; Hartman, Mikael; Mazlan, Rifhan; Taib, Nur Aishah

    2015-12-21

    To explore and compare barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia. A qualitative interview study with thematic analysis of transcripts. 67 patients with self-discovered breast symptoms were included in the analysis. Of these, 36% were of Malay ethnicity, 39% were Chinese and 25% Indian, with an average age of 58 years (range 24-82 years). The number of women diagnosed at early stages of cancer almost equalled those at advanced stages. Approximately three-quarters presented with a painless lump, one-quarter experienced a painful lump and 10% had atypical symptoms. University hospital setting in Singapore and Malaysia. Patients revealed barriers to early presentation not previously reported: the poor quality of online website information about breast symptoms, financial issues and the negative influence of relatives in both countries, while perceived poor quality of care and services in state-run hospitals and misdiagnosis by healthcare professionals were reported in Malaysia. The pattern of presentation by ethnicity remained unchanged where more Malay delayed help-seeking and had more advanced cancer compared to Chinese and Indian patients. There are few differences in the pattern of presentation and in the reported barriers to seek medical care after symptom discovery between Singapore and Malaysia despite their differing economic status. Strategies to reduce delayed presentation are: a need to improve knowledge of disease, symptoms and causes, quality of care and services, and quality of online information; and addressing fear of diagnosis, treatment and hospitalisation, with more effort focused on the Malay ethnic group. Training is needed to avoid missed diagnoses and other factors contributing to delay among health professionals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Systematic analysis of early phase clinical studies for patients with breast cancer: Inclusion of patients with brain metastasis.

    Science.gov (United States)

    Costa, R; Gill, N; Rademaker, A W; Carneiro, B A; Chae, Y K; Kumthekar, P; Gradishar, W J; Kurzrock, R; Giles, F J

    2017-04-01

    This systematic review aims to better define the limitations and patterns with which patients with MBC and CNS metastasis are enrolled into early phase developmental therapeutics trials. In June 2016, PubMed search was conducted using the following keywords: "Breast cancer". Drug-development phase 1, phase 2 or phase 1/2 trials for patients with MBC were included. Multiple-histology trials and trials without an efficacy endpoint were excluded. In total, 1474 studies were included; Inclusion criteria for 423 (29%) allowed for CNS metastasis, 770 (52%) either excluded or did not document eligibility of patients with CNS disease. Trials accruing patients with HER2-positive MBC and including targeted therapies had higher odds of allowing for patients with CNS disease (adjusted OR 1.56, 95% CI 1.08-2.2.6; p=0.019 and 1.49, 95% 1.08-2.06; p=0.014, respectively). There were also higher odds of accrual of patients with CNS involvement into clinical trials over time (odds ratio=1.10, 95% CI 1.07-1.12; pphase clinical trials either did not clearly document or did not allow for accrual of patients with CNS disease. Early phase trials with targeted agents or enrolling HER2+ MBC had higher odds of permitting CNS metastases. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Affective facilitation of early visual cortex during rapid picture presentation at 6 and 15 Hz.

    Science.gov (United States)

    Bekhtereva, Valeria; Müller, Matthias M

    2015-12-01

    The steady-state visual evoked potential (SSVEP), a neurophysiological marker of attentional resource allocation with its generators in early visual cortex, exhibits enhanced amplitude for emotional compared to neutral complex pictures. Emotional cue extraction for complex images is linked to the N1-EPN complex with a peak latency of ∼140-160 ms. We tested whether neural facilitation in early visual cortex with affective pictures requires emotional cue extraction of individual images, even when a stream of images of the same valence category is presented. Images were shown at either 6 Hz (167 ms, allowing for extraction) or 15 Hz (67 ms per image, causing disruption of processing by the following image). Results showed SSVEP amplitude enhancement for emotional compared to neutral images at a presentation rate of 6 Hz but no differences at 15 Hz. This was not due to featural differences between the two valence categories. Results strongly suggest that individual images need to be displayed for sufficient time allowing for emotional cue extraction to drive affective neural modulation in early visual cortex.

  2. Systematic review of sedentary behavior and cognitive development in early childhood.

    Science.gov (United States)

    Carson, Valerie; Kuzik, Nicholas; Hunter, Stephen; Wiebe, Sandra A; Spence, John C; Friedman, Alinda; Tremblay, Mark S; Slater, Linda G; Hinkley, Trina

    2015-09-01

    To comprehensively review observational and experimental studies examining the relationship between sedentary behavior and cognitive development during early childhood (birth to 5years). Electronic databases were searched in July, 2014 and no limits were imposed on the search. Included studies had to be peer-reviewed, published, and meet the a priori determined population (apparently healthy children aged birth to 5years), intervention (duration, types, and patterns of sedentary behavior), comparator (various durations, types, or patterns of sedentary behavior), and outcome (cognitive development) study criteria. Data extraction occurred in October and November 2014 and study quality and risk of bias were assessed in December 2014. A total of 37 studies, representing 14,487 participants from nine different countries were included. Thirty-one studies used observational study designs and six studies used experimental study designs. Across study designs, increased or higher screen time (most commonly assessed as television viewing (TV)), reading, child-specific TV content, and adult-specific TV content had detrimental (negative) associations with cognitive development outcomes for 38%, 0%, 8%, and 25% of associations reported, respectively, and beneficial (positive) associations with cognitive development outcomes for 6%, 60%, 13%, and 3% of associations reported, respectively. Ten studies were moderate quality and 27 studies were weak quality. The type of sedentary behavior, such as TV versus reading, may have different impacts on cognitive development in early childhood. Future research with reliable and valid tools and adequate sample sizes that examine multiple cognitive domains (e.g., language, spatial cognition, executive function, memory) are needed. Registration no. CRD42014010004. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Efficacy of light based detection systems for early detection of oral cancer and oral potentially malignant disorders: Systematic review

    Science.gov (United States)

    Reddy-Kantharaj, Yashoda-Bhoomi; Rakesh, Nagaraju; Janardhan-Reddy, Sujatha; Sahu, Shashikant

    2016-01-01

    Background Earlier detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is essential for dental professionals to improve patient survival rates. The aim of this systematic review is to to evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of OSCC and OPMD. Material and Methods The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE] and Science direct. The search was for limited articles published in English or with an English abstract and articles published during the period from January 2005 to April 2014. Clinical trials utilized ViziLite, Microlux TM/DL and Visual Enhanced Light scope (VELscope) for early detection of OPMD and OSCC. Results Twenty primary studies published satisfied our criteria for selection - 10 utilised chemiluminescence and 10 tissue autofluorescence. Senstivity of Vizilite for detecting OSCC nad OPMD ranged from 77.1 % to 100% and specificity was low that ranged from 0% to 27.8%.Most have shown that chemiluminescence increases the brightness and margins of oral mucosal white lesions and thus assist in identification of mucosal lesions not considered under Conventional visual examination. However, it preferentially detects leukoplakia and may fail to spot red patches. Clinical trials demonstrated that sensitivity of VELscope in detecting malignancy and OPMD ranged from 22 % to 100 % and specificity ranged from 16 % to 100%. Most studies concluded that VELscope can help the experienced clinician to find oral precursor malignant lesions. But it couldnot differentiate between dysplasia and benign inflammatory conditions. Conclusions Both devices are simple, non-invasive test of the oral mucosa but are suited for clinicians with sufficient experience and training. More clinical trials in future should be conducted to establish optical imaging as an efficacious adjunct

  4. The tooth, the whole tooth, and nothing but the tooth: Can dental pain ever be the sole presenting symptom of a myocardial infarction? A systematic review

    OpenAIRE

    Jalali, N; Vilke, GM; Korenevsky, M; Castillo, EM; Wilson, MP

    2014-01-01

    Background Pain symptoms related to cardiac ischemia can vary greatly from patient to patient. However, should emergency physicians consider the possibility of myocardial infarction in patients who present solely with dental pain? Objective This is a systematic review of the literature investigating the incidence of jaw, tooth, or facial pain as the sole symptom of cardiac ischemia. Methods Studies investigating jaw, tooth, or facial pain of cardiac origin were identified using the PubMed dat...

  5. Systematic variation of central mass density slope in early-type galaxies

    CERN Document Server

    Tortora, C; Napolitano, N R; Romanowsky, A J; Ferreras, I; de Carvalho, R R

    2015-01-01

    We study the total density distribution in the central regions ($<\\, 1$ effective radius, $R_{\\rm e}$) of early-type galaxies (ETGs), using data from the SPIDER survey. We model each galaxy with two components (dark matter halo + stars), exploring different assumptions for the dark matter (DM) halo profile, and leaving stellar mass-to-light ($M_{\\rm \\star}/L$) ratios as free fitting parameters to the data. For a Navarro et al. (1996) profile, the slope of the total mass profile is non-universal. For the most massive and largest ETGs, the profile is isothermal in the central regions ($\\sim R_{\\rm e}/2$), while for the low-mass and smallest systems, the profile is steeper than isothermal, with slopes similar to those for a constant-M/L profile. For a concentration-mass relation steeper than that expected from simulations, the correlation of density slope with mass tends to flatten. Our results clearly point to a "non-homology" in the total mass distribution of ETGs, which simulations of galaxy formation sugg...

  6. Systematic Variation of Central Mass Density Slope in Early-Type Galaxies

    Science.gov (United States)

    Tortora, C.; La Barbera, F.; Napolitano, N. R.; Romanowsky, A. J.; Ferreras, I.; de Carvalho, R. R.

    We study the total density distribution in the central regions (≲ 1 effective radius, R e) of early-type galaxies (ETGs), using data from the SPIDER survey (La Barbera et al., MNRAS 408:1313, 2010). We model each galaxy with two components (dark matter halo + stars), exploring different assumptions for the dark matter (DM) halo profile, and leaving stellar mass-to-light (M ⋆/L) ratios as free fitting parameters to the data. For a Navarro et al. (ApJ 462:563, 1996) profile, the slope of the total mass profile is non-universal. For the most massive and largest ETGs, the profile is isothermal in the central regions (˜ Re/2), while for the low-mass and smallest systems, the profile is steeper than isothermal, with slopes similar to those for a constant-M/L profile. For a concentration-mass relation steeper than that expected from simulations, the correlation of density slope with mass tends to flatten. Our results clearly point to a "non-homology" in the total mass distribution of ETGs, which simulations of galaxy formation suggest may be related to a varying role of dissipation with galaxy mass.

  7. Effectiveness of routine visits and routine tests in detecting isolated locoregional recurrences after treatment for early-stage invasive breast cancer : A meta-analysis and systematic review

    NARCIS (Netherlands)

    de Bock, GH; Bonnema, J; van der Hage, J; Kievit, J; van de Velde, CJH

    2004-01-01

    Purpose To review the effectiveness of routine visits and routine tests in detecting isolated locoregional recurrences in asymptomatic patients after treatment for early-stage invasive breast cancer. Methods Systematic review and meta-analysis. The proportion of isolated locoregional recurrences dia

  8. Experiences of acute pain in children who present to a healthcare facility for treatment: a systematic review of qualitative evidence.

    Science.gov (United States)

    Pope, Nicole; Tallon, Mary; McConigley, Ruth; Leslie, Gavin; Wilson, Sally

    2017-06-01

    Pain is a universal and complex phenomenon that is personal, subjective and specific. Despite growing knowledge in pediatric pain, management of children's pain remains sub-optimal and is linked to negative behavioral and physiological consequences later in life. As there is no synthesis of these studies, it was timely to undertake a systematic review. To identify, evaluate and synthesize the existing qualitative evidence on children's experiences of acute pain, including pain management, within a healthcare facility. Children aged four to 18 years (inclusive) attending a healthcare facility who experienced acute pain associated with any injury, medical condition or treatment. Children's experiences and perceptions of their acute pain, pain management and expectations of others in managing their pain. Studies on children's experiences of pain in the postoperative context were excluded as a systematic review exploring this phenomenon had previously been published. Studies reporting on children's experiences of chronic pain were also excluded. Any healthcare facility including general practitioners' surgeries, hospitals, emergency departments and outpatient clinics. Qualitative studies including phenomenology, grounded theory, ethnography, action research and feminist research designs. Using a three-step search strategy, databases were searched in December 2015 to identify both published and unpublished articles from 2000 to 2015. Studies published in languages other than English were excluded. All studies that met the inclusion criteria were assessed by at least two independent reviewers for methodological quality using a standardized critical appraisal tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data were extracted from the papers included in the review using standardized data extraction tool from JBI-QARI. Findings were pooled using JBI-QARI. Findings were rated according to their level of credibility and

  9. Device diagnostics and early identification of acute decompensated heart failure: a systematic review.

    Science.gov (United States)

    Blair, Tara Leslie

    2014-01-01

    Traditional methods of heart failure (HF) management are based on reactive strategies to treat late indicators of decompensated HF. Advances in monitoring methods have become available with the evolution of implantable cardioverter-defibrillators and cardiac-resynchronization therapy devices. These devices provide new diagnostic data and remote monitoring capabilities that allow clinicians to proactively monitor patients for earlier signs of worsening HF. The integration of data obtained from implantable cardioverter-defibrillator and cardiac-resynchronization therapy technology could improve outpatient HF care, potentially leading to decreased readmission rates and improved patient outcomes. This review will synthesize the literature regarding the efficacy of device diagnostic data and the usability of the data in the clinical setting. Articles for review were obtained using Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PubMed, and ClinicalTrials.gov. Device diagnostics showed strong correlation with established HF biomarkers and hemodynamic measures. The findings from this review indicate that device diagnostic parameters predict impending HF much earlier than traditional methods of monitoring do. Device diagnostics are also more accurate in the early prediction of HF when compared with noninvasive objective measures, particularly when multiple parameters are combined and monitored for trends. Device diagnostics possess a distinct advantage over traditional methods of monitoring for HF because they allow clinicians to remotely monitor the status of their HF patients without relying on patient compliance for data entry and reporting. Studies regarding the efficacy of device diagnostic parameters suggest that their integration into clinical practice will provide a more accurate and reliable mechanism for assisting clinicians in risk stratifying and predicting potential episodes of decompensated HF.

  10. Systematic trends in total-mass profiles from dynamical models of early-type galaxies

    Science.gov (United States)

    Poci, Adriano; Cappellari, Michele; McDermid, Richard M.

    2017-01-01

    We study trends in the slope of the total mass profiles and dark matter fractions within the central half-light radius of 258 early-type galaxies, using data from the volume-limited ATLAS3D survey. We use three distinct sets of dynamical models, which vary in their assumptions and also allow for spatial variations in the stellar mass-to-light ratio, to test the robustness of our results. We confirm that the slopes of the total mass profiles are approximately isothermal, and investigate how the total-mass slope depends on various galactic properties. The most statistically-significant correlations we find are a function of either surface density, Σe, or velocity dispersion, σe. However there is evidence for a break in the latter relation, with a nearly universal logarithmic slope above log10[σe/(km s-1)] ˜ 2.1 and a steeper trend below this value. For the 142 galaxies above that critical σe value, the total mass-density logarithmic slopes have a mean value = -2.193 ± 0.016 (1σ error) with an observed rms scatter of only σ _{γ ^' }= 0.168 ± 0.015. Considering the observational errors, we estimate an intrinsic scatter of σ _{γ ^' }^intr ≈ 0.15. These values are broadly consistent with those found by strong lensing studies at similar radii and agree, within the tight errors, with values recently found at much larger radii via stellar dynamics or HI rotation curves (using significantly smaller samples than this work).

  11. The anatomy and systematic position of the early Miocene proconsulid from Meswa Bridge, Kenya.

    Science.gov (United States)

    Harrison, Terry; Andrews, Peter

    2009-05-01

    A small collection of fossil catarrhines was recovered from the early Miocene locality of Meswa Bridge in western Kenya between 1978 and 1980. The associated fauna from Meswa Bridge indicates an age older than 20 Ma. Much of the material has been briefly described previously, and its taxonomic status considered. The material can be assigned to a minimum of four individuals, all of which are infants or juveniles. Although the specimens were shown to belong to a distinct species of Proconsul, the taxon was not named, primarily because many of the specimens belonged to immature individuals. Nevertheless, the combined morphological features of the deciduous and permanent teeth allow the diagnosis of a new species of Proconsul, which is formally named here as P. meswae. It is a large-sized species, similar in dental size to P. nyanzae. The main features distinguishing it from all other previously named species of Proconsul are: incisors and deciduous incisors relatively low crowned; upper deciduous canines relatively higher crowned and more robust; molars and deciduous premolars relatively broader and higher crowned, with a more pronounced degree of buccolingual flare and better developed cingula; size differential between molars not as marked; dP(4) with a longer mesial fovea and smaller hypoconulid and distal fovea; P(4) relatively broader, with a better developed buccal cingulum; lower molars less rectangular with a longer mesial fovea, smaller distal fovea, more restricted talonid basin, and a tendency for a smaller hypoconulid; dP(4) and upper molars with strongly buccolingually splayed roots; mandibular corpus in infants relatively deeper and more slender; maxilla with a well developed canine jugum and fossa. The broader and more flared molars with better developed cingula indicate that the Meswa Bridge species is more primitive than other species of Proconsul. The inference that it is a stem member of the Proconsul clade is consistent with the estimated age of

  12. Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review.

    Science.gov (United States)

    Frank, D A; Augustyn, M; Knight, W G; Pell, T; Zuckerman, B

    2001-03-28

    Despite recent studies that failed to show catastrophic effects of prenatal cocaine exposure, popular attitudes and public policies still reflect the belief that cocaine is a uniquely dangerous teratogen. To critically review outcomes in early childhood after prenatal cocaine exposure in 5 domains: physical growth; cognition; language skills; motor skills; and behavior, attention, affect, and neurophysiology. Search of MEDLINE and Psychological Abstracts from 1984 to October 2000. Studies selected for detailed review (1) were published in a peer-reviewed English-language journal; (2) included a comparison group; (3) recruited samples prospectively in the perinatal period; (4) used masked assessment; and (5) did not include a substantial proportion of subjects exposed in utero to opiates, amphetamines, phencyclidine, or maternal human immunodeficiency virus infection. Thirty-six of 74 articles met criteria and were reviewed by 3 authors. Disagreements were resolved by consensus. After controlling for confounders, there was no consistent negative association between prenatal cocaine exposure and physical growth, developmental test scores, or receptive or expressive language. Less optimal motor scores have been found up to age 7 months but not thereafter, and may reflect heavy tobacco exposure. No independent cocaine effects have been shown on standardized parent and teacher reports of child behavior scored by accepted criteria. Experimental paradigms and novel statistical manipulations of standard instruments suggest an association between prenatal cocaine exposure and decreased attentiveness and emotional expressivity, as well as differences on neurophysiologic and attentional/affective findings. Among children aged 6 years or younger, there is no convincing evidence that prenatal cocaine exposure is associated with developmental toxic effects that are different in severity, scope, or kind from the sequelae of multiple other risk factors. Many findings once thought

  13. The experiences of acute non-surgical pain of children who present to a healthcare facility for treatment: a systematic review protocol.

    Science.gov (United States)

    Pope, Nicole; Tallon, Mary; McConigley, Ruth; Wilson, Sally

    2015-10-01

    The qualitative objective of this systematic review is to identify and synthesize the best available evidence on experiences of acute non-surgical pain, including pain management, of children (between four to 18 years) when they present to a healthcare facility for treatment.The specific objectives are to identify: The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage". The pain experience is multifaceted and complex, extending beyond the physiological interpretation of a noxious stimulus, encompassing other dimensions, including; psychological, cognitive, sociocultural, affective and emotional factors. Pain can be described as chronic (persisting for three months or more) or acute (a time limited response to a noxious stimuli). Over the past 50 years clinical research has made revolutionary contributions to better understanding pediatric pain. The once pervasive erroneous notion that infants do not experience pain the same way as adults has been firmly dispelled. We now know that nervous system structures associated with the physiological interpretation of pain are functional as early as fetal development. Despite this critical knowledge and the growing global commitment to improving pediatric pain management in clinical practice, evidence repeatedly suggests that pain management remains suboptimal and inconsistent, a phenomenon commonly referred to as oligoanalgesia. Research evidence has linked poorly managed pain in the pediatric population to negative behavioral and physiological consequences later in life. Effective pain management is therefore a priority area for health care professionals. Improved understanding of children's experiences of acute non-surgical pain may lead to improved pain management and a reduction in oligoanalgesia.In the 1970s and 1980s, studies began exploring the subjective experiences of

  14. Wilson?s disease presenting as rapid eye movement sleep behavior disorder: a possible window to early treatment

    Directory of Open Access Journals (Sweden)

    Gotthard G. Tribl

    2014-09-01

    Full Text Available Objective To describe characteristics of REM sleep behavior disorder in Wilson’s disease. Method Questionnaire-based interviews (patients and relatives, neurological examinations, two-week prospective dream-diary, video-polysomnography, transcranial sonography, MRI. Results Four Wilson’s disease cases with REM sleep behavior disorder were described; three had REM sleep behavior disorder as initial symptom. All showed mesencephalic tegmental/tectal sonographic hyperechogenicities and two presented ponto-mesencephalic tegmental MRI hyperintensities. Conclusion This first description of REM sleep behavior disorder in Wilson’s disease in literature documents REM sleep behavior disorder as a possible presenting symptom of Wilson’s disease and adds further evidence to the parallelism of Parkinson’s disease and Wilson’s disease in phenotype and brainstem topography, which ought to be further studied. REM sleep behavior disorder has prognostic relevance for neurodegeneration in α-synucleinopathies. In Wilson’s disease, usefulness of early diagnosis and treatment are already well established. REM sleep behavior disorder in Wilson’s disease offers a possible theoretical model for potential early treatment in this extrapyramidal and brainstem paradigm syndrome, previewing the possibility of neuroprotective treatment for REM sleep behavior disorder in “pre-clinical” Parkinson’s disease.

  15. History of the early dipteran systematics in Italy: from Lyncei to Battista Grassi.

    Science.gov (United States)

    Baccetti, B

    2008-12-01

    This presentation starts with Galileo's discovery of the microscope and the first Lyncei. Giovanni Heckius and Francesco Stelluti demonstrated different kinds of mosquitoes. Later, in Florence, the Academy of Cimento solved the problem of mosquito reproduction with the discoveries of Francesco Redi, Pietro Paolo da Sangallo, Giuseppe Del Papa and Giovanni Maria Lancisi in the 18th century. In 19th century Eugenio Ficalbi reviewed the Italian Culicids. Once Battista Grassi solved the cycle of Anopheles and Plasmodia, further researches followed by Golgi, Celli, Marchiafava, Bastianelli and Bignami, as well as by Roland Ross.

  16. Discussion on the systematic position of the Early Cambrian priapulomorph worms

    Institute of Scientific and Technical Information of China (English)

    HUANG Diying; CHEN Junyuan; J. VANNIER

    2006-01-01

    @@ Priapulid worms form a small marine phylum in present-day environments with only 18 described species, but they were the most abundant animals in the endobenthic communities of the Cambrian. They are particularly well represented in the Lower Cambrian Maotianshan Shale of China [1-3] and the Middle Cambrian Burgess Shale of Canada [4]. The priapulid worms from the 530 Ma old Maotianshan Shale 5 be placed within 6 basic groups: selkirkiid, corynetid, anningid, palaeoscolecidan, tylotitid and priapuliid [5]. In addition, another important endobenthic worm phylum, the Sipuncula has been also reported from the Maotianshan Shale [6].

  17. Effect of health belief model and health promotion model on breast cancer early diagnosis behavior: a systematic review.

    Science.gov (United States)

    Ersin, Fatma; Bahar, Zuhal

    2011-01-01

    Breast cancer is an important public health problem on the grounds that it is frequently seen and it is a fatal disease. The objective of this systematic analysis is to indicate the effects of interventions performed by nurses by using the Health Belief Model (HBM) and Health Promotion Model (HPM) on the breast cancer early diagnosis behaviors and on the components of the Health Belief Model and Health Promotion Model. The reveiw was created in line with the Centre for Reviews and Dissemination guide dated 2009 (CRD) and developed by York University National Institute of Health Researches. Review was conducted by using PUBMED, OVID, EBSCO and COCHRANE databases. Six hundred seventy eight studies (PUBMED: 236, OVID: 162, EBSCO: 175, COCHRANE:105) were found in total at the end of the review. Abstracts and full texts of these six hundred seventy eight studies were evaluated in terms of inclusion and exclusion criteria and 9 studies were determined to meet the criteria. Samplings of the studies varied between ninety four and one thousand six hundred fifty five. It was detected in the studies that educations provided by taking the theories as basis became effective on the breast cancer early diagnosis behaviors. When the literature is examined, it is observed that the experimental researches which compare the concepts of Health Belief Model (HBM) and Health Promotion Model (HPM) preoperatively and postoperatively and show the effect of these concepts on education and are conducted by nurses are limited in number. Randomized controlled studies which compare HBM and HPM concepts preoperatively and postoperatively and show the efficiency of the interventions can be useful in evaluating the efficiency of the interventions.

  18. A systematic review of decision aids for patients making a decision about treatment for early breast cancer.

    Science.gov (United States)

    Nicholas Zdenkowski; Butow, Phyllis; Tesson, Stephanie; Boyle, Frances

    2016-04-01

    Several complex treatment decisions may be offered to women with early stage breast cancer, about a range of treatments from different modalities including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids can facilitate shared decision-making and improve decision-related outcomes. We aimed to systematically identify, describe and appraise the literature on treatment decision aids for women with early breast cancer, synthesise the data and identify breast cancer decisions that lack a decision aid. A prospectively developed search strategy was applied to MEDLINE, the Cochrane databases, EMBASE, PsycINFO, Web of Science and abstract databases from major conferences. Data were extracted into a pre-piloted form. Quality and risk of bias were measured using Qualsyst criteria. Results were synthesised into narrative format. Thirty-three eligible articles were identified, evaluating 23 individual treatment decision aids, comprising 13 randomised controlled trial reports, seven non-randomised comparative studies, eight single-arm pre-post studies and five cross-sectional studies. The decisions addressed by these decision aids were: breast conserving surgery versus mastectomy (+/- reconstruction); use of chemotherapy and/or endocrine therapy; radiotherapy; and fertility preservation. Outcome measures were heterogeneous, precluding meta-analysis. Decisional conflict decreased, and knowledge and satisfaction increased, without any change in anxiety or depression, in most studies. No studies were identified that evaluated decision aids for neoadjuvant systemic therapy, or contralateral prophylactic mastectomy. Decision aids are available and improved decision-related outcomes for many breast cancer treatment decisions including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids for neoadjuvant systemic therapy and contralateral prophylactic mastectomy could not be found, and may be warranted.

  19. Blood levels of vitamin D and early stage breast cancer prognosis: a systematic review and meta-analysis.

    Science.gov (United States)

    Rose, April A N; Elser, Christine; Ennis, Marguerite; Goodwin, Pamela J

    2013-10-01

    Vitamin D regulates expression of genes important in development and progression of breast cancer. The association of vitamin D with breast cancer outcomes among breast cancer patients is controversial. We conducted a systematic review and meta-analysis of this association in early stage breast cancer outcome. We searched MEDLINE (1982-May 1, 2013), the American Society of Clinical Oncology (2009-2012), and the San Antonio Breast Cancer Symposium (2010-2012) for abstracts, using the following keywords: "breast cancer" and "prognosis" or "survival", and "vitamin D" or" calcitriol" to identify studies reporting the associations of blood vitamin D levels (drawn close to diagnosis) with breast cancer outcomes. Meta-analyses were performed using an inverse-variance weighted fixed-effects model with Stata Version 12. Eight studies including 5,691 patients were identified. Vitamin D deficiency was variably categorized across studies; a median of 36.8 % of patients were classified as deficient. Low vitamin D levels were associated with a pooled hazard ratio of 2.13 (95 % CI 1.64-2.78) and 1.76 (95 % CIs 1.35-2.30) for recurrence (six studies) and death (four studies), respectively, with no evidence of significant heterogeneity across studies. There was potential evidence of a publication bias in studies examining associations with death (but not in those examining associations with recurrence). These findings support an association of low levels of vitamin D with increased risk of recurrence and death in early stage breast cancer patients. Given the observational nature of the included studies, it cannot be concluded that this association is causal. Further research is warranted to investigate the potential beneficial effects of vitamin D in breast cancer.

  20. Early onset behavioral variant frontotemporal dementia due to the C9ORF72 hexanucleotide repeat expansion: psychiatric clinical presentations.

    Science.gov (United States)

    Arighi, Andrea; Fumagalli, Giorgio G; Jacini, Francesca; Fenoglio, Chiara; Ghezzi, Laura; Pietroboni, Anna M; De Riz, Milena; Serpente, Maria; Ridolfi, Elisa; Bonsi, Rossana; Bresolin, Nereo; Scarpini, Elio; Galimberti, Daniela

    2012-01-01

    A hexanucleotide repeat expansion in the first intron of C9ORF72 has been shown to be responsible for a high number of familial cases of amyotrophic lateral sclerosis or frontotemporal lobar degeneration with or without concomitant motor neuron disease phenotype and TDP-43 based pathology. Here, we report on three cases carrying the hexanucleotide repeat expansion with an atypical presentation consisting in the development of psychiatric symptoms. Patient #1, a 53 year old man with positive family history for dementia, presented with mood deflection, characterized by apathy, social withdraw, and irritability in the last two years. He was diagnosed with "mild cognitive impairment due to depressive syndrome" six months later and subsequently with Alzheimer's disease. Patient #2, a woman with positive family history for dementia, developed behavioral disturbances, aggressiveness, and swearing at 57 years of age. Patient #3 presented, in the absence of brain atrophy, with mystical delirium with auditory hallucinations at 44 years of age, and did not present neurological symptoms over a 7-year follow up. The description of these cases underlines that the hexanucleotide repeat expansion in chromosome 9 could be associated with early onset psychiatric presentations.

  1. Determinants of the direction illusion: motion speed and dichoptic presentation interact to reveal systematic individual differences in sign.

    Science.gov (United States)

    Chen, Tony T; Maloney, Ryan T; Clifford, Colin W G

    2014-07-17

    When two fields of dots with different directions of movement are presented in tandem, the perceived direction of one is biased by the presence of the other. Although this ‘‘direction illusion’’ typically involves repulsion, with an exaggeration of the perceived angular difference in direction between the dot fields, attraction effects, where the perceived difference is reduced, have also been found under certain presentation conditions. Earlier literature has been inconsistent, and there is debate surrounding the nature of the interactions that facilitate the direction illusion, as well as whether they occur at a local or global stage of the motion processing hierarchy. Here we measured the operating characteristics of the direction illusion by parametrically varying inducer contrast and coherence while examining the effects of stimulus speed and dichoptic presentation. It was found that the magnitude and sign of the direction illusion differed substantially from earlier research. Furthermore, there appeared to be significant interindividual variability, with dichoptic presentation producing an attractive rather than repulsive direction illusion in some participants.

  2. Umbilical cord serum lipids between early and late clamping in full-term newborns. A systematic assignment treatment group.

    Science.gov (United States)

    Florido, Jesús; de Paco-Matallana, Catalina; Quezada, M Soledad; Garrido-Sánchez, M Carmen; Padilla, Carmen; Ocón, Olga; Luna, Juan De Dios; Ochoa-Herrera, Julio Jose

    2015-01-01

    The aim of the current study was to determine any relationship between the timing of clamping of the umbilical cord and the lipid levels circulating in umbilical artery and vein. We studied a clinical trial with systematic assignment in 229 single-fetus full-term deliveries with normal gestational course and spontaneous delivery; out of these, 111 were subjected to early clamping (EC, within 10 s of delivery) and 118 to late clamping (LC, at 2 min). In all cases, total cholesterol (TC), triglycerides (TG), and phospholipids were measured in sera from umbilical artery and vein. TC and TG values were significantly higher in the EC group than in the LC group in both umbilical artery and vein. Comparing values between umbilical artery and vein in the two clamping groups, in the EC group, all studied lipids TC, TG and phospholipids were significantly higher in vein than in artery. In the LC group, only TC was higher in vein. Umbilical cord lipid levels are related to the timing of umbilical cord clamping, finding which is noteworthy, because they are essential component of postnatal development. Our study confirms that delivery acts as an important modifier of fetal lipid levels.

  3. Key components of early intervention programs for preterm infants and their parents: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Benzies Karen M

    2013-01-01

    Full Text Available Abstract Background Preterm infants are at greater risk for neurodevelopmental disabilities than full term infants. Interventions supporting parents to improve the quality of the infant’s environment should improve developmental outcomes for preterm infants. Many interventions that involve parents do not measure parental change, nor is it clear which intervention components are associated with improved parental outcomes. The aim of this review was to categorize the key components of early intervention programs and determine the direct effects of components on parents, as well as their preterm infants. Methods MEDLINE, EMBASE, CINAHL, ERIC, and Cochrane Database of Systematic Reviews were searched between 1990 and December 2011. Eligible randomized controlled trials (RCTs included an early intervention for preterm infants, involved parents, and had a community component. Of 2465 titles and abstracts identified, 254 full text articles were screened, and 18 met inclusion criteria. Eleven of these studies reported maternal outcomes of stress, anxiety, depressive symptoms, self-efficacy, and sensitivity/responsiveness in interactions with the infant. Meta-analyses using a random effects model were conducted with these 11 studies. Results Interventions employed multiple components categorized as (a psychosocial support, (b parent education, and/or (c therapeutic developmental interventions targeting the infant. All interventions used some form of parenting education. The reporting quality of most trials was adequate, and the risk of bias was low based on the Cochrane Collaboration tool. Meta-analyses demonstrated limited effects of interventions on maternal stress (Z = 0.40, p = 0.69 and sensitivity/responsiveness (Z = 1.84, p = 0.07. There were positive pooled effects of interventions on maternal anxiety (Z = 2.54, p = 0.01, depressive symptoms (Z = 4.04, p Z = 2.05, p = 0.04. Conclusions Positive and clinically meaningful effects of early

  4. VEGAS: A VST Early-type GAlaxy Survey. I. Presentation, wide-field surface photometry, and substructures in NGC 4472

    CERN Document Server

    Capaccioli, Massimo; Grado, Aniello; Iodice, Enrichetta; Limatola, Luca; Napolitano, Nicola R; Cantiello, Michele; Paolillo, Maurizio; Romanowsky, Aaron J; Forbes, Duncan A; Puzia, Thomas H; Raimondo, Gabriella; Schipani, Pietro

    2015-01-01

    We present the VST Early-type GAlaxy Survey (VEGAS), which is designed to obtain deep multiband photometry in g, r, i, of about one hundred nearby galaxies down to 27.3, 26.8, and 26 mag/arcsec^2 respectively, using the ESO facility VST/OmegaCAM.} The goals of the survey are 1) to map the light distribution up to ten effective radii, r_e, 2) to trace color gradients and surface brightness fluctuation gradients out to a few r_e for stellar population characterization, and 3) to obtain a full census of the satellite systems (globular clusters and dwarf galaxies) out to 20% of the galaxy virial radius. The external regions of galaxies retain signatures of the formation and evolution mechanisms that shaped them, and the study of nearby objects enables a detailed analysis of their morphology and interaction features. To clarify the complex variety of formation mechanisms of early-type galaxies (ETGs), wide and deep photometry is the primary observational step, which at the moment has been pursued with only a few d...

  5. RETRACTED: Effect of early versus late or no tracheostomy on mortality of critically ill patients receiving mechanical ventilation: a systematic review and meta-analysis.

    Science.gov (United States)

    Siempos, Ilias I; Ntaidou, Theodora K; Filippidis, Filippos T; Choi, Augustine M K

    2014-06-26

    Delay of tracheostomy for roughly 2 weeks after translaryngeal intubation of critically ill patients is the presently recommended practice and is supported by findings from large trials. However, these trials were suboptimally powered to detect small but clinically important effects on mortality. We aimed to assess the mortality benefit of early versus late or no tracheostomy in critically ill patients who need mechanical ventilation. We systematically searched PubMed, CINAHL, Embase, Web of Science, DOAJ, the Cochrane Library, references of relevant articles, scientific conference proceedings, and grey literature up to Aug 31, 2013, to identify randomised controlled trials comparing early tracheostomy (done within 1 week after translaryngeal intubation) with late (done any time after the first week of mechanical ventilation) or no tracheostomy and reporting on mortality or incidence of pneumonia in critically ill patients under mechanical ventilation. Our primary outcomes were all-cause mortality during the stay in the intensive-care unit and incidence of ventilator-associated pneumonia. We calculated pooled odds ratios (OR), pooled risk ratios (RR), and 95% CIs with a random-effects model. All but complications analyses were done on an intention-to-treat basis. Analyses of 13 trials (2434 patients, 800 deaths) showed that all-cause mortality in the intensive-care unit was significantly lower in patients assigned to the early versus the late or no tracheostomy group (OR 0·72, 95% CI 0·53-0·98; p=0·04). This finding represents an 18% reduction in the relative risk of death, translating to a 5% absolute improvement in survival (from 65% to 70%). This result persisted when we considered only trials with a low risk of bias (663 deaths; OR 0·68, 95% CI 0·49-0·95; p=0·02; eight trials with 1934 patients). There was no evidence of a difference between the compared groups for 1-year mortality (788 deaths; RR 0·93, 95% CI 0·85-1·02; p=0·14; three trials with

  6. Spontaneous tumour lysis syndrome in hepatocellular carcinoma presenting with hypocalcemic tetany: An unusual case and systematic literature review.

    Science.gov (United States)

    Agarwala, Roshan; Batta, Akash; Suryadevera, Varun; Kumar, Vivek; Sharma, Vishal; Rana, Surinder Singh

    2017-06-01

    Tumour lysis syndrome is an oncological emergency which is usually seen following chemotherapy for rapidly proliferating haematological malignancies. Spontaneous tumour lysis syndrome is rare in solid tumour and even rarer with hepatocellular carcinoma (HCC). Tumour lysis syndrome in the setting of HCC is usually reported as a consequence of therapeutic interventions like sorafenib administration or trans-arterial chemoembolization. We report about a case of a young lady with chronic hepatitis B related HCC who developed spontaneous tumour lysis syndrome and presented with hypocalcemic tetany. We also compare this case with the previously reported cases of spontaneous tumour lysis syndrome in hepatocellular carcinoma. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. The HEART score for early rule out of acute coronary syndromes in the emergency department: a systematic review and meta-analysis.

    Science.gov (United States)

    Van Den Berg, Patricia; Body, Richard

    2017-05-01

    The objective of this systematic review was to summarise the current evidence on the diagnostic accuracy of the HEART score for predicting major adverse cardiac events in patients presenting with undifferentiated chest pain to the emergency department. Two investigators independently searched Medline, Embase and Cochrane databases between 2008 and May 2016 identifying eligible studies providing diagnostic accuracy data on the HEART score for predicting major adverse cardiac events as the primary outcome. For the 12 studies meeting inclusion criteria, study characteristics and diagnostic accuracy measures were systematically extracted and study quality assessed using the QUADAS-2 tool. After quality assessment, nine studies including data from 11,217 patients were combined in the meta-analysis applying a generalised linear mixed model approach with random effects assumption (Stata 13.1). In total, 15.4% of patients (range 7.3-29.1%) developed major adverse cardiac events after a mean of 6 weeks' follow-up. Among patients categorised as 'low risk' and suitable for early discharge (HEART score 0-3), the pooled incidence of 'missed' major adverse cardiac events was 1.6%. The pooled sensitivity and specificity of the HEART score for predicting major adverse cardiac events were 96.7% (95% confidence interval (CI) 94.0-98.2%) and 47.0% (95% CI 41.0-53.5%), respectively. Patients with a HEART score of 0-3 are at low risk of incident major adverse cardiac events. As 3.3% of patients with major adverse cardiac events are 'missed' by the HEART score, clinicians must ask whether this risk is acceptably low for clinical implementation.

  8. Presenting Twins Are Exposed to Higher Levels of Inflammatory Mediators than Nonpresenting Twins as Early as the Midtrimester of Pregnancy.

    Directory of Open Access Journals (Sweden)

    Seung Mi Lee

    Full Text Available Presenting twins are less likely to develop respiratory complications than non-presenting twins. The precise reason for this difference is not well understood, although it is known that the presence of inflammation reduces the risk of respiratory morbidity at birth. To further investigate this association, we compared the concentrations of inflammatory biomarkers in mid-trimester amniotic fluid (AF of asymptomatic twin pairs.The study population consisted of women with twin pregnancies who underwent mid-trimester amniocentesis (15-20 weeks for routine clinical indications and delivered at term. AF was analyzed for pro-inflammatory cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, IL-15, IFN-γ, TNF-α, matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, MMP-12, and chemokines (Complement Factor D/Adipsin, Serpin E1/PAI-1, Adiponectin/Acrp30, CRP, CCL2/MCP-1, Leptin, Resistin using Luminex Performance Assay multiplex kits. Data were analyzed using Wilcoxon signed rank test.A total of 82 twin pairs were enrolled. Mid-trimester AF concentrations of IL-8, MMP-8, CRP, MCP-1, leptin, and resistin were significantly higher in the presenting twin compared with the non-presenting twin (p<0.05 for each. Differences in AF concentrations of IL-8, MMP-8, and CRP persisted after adjustment for the fetal growth restriction at the time of birth and chorionicity.These data suggest that, as early as the mid-trimester, the presenting fetus in an otherwise uncomplicated twin pregnancy is exposed to higher levels of pro-inflammatory mediators (especially IL-8, MMP-8, and CRP than its non-presenting co-twin. Whether this pro-inflammatory milieu reduces the risk of neonatal respiratory morbidity at birth or has other functional implications needs to be further evaluated.

  9. Is early oral feeding after gastric cancer surgery feasible? A systematic review and meta-analysis of randomized controlled trials.

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    Xiaoping Liu

    Full Text Available AIM: To assess the feasibility and safety of early oral feeding (EOF after gastrectomy for gastric cancer through a systematic review and meta-analysis based on randomized controlled trials. METHODS: A literature search in PubMed, Embase, Web of Science and Cochrane library databases was performed for eligible studies published between January 1995 and March 2014. Systematic review was carried out to identify randomized controlled trials comparing EOF and traditional postoperative oral feeding after gastric cancer surgery. Meta-analyses were performed by either a fixed effects model or a random effects model according to the heterogeneity using RevMan 5.2 software. RESULTS: Six studies remained for final analysis. Included studies were published between 2005 and 2013 reporting on a total of 454 patients. No significant differences were observed for postoperative complication (RR = 0.95; 95%CI, 0.70 to 1.29; P = 0.75, the tolerability of oral feeding (RR = 0.98; 95%CI, 0.91 to 1.06; P = 0.61, readmission rate (RR = 1; 95%CI, 0.30 to 3.31; P = 1.00 and incidence of anastomotic leakage (RR = 0.31; 95%CI, 0.01 to 7.30; P = 0.47 between two groups. EOF after gastrectomy for gastric cancer was associated with significant shorter duration of the hospital stay (WMD = -2.36; 95%CI, -3.37 to -1.34; P<0.0001 and time to first flatus (WMD = -19.94; 95%CI, -32.03 to -7.84; P = 0.001. There were no significant differences in postoperative complication, tolerability of oral feeding, readmission rates, duration of hospital stay and time to first flatus among subgroups stratified by the time to start EOF or by partial and total gastrectomy or by laparoscopic and open surgery. CONCLUSIONS: The result of this meta-analysis showed that EOF after gastric cancer surgery seems feasible and safe, even started at the day of surgery irrespective of the extent of the gastric resection and the type of surgery. However, more

  10. The Early Differentiation History of Mars from W-182-Nd-142 Isotope Systematics in the SNC Meteorites

    Science.gov (United States)

    Foley, C. Nicole; Wadhwa, M.; Borg, L. E.; Janney, P. E.; Hines, R.; Grove, T. L.

    2005-01-01

    We report here the results of an investigation of W and Nd isotopes in the SNC (Shergottite-Nakhlite-Chassignite (martian)) meteorites. We have determined that epsilon W-182 values in the nakhlites are uniform within analytical uncertainties and have an average value of approx. 3. Also, while epsilon W-182 values in the shergottites have a limited range (from 0.3-0.7), their epsilon Nd-142 values vary considerably (from -0.2-0.9). There appears to be no correlation between epsilon W-182 and epsilon Nd-142 in the nakhlites and shergottites. These results shed new light on early differentiation processes on Mars, particularly on the timing and nature of fractionation in silicate reservoirs. Assuming a two-stage model, the metallic core is estimated to have formed at approx. 12 Myr after the beginning of the solar system. Major silicate differentiation established the nakhlite source reservoir before approx. 4542 Ma and the shergottite source reservoirs at 4525 [sup +19 sub -21] Ma. These ages imply that, within the uncertainties afforded by the Hf-182-W-182 and Sm-146-Nd-142 chronometers, the silicate differentiation events that established the source reservoirs of the nakhlites and shergottites may have occurred contemporaneously, possibly during crystallization of a global magma ocean. The distinct W-182-Nd-142 isotope systematics in the nakhlites and the shergottites imply the presence of at least three isotopically distinct silicate reservoirs on Mars, two of which are depleted in incompatible lithophile elements relative to chondrites, and the third is enriched. The two depleted silicate reservoirs most likely reside in the Martian mantle, while the enriched reservoir could be either in the crust or the mantle. Therefore, the W-182-Nd-142 isotope systematics indicate that the nakhlites and the shergottites originated from distinct source reservoirs and cannot be petrogenetically related. A further implication is that the source reservoirs of the nakhlites and

  11. Early

    Directory of Open Access Journals (Sweden)

    Kamel Abd Elaziz Mohamed

    2014-04-01

    Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

  12. Challenges in the management of early versus late presenting congenital diaphragmatic hernia in a poor resource setting

    Directory of Open Access Journals (Sweden)

    Abubakar Auwal

    2011-01-01

    Full Text Available Background: Despite the advances in management, congenital diaphragmatic hernia (CDH has continued to pose a significant challenge to paediatric surgeons. This is amplified in a setting like ours where there is a dearth of facilities to cope with the problem of CDH. This study was undertaken to highlight the peculiarities of the management of CDH in a poor resource setting. Methods: All confirmed cases of CDH were prospectively documented from 2003 till date. Results: Seven children were treated from 2003 till date. The diaphragmatic defect was on the left side in six (83.8% and on the right side in one (17.7%. All the patients had primary closure of the defect without patch via an abdominal approach. The three patients presenting at birth died while the remaining four patients survived. Conclusion: With inadequate neonatal intensive care facilities, the severe early presenting CDH has a dismal prognosis. In contrast, the late presenting CDH poses more diagnostic challenges; but once identified and appropriate treatment instituted, it has an excellent prognosis. We recommend that physicians should include CDH in the differential diagnosis of patients with birth asphyxia and in patients with chronic respiratory symptoms with failure to thrive.

  13. Promoting early presentation of breast cancer in older women: implementing an evidence-based intervention in routine clinical practice.

    Science.gov (United States)

    Forbes, Lindsay J L; Forster, Alice S; Dodd, Rachael H; Tucker, Lorraine; Laming, Rachel; Sellars, Sarah; Patnick, Julietta; Ramirez, Amanda J

    2012-01-01

    Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women.

  14. Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

    Science.gov (United States)

    Forbes, Lindsay J. L.; Forster, Alice S.; Dodd, Rachael H.; Tucker, Lorraine; Laming, Rachel; Sellars, Sarah; Patnick, Julietta; Ramirez, Amanda J.

    2012-01-01

    Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women. PMID:23213334

  15. Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

    Directory of Open Access Journals (Sweden)

    Lindsay J. L. Forbes

    2012-01-01

    Full Text Available Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2. Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women.

  16. Ex-vivo evaluation of an early caries detector based on integrated OCT and polarized Raman spectroscopy (Conference Presentation)

    Science.gov (United States)

    Lamouche, Guy; Padioleau, Christian; Hewko, Mark; Smith, Michael S. D.; Schattka, Bernie J.; Fulton, Crystal; Gauthier, Bruno; Beauchesne, André; Ko, Alex C.; Choo-Smith, Lin-P'ing; Sowa, Michael G.

    2017-02-01

    Early detection of incipient caries would allow dentists to provide more effective measures to delay or to reverse caries' progression at earlier stage. Such earlier intervention could lead to improved oral health for the patients and reduced burden to the health system. Previously, we have demonstrated that the combination of morphological and biochemical information furnished by optical coherence tomography (OCT) and polarized Raman spectroscopy (PRS), respectively, provided a unique tool for dental caries management. In this study we will report the first pre-clinical caries detection system that includes a hand-held probe with a size slightly larger than a tooth brush. This probe presents a novel platform combining both OCT and PRS optics in a very tight space ideal for clinical practice. OCT cross-sectional images of near-surface enamel morphology are obtained with miniaturized MEMS scanning device and are processed in real-time to identify culprit regions. These regions are sequentially analyzed with polarized Raman spectroscopy for further confirmation. PRS is performed using 830nm laser line and four detection channels in order to obtain polarized Raman spectroscopic data, i.e. depolarization ratio of the hydroxyapatite Raman band at 960 cm-1. A detailed description of this hand-held caries detector and ex-vivo/in-vivo test results will be presented.

  17. Effect of early versus late or no tracheostomy on mortality and pneumonia of critically ill patients receiving mechanical ventilation: a systematic review and meta-analysis.

    Science.gov (United States)

    Siempos, Ilias I; Ntaidou, Theodora K; Filippidis, Filippos T; Choi, Augustine M K

    2015-02-01

    Delay of tracheostomy for roughly 2 weeks after translaryngeal intubation of critically ill patients is the presently recommended practice and is supported by findings from large trials. However, these trials were suboptimally powered to detect small but clinically important effects on mortality. We aimed to assess the benefit of early versus late or no tracheostomy on mortality and pneumonia in critically ill patients who need mechanical ventilation. We systematically searched PubMed, CINAHL, Embase, Web of Science, DOAJ, the Cochrane Library, references of relevant articles, scientific conference proceedings, and grey literature up to Aug 31, 2013, to identify randomised controlled trials comparing early tracheostomy (done within 1 week after translaryngeal intubation) with late (done any time after the first week of mechanical ventilation) or no tracheostomy and reporting on mortality or incidence of pneumonia in critically ill patients under mechanical ventilation. Our primary outcomes were all-cause mortality during the stay in the intensive-care unit and incidence of ventilator-associated pneumonia. Mortality during the stay in the intensive-care unit was a composite endpoint of definite intensive-care-unit mortality, presumed intensive-care-unit mortality, and 28-day mortality. We calculated pooled odds ratios (OR), pooled risk ratios (RR), and 95% CIs with a random-effects model. All but complications analyses were done on an intention-to-treat basis. Analyses of 13 trials (2434 patients, 648 deaths) showed that all-cause mortality in the intensive-care unit was not significantly lower in patients assigned to the early versus the late or no tracheostomy group (OR 0·80, 95% CI 0·59-1·09; p=0·16). This result persisted when we considered only trials with a low risk of bias (511 deaths; OR 0·80, 95% CI 0·59-1·09; p=0·16; eight trials with 1934 patients). Incidence of ventilator-associated pneumonia was lower in mechanically ventilated patients assigned

  18. What guidance are researchers given on how to present network meta-analyses to end-users such as policymakers and clinicians? A systematic review.

    Directory of Open Access Journals (Sweden)

    Shannon M Sullivan

    Full Text Available INTRODUCTION: Network meta-analyses (NMAs are complex methodological approaches that may be challenging for non-technical end-users, such as policymakers and clinicians, to understand. Consideration should be given to identifying optimal approaches to presenting NMAs that help clarify analyses. It is unclear what guidance researchers currently have on how to present and tailor NMAs to different end-users. METHODS: A systematic review of NMA guidelines was conducted to identify guidance on how to present NMAs. Electronic databases and supplementary sources were searched for NMA guidelines. Presentation format details related to sample formats, target audiences, data sources, analysis methods and results were extracted and frequencies tabulated. Guideline quality was assessed following criteria developed for clinical practice guidelines. RESULTS: Seven guidelines were included. Current guidelines focus on how to conduct NMAs but provide limited guidance to researchers on how to best present analyses to different end-users. None of the guidelines provided reporting templates. Few guidelines provided advice on tailoring presentations to different end-users, such as policymakers. Available guidance on presentation formats focused on evidence networks, characteristics of individual trials, comparisons between direct and indirect estimates and assumptions of heterogeneity and/or inconsistency. Some guidelines also provided examples of figures and tables that could be used to present information. CONCLUSIONS: Limited guidance exists for researchers on how best to present NMAs in an accessible format, especially for non-technical end-users such as policymakers and clinicians. NMA guidelines may require further integration with end-users' needs, when NMAs are used to support healthcare policy and practice decisions. Developing presentation formats that enhance understanding and accessibility of NMAs could also enhance the transparency and legitimacy of

  19. Brain changes in early-onset bipolar and unipolar depressive disorders: a systematic review in children and adolescents.

    Science.gov (United States)

    Serafini, Gianluca; Pompili, Maurizio; Borgwardt, Stefan; Houenou, Josselin; Geoffroy, Pierre Alexis; Jardri, Renaud; Girardi, Paolo; Amore, Mario

    2014-11-01

    Pediatric bipolar disorder (BD) and unipolar disorder (UD) share common symptomatic and functional impairments. Various brain imaging techniques have been used to investigate the integrity of brain white matter (WM) and gray matter (GM) in these disorders. Despite promising preliminary findings, it is still unclear whether these alterations may be considered as common trait markers or may be used to distinguish BD from UD. A systematic literature search of studies between 1980 and September 2013 which reported WM/GM changes in pediatric and adolescent BD/UD, as detected by diffusion tensor imaging and voxel-based analysis was conducted. Of the 34 articles judged as eligible, 17 fulfilled our inclusion criteria and were finally retained in this review. More abnormalities have been documented in the brains of children and adolescents with BD than UD. Reductions in the volume of basal ganglia and the hippocampus appeared more specific for pediatric UD, whereas reduced corpus callosum volume and increased rates of deep WM hyperintensities were more specific for pediatric BD. Seminal papers failed to address the possibility that the differences between unipolar and bipolar samples might be related to illness severity, medication status, comorbidity or diagnosis. UD and BD present both shared and distinctive impairments in the WM and GM compartments. More WM abnormalities have been reported in children and adolescents with bipolar disease than in those with unipolar disease, maybe as a result of a low number of DTI studies in pediatric UD. Future longitudinal studies should investigate whether neurodevelopmental changes are diagnosis-specific.

  20. Heavy Proteinuria as a Manifestation of Acute Allograft Rejection Presenting Early after Kidney Transplantation: A Retrospective, Single-Center Case Series

    Science.gov (United States)

    2009-01-01

    Abstract: The differential diagnosis of heavy proteinuria presenting early after kidney transplantation has generally included de novo or recurrent...SUPPLEMENTARY NOTES 14. ABSTRACT The differential diagnosis of heavy proteinuria presenting early after kidney transplantation has generally included de novo...Deceased Donor 1 IgA Nephropathy 9 days 100mg% dipstick 1.5 5.8 Urine dip negative 1.5 0.5 gm/Kg/d x 5d 5 53 F AA Deceased Donor 2 Membranous

  1. PGE, Re-Os, and Mo isotope systematics in Archean and early Proterozoic sedimentary systems as proxies for redox conditions of the early Earth

    Science.gov (United States)

    Siebert, C.; Kramers, J. D.; Meisel, Th.; Morel, Ph.; Nägler, Th. F.

    2005-04-01

    Re-Os data and PGE concentrations as well as Mo concentrations and isotope data are reported for suites of fine clastic sediments and black shales from the Barberton Greenstone Belt, South Africa (Fig Tree and Moodies Groups, 3.25-3.15 Ga), the Belingwe Greenstone Belt, Zimbabwe (Manjeri Formation, ca. 2.7 Ga) and shales from the Witwatersrand, Ventersdorp and Transvaal Supergroups, South Africa ranging from 2.95 to 2.2 Ga. Moderately oxidizing conditions are required to mobilize Re and Mo in the environment, Mo fractionation only occurs in solution, and these parameters thus have potential use as paleoredox proxies for the early Earth. PGE + Re abundance patterns of Barberton Greenstone Belt sediments are uniform and very similar in shape to those of komatiites. This indicates (1) that the PGE came from a source of predominantly ultramafic composition and, (2) that PGE were transported and deposited essentially in particulate form. Sediments from the younger Belingwe Greenstone Belt show more fractionated PGE + Re patterns and have Re/Os ratios 10 to 100× higher than those of Barberton sediments. Their PGE abundance patterns and Re/Os ratios are intermediate between those of the mid-Archean shales and Neoproterozoic to Recent black shales. They reflect scavenging of Re from solution in the sedimentary environment. δ 98/95Mo values of black shales of all ages correlate with their concentrations. The Barberton Greenstone Belt samples have ˜1-3 ppm Mo, similar to a granitoid-basaltic source. This Mo has δ 98/95Mo between -1.9 and -2.4‰ relative to present day mean ocean water molybdenum, MOMO and is thus not isotopically fractionated relative to such a source. Similar to the PGE this indicates transport in solid form. Sediments from the Belingwe Greenstone Belt show in part enhanced Mo concentrations (up to 6 ppm) and Mo isotope fractionation (δ 98/95Mo up to -1.4‰ relative to MOMO). The combined PGE + Re and Mo data show mainly reducing conditions in the

  2. The tooth, the whole tooth, and nothing but the tooth: can dental pain ever be the sole presenting symptom of a myocardial infarction? A systematic review.

    Science.gov (United States)

    Jalali, Nima; Vilke, Gary M; Korenevsky, Melissa; Castillo, Edward M; Wilson, Michael P

    2014-06-01

    Pain symptoms related to cardiac ischemia can vary greatly from patient to patient. However, should emergency physicians consider the possibility of myocardial infarction in patients who present solely with dental pain? This is a systematic review of the literature investigating the incidence of jaw, tooth, or facial pain as the sole symptom of cardiac ischemia. Studies investigating jaw, tooth, or facial pain of cardiac origin were identified using the PubMed database. All English studies in which cardiac pain originated in the face, teeth, or jaw were screened for inclusion. Data were abstracted from each study utilizing a structured review process, and rated for methodological quality. Eighteen studies met study criteria: 16 were case reports, and the remaining 2 were prospective cohort studies. After quality assessment and categorization, nine reports were categorized as weak, eight moderate, and one strong methodological quality. Cardiac ischemia may present in no anatomic location other than face or jaw. However, despite frequent claims in the literature to the contrary, the lack of methodological quality of the studies investigated impedes a firm conclusion of face, jaw, or tooth pain as the only symptom of cardiac insufficiency. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Cortisol, heart rate, and blood pressure as early markers of PTSD risk: A systematic review and meta-analysis.

    Science.gov (United States)

    Morris, Matthew C; Hellman, Natalie; Abelson, James L; Rao, Uma

    2016-11-01

    Individuals with posttraumatic stress disorder (PTSD) typically exhibit altered hypothalamic-pituitary-adrenal (HPA) function and sympathetic nervous system (SNS) activity. The goals of this study were to determine whether HPA and SNS alterations in the immediate aftermath of trauma predict subsequent PTSD symptom development and whether inconsistencies observed between studies can be explained by key demographic and methodological factors. This work informs secondary prevention of PTSD by identifying subgroups of trauma survivors at risk for PTSD. This meta-analysis (26 studies, N=5186 individuals) revealed that higher heart rate measured soon after trauma exposure was associated with higher PTSD symptoms subsequently (r=0.13). Neither cortisol (r=-0.07) nor blood pressure (diastolic: r=-0.01; systolic: r=0.02) were associated with PTSD symptoms which may be influenced by methodological limitations. Associations between risk markers (heart rate, cortisol, systolic blood pressure) and PTSD symptoms were in the positive direction for younger samples and negative direction for older samples. These findings extend developmental traumatology models of PTSD by revealing an age-related shift in the presentation of early risk markers. More work will be needed to identify risk markers and pathways to PTSD while addressing methodological limitations in order to shape and target preventive interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. [Obese woman presenting as vocal cord abductor paralysis and floppy arytenoid associated with early signs of multiple system atrophy].

    Science.gov (United States)

    Sakuta, Hideki; Miyamoto, Masayuki; Suzuki, Keisuke; Miyamoto, Tomoyuki; Nakajima, Itsuo; Nakamura, Toshiki; Hirata, Koichi

    2012-01-01

    In multiple system atrophy (MSA), sleep-related breathing disorders are commonly observed, including vocal cord abductor paralysis (VCAP), which can cause sudden death. In its early stage, VCAP occurs only during sleep, but as the disease progresses, it appears when both awake and asleep. We encountered a 59-year-old obese woman who had been under continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea syndrome (OSAS) for approximately one year but later developed acute respiratory failure because of VCAP. VCAP was the predominant finding that led to the diagnosis of MSA in our patient. On laryngoscopic examination, the movement of the patient's larynx was normal during wakefulness, but VCAP, paradoxical movements of the vocal cord and a floppy arytenoid were observed during drug-induced sleep. We suggest that detection of VCAP and laryngopharyngeal abnormalities such as floppy arytenoid in the early stage of MSA is important for determining treatment options.

  5. Herpes Simplex Virus Hepatitis: A Presentation of Multi-Institutional Cases to Promote Early Diagnosis and Management of the Disease

    Directory of Open Access Journals (Sweden)

    Ashwinee Natu

    2017-01-01

    Full Text Available Objective. To compare three cases of Herpes simplex virus (HSV hepatitis to increase early diagnosis of the disease. Case  1. A 23-year-old man with Crohn’s disease and oral HSV. HSV hepatitis was diagnosed clinically and he improved with acyclovir. Case  2. An 18-year-old G1P0 woman with transaminitis. Despite early empiric acyclovir therapy, she died due to fulminant liver failure. Case  3. A 65-year-old woman who developed transaminitis after liver transplant. Diagnosis was confirmed by biopsy and she had resolution of acute liver failure with acyclovir. Conclusion. It is imperative that clinicians be aware of patients at high risk for developing HSV hepatitis to increase timely diagnosis and prevent morbidity and fatality.

  6. Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review

    DEFF Research Database (Denmark)

    Herbst, Christine; Rehan, Fareed A; Brillant, Corinne;

    2010-01-01

    Combined modality treatment (CMT) of chemotherapy followed by localized radiotherapy is standard treatment for patients with early stage Hodgkin's lymphoma. However, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication...

  7. New photoacoustic platform for early detection of circulating clots to prevent stroke and other fatal thromboembolic complications (Conference Presentation)

    Science.gov (United States)

    Carey, Kai A.

    2017-03-01

    Nearly 800,000 people in the U.S. experience an incident of stroke each year; 80% of these are first time occurrences and 87% are ischemic in nature. Someone dies of a stroke every few minutes in the U.S. but despite its prevalence there have been minimal advances in the early detection and screening of thromboembolic events, especially during patient post-operative periods or in genetically predisposed individuals. Environmental or genetic factors may disrupt the balance between coagulation and lysis of micro-thrombi in circulation and increase the risk of stroke. We introduced here a novel in vivo multicolor negative-contrast photoacoustic (PA) flow cytometry (PAFC ) platform with many innovations including customized high pulse repetition rate 1064 laser from IPG Photonics Corporation, powerful laser diode array, multichannel optical schematic, and time-resolved recording system. Using animal models, we verified the potential of this technology to detect small clots in relatively large vessels in vivo. If future clinical trials using a cost-effective, easy-to-use, safe, watch-like, wearable PA probe are successful, PAFC could provide breakthroughs in early monitoring of the growth in size and number of small clots that may predict and potentially prevent fatal thromboembolic complications. We also believe that this technology could be utilized to assess therapeutic benefits of anticoagulants and develop more efficient dosage in treatments by analyzing changes in the composition and frequency of micro-thrombi

  8. Systematic review

    DEFF Research Database (Denmark)

    Enggaard, Helle

    2016-01-01

    Title: Systematic review a method to promote nursing students skills in Evidence Based Practice Background: Department of nursing educate students to practice Evidence Based Practice (EBP), where clinical decisions is based on the best available evidence, patient preference, clinical experience...... with systematic review is used to develop didactic practice end evidence based teaching in different part of the education. Findings: The poster will present how teacher’s training and experiences with systematic review contribute to the nursing education in relation to didactic, research methodology and patient...... sources of evidence influence EBP. Furthermore teachers skills in systematic review will be used to develop systematic reviews on topics in the education where there aren’t any in order to promote Evidence Based Teaching....

  9. Negotiating Islamisation and resistance : a study of religions, politics and social change in West Java from the early 20th Century to the present

    NARCIS (Netherlands)

    Bamualim, Chaider S.

    2015-01-01

    This study shows how Islamisation took place and how it was contested and negotiated in West Java. It focuses on three important religious variants: Islam, Aliran Kebatinan and Christianity and covers the early twentieth century to the present, with the emphasis on the period after 1965. Conflicts

  10. Negotiating Islamisation and resistance : a study of religions, politics and social change in West Java from the early 20th Century to the present

    NARCIS (Netherlands)

    Bamualim, Chaider S.

    2015-01-01

    This study shows how Islamisation took place and how it was contested and negotiated in West Java. It focuses on three important religious variants: Islam, Aliran Kebatinan and Christianity and covers the early twentieth century to the present, with the emphasis on the period after 1965. Conflicts b

  11. Early insights into the neurobiology of pain in sickle cell disease: A systematic review of the literature.

    Science.gov (United States)

    Brandow, Amanda M; Farley, Rebecca A; Panepinto, Julie A

    2015-09-01

    Novel insights into the neurobiology of sickle cell disease (SCD) pain have recently been discovered. We systematically reviewed the literature focusing on original research that examined the biology of pain in SCD and/or addressed assessment or treatment of neuropathic pain in SCD. This review of 15 articles that met inclusion criteria provides epidemiological, basic, and clinical data that support central and/or peripheral nervous system abnormalities likely contribute to sickle cell pain. Continued basic and clinical investigation into pain neurobiology is imperative to translate these discoveries into novel ways to assess and treat neuropathic pain and decrease patient suffering.

  12. Laryngeal carcinoma presented with thyroid mass symptoms: The importance of early onset hoarseness and absent of laryngeal crepitus

    Directory of Open Access Journals (Sweden)

    Chuen Shiun Chew

    2017-03-01

    Full Text Available Presentation of stridor with a marked anterior neck swelling is always presumed as thyroid mass compressing on the airway. However, a history of progressive hoarseness prior to the stridor should be taken into consideration as the airway obstruction might be due to intraluminal airway compression. We report an atypical presentation of laryngeal cancer with anterior neck swelling, which moved with swallowing, mimicking a thyroid tumour which cause delay of the management.

  13. The Benefits of Publishing Systematic Quantitative Literature Reviews for PhD Candidates and Other Early-Career Researchers

    Science.gov (United States)

    Pickering, Catherine; Byrne, Jason

    2014-01-01

    Universities increasingly expect students to publish during a PhD candidature because it benefits the candidate, supervisor, institution, and wider community. Here, we describe a method successfully used by early-career researchers including PhD candidates to undertake and publish literature reviews--a challenge for researchers new to a field. Our…

  14. Early dual versus mono antiplatelet therapy for acute non-cardioembolic ischemic stroke or transient ischemic attack: an updated systematic review and meta-analysis.

    Science.gov (United States)

    Wong, Ka Sing Lawrence; Wang, Yilong; Leng, Xinyi; Mao, Chen; Tang, Jinling; Bath, Philip M W; Markus, Hugh S; Gorelick, Philip B; Liu, Liping; Lin, Wenhua; Wang, Yongjun

    2013-10-08

    Emerging studies suggest that early administration of dual antiplatelet therapy may be better than monotherapy for prevention of early recurrent stroke and cardiovascular outcomes in acute ischemic stroke and transient ischemic attack (TIA). We performed a meta-analysis of randomized, controlled trials evaluating dual versus mono antiplatelet therapy for acute noncardioembolic ischemic stroke or TIA. We assessed randomized, controlled trials investigating dual versus mono antiplatelet therapy published up to November 2012 and the CHANCE trial (Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events), for efficacy and safety outcomes in adult patients with acute noncardioembolic ischemic stroke or TIA with treatment initiated within 3 days of ictus. In total, 14 studies of 9012 patients were included in the systematic review and meta-analysis. Dual antiplatelet therapy significantly reduced risk of stroke recurrence (risk ratio, 0.69; 95% confidence interval, 0.60-0.80; Pstroke, TIA, acute coronary syndrome, and all death (risk ratio, 0.71; 95% confidence interval, 0.63-0.81; Pacute noncardioembolic ischemic stroke or TIA, dual therapy was more effective than monotherapy in reducing risks of early recurrent stroke. The results of the CHANCE study are consistent with previous studies done in other parts of the world.

  15. Diffuse optical measurements of head and neck tumor hemodynamics for early prediction of radiation therapy (Conference Presentation)

    Science.gov (United States)

    Dong, Lixin; Kudrimoti, Mahesh; Irwin, Daniel; Chen, Li; Shang, Yu; Li, Xingzhe; Stevens, Scott D.; Shelton, Brent J.; Yu, Guoqiang

    2016-03-01

    Radiation therapy is a principal modality for head and neck cancers and its efficacy depends on tumor hemodynamics. Our laboratory developed a hybrid diffuse optical instrument allowing for simultaneous measurements of tumor blood flow and oxygenation. In this study, the clinically involved cervical lymph node was monitored by the hybrid instrument once a week over the treatment period of seven weeks. Based on treatment outcomes within one year, patients were classified into a complete response group (CR) and an incomplete response group (IR) with remote metastasis and/or local recurrence. A linear mixed models was used to compare tumor hemodynamic responses to the treatment between the two groups. Interestingly, we found that human papilloma virus (HPV-16) status largely affected tumor hemodynamic responses. For HPV-16 negative tumors, significant differences in blood flow index (BFI, p = 0.007) and reduced scattering coefficient (μs', p = 0.0005) were observed between the two groups; IR tumors exhibited higher μs' values and a continuous increase in BFI over the treatment period. For HPV-16 positive tumors, oxygenated hemoglobin concentration ([HbO2]) and blood oxygen saturation (StO2) were significant different (p = 0.003 and 0.01, respectively); IR group showed lower [HbO2] and StO2. Our results imply HPV-16 negative tumors with higher density of vasculature (μs') and higher blood flow show poor responses to radiotherapy and HPV-16 positive tumors with lower tissue oxygenation level (lower StO2 and [HbO2]) exhibit poor treatment outcomes. Our diffuse optical measurements show the great potential for early prediction of radiotherapy in head and neck cancers.

  16. The Effectiveness of Classroom-Based Supplementary Video Presentations in Supporting Emergent Literacy Development in Early Childhood Education

    Science.gov (United States)

    Sadik, Alaa M.; Badr, Khadeja

    2012-01-01

    This study investigated the impact of supplementary video presentations in supporting young children's emergent literacy development. Videos were produced by teachers using prototype software developed specifically for the purpose of this study. The software obtains media content from a variety of resources and devices, including webcam,…

  17. Laparoscopic versus Open Omental Patch Repair for Early Presentation of Perforated Peptic Ulcer: Matched Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Daniel Jin Keat Lee

    2016-01-01

    Full Text Available Introduction. The aim of this study was to compare the outcomes between laparoscopic and open omental patch repair (LOPR versus OR in patients with similar presentation of perforated peptic ulcer (PPU. The secondary aim was to evaluate the outcomes according to the severity of peritonitis. Methods. All patients who underwent omental patch repair at two university-affiliated institutes between January 2010 and December 2014 were reviewed. Matched cohort between LOPR and OR groups was achieved by only including patients that had ulcer perforation 21, LOPR is also shown to benefit, particularly resulting in significant shorter LOS (4 days versus 11 days, p<0.01. Conclusion. LOPR offers improved short-term outcomes in patients who present within 48 hours and with perforation size <2 cm. LOPR also proved to be more beneficial in high MPI cases.

  18. Reno-invasive fungal infection presenting as acute renal failure: importance of renal biopsy for early diagnosis.

    Science.gov (United States)

    Ranjan, Priyadarshi; Chipde, Saurabh Sudhir; Vashistha, Saurabh; Kumari, Neeraj; Kapoor, Rakesh

    2014-11-01

    Renal zygomycosis, caused by invasive fungi, is a rare and potentially fatal infection. The patient usually presents with non-specific symptoms and renal failure. A 34-year-old male non-diabetic and without any predisposing factors for systemic fungal infection presented to the emergency department with diffuse abdominal pain, high-grade fever and acute renal failure with a serum creatinine of 6.5. A computed tomography showed bilateral diffuse globular nephromegaly. A urine smear for fungal examination showed right angle branching hyphae and kidney biopsy showed fungal hyphae within the glomeruli, tubules and interstitium. Although radiological investigations can give us a clue, the definitive diagnosis can only be made by kidney biopsy. A high index of suspicion and timely diagnosis is important for a proper management.

  19. The role of acuity of illness at presentation in early mortality in black children with acute myeloid leukemia.

    Science.gov (United States)

    Winestone, Lena E; Getz, Kelly D; Miller, Tamara P; Wilkes, Jennifer J; Sack, Leah; Li, Yimei; Huang, Yuan-Shung; Seif, Alix E; Bagatell, Rochelle; Fisher, Brian T; Epstein, Andrew J; Aplenc, Richard

    2017-02-01

    Black patients with acute myeloid leukemia (AML) experience higher mortality than White patients. We compared induction mortality, acuity of illness prior to chemotherapy, and insurance type between Black and White patients to assess whether acuity of presentation mediates the disparity. Within a retrospective cohort of 1,122 children with AML treated with two courses of standard induction chemotherapy between 2004 and 2014 in the Pediatric Health Information System (PHIS) database, the association between race (Black versus White) and inpatient mortality during induction was examined. Intensive Care Unit (ICU)-level resource utilization during the first 72 hours following admission for initial AML chemotherapy was evaluated as a potential mediator. The total effect of race on mortality during Induction I revealed a strong association (unadjusted HR 2.75, CI: 1.18, 6.41). Black patients had a significantly higher unadjusted risk of requiring ICU-level resources within the first 72 hours after initial presentation (17% versus 11%; RR 1.52, CI: 1.04, 2.24). Mediation analyses revealed the indirect effect of race through acuity accounted for 61% of the relative excess mortality during Induction I. Publicly insured patients experienced greater induction mortality than privately insured patients regardless of race. Black patients with AML have significantly greater risk of induction mortality and are at increased risk for requiring ICU-level resources soon after presentation. Higher acuity amongst Black patients accounts for a substantial portion of the relative excess mortality during Induction I. Targeting factors affecting acuity of illness at presentation may lessen racial disparities in AML induction mortality.

  20. Child-Staff Ratios in Early Childhood Education and Care Settings and Child Outcomes: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Perlman, Michal; Fletcher, Brooke; Falenchuk, Olesya; Brunsek, Ashley; McMullen, Evelyn; Shah, Prakesh S.

    2017-01-01

    Child-staff ratios are a key quality indicator in early childhood education and care (ECEC) programs. Better ratios are believed to improve child outcomes by increasing opportunities for individual interactions and educational instruction from staff. The purpose of this systematic review, and where possible, meta-analysis, was to evaluate the association between child-staff ratios in preschool ECEC programs and children’s outcomes. Searches of Medline, PsycINFO, ERIC, websites of large datasets and reference sections of all retrieved articles were conducted up to July 3, 2015. Cross-sectional or longitudinal studies that evaluated the relationship between child-staff ratios in ECEC classrooms serving preschool aged children and child outcomes were independently identified by two reviewers. Data were independently extracted from included studies by two raters and differences between raters were resolved by consensus. Searches revealed 29 eligible studies (31 samples). Child-staff ratios ranged from 5 to 14.5 preschool-aged children per adult with a mean of 8.65. All 29 studies were included in the systematic review. However, the only meta-analysis that could be conducted was based on three studies that explored associations between ratios and children’s receptive language. Results of this meta-analysis were not significant. Results of the qualitative systematic review revealed few significant relationships between child-staff ratios and child outcomes construed broadly. Thus, the available literature reveal few, if any, relationships between child-staff ratios in preschool ECEC programs and children’s developmental outcomes. Substantial heterogeneity in the assessment of ratios, outcomes measured, and statistics used to capture associations limited quantitative synthesis. Other methodological limitations of the research integrated in this synthesis are discussed. PMID:28103288

  1. Occult breast primary malignancy presenting as isolated axillary lymph node metastasis - early detection of primary site by 18F-FDG PET/CT.

    Science.gov (United States)

    Soundararajan, Ramya; Naswa, Niraj; Karunanithi, Sellam; Walia, Ritika; Kumar, Rakesh; Bal, Chandrasekhar

    2016-01-01

    Breast cancer patients rarely present with isolated axillary lymph node metastasis without any clinical or radiological evidence of primary tumor. Identification of the primary site of tumor helps in planning appropriate patient management which has definite impact on patient's survival. We present here a case of 30-year-old female who presented with isolated right axillary lymph node metastasis with no evidence of primary tumor clinically. Conventional imaging modalities were negative for primary site. She underwent whole body 18F-Flurodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and it contributed significantly in early detection of occult primary tumor in right breast.

  2. Sex differences in early-life programming of the hypothalamic-pituitary-adrenal axis in humans suggest increased vulnerability in females: a systematic review.

    Science.gov (United States)

    Carpenter, T; Grecian, S M; Reynolds, R M

    2017-04-01

    Fetal glucocorticoid overexposure is a key mechanism linking early development with later-life disease. In humans, low birth weight associates with increased fasting cortisol, hypothalamic-pituitary-adrenal (HPA) axis reactivity, and with cardiovascular risk and cognitive decline. As there are sex differences in these adult diseases, we hypothesized that there may be sex differences in programming of the HPA axis in response to prenatal stressors. We conducted a systematic review following Meta-Analysis of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched Embase, MEDLINE and Web of Science from inception to 31 October 2016. We included studies related to sex differences, prenatal exposures and HPA axis. We excluded studies investigating specific disease states. The 23 included studies investigated the consequences of low birth weight, preterm birth and maternal stressors of asthma, psychosocial stress and glucocorticoid medications on HPA axis outcomes of placental glucocorticoid biology and offspring HPA axis function in early life and later life. Female offspring exposed to stressors had increased HPA axis reactivity compared with males. Furthermore, the female placenta increased its permeability to maternal glucocorticoids following maternal stress with changes in the expression of 11β-hydroxysteroid dehydrogenase enzymes in response to maternal glucocorticoid exposure or asthma. Among males there was some evidence of altered diurnal cortisol secretion. We conclude that although there is some evidence of male vulnerability leading to altered diurnal cortisol secretion, the female HPA axis is more vulnerable to programming, particularly in terms of its reactivity; this suggests a mechanism underlying sex differences in later-life diseases.

  3. Differences in clinical presentation between bipolar I and II disorders in the early stages of bipolar disorder

    DEFF Research Database (Denmark)

    Vinberg, Maj; Mikkelsen, Rie Lambaek; Kirkegaard, Thomas;

    2017-01-01

    level, the presence of comorbid personality disorders and coping strategies. METHODS: Diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Disorders. Clinical symptoms were rated with the Young Mania Rating Scale and the Hamilton Depression Rating Scale, and functional status...... using the Coping Inventory for Stressful Situations. RESULTS: In total, 344 patients were included (BD I (n=163) and BD II (n=181). Patients with BD II presented with significantly more depressive symptoms, more cognitive complaints, lower overall functioning, and a higher prevalence of comorbid...

  4. The QT dispersion and QTc dispersion in patients presenting with acute neurological events and its impact on early prognosis

    Directory of Open Access Journals (Sweden)

    Kailash Kumar Rahar

    2016-01-01

    Full Text Available Aims: To find out and investigate whether the QT dispersion and QTc dispersion is related to type and prognosis of the acute stroke in patients presenting within 24 h of the onset of stroke. Settings and Design: This was a observational study conducted at Mahatma Gandhi Hospital, Dr. SN. Medical College, Jodhpur, during January 2014 to January 2015. Subjects and Methods: The patients presented within 24 h of onset of acute stroke (hemorrhagic, infarction, or transient ischemic event were included in the study. The stroke was confirmed by computed tomography scan and magnetic resonance imaging. Patients with (i altered sensorium because of metabolic, infective, seizures, trauma, or tumor; (ii prior history of cardiovascular disease, electrocardiographic abnormalities' because of dyselectrolytemia; and (iii and patients who were on drugs (antiarrhythmic drugs, antipsychotic drugs, erythromycin, theophylline, etc., which known to cause electrocardiogram changes, were excluded from the study. National Institute of Health Stroke Score (NIHSS was calculated at the time of admission and Modified Rankin Scale (MRS at the time of discharge. Fifty age- and sex-matched healthy controls included. Statistical Analysis Used: Student's t-test, ANOVA, and area under curve for sensitivity and specificity for the test. Results: We included 52 patients (male/female: 27/25 and 50 controls (26/24. The mean age of patients was 63.17 ± 08.90 years. Of total patients, infarct was found in 32 (61.53%, hemorrhage in 18 (34.61%, transient ischemic attack (TIA in 1 (1.9%, and subarachnoid hemorrhage in 1 (1.9% patient. The QT dispersion and QTc dispersion were significantly higher in cases as compare to controls. (87.30 ± 24.42 vs. 49.60 ± 08.79 ms; P < 0.001 and (97.53 ± 27.36 vs. 56.28 ± 09.86 ms; P < 0.001. Among various types of stroke, the mean QT dispersion and QTc dispersion were maximum and significantly higher in hemorrhagic stroke as compared to infarct and

  5. The QT dispersion and QTc dispersion in patients presenting with acute neurological events and its impact on early prognosis.

    Science.gov (United States)

    Rahar, Kailash Kumar; Pahadiya, Hans Raj; Barupal, Kishan Gopal; Mathur, C P; Lakhotia, Manoj

    2016-01-01

    To find out and investigate whether the QT dispersion and QTc dispersion is related to type and prognosis of the acute stroke in patients presenting within 24 h of the onset of stroke. This was a observational study conducted at Mahatma Gandhi Hospital, Dr. SN. Medical College, Jodhpur, during January 2014 to January 2015. The patients presented within 24 h of onset of acute stroke (hemorrhagic, infarction, or transient ischemic event) were included in the study. The stroke was confirmed by computed tomography scan and magnetic resonance imaging. Patients with (i) altered sensorium because of metabolic, infective, seizures, trauma, or tumor; (ii) prior history of cardiovascular disease, electrocardiographic abnormalities' because of dyselectrolytemia; and (iii) and patients who were on drugs (antiarrhythmic drugs, antipsychotic drugs, erythromycin, theophylline, etc.,) which known to cause electrocardiogram changes, were excluded from the study. National Institute of Health Stroke Score (NIHSS) was calculated at the time of admission and Modified Rankin Scale (MRS) at the time of discharge. Fifty age- and sex-matched healthy controls included. Student's t-test, ANOVA, and area under curve for sensitivity and specificity for the test. We included 52 patients (male/female: 27/25) and 50 controls (26/24). The mean age of patients was 63.17 ± 08.90 years. Of total patients, infarct was found in 32 (61.53%), hemorrhage in 18 (34.61%), transient ischemic attack (TIA) in 1 (1.9%), and subarachnoid hemorrhage in 1 (1.9%) patient. The QT dispersion and QTc dispersion were significantly higher in cases as compare to controls. (87.30 ± 24.42 vs. 49.60 ± 08.79 ms; P < 0.001) and (97.53 ± 27.36 vs. 56.28 ± 09.86 ms; P < 0.001). Among various types of stroke, the mean QT dispersion and QTc dispersion were maximum and significantly higher in hemorrhagic stroke as compared to infarct and TIA (P < 0.001). The mean QT dispersion and QTc dispersion was found significantly high

  6. Present-day cosmic abundances. A comprehensive study of nearby early B-type stars and implications for stellar and Galactic evolution and interstellar dust models

    CERN Document Server

    Nieva, Maria-Fernanda; 10.1051/0004-6361/201118158

    2012-01-01

    Aims. A sample of early B-type stars in OB associations and the field within the solar neighbourhood is studied comprehensively. Present-day abundances for the astrophysically most interesting chemical elements are derived. Methods. High-resolution and high-S/N spectra of early B-type stars are analysed in NLTE. Atmospheric parameters are derived from the simultaneous establishment of independent indicators, from multiple ionization equilibria and the hydrogen Balmer lines. Results. Teff is constrained to 1-2% and logg to less than 15% uncertainty. Absolute values for metal abundances are determined to better than 25% uncertainty. The synthetic spectra match the observations reliably over almost the entire visual spectral range. Conclusions. A present-day cosmic abundance standard is established. Our results i) resolve the discrepancy between a chemical homogeneous local gas-phase ISM and a chemically inhomogeneous young stellar component, ii) facilitate the amount of heavy elements locked up in the interstel...

  7. Effectiveness of very early workplace interventions to reduce sickness absence: A systematic review of the literature and meta-analysis

    Science.gov (United States)

    Vargas-Prada, Sergio; Demou, Evangelia; Lalloo, Drushca; Avila-Palencia, Ione; Sanati, Kaveh A.; Sampere, Maite; Freer, Kerry; Serra, Consol; Macdonald, Ewan B.

    2017-01-01

    Objective “To investigate the effectiveness of workplace interventions for return to work (RTW) delivered at very early stages (design of the studies, notably the extent and timing of usual care provided and variable compliance/crossover between groups could however explain the lack of demonstrated benefit. Consensus is required on the definition of ‘early’ and ‘very early’ interventions and further research is recommended to improve understanding of the factors influencing when and how best to intervene for maximum gain. PMID:27271024

  8. The systematization of practice

    DEFF Research Database (Denmark)

    Vidal, Rene Victor Valqui

    2002-01-01

    this paper presents an approach for the systematization of practical experiences whitin Operations Research, Community work, Systems Sciences, Action Research, etc. A case study is presented: the systematization of the activities of a development center in Denmark.......this paper presents an approach for the systematization of practical experiences whitin Operations Research, Community work, Systems Sciences, Action Research, etc. A case study is presented: the systematization of the activities of a development center in Denmark....

  9. An unusual cause of S1 radicular pain presenting as early phantom pain in a transfemoral amputee: a case report.

    Science.gov (United States)

    Smuck, Matthew; Christensen, Sara; Lee, Stan S; Sagher, Oren

    2008-01-01

    Recent epidemiologic studies have shown back pain to be a significant cause of pain in lower-limb amputees, but only a handful of cases have reported sciatica in amputees. The symptoms are usually described as a phantom pain or neuropathic pain in the residual limb that is often refractory to conventional treatments. These symptoms typically occur with back pain and are distinct from the patient's usual symptoms. Interestingly, back pain is not a universal finding. We present a patient with presumed phantom limb pain subsequently discovered to be caused by an S1 radiculopathy. This patient's supposed phantom pain persisted despite multiple medication trials. Initial work-up revealed a sciatic neuroma at the stump. Treatments targeting this neuroma were unsuccessful. Further evaluation found that a sacroiliac joint screw placed to stabilize a pelvic fracture had intruded into the S1 neuroforamen. A diagnostic S1 nerve block temporarily relieved the patient's pain, and the screw was removed. Pain persisted and a spinal cord stimulator was placed resulting in improvement of his pain. Because conventional diagnostic tests are limited, including physical exam and electromyography, a fluoroscopically guided selective spinal nerve block proved to be a useful diagnostic tool in this patient.

  10. SIV Encephalitis Lesions Are Composed of CD163+ Macrophages Present in the Central Nervous System during Early SIV Infection and SIV-Positive Macrophages Recruited Terminally with AIDS

    Science.gov (United States)

    Nowlin, Brian T.; Burdo, Tricia H.; Midkiff, Cecily C.; Salemi, Marco; Alvarez, Xavier; Williams, Kenneth C.

    2016-01-01

    Macrophage recruitment to the central nervous system (CNS) during AIDS pathogenesis is poorly understood. We measured the accumulation of brain perivascular (CD163+) and inflammatory (MAC387+) macrophages in SIV-infected monkeys. Monocyte progenitors were 5-bromo-2′-deoxyuridine (BrdU) labeled in bone marrow, and CNS macrophages were labeled serially with fluorescent dextrans injected into the cisterna magna. MAC387+ macrophages accumulated in the meninges and choroid plexus in early inflammation and in the perivascular space and SIV encephalitis (SIVE) lesions late. CD163+ macrophages accumulated in the perivascular space and SIVE lesions with late inflammation. Most of the BrdU+ cells were MAC387+; however, CD163+BrdU+ macrophages were present in the meninges and choroid plexus with AIDS. Most (81.6% ± 1.8%) of macrophages in SIVE lesions were present in the CNS before SIVE lesion formation. There was a 2.9-fold increase in SIVp28+ macrophages entering the CNS late compared with those entering early (P CD163+ macrophage recruitment to the CNS inversely correlated with time to death (P CD163 correlated with CD163+ macrophage recruitment (P = 0.02). Most perivascular macrophages that comprise SIVE lesions and multinucleated giant cells are present in the CNS early, before SIVE lesions are formed. Most SIV-infected macrophages traffic to the CNS terminally with AIDS. PMID:25963554

  11. SIV encephalitis lesions are composed of CD163(+) macrophages present in the central nervous system during early SIV infection and SIV-positive macrophages recruited terminally with AIDS.

    Science.gov (United States)

    Nowlin, Brian T; Burdo, Tricia H; Midkiff, Cecily C; Salemi, Marco; Alvarez, Xavier; Williams, Kenneth C

    2015-06-01

    Macrophage recruitment to the central nervous system (CNS) during AIDS pathogenesis is poorly understood. We measured the accumulation of brain perivascular (CD163(+)) and inflammatory (MAC387(+)) macrophages in SIV-infected monkeys. Monocyte progenitors were 5-bromo-2'-deoxyuridine (BrdU) labeled in bone marrow, and CNS macrophages were labeled serially with fluorescent dextrans injected into the cisterna magna. MAC387(+) macrophages accumulated in the meninges and choroid plexus in early inflammation and in the perivascular space and SIV encephalitis (SIVE) lesions late. CD163(+) macrophages accumulated in the perivascular space and SIVE lesions with late inflammation. Most of the BrdU(+) cells were MAC387(+); however, CD163(+)BrdU(+) macrophages were present in the meninges and choroid plexus with AIDS. Most (81.6% ± 1.8%) of macrophages in SIVE lesions were present in the CNS before SIVE lesion formation. There was a 2.9-fold increase in SIVp28(+) macrophages entering the CNS late compared with those entering early (P CD163(+) macrophage recruitment to the CNS inversely correlated with time to death (P CD163 correlated with CD163(+) macrophage recruitment (P = 0.02). Most perivascular macrophages that comprise SIVE lesions and multinucleated giant cells are present in the CNS early, before SIVE lesions are formed. Most SIV-infected macrophages traffic to the CNS terminally with AIDS. Copyright © 2015 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  12. Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yu Chen

    2014-01-01

    Full Text Available Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62% patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P<0.0001 and complication incidence (RR, 0.68, P<0.0001. The mean interval from open abdomen to definitive closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen.

  13. Disparity, decimation and the Cambrian "explosion": comparison of early Cambrian and present faunal communities with emphasis on velvet worms (Onychophora).

    Science.gov (United States)

    Monge-Nájera, J; Hou, X

    2000-01-01

    The controversy about a Cambrian "explosion" of morphological disparity (followed by decimation), cladogenesis and fossilization is of central importance for the history of life. This paper revisits the controversy (with emphasis in onychophorans, which include emblematic organisms such as Hallucigenia), presents new data about the Chengjiang (Cambrian of China) faunal community and compares it and the Burgess Shale (Cambrian of Canada) with an ecologically similar but modern tropical marine site where onychophorans are absent, and with a modern neotropical terrestrial onychophoran community. Biovolume was estimated from material collected in Costa Rica and morphometric measurements were made on enlarged images of fossils. Cambrian tropical mudflats were characterized by the adaptive radiation of two contrasting groups: the vagile arthropods and the sessile poriferans. Arthropods were later replaced as the dominant benthic taxon by polychaetes. Vagility and the exoskeleton may explain the success of arthropods from the Cambrian to the modern marine and terrestrial communities, both in population and biovolume. Food ecological displacement was apparent in the B. Shale, but not in Chengjiang or the terrestrial community. When only hard parts were preserved, marine and terrestrial fossil deposits of tropical origin are even less representative than deposits produced by temperate taxa, Chengjiang being an exception. Nutrient limitations might explain why deposit feeding is less important in terrestrial onychophoran communities, where carnivory, scavenging and omnivory (associated with high motility and life over the substrate) became more important. Fossil morphometry supports the interpretation of "lobopod animals" as onychophorans, whose abundance in Chengjiang was equal to their abundance in modern communities. The extinction of marine onychophorans may reflect domination of the infaunal habitat by polychaetes. We conclude that (1) a mature ecological community

  14. Efficacy of Aloe Vera Supplementation on Prediabetes and Early Non-Treated Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Zhang, Yiyi; Liu, Wen; Liu, Dan; Zhao, Tieyun; Tian, Haoming

    2016-01-01

    The aim of this study was to evaluate evidence for the efficacy of aloe vera on managing prediabetes and early non-treated diabetes mellitus. We performed a systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials until 28 January 2016. A total of five randomized controlled trials (RCTs) involving 415 participants were included. Compared with the controls, aloe vera supplementation significantly reduced the concentrations of fasting blood glucose (FBG) (p = 0.02; weighed mean difference [WMD]: −30.05 mg/dL; 95% confidence interval [CI]: −54.87 to −5.23 mg/dL), glycosylated hemoglobin A1c (HbA1c) (p Aloe vera was superior to placebo in increasing serum high density lipoprotein-cholesterol (HDL-C) levels (p = 0.04). Only one adverse event was reported. The evidence from RCTs showed that aloe vera might effectively reduce the levels of FBG, HbA1c, triglyceride, TC and LDL-C, and increase the levels of HDL-C on prediabetes and early non-treated diabetic patients. Limited evidence exists about the safety of aloe vera. Given the small number and poor quality of RCTs included in the meta-analysis, these results are inconclusive. A large-scale, well-designed RCT is needed to further address this issue. PMID:27347994

  15. Efficacy of Aloe Vera Supplementation on Prediabetes and Early Non-Treated Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Zhang, Yiyi; Liu, Wen; Liu, Dan; Zhao, Tieyun; Tian, Haoming

    2016-06-23

    The aim of this study was to evaluate evidence for the efficacy of aloe vera on managing prediabetes and early non-treated diabetes mellitus. We performed a systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials until 28 January 2016. A total of five randomized controlled trials (RCTs) involving 415 participants were included. Compared with the controls, aloe vera supplementation significantly reduced the concentrations of fasting blood glucose (FBG) (p = 0.02; weighed mean difference [WMD]: -30.05 mg/dL; 95% confidence interval [CI]: -54.87 to -5.23 mg/dL), glycosylated hemoglobin A1c (HbA1c) (p Aloe vera was superior to placebo in increasing serum high density lipoprotein-cholesterol (HDL-C) levels (p = 0.04). Only one adverse event was reported. The evidence from RCTs showed that aloe vera might effectively reduce the levels of FBG, HbA1c, triglyceride, TC and LDL-C, and increase the levels of HDL-C on prediabetes and early non-treated diabetic patients. Limited evidence exists about the safety of aloe vera. Given the small number and poor quality of RCTs included in the meta-analysis, these results are inconclusive. A large-scale, well-designed RCT is needed to further address this issue.

  16. Disparity, decimation and the Cambrian "explosion": comparison of early Cambrian and Present faunal communities with emphasis on velvet worms (Onychophora

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    Julián Monge-Nájera

    2000-06-01

    Full Text Available The controversy about a Cambrian "explosion" of morphological disparity (followed by decimation, cladogenesis and fossilization is of central importance for the history of life. This paper revisits the controversy (with emphasis in onychophorans, which include emblematic organisms such as Hallucigenia, presents new data about the Chengjiang (Cambrian of China faunal community and compares it and the Burgess Shale (Cambrian of Canada with an ecologically similar but modern tropical marine site where onychophorans are absent, and with a modern neotropical terrestrial onychophoran community. Biovolume was estimated from material collected in Costa Rica and morphometric measurements were made on enlarged images of fossils. Cambrian tropical mudflats were characterized by the adaptive radiation of two contrasting groups: the vagile arthropods and the sessile poriferans. Arthropods were later replaced as the dominant benthic taxon by polychaetes. Vagility and the exoskeleton may explain the success of arthropods from the Cambrian to the modern marine and terrestrial communities, both in population and biovolume. Food ecological displacement was apparent in the B. Shale, but not in Chengjiang or the terrestrial community. When only hard parts were preserved, marine and terrestrial fossil deposits of tropical origin are even less representative than deposits produced by temperate taxa, Chengjiang being an exception. Nutrient limitations might explain why deposit feeding is less important in terrestrial onychophoran communities, where carnivory, scavenging and omnivory (associated with high motility and life over the substrate became more important. Fossil morphometry supports the interpretation of "lobopod animals" as onychophorans, whose abundance in Chengjiang was equal to their abundance in modern communities. The extinction of marine onychophorans may reflect domination of the infaunal habitat by polychaetes. We conclude that (1 a mature ecological

  17. A new brittle star from the early Carboniferous of Poland and its implications on Paleozoic modern-type ophiuroid systematics

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    Ben Thuy

    2015-12-01

    Full Text Available The fossil record of Paleozoic ophiuroids includes a number of forms which share striking similarities with modern relatives in terms of skeletal morphology. These so called modern-type Paleozoic ophiuroids yield an enormous potential for a better understanding of ophiuroid evolution, yet the scarcity of accurate and sufficiently detailed morphological descriptions available to date precludes any further-reaching assessments. Here, we describe an articulated ophiuroid specimen from the Late Tournaisian (early Carboniferous of Czatkowice quarry, southern Poland, as a new species Aganaster jagiellonicus sp. nov. The good preservation of the specimen allowed for a morphological analysis at a level comparable to recent ophiuroid descriptions. It shows remarkable morphological similarities with extant former ophiolepidids Ophiomusium and Ophiosphalma. The new find thus contributes to a solid basis for future investigations on the position of the modern-type Paleozoic ophiuroid in the phylogeny of the class.

  18. SYMPTOM PRESENTATIONS AND CLASSIFICATION OF AUTISM SPECTRUM DISORDER IN EARLY CHILDHOOD: APPLICATION TO THE DIAGNOSTIC CLASSIFICATION OF MENTAL HEALTH AND DEVELOPMENTAL DISORDERS OF INFANCY AND EARLY CHILDHOOD (DC:0-5).

    Science.gov (United States)

    Soto, Timothy; Giserman Kiss, Ivy; Carter, Alice S

    2016-09-01

    Over the past 5 years, a great deal of information about the early course of autism spectrum disorder (ASD) has emerged from longitudinal prospective studies of infants at high risk for developing ASD based on a previously diagnosed older sibling. The current article describes early ASD symptom presentations and outlines the rationale for defining a new disorder, Early Atypical Autism Spectrum Disorder (EA-ASD) to accompany ASD in the new revision of the ZERO TO THREE Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-5) (in press) alternative diagnostic classification manual. EA-ASD is designed to identify children who are 9 to 36 months of age presenting with a minimum of (a) two social-communication symptoms and (b) one repetitive and restricted behavior symptom as well as (c) evidence of impairment, with the intention of providing these children with appropriately tailored services and improving the likelihood of optimizing their development. © 2016 Michigan Association for Infant Mental Health.

  19. Early excision and late excision of heterotopic ossification after traumatic brain injury are equivalent: a systematic review of the literature.

    Science.gov (United States)

    Chalidis, Byron; Stengel, Dirk; Giannoudis, Peter V

    2007-11-01

    Heterotopic ossification (HO) is a common complication in patients with coma after brain injury. As the optimal timing of surgical resection is still controversial and unclear, a review of the literature was performed in order to determine the impact of early operation on recurrence rate and joint mobility. We identified all types of studies dealing with surgical excision of HO in patients after head injury in major medical and publishers' databases. Publication bias and statistical heterogeneity were assessed by funnel-plot asymmetry and Galbraith regression. We abstracted demographic and outcome information from manuscripts that tabulated individual patient data (IPD) to build univariate logistic and linear regression models. Means and proportions for random-effects meta-regression analysis were also obtained. Of 318 studies originally identified, 16 observational studies enrolling 255 patients (212 men, 329 affected joints, mean age of 30.6 [+/-SEM of 1.4] years) were included in the analysis. The reported overall recurrence rate in eleven studies was 38/192 (19.8%). Both IPD and meta-regression analysis failed to show a marked impact of the interval to resection on the probability of recurrence (odds ratio 1.00, 95% CI 0.98-1.03). The predicted probability of recurrence after 13, 21, and 30 months of waiting was 9%, 14%, and 19%, respectively. The length of coma period and patient's neurologic deficit were statistically significant negative predictors for both recurrence rate and functional outcome. Although no conclusive inferences can be drawn from the identified studies, the available data do not support the concept that early excision triggers later recurrence.

  20. DYNAMICAL VERSUS STELLAR MASSES IN COMPACT EARLY-TYPE GALAXIES: FURTHER EVIDENCE FOR SYSTEMATIC VARIATION IN THE STELLAR INITIAL MASS FUNCTION

    Energy Technology Data Exchange (ETDEWEB)

    Conroy, Charlie [Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064 (United States); Dutton, Aaron A. [Max Planck Institute for Astronomy, Königstuhl 17, D-69117 Heidelberg (Germany); Graves, Genevieve J. [Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544 (United States); Mendel, J. Trevor [Max-Planck-Institute for Extraterrestrial Physics, Giessenbachstrasse, D-85748 Garching (Germany); Van Dokkum, Pieter G. [Department of Astrophysical Sciences, Yale University, New Haven, CT 06511 (United States)

    2013-10-20

    Several independent lines of evidence suggest that the stellar initial mass function (IMF) in early-type galaxies becomes increasingly 'bottom-heavy' with increasing galaxy mass and/or velocity dispersion, σ. Here we consider evidence for IMF variation in a sample of relatively compact early-type galaxies drawn from the Sloan Digital Sky Survey. These galaxies are of sufficiently high stellar density that a dark halo likely makes a minor contribution to the total dynamical mass, M {sub dyn}, within one effective radius. We fit our detailed stellar population synthesis models to the stacked absorption line spectra of these galaxies in bins of σ and find evidence from IMF-sensitive spectral features for a bottom-heavy IMF at high σ. We also apply simple 'mass-follows-light' dynamical models to the same data and find that M {sub dyn} is significantly higher than what would be expected if these galaxies were stellar dominated and had a universal Milky Way IMF. Adopting M {sub dyn} ≈ M {sub *} therefore implies that the IMF is 'heavier' at high σ. Most importantly, the quantitative amount of inferred IMF variation is very similar between the two techniques, agreeing to within ∼< 0.1 dex in mass. The agreement between two independent techniques, when applied to the same data, provides compelling evidence for systematic variation in the IMF as a function of early-type galaxy velocity dispersion. Any alternative explanations must reproduce both the results from dynamical and stellar population-based techniques.

  1. Biomarkers in saliva for the detection of oral squamous cell carcinoma and their potential use for early diagnosis: a systematic review.

    Science.gov (United States)

    Gualtero, Diego F; Suarez Castillo, Angela

    2016-01-01

    Objective To determine the capacity of salivary biomarkers in the early diagnosis of oral squamous cell carcinoma. Study design A systematic review of the literature was performed based on the English titles listed in the PubMed, EBSCO, Cochrane, Science Direct, ISI web Science and SciELO databases using the following search descriptors: Oral cancer, diagnosis, biomarkers, saliva and oral squamous cell carcinoma. Abstracts and full-text articles were assessed independently by two reviewers. International checklists for assessment of methodological quality were used. Levels of evidence and grades of recommendation through the Scottish Intercollegiate Guidelines Network (SIGN) template were recognized. The units of analysis were identified through a reference matrix. Results Through the research strategy and after application of different filters and considering choosing criteria, six studies were obtained for analysis. Salivary biomarkers for oral cancer most frequently found were mRNA and proteins for IL-8, CD44, MMP-1 and MMP-3. New peptide-biomarkers such as Cyfra 21-1 and ZNF510 were found. ZNF 510 was the only biomarker which increased in the population with tumour stage T1 + T2 and T3 + T4. Only one study showed a sensitivity and specificity of 96% when the biomarker ZNF 510 is employed to discriminate early and late tumour stages. Conclusions There is no sufficient scientific evidence to support the capacity of the identified salivary biomarkers for the early diagnosis of oral cancer (sub-clinical stages of the pathogenic period before cancer phenotypes are manifested). Salivary biomarkers, however, may be employed to discriminate between healthy and cancer patients.

  2. Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis.

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    Grace J Chan

    2013-08-01

    Full Text Available Neonatal infections cause a significant proportion of deaths in the first week of life, yet little is known about risk factors and pathways of transmission for early-onset neonatal sepsis globally. We aimed to estimate the risk of neonatal infection (excluding sexually transmitted diseases [STDs] or congenital infections in the first seven days of life among newborns of mothers with bacterial infection or colonization during the intrapartum period.We searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, and the World Health Organization Regional Databases for studies of maternal infection, vertical transmission, and neonatal infection published from January 1, 1960 to March 30, 2013. Studies were included that reported effect measures on the risk of neonatal infection among newborns exposed to maternal infection. Random effects meta-analyses were used to pool data and calculate the odds ratio estimates of risk of infection. Eighty-three studies met the inclusion criteria. Seven studies (8.4% were from high neonatal mortality settings. Considerable heterogeneity existed between studies given the various definitions of laboratory-confirmed and clinical signs of infection, as well as for colonization and risk factors. The odds ratio for neonatal lab-confirmed infection among newborns of mothers with lab-confirmed infection was 6.6 (95% CI 3.9-11.2. Newborns of mothers with colonization had a 9.4 (95% CI 3.1-28.5 times higher odds of lab-confirmed infection than newborns of non-colonized mothers. Newborns of mothers with risk factors for infection (defined as prelabour rupture of membranes [PROM], preterm <37 weeks PROM, and prolonged ROM had a 2.3 (95% CI 1.0-5.4 times higher odds of infection than newborns of mothers without risk factors.Neonatal infection in the first week of life is associated with maternal infection and colonization. High-quality studies, particularly from settings with high neonatal mortality, are needed to

  3. Of flies, mice and men: a systematic approach to understanding the early life origins of chronic lung disease.

    Science.gov (United States)

    Krauss-Etschmann, Susanne; Bush, Andrew; Bellusci, Saverio; Brusselle, Guy G; Dahlén, Sven Erik K; Dehmel, Stefan; Eickelberg, Oliver; Gibson, Greg; Hylkema, Machteld N; Knaus, Petra; Königshoff, Melanie; Lloyd, Clare M; Macciarini, Paolo; Mailleux, Arnaud; Marsland, Benjamin J; Postma, Dirkje S; Roberts, Graham; Samakovlis, Christos; Stocks, Janet; Vandesompele, Joke; Wjst, Matthias; Holloway, John

    2013-04-01

    Despite intensive research efforts, the aetiology of the majority of chronic lung diseases (CLD) in both, children and adults, remains elusive. Current therapeutic options are limited, providing only symptomatic relief, rather than treating the underlying condition, or preventing its development in the first place. Thus, there is a strong and unmet clinical need for the development of both, novel effective therapies and preventative strategies for CLD. Many studies suggest that modifications of prenatal and/or early postnatal lung development will have important implications for future lung function and risk of CLD throughout life. This view represents a fundamental change of current pathophysiological concepts and treatment paradigms, and holds the potential to develop novel preventative and/or therapeutic strategies. However, for the successful development of such approaches, key questions, such as a clear understanding of underlying mechanisms of impaired lung development, the identification and validation of relevant preclinical models to facilitate translational research, and the development of concepts for correction of aberrant development, all need to be solved. Accordingly, a European Science Foundation Exploratory Workshop was held where clinical, translational and basic research scientists from different disciplines met to discuss potential mechanisms of developmental origins of CLD, and to identify major knowledge gaps in order to delineate a roadmap for future integrative research.

  4. Enhanced detection of paroxysmal atrial fibrillation by early and prolonged continuous holter monitoring in patients with cerebral ischemia presenting in sinus rhythm.

    Science.gov (United States)

    Stahrenberg, Raoul; Weber-Krüger, Mark; Seegers, Joachim; Edelmann, Frank; Lahno, Rosine; Haase, Beatrice; Mende, Meinhard; Wohlfahrt, Janin; Kermer, Pawel; Vollmann, Dirk; Hasenfuss, Gerd; Gröschel, Klaus; Wachter, Rolf

    2010-12-01

    Diagnosis of paroxysmal atrial fibrillation is difficult but highly relevant in patients presenting with cerebral ischemia yet free from atrial fibrillation on admission. Early initiation and prolongation of continuous Holter monitoring may improve diagnostic yield compared with the standard of care including a 24-hour Holter recording. In the observational Find-AF trial (ISRCTN 46104198), consecutive patients presenting with symptoms of cerebral ischemia were included. Patients free from atrial fibrillation at presentation received 7-day Holter monitoring. Two hundred eighty-one patients were prospectively included. Forty-four (15.7%) had atrial fibrillation documented by routine electrocardiogram on admission. All remaining patients received Holter monitors at a median of 5.5 hours after presentation. In those 224 patients who received Holter monitors but had no previously known paroxysmal atrial fibrillation, the detection rate with early and prolonged (7 days) Holter monitoring (12.5%) was significantly higher than for any 24-hour (mean of 7 intervals: 4.8%, P = 0.015) or any 48-hour monitoring interval (mean of 6 intervals: 6.4%, P = 0.023). Of those 28 patients with new atrial fibrillation on Holter monitoring, 15 (6.7%) had been discharged without therapeutic anticoagulation after routine clinical care (ie, with data from 24-hour Holter monitoring only). Detection rates were 43.8% or 6.3% for short supraventricular runs of ≥ 10 beats or prolonged episodes (> 5 hours) of atrial fibrillation, respectively. Diagnostic yield appeared to be only slightly and not significantly increased during the first 3 days after the index event. Prolongation of Holter monitoring in patients with symptoms of cerebral ischemic events increases the rate of detection of paroxysmal atrial fibrillation up to Day 7, leading to a relevant change in therapy in a substantial number of patients. Early initiation of monitoring does not appear to be crucial. Hence, prolonged Holter

  5. Treatment outcome of immediate, early and conventional single-tooth implants in the aesthetic zone : a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction

    NARCIS (Netherlands)

    den Hartog, Laurens; Huddleston Slater, James J. R.; Vissink, Arjan; Meijer, Henny J. A.; Raghoebar, Gerry M.

    2008-01-01

    den Hartog L, Huddleston Slater JJR, Vissink A, Meijer HJA, Raghoebar GM. Treatment outcome of immediate, early and conventional single-tooth implants in the aesthetic zone: a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction. J Clin Periodontol 2008; 35: 10

  6. A systematic review and methodological evaluation of published cost-effectiveness analyses of aromatase inhibitors versus tamoxifen in early stage breast cancer.

    Directory of Open Access Journals (Sweden)

    Ava A John-Baptiste

    Full Text Available BACKGROUND: A key priority in developing policies for providing affordable cancer care is measuring the value for money of new therapies using cost-effectiveness analyses (CEAs. For CEA to be useful it should focus on relevant outcomes and include thorough investigation of uncertainty. Randomized controlled trials (RCTs of five years of aromatase inhibitors (AI versus five years of tamoxifen in the treatment of post-menopausal women with early stage breast cancer, show benefit of AI in terms of disease free survival (DFS but not overall survival (OS and indicate higher risk of fracture with AI. Policy-relevant CEA of AI versus tamoxifen should focus on OS and include analysis of uncertainty over key assumptions. METHODS: We conducted a systematic review of published CEAs comparing an AI to tamoxifen. We searched Ovid MEDLINE, EMBASE, PsychINFO, and the Cochrane Database of Systematic Reviews without language restrictions. We selected CEAs with outcomes expressed as cost per life year or cost per quality adjusted life year (QALY. We assessed quality using the Neumann checklist. Using structured forms two abstractors collected descriptive information, sources of data, baseline assumptions on effectiveness and adverse events, and recorded approaches to assessing parameter uncertainty, methodological uncertainty, and structural uncertainty. RESULTS: We identified 1,622 citations and 18 studies met inclusion criteria. All CE estimates assumed a survival benefit for aromatase inhibitors. Twelve studies performed sensitivity analysis on the risk of adverse events and 7 assumed no additional mortality risk with any adverse event. Sub-group analysis was limited; 6 studies examined older women, 2 examined women with low recurrence risk, and 1 examined women with multiple comorbidities. CONCLUSION: Published CEAs comparing AIs to tamoxifen assumed an OS benefit though none has been shown in RCTs, leading to an overestimate of the cost-effectiveness of AIs

  7. Evaluation of systematic assessment of asthma-like symptoms and tobacco smoke exposure in early childhood by well-child professionals: a randomised trial.

    Directory of Open Access Journals (Sweden)

    Esther Hafkamp-de Groen

    Full Text Available This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals.Sixteen well-child centres in Rotterdam, the Netherlands, were randomised into 8 centres where the brief assessment form regarding asthma-like symptoms and ETS exposure was used and 8 centres that applied usual care. 3596 and 4179 children (born between April 2002 and January 2006 and their parents visited the intervention and control centres, respectively. At child's age 6 years, physician-diagnosed asthma ever, wheezing, fractional exhaled nitric oxide (FeNO, airway resistance (Rint, health-related quality of life (HRQOL and ETS exposure at home ever were measured. Linear mixed models were applied.No differences in asthma, wheezing, FeNO, Rint or HRQOL measurements between intervention and control group were found using multilevel regression in an intention-to-treat analysis (p>0.05. Children of whom the parents were interviewed by using the brief assessment form at the intervention well-child centres had a decreased risk on ETS exposure at home ever, compared to children who visited the control well-child centres, in an explorative per-protocol analysis (aOR = 0.71, 95% CI:0.59-0.87.Systematic assessment and counselling of asthma-like symptoms and ETS exposure in early childhood by well-child care professionals using a brief assessment form was not effective in reducing the prevalence of physician-diagnosed asthma ever and wheezing, and did not improve FeNO, Rint or HRQOL at age 6 years. Our results hold some promise for interviewing parents and using information leaflets at well-child centres to reduce ETS exposure at home in preschool children.Controlled-Trials.com ISRCTN15790308.

  8. Systematic Review of Metabolic Syndrome Biomarkers: A Panel for Early Detection, Management, and Risk Stratification in the West Virginian Population

    OpenAIRE

    Srikanthan, Krithika; Feyh, Andrew; Visweshwar, Haresh; Shapiro, Joseph I.; Sodhi, Komal

    2016-01-01

    Introduction: Metabolic syndrome represents a cluster of related metabolic abnormalities, including central obesity, hypertension, dyslipidemia, hyperglycemia, and insulin resistance, with central obesity and insulin resistance in particular recognized as causative factors. These metabolic derangements present significant risk factors for cardiovascular disease, which is commonly recognized as the primary clinical outcome, although other outcomes are possible. Metabolic syndrome is a progress...

  9. Achievement of NICE quality standards for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.

    Science.gov (United States)

    Ledingham, Joanna M; Snowden, Neil; Rivett, Ali; Galloway, James; Ide, Zoe; Firth, Jill; MacPhie, Elizabeth; Kandala, Ngianga; Dennison, Elaine M; Rowe, Ian

    2017-02-01

    A national audit was performed assessing the early management of suspected inflammatory arthritis by English and Welsh rheumatology units. The aim of this audit was to measure the performance of rheumatology services against National Institute for Health and Care Excellence (NICE) quality standards (QSs) for the management of early inflammatory arthritis benchmarked to regional and national comparators for the first time in the UK. All individuals >16 years of age presenting to rheumatology services in England and Wales with suspected new-onset inflammatory arthritis were included in the audit. Information was collected against six NICE QSs that pertain to early inflammatory arthritis management. We present national data for the 6354 patients recruited from 1 February 2014 to 31 January 2015; 97% of trusts and health boards in England and Wales participated in this audit. Only 17% of patients were referred by their general practitioner within 3 days of first presentation. Specialist rheumatology assessment occurred within 3 weeks of referral in 38% of patients. The target of DMARD initiation within 6 weeks of referral was achieved in 53% of RA patients; 36% were treated with combination DMARDs and 82% with steroids within the first 3 months of specialist care. Fifty-nine per cent of patients received structured education on their arthritis within 1 month of diagnosis. In total, 91% of patients had a treatment target set; the agreed target was achieved within 3 months of specialist review in only 27% of patients. Access to urgent advice via a telephone helpline was reported to be available in 96% of trusts. The audit has highlighted gaps between NICE standards and delivery of care, as well as substantial geographic variability. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Early mortality in adults initiating antiretroviral therapy (ART in low- and middle-income countries (LMIC: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Amita Gupta

    Full Text Available BACKGROUND: We systematically reviewed observational studies of early mortality post-antiretroviral therapy (ART initiation in low- and middle-income countries (LMIC in Asia, Africa, and Central and South America, as defined by the World Bank, to summarize what is known. METHODS AND FINDINGS: Studies published in English between January 1996 and December 2010 were searched in Medline and EMBASE. Three independent reviewers examined studies of mortality within one year post-ART. An article was included if the study was conducted in a LMIC, participants were initiating ART in a non-clinical trial setting and were ≥15 years. Fifty studies were included; 38 (76% from sub-Saharan Africa (SSA, 5 (10% from Asia, 2 (4% from the Americas, and 5 (10% were multi-regional. Median follow-up time and pre-ART CD4 cell count ranged from 3-55 months and 11-192 cells/mm(3, respectively. Loss-to-follow-up, reported in 40 (80% studies, ranged from 0.3%-27%. Overall, SSA had the highest pooled 12-month mortality probability of 0.17 (95% CI 0.11-0.24 versus 0.11 (95% CI 0.10-0.13 for Asia, and 0.07 (95% CI 0.007-0.20 for the Americas. Of 14 (28% studies reporting cause-specific mortality, tuberculosis (TB (5%-44%, wasting (5%-53%, advanced HIV (20%-37%, and chronic diarrhea (10%-25% were most common. Independent factors associated with early mortality in 30 (60% studies included: low baseline CD4 cell count, male sex, advanced World Health Organization clinical stage, low body mass index, anemia, age greater than 40 years, and pre-ART quantitative HIV RNA. CONCLUSIONS: Significant heterogeneity in outcomes and in methods of reporting outcomes exist among published studies evaluating mortality in the first year after ART initiation in LMIC. Early mortality rates are highest in SSA, and opportunistic illnesses such as TB and wasting syndrome are the most common reported causes of death. Strategies addressing modifiable risk factors associated with early death are

  11. A systematic review on identifying risk factors associated with early sexual debut and coerced sex among adolescents and young people in communities.

    Science.gov (United States)

    Lee, Regina Lai Tong; Yuen Loke, Alice; Hung, Tsz Man Tommy; Sobel, Howard

    2017-06-21

    To review literature on identifying the risk factors associated with early sexual coerced debut with the aim to facilitate the health care workers' planning of relevant health services to improve intervention strategies for delaying of early coerced sexual debut or forced sexual debut (CSD/FSD) in the communities. Identifying the risk factors associated with coercion at first sex is crucial for developing appropriate sexual and reproductive health information and health promotion in response. However, current knowledge about the risk factors associated with coercion, sexual debut (SD), and delayed SD among young people is limited. Health information programs are important during adolescence, when young people are developing their values and beliefs about sexual activity and sexual norms. However, little is known about those risk factors on initiation of early sexual debut in order to plan relevant interventions that can delay SD and prevent coerced sexual debut or forced sexual debut (CSD/FSD) in this population. A systematic review. An extensive literature search using Medline (PubMed), Nursing Journals (PubMed), Web of Science, PsychINFO and CINAHL. The search generated 39 published studies that met our inclusion and exclusion criteria. Thirty-two articles passed the quality appraisal and were selected. This review identified six domains of risk factors, categorized as: (1) the individual domain, (2) the family domain, (3) the partner/peer domain, (4) the school domain, (5) the community domain, and (6) the cultural domain. These factors highlight the influences on sexual decision-making among adolescents and young people and the timing of their first sexual intercourse. It is important to utilize the outcome of this review's categorization of identified risk factors to facilitate the health care workers and plan relevant sexual and reproductive health programs more accessible to adolescents, especially young females and their parents. There is a need to evaluate

  12. The Influence of the Early Retirement Process on Satisfaction with Early Retirement and Psychological Well-Being

    Science.gov (United States)

    Potocnik, Kristina; Tordera, Nuria; Peiro, Jose Maria

    2010-01-01

    The present study explores the influence of the early retirement process on adjustment to early retirement, taking into account the roles of individual characteristics and social context in this process. We proposed a systematic model integrating perceived ability to continue working, organizational pressures toward early retirement and group…

  13. Work absence and return 2: Predictors of early retirement: a Dutch prospective cohort study. Oral presentations: Day 2: Thursday, September 8, 2011. 22nd International Conference on Epidemiology in Occupational Health EPICOH 2011 September 7-9, 2011, Oxford, UK

    NARCIS (Netherlands)

    Geuskens, G.; Koppes, L.; Ybema, J.F.

    2011-01-01

    Objectives Despite the current debate on early retirement, relatively few longitudinal studies investigated determinants of (non-disability) early retirement. The aim of the present study was to identify (changes in) risk factors that predict early retirement. Methods Data of the Netherlands Working

  14. Efficacy of Aloe Vera Supplementation on Prediabetes and Early Non-Treated Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Yiyi Zhang

    2016-06-01

    Full Text Available The aim of this study was to evaluate evidence for the efficacy of aloe vera on managing prediabetes and early non-treated diabetes mellitus. We performed a systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials until 28 January 2016. A total of five randomized controlled trials (RCTs involving 415 participants were included. Compared with the controls, aloe vera supplementation significantly reduced the concentrations of fasting blood glucose (FBG (p = 0.02; weighed mean difference [WMD]: −30.05 mg/dL; 95% confidence interval [CI]: −54.87 to −5.23 mg/dL, glycosylated hemoglobin A1c (HbA1c (p < 0.00001; WMD: −0.41%; 95% CI: −0.55% to −0.27%, triglyceride (p = 0.0001, total cholesterol (TC (p < 0.00001, and low density lipoprotein-cholesterol (LDL-C (p < 0.00001. Aloe vera was superior to placebo in increasing serum high density lipoprotein-cholesterol (HDL-C levels (p = 0.04. Only one adverse event was reported. The evidence from RCTs showed that aloe vera might effectively reduce the levels of FBG, HbA1c, triglyceride, TC and LDL-C, and increase the levels of HDL-C on prediabetes and early non-treated diabetic patients. Limited evidence exists about the safety of aloe vera. Given the small number and poor quality of RCTs included in the meta-analysis, these results are inconclusive. A large-scale, well-designed RCT is needed to further address this issue.

  15. No evidence for early modulation of evoked responses in primary visual cortex to irrelevant probe stimuli presented during the attentional blink.

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    Oscar Jacoby

    Full Text Available BACKGROUND: During rapid serial visual presentation (RSVP, observers often miss the second of two targets if it appears within 500 ms of the first. This phenomenon, called the attentional blink (AB, is widely held to reflect a bottleneck in the processing of rapidly sequential stimuli that arises after initial sensory registration is complete (i.e., at a relatively late, post-perceptual stage of processing. Contrary to this view, recent fMRI studies have found that activity in the primary visual area (V1, which represents the earliest cortical stage of visual processing, is attenuated during the AB. Here we asked whether such changes in V1 activity during the AB arise in the initial feedforward sweep of stimulus input, or instead reflect the influence of feedback signals from higher cortical areas. METHODOLOGY/PRINCIPAL FINDINGS: EEG signals were recorded while participants monitored a sequential stream of distractor letters for two target digits (T1 and T2. Neural responses associated with an irrelevant probe stimulus presented simultaneously with T2 were measured using an ERP marker--the C1 component--that reflects initial perceptual processing of visual information in V1. As expected, T2 accuracy was compromised when the inter-target interval was brief, reflecting an AB deficit. Critically, however, the magnitude of the early C1 component evoked by the probe was not reduced during the AB. CONCLUSIONS/SIGNIFICANCE: Our finding that early sensory processing of irrelevant probe stimuli is not suppressed during the AB is consistent with theoretical models that assume that the bottleneck underlying the AB arises at a post-perceptual stage of processing. This suggests that reduced neural activity in V1 during the AB is driven by re-entrant signals from extrastriate areas that regulate early cortical activity via feedback connections with V1.

  16. Sulfur Dioxide and the Production of Sulfuric Acid on Present-Day and Early Mars: Implications for the Lack of Detected Carbonates on the Surface

    Science.gov (United States)

    Levine, Joel S.; Summers, Michael E.

    2008-01-01

    In the early history of Mars, volcanic activity associated with the formation of the Tharsis ridge produced a very large amount of atmospheric SO2--on the order of a bar of atmospheric SO2. In the present-day atmosphere of Mars, the lifetime of SO2 is relatively short with a lifetime of less than a day. The short lifetime of SO2 in the present Mars atmosphere makes the production of significant levels of H2SO4 very difficult since the SO2 may be destroyed by various chemical and photochemical processes before the SO2 can be converted to H2SO4. However, photochemical calculations performed and described here, indicate that enhanced atmospheric levels of CO2 in the early atmosphere of Mars resulted in a significantly enhanced atmospheric lifetime for SO2 up to several years. With a significantly enhanced atmospheric lifetime, SO2 could readily form large amounts of H2SO4, which precipitated out of the atmosphere in the form of droplets. The precipitated H2SO4 then reacted with potential surface carbonates, destroying the carbonates and resulting in the abundant and widespread distribution of sulfates on the surface of Mars as detected by recent Mars missions.

  17. Association of early age at establishment of chronic hepatitis B infection with persistent viral replication, liver cirrhosis and hepatocellular carcinoma: a systematic review.

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    Yusuke Shimakawa

    Full Text Available Age at infection with hepatitis B virus (HBV is a known risk factor for chronic HBV infection. However, in addition, there is some evidence that early age at infection further increases the risk of primary liver cancer beyond its association with increased risk of chronic infection. This systematic review of observational studies assesses the association between age at initiation of chronic HBV infection and liver cirrhosis, hepatocellular carcinoma, and their predictors including indicators of ongoing viral replication and hepatic damage. The review includes birth order and maternal HBV serology as proxies for age at infection. Electronic searches in two English-language (Medline and Embase, until Jan 2012 and two Chinese-language (CNKI and SinoMed, until Sep 2012 databases without language restriction and manual search through reference lists identified 7,077 papers, of which 19 studies of 21 outcomes (8 primary liver cancer, 1 liver cirrhosis, 10 viral replication and 2 liver inflammation are included. One study directly examined the age at infection in a longitudinal cohort, 12 assessed maternal sero-status and 6 investigated birth order. The direction of associations in all studies was in accordance with our hypothesis that earlier age at infection is associated with worse outcomes in addition to its effect of increasing the probability of chronic HBV infection. This has implications for the control of hepatitis B.

  18. Systematic Detections of Early Aftershocks and Remotely Triggered Seismicity in China Following the 2015 Mw7.8 Gorkha, Nepal earthquake

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    Wu, J.; Peng, Z.; Yao, D.; LI, L.; Meng, X.; Wang, B.; Wang, W.; Li, C.

    2015-12-01

    some time delays). The early aftershocks show systematic along-strike migrations, similar to other recently studied aftershock sequences. Our next step is to extend the same analysis to longer time period before and after the mainshock to detect potential foreshocks and investigate longer-time evolutions of seismicity in Nepal.

  19. Early Death in Two Patients with Acute Promyelocytic Leukemia Presenting the bcr3 Isoform, FLT3-ITD Mutation, and Elevated WT1 Level

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    Marianna Greco

    2013-01-01

    Full Text Available Despite major advances in the treatment of acute promyelocytic leukemia (APL, the problem of early death (ED remains unsolved. Alongside the currently known clinical and hematological risk factors, prognostic significance has been attributed to internal tandem duplication mutations of the fms-like tyrosine kinase-3 (FLT3-ITD, hypogranular variant morphology, and the bcr-3 isoform of PML-RARα. We describe premature death of two patients with the hypogranular variant of APL who presented remarkably high expression levels of Wilms' tumor gene (WT1. Our results point to WT1 as an important prognostic factor of ED that needs to be promptly evaluated in all newly diagnosed cases of APL.

  20. Locally advanced adenocarcinoma of the rectum presenting with necrotising fasciitis of the perineum: successful management with early aggressive surgery and multimodal therapy.

    Science.gov (United States)

    Ferreira, Luís; Alexandrino, Henrique; Soares Leite, Júlio; Castro Sousa, Francisco

    2015-12-16

    Colorectal cancer is a common malignant neoplasm and its treatment usually involves surgery associated, in some cases, depending on the staging, with chemoradiotherapy. Necrotising fasciitis of the perineum is a highly lethal infection of the perineum, perirectal tissues and genitals, requiring emergency surgical debridement, broad-spectrum antibiotics and control of sepsis. We present the case of a 59-year-old man with necrotising fasciitis of the perineum as the first clinical manifestation of locally advanced adenocarcinoma of the rectum, in which successful management consisted of early and aggressive surgical debridement, followed by multimodal therapy with curative intent. 2 years and 6 months after surgery the patient is well, with no evidence of local or systemic relapse.

  1. mRNA Structural constraints on EBNA1 synthesis impact on in vivo antigen presentation and early priming of CD8+ T cells.

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    Judy T Tellam

    2014-10-01

    Full Text Available Recent studies have shown that virally encoded mRNA sequences of genome maintenance proteins from herpesviruses contain clusters of unusual structural elements, G-quadruplexes, which modulate viral protein synthesis. Destabilization of these G-quadruplexes can override the inhibitory effect on self-synthesis of these proteins. Here we show that the purine-rich repetitive mRNA sequence of Epstein-Barr virus encoded nuclear antigen 1 (EBNA1 comprising G-quadruplex structures, limits both the presentation of MHC class I-restricted CD8(+ T cell epitopes by CD11c(+ dendritic cells in draining lymph nodes and early priming of antigen-specific CD8(+ T-cells. Destabilization of the G-quadruplex structures through codon-modification significantly enhanced in vivo antigen presentation and activation of virus-specific T cells. Ex vivo imaging of draining lymph nodes by confocal microscopy revealed enhanced antigen-specific T-cell trafficking and APC-CD8(+ T-cell interactions in mice primed with viral vectors encoding a codon-modified EBNA1 protein. More importantly, these antigen-specific T cells displayed enhanced expression of the T-box transcription factor and superior polyfunctionality consistent with the qualitative impact of translation efficiency. These results provide an important insight into how viruses exploit mRNA structure to down regulate synthesis of their viral maintenance proteins and delay priming of antigen-specific T cells, thereby establishing a successful latent infection in vivo. Furthermore, targeting EBNA1 mRNA rather than protein by small molecules or antisense oligonucleotides will enhance EBNA1 synthesis and the early priming of effector T cells, to establish a more rapid immune response and prevent persistent infection.

  2. Impact of SMS/GPRS printers in reducing time to early infant diagnosis compared to routine result reporting: a systematic review and meta-analysis.

    Science.gov (United States)

    Vojnov, Lara; Markby, Jessica; Boeke, Caroline; Penazzato, Martina; Urick, Brittany; Ghadrshenas, Anisa; Harris, Lindsay; Ford, Nathan; Peter, Trevor

    2017-08-18

    Despite significant gains made towards improving access, early infant diagnosis (EID) testing programs suffer from long test turnaround times that result in substantial loss to follow-up and mortality associated with delays in antiretroviral therapy initiation. These delays in treatment initiation are particularly impactful due to significant HIV-related infant mortality observed by 2-3 months of age. Short message service (SMS) and general packet radio service (GPRS) printers allow test results to be transmitted immediately to health care facilities upon completion of testing in the laboratory. We conducted a systematic review and meta-analysis to assess the benefit of using SMS/GPRS printers to increase the efficiency of EID test result delivery compared with traditional courier paper-based results delivery methods. We identified 11 studies contributing data for over 16,000 patients from East and Southern Africa. The test turnaround time from specimen collection to result received at the health care facility with courier paper-based methods was 68.0 days (n=6,835), while the test turnaround time with SMS/GPRS printers was 51.1 days (n=6,711), resulting in a 2.5 week (25%) reduction in turnaround time. Courier paper-based EID test result delivery methods are estimated to add 2.5 weeks to EID test turnaround times in low resource settings and increase the risk that infants receive test results during or after the early peak of infant mortality. SMS/GPRS result delivery to health care facility printers significantly reduced test turnaround time and may reduce this risk. SMS/GPRS printers should be considered for expedited delivery of EID and other centralized laboratory test results.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used

  3. Early trauma-focused cognitive-behavioural therapy to prevent chronic post-traumatic stress disorder and related symptoms: A systematic review and meta-analysis

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    Kirkehei Ingvild

    2008-09-01

    Full Text Available Abstract Background Early trauma-focused cognitive-behavioural therapy (TFCBT holds promise as a preventive intervention for people at risk of developing chronic post-traumatic stress disorder (PTSD. The aim of this review was to provide an updated evaluation of the effectiveness of early TFCBT on the prevention of PTSD in high risk populations. Methods We performed a systematic literature search in international electronic databases (MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, ISI and PILOTS and included randomised controlled trials comparing TFCBT delivered within 3 months of trauma, to alternative interventions. All included studies were critically appraised using a standardised checklist. Two independent reviewers selected studies for inclusion and assessed study quality. Data extraction was performed by one reviewer and controlled by another. Where appropriate, we entered study results into meta-analyses. Results Seven articles reporting the results of five RCTs were included. All compared TFCBT to supportive counselling (SC. The study population was patients with acute stress disorder (ASD in four trials, and with a PTSD diagnosis disregarding the duration criterion in the fifth trial. The overall relative risk (RR for a PTSD diagnosis was 0.56 (95% CI 0.42 to 0.76, 1.09 (95% CI 0.46 to 2.61 and 0.73 (95% CI 0.51 to 1.04 at 3–6 months, 9 months and 3–4 years post treatment, respectively. A subgroup analysis of the four ASD studies only resulted in RR = 0.36 (95% CI 0.17 to 0.78 for PTSD at 3–6 months. Anxiety and depression scores were generally lower in the TFCBT groups than in the SC groups. Conclusion There is evidence for the effectiveness of TFCBT compared to SC in preventing chronic PTSD in patients with an initial ASD diagnosis. As this evidence originates from one research team replications are necessary to assess generalisability. The evidence about the effectiveness of TFCBT in traumatised populations without an ASD

  4. Falsifications and corroborations: Karl Popper's influence on systematics.

    Science.gov (United States)

    Helfenbein, Kevin G; DeSalle, Rob

    2005-04-01

    Over the last three decades, the philosophy of Karl Raimund Popper has had a strong influence on the field of systematic biology. Unequivocally, no other philosopher's work has had such an influence during this formative period in systematics. Much, but not all, of the early discourse on Popper and systematics dealt with the philosophical basis of systematics as a science. More recently Popper's work has been discussed in the systematics literature in relation to specific methodologies such as parsimony and maximum likelihood. In this paper, we provide the reader with a concise summary of Popper's ideas relevant to systematics, review the systematic literature invoking or declining Popper's importance to the field, and make a recommendation for the future course of philosophical thinking in systematics. We try to make clear various authors' interpretations of Popper's work and how those interpretations have impacted systematic thought. Although the reader may come away from this review with a clearer idea of Popper's relevance or lack thereof, our primary hope is that the reader will be compelled to question him- or herself about the philosophical basis of the systematic work that he or she does, and to delve into the literature herein cited. We begin by presenting a synopsis of Popper's philosophical views to allow those views to be placed in the context of systematics.

  5. The impact of educational interventions on attitudes of emergency department staff towards patients with substance-related presentations: a quantitative systematic review.

    Science.gov (United States)

    Gonzalez, Miriam; Clarke, Diana E; Pereira, Asha; Boyce-Gaudreau, Krystal; Waldman, Celeste; Demczuk, Lisa; Legare, Carol

    2017-08-01

    Visits to emergency departments for substance use/abuse are common worldwide. However, emergency department health care providers perceive substance-using patients as a challenging group to manage which can lead to negative attitudes. Providing education or experience-based exercises may impact positively on behaviors towards this patient population. Whether staff attitudes are similarly impacted by knowledge acquired through educational interventions remains unknown. To synthesize available evidence on the relationship between new knowledge gained through substance use educational interventions and emergency department health care providers' attitudes towards patients with substance-related presentations. Health care providers working in urban and rural emergency departments of healthcare facilities worldwide providing care to adult patients with substance-related presentations. Quantitative papers examining the impact of substance use educational interventions on health care providers' attitudes towards substance using patients. Experimental and non-experimental study designs. Emergency department staff attitudes towards patients presenting with substance use/abuse. A three-step search strategy was conducted in August 2015 with a search update in March 2017. Studies published since 1995 in English, French or Spanish were considered for inclusion. Two reviewers assessed studies for methodological quality using critical appraisal checklists from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Reviewers agreed on JBI-MAStARI methodological criteria a study must meet in order to be included in the review (e.g. appropriate use of statistical analysis). The data extraction instrument from JBI-MAStARI was used. As statistical pooling of the data was not possible, the findings are presented in narrative form. A total of 900 articles were identified as relevant for this review. Following abstract and full text

  6. Present-day cosmic abundances. A comprehensive study of nearby early B-type stars and implications for stellar and Galactic evolution and interstellar dust models

    Science.gov (United States)

    Nieva, M.-F.; Przybilla, N.

    2012-03-01

    Context. Early B-type stars are ideal indicators for present-day cosmic abundances since they preserve their pristine abundances and typically do not migrate far beyond their birth environments over their short lifetimes, in contrast to older stars like the Sun. They are also unaffected by depletion onto dust grains, unlike the cold/warm interstellar medium (ISM) or H ii regions. Aims: A carefully selected sample of early B-type stars in OB associations and the field within the solar neighbourhood is studied comprehensively. Quantitative spectroscopy is used to characterise their atmospheric properties in a self-consistent way. Present-day abundances for the astrophysically most interesting chemical elements are derived in order to investigate whether a present-day cosmic abundance standard can be established. Methods: High-resolution and high-S/N FOCES, FEROS and ELODIE spectra of well-studied sharp-lined early B-type stars are analysed in non-LTE. Line-profile fits based on extensive model grids and an iterative analysis methodology are used to constrain stellar parameters and elemental abundances at high accuracy and precision. Atmospheric parameters are derived from the simultaneous establishment of independent indicators, from multiple ionization equilibria and the Stark-broadened hydrogen Balmer lines, and they are confirmed by reproduction of the stars' global spectral energy distributions. Results: Effective temperatures are constrained to 1-2% and surface gravities to less than 15% uncertainty, along with accurate rotational, micro- and macroturbulence velocities. Good agreement of the resulting spectroscopic parallaxes with those from the new reduction of the Hipparcos catalogue is obtained. Absolute values for abundances of He, C, N, O, Ne, Mg, Si and Fe are determined to better than 25% uncertainty. The synthetic spectra match the observations reliably over almost the entire visual spectral range. Three sample stars, γ Ori, o Per and θ1 Ori D, are

  7. Early diagnosis and treatment of invasive aspergillosis as a main determinant of outcome – review of literature according to the presented case report

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    Michał Borys

    2017-03-01

    Although. [i]Aspergillus spp[/i] infection is not the major cause of morbidity in Intensive Care Units (ICUs, mortality among patients treated for it is tremendous. Moreover, invasive aspergillosis (IA is an independent risk factor of hospital costs and length of stay. The prevalence of this disease is inversely correlated with the immunocompetence of individuals; for instance, the incidence of IA among patients with leukemia is estimated as high as 12.7%. Although there is a significant improvement in the antifungal armamentarium, the appropriate treatment is still being given too late, mostly because of late diagnosis. As well as the diagnosis, the criteria for recognition of IA constitute a challenge. [b]Objective[/b]. The aim of this review, based on a case report, is to introduce the problem of poor diagnosis and treatment of IA, especially in the critical care settings. The presented scenario is an example which assists in showing the evidence-based medicine (EBM approach to the treatment of fungal infections. Furthermore, to demonstrate the appropriate approach to diagnosis and treatment of invasive aspergillosis, the guidelines of The European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG are presented. [b]Conclusions.[/b] According to presented literature, Galactomannan assay enables early diagnosis and remains a specific and sensitive tool to diagnose [i]Asppergillosis, [/i]both in serum and BAL fluid. The guidelines recommend voriconazole as a first line treatment in IA. Failure to detect and implement proper antifungal treatment may lead to fatal consequences, as in the presented case.

  8. CD40-induced aggregation of MHC class II and CD80 on the cell surface leads to an early enhancement in antigen presentation.

    Science.gov (United States)

    Clatza, Abigail; Bonifaz, Laura C; Vignali, Dario A A; Moreno, José

    2003-12-15

    Ligation of CD40 on B cells increases their ability to present Ag and to activate MHC class II (MHC-II)-restricted T cells. How this occurs is not entirely clear. In this study we demonstrate that CD40 ligation on Ag-presenting B cells (APC) for a short period between 30 min and 3 h has a rapid, augmenting effect on the ability of a B cell line and normal B cells to activate T cells. This is not due to alterations in Ag processing or to an increase in surface expression of CD80, CD86, ICAM-1, or MHC-II. This effect is particularly evident with naive, resting T lymphocytes and appears to be more pronounced under limiting Ag concentrations. Shortly after CD40 ligation on a B cell line, MHC-II and CD80 progressively accumulated in cholesterol-enriched microdomains on the cell surface, which correlated with an initial enhancement in their Ag presentation ability. Moreover, CD40 ligation induced a second, late, more sustained enhancement of Ag presentation, which correlates with a significant increase in CD80 expression by APC. Thus, CD40 signaling enhances the efficiency with which APC activate T cells by at least two related, but distinct, mechanisms: an early stage characterized by aggregation of MHC-II and CD80 clusters, and a late stage in which a significant increase in CD80 expression is observed. These results raise the possibility that one important role of CD40 is to contribute to the formation of the immunological synapse on the APC side.

  9. Early Hepatic Dysfunction Is Associated with a Worse Outcome in Patients Presenting with Acute Respiratory Distress Syndrome: A Post-Hoc Analysis of the ACURASYS and PROSEVA Studies

    Science.gov (United States)

    Dizier, Stéphanie; Forel, Jean-Marie; Ayzac, Louis; Richard, Jean-Christophe; Hraiech, Sami; Lehingue, Samuel; Loundou, Anderson; Roch, Antoine; Guerin, Claude; Papazian, Laurent

    2015-01-01

    Introduction Bilirubin is well-recognized marker of hepatic dysfunction in intensive care unit (ICU) patients. Multiple organ failure often complicates acute respiratory distress syndrome (ARDS) evolution and is associated with high mortality. The effect of early hepatic dysfunction on ARDS mortality has been poorly investigated. We evaluated the incidence and the prognostic significance of increased serum bilirubin levels in the initial phase of ARDS. Methods The data of 805 patients with ARDS were retrospectively analysed. This population was extracted from two recent multicenter, prospective and randomised trials. Patients presenting with ARDS with a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen < 150 mmHg measured with a PEEP ≥ 5 cm of water were included. The total serum bilirubin was measured at inclusion and at days 2, 4, 7 and 14. The primary objective was to analyse the bilirubin at inclusion according to the 90-day mortality rate. Results The 90-day mortality rate was 33.8% (n = 272). The non-survivors were older, had higher Sepsis-related Organ Failure Assessment (SOFA) score and were more likely to have a medical diagnosis on admission than the survivors. At inclusion, the SOFA score without the liver score (10.3±2.9 vs. 9.0±3.0, p<0.0001) and the serum bilirubin levels (36.1±57.0 vs. 20.5±31.5 μmol/L, p<0.0001) were significantly higher in the non-survivors than in the survivors. Age, the hepatic SOFA score, the coagulation SOFA score, the arterial pH level, and the plateau pressure were independently associated with 90-day mortality in patients with ARDS. Conclusion Bilirubin used as a surrogate marker of hepatic dysfunction and measured early in the course of ARDS was associated with the 90-day mortality rate. PMID:26636318

  10. Investigation of Fossil Insect Systematics of Specimens Collected at the Clare Quarry Site in the Florissant Fossil Beds, Florissant, Colorado from 1996 to Present

    Science.gov (United States)

    Cancellare, J. A.; Villalobos, J. I.; Lemone, D.

    2012-12-01

    antennae,and leg structures are problematic in most specimens. Other factors affecting specimen quality include specimen orientation, partial specimens due to breaks in the matrix, the degree of preservation and effects of weathering. To date classification is strictly superficial. One of the early objectives of this work was to collect series of the same genera however there is no discernible pattern below the ordinal level. In this phase the primary objective will be to place as many insect specimens into families as possible. Many insect families (but no genera) found in the Florissant persist today. Tools used in the initial sorting and extraction process are pin vices, Exacto Knives, razor blades and a Bausch and Lomb zoom dissecting scope fitted with a circular fluorescent illumination ring with magnification ranging from 7 to 45 diameters. During the summer of 2012, twenty one Tipulid specimens were photographed by the Mid - Atlantic Geo - Image Collection (M.A.G. I. C.), Northern Virginia Community College, in order to test the system's efficacy in specimen comparison within series. Preservation of specimens in the Florissant Fossil Beds occurred during the Eocene - Oligocene Transition. Future use of the results generated in this study may have application in the study of climate change.

  11. The Systematic Evaluation of Identifying the Infarct Related Artery Utilizing Cardiac Magnetic Resonance in Patients Presenting with ST-Elevation Myocardial Infarction

    Science.gov (United States)

    Hamo, Carine E.; Klem, Igor; Rao, Sunil V.; Songco, Vincent; Najjar, Samer; Lakatta, Edward G.; Raman, Subha V.; Harrington, Robert A.; Heitner, John F.

    2017-01-01

    Background Identification of the infarct-related artery (IRA) in patients with STEMI using coronary angiography (CA) is often based on the ECG and can be challenging in patients with severe multi-vessel disease. The current study aimed to determine how often percutaneous intervention (PCI) is performed in a coronary artery different from the artery supplying the territory of acute infarction on cardiac magnetic resonance imaging (CMR). Methods We evaluated 113 patients from the Reduction of infarct Expansion and Ventricular remodeling with Erythropoetin After Large myocardial infarction (REVEAL) trial, who underwent CMR within 4±2 days of revascularization. Blinded reviewers interpreted CA to determine the IRA and CMR to determine the location of infarction on a 17-segment model. In patients with multiple infarcts on CMR, acuity was determined with T2-weighted imaging and/or evidence of microvascular obstruction. Results A total of 5 (4%) patients were found to have a mismatch between the IRA identified on CMR and CA. In 4/5 cases, there were multiple infarcts noted on CMR. Thirteen patients (11.5%) had multiple infarcts in separate territories on CMR with 4 patients (3.5%) having multiple acute infarcts and 9 patients (8%) having both acute and chronic infarcts. Conclusions In this select population of patients, the identification of the IRA by CA was incorrect in 4% of patients presenting with STEMI. Four patients with a mismatch had an acute infarction in more than one coronary artery territory on CMR. The role of CMR in patients presenting with STEMI with multi-vessel disease on CA deserves further investigation. PMID:28060863

  12. Collagen type XII and versican are present in the early stages of cartilage tissue formation by both redifferentating passaged and primary chondrocytes.

    Science.gov (United States)

    Taylor, Drew W; Ahmed, Nazish; Parreno, Justin; Lunstrum, Gregory P; Gross, Allan E; Diamandis, Eleftherios P; Kandel, Rita A

    2015-02-01

    Current approaches to cartilage tissue engineering require a large number of chondrocytes. Although chondrocyte numbers can be expanded in monolayer culture, the cells dedifferentiate and unless they can be redifferentiated are not optimal to use for cartilage repair. We took advantage of the differential effect of culture conditions on the ability of passaged and primary chondrocytes to form cartilage tissue to dissect out the extracellular matrix (ECM) molecules produced and accumulated in the early stages of passaged cell cartilage tissue formation as we hypothesized that passaged bovine cells that form cartilage accumulate a pericellular matrix that differs from cells that do not form cartilage. Twice passaged bovine chondrocytes (P2) (cartilage forming), or as a control primary chondrocytes (P0) (which do not generate cartilage), were cultured on three-dimensional membrane inserts in serum-free media. P2 redifferentiation was occurring during the first 8 days as indicated by increased expression of the chondrogenic genes Sox9, collagen type II, aggrecan, and COMP, suggesting that this is an appropriate time period to examine the ECM. Mass spectrometry showed that the P2 secretome (molecules released into the media) at 1 week had higher levels of collagen types I, III, and XII, and versican while type II collagen and COMP were found at higher levels in the P0 secretome. There was increased collagen synthesis and retention by P2 cells compared to P0 cells as early as 3 days of culture. Confocal microscopy showed that types XII, III, and II collagen, aggrecan, versican, and decorin were present in the ECM of P2 cells. In contrast, collagen types I, II, and III, aggrecan, and decorin were present in the ECM of P0 cells. As primary chondrocytes grown in serum-containing media, a condition that allows for the generation of cartilage tissue in vitro, also accumulate versican and collagen XII, this study suggests that these molecules may be necessary to provide a

  13. Performance of computed tomographic urography in diagnosis of upper urinary tract urothelial carcinoma, in patients presenting with hematuria: Systematic review and meta-analysis

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    Chlapoutakis, Konstantinos [Department of Radiology, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Theocharopoulos, Nicholas [Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Department of Natural Sciences, Technological Education Institute of Crete, P.O. Box 140, 71004 Iraklion, Crete (Greece); Yarmenitis, Spyros [Department of Radiology, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Damilakis, John [Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece)], E-mail: damilaki@med.uoc.gr

    2010-02-15

    Computed tomographic urography (CTU) is a relatively new diagnostic imaging technique, which combines the diagnostic advantages introduced by helical tomographic imaging, with the established technique of imaging during the renal excretory phase, into one single examination. Increasing availability of multidetector computed tomography (MDCT) units, further promotes the technique as the 'one-stop-shop' for the imaging investigation of patients with haematuria. We reviewed and meta-analyzed published literature, in order to evaluate the performance of CTU for the detection of upper urinary tract urothelial tumors. CTU proved to be a very sensitive and specific method for the detection of urothelial malignancy, with sensitivity ranging between 88% and 100%, and specificity between 93% and 100%. Pooled sensitivity was 96% (95% CI: 88-100%) and pooled specificity was 99% (95% CI: 98-100%). Direct comparison of the method with intravenous urography (IVU), confirmed the superiority of CTU over IVU in terms of sensitivity and specificity. Major drawbacks of CTU are increased radiation risk, injection of iodinated contrast media which may potentially be accompanied by serious side effects and increased cost, estimated as roughly three times that of IVU. According to our study, CTU is the method of choice for the detection of pathology in 'high risk' haematuria patients, i.e. patients older than 40 years of age presenting with gross haematuria.

  14. Diagnostic accuracy of sensitive or high-sensitive troponin on presentation for myocardial infarction: a meta-analysis and systematic review

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    Sethi A

    2014-07-01

    Full Text Available Ankur Sethi,1 Anurag Bajaj,2 Gurveen Malhotra,1 Rohit R Arora,1 Sandeep Khosla1 1Department of Medicine, Division of Cardiology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA; 2Department of Medicine, Wright Center of Graduate Medical Education, Scranton, PA, USA Background: Recently, high-sensitive troponin (hsTrop assays consistent with professional societies' recommendations became available. We aimed to summarize the evidence on the diagnostic accuracy of hsTrop on presentation. Methods: We searched electronic databases for studies evaluating the diagnostic accuracy of hsTrop in suspected acute coronary syndrome (ACS patients. Random effect meta-analyses and meta-regression were performed. Primary and secondary analyses were restricted to studies using conventional Trop and hsTrop in the reference standard, respectively. Results: Fifteen studies with a total of 8,628 patients met the inclusion criteria for the primary analysis. hsTrop T (Hoffman-La Roche Ltd and hsTrop I (Siemens had sensitivities of 0.89 (95% confidence interval [CI]: 0.86–0.91 and 0.90 (95% CI: 0.87–0.92 and specificities of 0.79 (95% CI: 0.77–0.80 and 0.89 (95% CI: 0.87–0.90, respectively. There was no statistically significant difference in the area under the curve between hsTrop (95% CI: 0.920 and conventional Trop (95% CI: 0.929 at the 99th percentile (P=0.62. hsTrop at the level of detection had a sensitivity of 0.97 (95% CI: 0.96–0.98 and a specificity of 0.41 (95% CI: 0.40–0.42. The studies using a cut-off at coefficient of variance <10% as opposed to the 99th percentile for the conventional assay used for diagnosis reported higher diagnostic accuracy (relative diagnostic odds ratio =2.13, P=0.02. Five studies were included in the secondary analysis; hsTrop T (Hoffman-La Roche Ltd had a sensitivity of 0.91 (95% CI: 0.89–0.93 and a specificity of 0.67 (95% CI: 0.63–0.70. There was significant heterogeneity among the

  15. Involving users in the design of a randomised controlled trial of an intervention to promote early presentation in breast cancer: qualitative study

    Directory of Open Access Journals (Sweden)

    Tompkins Charlotte

    2010-12-01

    Full Text Available Abstract Background The purpose of this study was to explore women's views of the design of a large pragmatic cost-effectiveness randomised controlled trial of the policy of offering a health professional-delivered intervention to promote early presentation with breast symptoms in older women and thereby improve survival, with a view to informing protocol development. The trial will recruit over 100,000 healthy women aged 67+, and outcome data will be collected on those who develop breast cancer. The scale of the trial and the need for long-term follow-up presented a number of design challenges in relation to obtaining consent, ascertaining and contacting participants who developed breast cancer, and collecting outcome data. Methods Qualitative study involving 69 women participating in 7 focus groups and 17 in-depth interviews. 15 women had a previous diagnosis of breast cancer and 54 did not. Results The women held strong views and had a good understanding of the rationale of the design of clinical trials. The women recognised that in a very large trial with long-term follow-up it was necessary to incorporate design features to make the trial feasible and efficient. Most strikingly, they supported the idea of opt-out consent and identifying women with breast cancer using routine datasets. Conclusions This model of user involvement engaged women well with the design challenges of the trial and led to improvements to the protocol. The study strengthens the case for user involvement, in particular through focus groups and in-depth interviews, in the design of trials.

  16. The epidermal growth factor receptor (EGFR / HER-1 gatekeeper mutation T790M is present in European patients with early breast cancer.

    Directory of Open Access Journals (Sweden)

    Vahid Bemanian

    Full Text Available The epidermal growth factor receptor (EGFR is one of the major oncogenes identified in a variety of human malignancies including breast cancer (BC. EGFR-mutations have been studied in lung cancer for some years and are established as important markers in guiding therapy with tyrosine kinase inhibitors (TKIs. In contrast, EGFR-mutations have been reported to be rare if not absent in human BC, although recent evidence has suggested a significant worldwide variation in somatic EGFR-mutations. Therefore, we investigated the presence of EGFR-mutations in 131 norwegian patients diagnosed with early breast cancer using real-time PCR methods. In the present study we identified three patients with an EGFR-T790M-mutation. The PCR-findings were confirmed by direct Sanger sequencing. Two patients had triple-negative BC (TNBC while the third was classified as luminal-A subtype. The difference in incidence of T790M mutations comparing the TNBC subgroup with the other BC subgroups was statistical significant (P = 0.023. No other EGFR mutations were identified in the entire cohort. Interestingly, none of the patients had received any previous cancer treatment. To our best knowledge, the EGFR-T790M-TKI-resistance mutation has not been previously detected in breast cancer patients. Our findings contrast with the observations made in lung cancer patients where the EGFR-T790M-mutation is classified as a typical "second mutation"causing resistance to TKI-therapy during ongoing anticancer therapy. In conclusion, we have demonstrated for the first time that the EGFR-T790M-mutation occurs in primary human breast cancer patients. In the present study the EGFR-T790M mutation was not accompanied by any simultaneous EGFR-activating mutation.

  17. Early mantle differentiation: constraint from {sup 146}Sm-{sup 142}Nd systematics; Radioactivite eteinte du {sup 146}Sm et differenciation precoce du manteau terrestre

    Energy Technology Data Exchange (ETDEWEB)

    Caro, G

    2005-07-15

    We present new ultra-high precision {sup 142}Nd/{sup 144}Nd measurements of early Archaean rocks using the new generation thermal ionization mass spectrometer TRITON. Repeated measurements of the Ames Nd standard demonstrate that the {sup 142}Nd/{sup 144}Nd ratio can be determined with external precision of 2 ppm (2s), allowing confident resolution of anomalies as small as 5 ppm. A major analytical improvement lies in the elimination of the double normalization procedure required to correct our former measurements from a secondary mass fractionation effect. Our new results indicate that metasediments, meta-basalts and orthogneisses from the 3.6 - 3.8 Ga West Greenland craton display positive {sup 142}Nd anomalies ranging from 8 to 15 ppm. Using a simple two-stage model with initial e{sup 143}Nd value of 1.9 {+-} 0.6 e-units, coupled {sup 147}Sm-{sup 143}Nd and {sup 146}Sm-{sup 142}Nd chronometry constrains mantle differentiation to 50 to 200 Ma after formation of the solar system. This chronological constraint is consistent with differentiation of the Earth's mantle during the late stage of crystallization of a magma ocean. We have developed a two-box model describing {sup 142}Nd and {sup 143}Nd isotopic evolution of depleted mantle during the subsequent evolution of the crust-mantle system. Our results indicate that early terrestrial proto-crust had a lifetime of ca. 500 Ma in order to produce the observed Nd isotope signature of Archaean rocks. In the context of this two box mantle-crust system, we model the evolution of isotopic and chemical heterogeneity of depleted mantle as a function of the mantle stirring time. Using the dispersion of {sup 142}Nd/{sup 144}Nd and {sup 143}Nd/{sup 144}Nd ratios observed in early Archaean rocks, we constrain the stirring time of early Earth's mantle to 100 - 150 Ma, a factor of 5 to 10 shorter than stirring time inferred from modern oceanic basalts. (author)

  18. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies

    Science.gov (United States)

    Bartsch, Emily; Medcalf, Karyn E; Park, Alison L

    2016-01-01

    Objective To develop a practical evidence based list of clinical risk factors that can be assessed by a clinician at ≤16 weeks’ gestation to estimate a woman’s risk of pre-eclampsia. Design Systematic review and meta-analysis of cohort studies. Data sources PubMed and Embase databases, 2000-15. Eligibility criteria for selecting studies Cohort studies with ≥1000 participants that evaluated the risk of pre-eclampsia in relation to a common and generally accepted clinical risk factor assessed at ≤16 weeks’ gestation. Data extraction Two independent reviewers extracted data from included studies. A pooled event rate and pooled relative risk for pre-eclampsia were calculated for each of 14 risk factors. Results There were 25 356 688 pregnancies among 92 studies. The pooled relative risk for each risk factor significantly exceeded 1.0, except for prior intrauterine growth restriction. Women with antiphospholipid antibody syndrome had the highest pooled rate of pre-eclampsia (17.3%, 95% confidence interval 6.8% to 31.4%). Those with prior pre-eclampsia had the greatest pooled relative risk (8.4, 7.1 to 9.9). Chronic hypertension ranked second, both in terms of its pooled rate (16.0%, 12.6% to 19.7%) and pooled relative risk (5.1, 4.0 to 6.5) of pre-eclampsia. Pregestational diabetes (pooled rate 11.0%, 8.4% to 13.8%; pooled relative risk 3.7, 3.1 to 4.3), prepregnancy body mass index (BMI) >30 (7.1%, 6.1% to 8.2%; 2.8, 2.6 to 3.1), and use of assisted reproductive technology (6.2%, 4.7% to 7.9%; 1.8, 1.6 to 2.1) were other prominent risk factors. Conclusions There are several practical clinical risk factors that, either alone or in combination, might identify women in early pregnancy who are at “high risk” of pre-eclampsia. These data can inform the generation of a clinical prediction model for pre-eclampsia and the use of aspirin prophylaxis in pregnancy. PMID:27094586

  19. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies.

    Science.gov (United States)

    Bartsch, Emily; Medcalf, Karyn E; Park, Alison L; Ray, Joel G

    2016-04-19

    To develop a practical evidence based list of clinical risk factors that can be assessed by a clinician at ≤ 16 weeks' gestation to estimate a woman's risk of pre-eclampsia. Systematic review and meta-analysis of cohort studies. PubMed and Embase databases, 2000-15. Cohort studies with ≥ 1000 participants that evaluated the risk of pre-eclampsia in relation to a common and generally accepted clinical risk factor assessed at ≤ 16 weeks' gestation. Two independent reviewers extracted data from included studies. A pooled event rate and pooled relative risk for pre-eclampsia were calculated for each of 14 risk factors. There were 25,356,688 pregnancies among 92 studies. The pooled relative risk for each risk factor significantly exceeded 1.0, except for prior intrauterine growth restriction. Women with antiphospholipid antibody syndrome had the highest pooled rate of pre-eclampsia (17.3%, 95% confidence interval 6.8% to 31.4%). Those with prior pre-eclampsia had the greatest pooled relative risk (8.4, 7.1 to 9.9). Chronic hypertension ranked second, both in terms of its pooled rate (16.0%, 12.6% to 19.7%) and pooled relative risk (5.1, 4.0 to 6.5) of pre-eclampsia. Pregestational diabetes (pooled rate 11.0%, 8.4% to 13.8%; pooled relative risk 3.7, 3.1 to 4.3), prepregnancy body mass index (BMI) >30 (7.1%, 6.1% to 8.2%; 2.8, 2.6 to 3.1), and use of assisted reproductive technology (6.2%, 4.7% to 7.9%; 1.8, 1.6 to 2.1) were other prominent risk factors. There are several practical clinical risk factors that, either alone or in combination, might identify women in early pregnancy who are at "high risk" of pre-eclampsia. These data can inform the generation of a clinical prediction model for pre-eclampsia and the use of aspirin prophylaxis in pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Infarct Size, Shock, and Heart Failure: Does Reperfusion Strategy Matter in Early Presenting Patients With ST-Segment Elevation Myocardial Infarction?

    Science.gov (United States)

    Shavadia, Jay; Zheng, Yinggan; Dianati Maleki, Neda; Huber, Kurt; Halvorsen, Sigrun; Goldstein, Patrick; Gershlick, Anthony H; Wilcox, Robert; Van de Werf, Frans; Armstrong, Paul W

    2015-08-24

    A pharmacoinvasive (PI) strategy for early presenting ST-segment elevation myocardial infarction nominally reduced 30-day cardiogenic shock and congestive heart failure compared with primary percutaneous coronary intervention (PPCI). We evaluated whether infarct size (IS) was related to this finding. Using the peak cardiac biomarker in patients randomized to PI versus PPCI within the Strategic Reperfusion Early After Myocardial Infarction (STREAM) trial, IS was divided into 3 groups: small (≤2 times the upper limit normal [ULN]), medium (>2 to ≤5 times the upper limit normal) and large (>5 times the upper limit normal). The association between IS and 30-day shock and congestive heart failure was subsequently examined. Data on 1701 of 1892 (89.9%) patients randomized to PI (n=853, 50.1%) versus PPCI (n=848, 49.9%) within STREAM were evaluated. A higher proportion of PPCI patients had a large IS (PI versus PPCI: small, 49.8% versus 50.2%; medium, 56.9% versus 43.1%; large, 48.4% versus 51.6%; P=0.035), despite comparable intergroup ischemic times for each reperfusion strategy. As IS increased, a parallel increment in shock and congestive heart failure occurred in both treatment arms, except for the small IS group. The difference in shock and congestive heart failure in the small IS group (4.4% versus 11.6%, P=0.026) in favor of PI likely relates to higher rates of aborted myocardial infarction with the PI strategy (72.7% versus 54.3%, P=0.005). After adjustment, a trend favoring PI persisted in this subgroup (relative risk 0.40, 95% CI 0.15 to 1.06, P=0.064); no difference in treatment-related outcomes was evident in the other 2 groups. A PI strategy appears to alter the pattern of IS after ST-segment elevation myocardial infarction, resulting in more medium and fewer large infarcts compared with PPCI. Despite a comparable number of small infarcts, PI patients in this group had more aborted myocardial infarctions and less 30-day shock and congestive heart failure

  1. S-LOCUS EARLY FLOWERING 3 is exclusively present in the genomes of short-styled buckwheat plants that exhibit heteromorphic self-incompatibility.

    Science.gov (United States)

    Yasui, Yasuo; Mori, Masashi; Aii, Jotaro; Abe, Tomoko; Matsumoto, Daiki; Sato, Shingo; Hayashi, Yoriko; Ohnishi, Ohmi; Ota, Tatsuya

    2012-01-01

    The different forms of flowers in a species have attracted the attention of many evolutionary biologists, including Charles Darwin. In Fagopyrum esculentum (common buckwheat), the occurrence of dimorphic flowers, namely short-styled and long-styled flowers, is associated with a type of self-incompatibility (SI) called heteromorphic SI. The floral morphology and intra-morph incompatibility are both determined by a single genetic locus named the S-locus. Plants with short-styled flowers are heterozygous (S/s) and plants with long-styled flowers are homozygous recessive (s/s) at the S-locus. Despite recent progress in our understanding of the molecular basis of flower development and plant SI systems, the molecular mechanisms underlying heteromorphic SI remain unresolved. By examining differentially expressed genes from the styles of the two floral morphs, we identified a gene that is expressed only in short-styled plants. The novel gene identified was completely linked to the S-locus in a linkage analysis of 1,373 plants and had homology to EARLY FLOWERING 3. We named this gene S-LOCUS EARLY FLOWERING 3 (S-ELF3). In an ion-beam-induced mutant that harbored a deletion in the genomic region spanning S-ELF3, a phenotype shift from short-styled flowers to long-styled flowers was observed. Furthermore, S-ELF3 was present in the genome of short-styled plants and absent from that of long-styled plants both in world-wide landraces of buckwheat and in two distantly related Fagopyrum species that exhibit heteromorphic SI. Moreover, independent disruptions of S-ELF3 were detected in a recently emerged self-compatible Fagopyrum species and a self-compatible line of buckwheat. The nonessential role of S-ELF3 in the survival of individuals and the prolonged evolutionary presence only in the genomes of short-styled plants exhibiting heteromorphic SI suggests that S-ELF3 is a suitable candidate gene for the control of the short-styled phenotype of buckwheat plants.

  2. Patient- and clinician-reported outcomes for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.

    Science.gov (United States)

    Ledingham, Joanna M; Snowden, Neil; Rivett, Ali; Galloway, James; Ide, Zoe; Firth, Jill; MacPhie, Elizabeth; Kandala, Ngianga; Dennison, Elaine M; Rowe, Ian

    2017-02-01

    Our aim was to conduct a national audit assessing the impact and experience of early management of inflammatory arthritis by English and Welsh rheumatology units. The audit enables rheumatology services to measure for the first time their performance, patient outcomes and experience, benchmarked to regional and national comparators. All individuals >16 years of age presenting to English and Welsh rheumatology services with suspected new-onset inflammatory arthritis were included in the audit. Clinician- and patient-derived outcome and patient-reported experience measures were collected. Data are presented for the 6354 patients recruited from 1 February 2014 to 31 January 2015. Ninety-seven per cent of English and Welsh trusts participated. At the first specialist assessment, the 28-joint DAS (DAS28) was calculated for 2659 (91%) RA patients [mean DAS28 was 5.0 and mean Rheumatoid Arthritis Impact of Disease (RAID) score was 5.6]. After 3 months of specialist care, the mean DAS28 was 3.5 and slightly >60% achieved a meaningful DAS28 reduction. The average RAID score and reduction in RAID score were 3.6 and 2.4, respectively. Of the working patients ages 16-65 years providing data, 7, 5, 16 and 37% reported that they were unable to work, needed frequent time off work, occasionally and rarely needed time off work due to their arthritis, respectively; only 42% reported being asked about their work. Seventy-eight per cent of RA patients providing data agreed with the statement 'Overall in the last 3 months I have had a good experience of care for my arthritis'; <2% disagreed. This audit demonstrates that most RA patients have severe disease at the time of presentation to rheumatology services and that a significant number continue to have high disease activity after 3 months of specialist care. There is a clear need for the National Health Service to develop better systems for capturing, coding and integrating information from outpatient clinics, including measures of

  3. Systematic text condensation

    DEFF Research Database (Denmark)

    Malterud, Kirsti

    2012-01-01

    To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies.......To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies....

  4. Early-life lead exposure recapitulates the selective loss of parvalbumin-positive GABAergic interneurons and subcortical dopamine system hyperactivity present in schizophrenia.

    Science.gov (United States)

    Stansfield, K H; Ruby, K N; Soares, B D; McGlothan, J L; Liu, X; Guilarte, T R

    2015-03-10

    Environmental factors have been associated with psychiatric disorders and recent epidemiological studies suggest an association between prenatal lead (Pb(2+)) exposure and schizophrenia (SZ). Pb(2+) is a potent antagonist of the N-methyl-D-aspartate receptor (NMDAR) and converging evidence indicates that NMDAR hypofunction has a key role in the pathophysiology of SZ. The glutamatergic hypothesis of SZ posits that NMDAR hypofunction results in the loss of parvalbumin (PV)-positive GABAergic interneurons (PVGI) in the brain. Loss of PVGI inhibitory control to pyramidal cells alters the excitatory drive to midbrain dopamine neurons increasing subcortical dopaminergic activity. We hypothesized that if Pb(2+) exposure in early life is an environmental risk factor for SZ, it should recapitulate the loss of PVGI and reproduce subcortical dopaminergic hyperactivity. We report that on postnatal day 50 (PN50), adolescence rats chronically exposed to Pb(2+) from gestation through adolescence exhibit loss of PVGI in SZ-relevant brain regions. PV and glutamic acid decarboxylase 67 kDa (GAD67) protein were significantly decreased in Pb(2+) exposed rats with no apparent change in calretinin or calbindin protein levels suggesting a selective effect on the PV phenotype of GABAergic interneurons. We also show that Pb(2+) animals exhibit a heightened locomotor response to cocaine and express significantly higher levels of dopamine metabolites and D2-dopamine receptors relative to controls indicative of subcortical dopaminergic hyperactivity. Our results show that developmental Pb(2+) exposure reproduces specific neuropathology and functional dopamine system changes present in SZ. We propose that exposure to environmental toxins that produce NMDAR hypofunction during critical periods of brain development may contribute significantly to the etiology of mental disorders.

  5. Clinical Presentation and Five-Year Therapeutic Management of Very Early-Onset Inflammatory Bowel Disease in a Large North American Cohort.

    Science.gov (United States)

    Oliva-Hemker, Maria; Hutfless, Susan; Al Kazzi, Elie S; Lerer, Trudy; Mack, David; LeLeiko, Neal; Griffiths, Anne; Cabrera, Jose; Otley, Anthony; Rick, James; Bousvaros, Athos; Rosh, Joel; Grossman, Andrew; Saeed, Shehzad; Kay, Marsha; Carvalho, Ryan; Keljo, David; Pfefferkorn, Marian; Faubion, William; Kappelman, Michael; Sudel, Boris; Schaefer, Marc E; Markowitz, James; Hyams, Jeffrey S

    2015-09-01

    To evaluate the presentation, therapeutic management, and long-term outcome of children with very early-onset (VEO) (≤ 5 years of age) inflammatory bowel disease (IBD). Data were obtained from an inception cohort of 1928 children with IBD enrolled in a prospective observational registry at multiple centers in North America. One hundred twelve children were ≤ 5 years of age with no child enrolled at year of age. Of those, 42.9% had Crohn's disease (CD), 46.4% ulcerative colitis (UC), and 10.7% had IBD-unclassified. Among the children with CD, children 1-5 years of age had more isolated colonic disease (39.6%) compared with 6- to 10-year-olds (25.3%, P = .04), and 11- to 16-year-olds (22.3%, P years. Children 1-5 years of age with CD had milder disease activity (45.8%) at diagnosis compared with the oldest group (28%, P = .01). Five years postdiagnosis, there was no difference in disease activity among the 3 groups. However, compared with the oldest group, a greater proportion of 1- to 5-year-olds with CD were receiving corticosteroids (P year-olds with UC were receiving mesalamine (P years of age. Five years after diagnosis, children with VEO-CD and VEO-UC are more likely to have been administered corticosteroids and immunomodulators despite similar disease activity in all age groups. This may suggest development of a more aggressive disease phenotype over time. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Multiple giant succular and fusiform right and left coronary artery aneurysms after early and adequate treatment of atypical kawasaki disease with unusual presentation.

    Directory of Open Access Journals (Sweden)

    Mostafa Behjati-Ardakani

    2014-06-01

    Full Text Available The major complication of Kawasaki disease is coronary artery dilatation and aneurysm. It occurs in approximately 15-25% of untreated children with Kawasaki Disease. Early diagnosis and treatment with Intravenous immune globulin (IVIG and aspirin (ASA can reduce the incidence of coronary artery abnormality to 2%-5%. We report one case of Atypical Kawasaki Disease with Multiple giant coronary artery aneurysms despite early adequate treatment with IVIG and ASA.

  7. Exploring the Relationship between Research and BIM Standardization: A Systematic Mapping of Early Studies on the IFC Standard (1997–2007

    Directory of Open Access Journals (Sweden)

    Mikael Laakso

    2016-02-01

    Full Text Available It has long been argued that the Industry Foundation Classes (IFC data model standard is the key to unlocking the potential of interoperable Building Information Modeling (BIM. Despite a wealth of published research literature incorporating IFC, there have been no attempts at systematically summarizing the literature related to the standard. Targeting both summation and analysis of thematic developments over time, we performed a comprehensive systematic literature review of IFC‐related research published between 1997 and 2007: the first 11 years of research on the standard. Through a systematic web‐retrieval process, 170 unique publications were collected, read, and mapped to a custom framework. The results reveal that journals and conferences have been an integral part of the technical evaluation and development of the standard. The full classification data is provided as an appendix to facilitate future research on IFC and other standards.

  8. Major element composition of an Early Enriched Reservoir: constraints from 142Nd/144Nd isotope systematics in the early Earth and high-pressure melting experiments of a primitive peridotite

    Science.gov (United States)

    Kondo, Nozomi; Yoshino, Takashi; Matsukage, Kyoko N.; Kogiso, Tetsu

    2016-12-01

    The Accessible Silicate Earth (ASE) has a higher 142Nd/144Nd ratio than most chondrites. Thus, if the Earth is assumed to have formed from these chondrites, a complement low-142Nd/144Nd reservoir is needed. Such a low-142Nd/144Nd reservoir is believed to have been derived from a melt in the early Earth and is called the Early Enriched Reservoir (EER). Although the major element composition of the EER is crucial for estimating its chemical and physical properties (e.g., density) and is also essential for understanding the origin and fate of the EER, which are both major factors that determine the present composition of the Earth, it has not yet been robustly established. In order to determine the major element composition of the EER, we estimated the age and pressure-temperature conditions to form the EER that would best explain its Nd isotopic characteristics, based on Sm-Nd partitioning and its dependence on pressure, temperature, and melting phase relations. Our estimate indicates that the EER formed within 33.5 Myr of Solar System formation and at near-solidus temperatures and shallow upper-mantle pressures. We then performed high-pressure melting experiments on primitive peridotite to determine the major element composition of the EER at estimated temperature at 7 GPa and calculated the density of the EER. The result of our experiments indicates that the near-solidus melt is iron-rich komatiite. The estimated density of the near-solidus melt is lower than that of the primitive peridotite, suggesting that the EER melt would have ascended in the mantle to form an early crust. Given that high mantle potential temperatures are assumed to have existed in the Hadean, it follows that the EER melt was generated at high pressure and, therefore, its composition would have been picritic to komatiitic. As the formation age of the EER estimated in our study precedes the last giant, lunar-forming impact, the picritic to komatiitic crust (EER) would most likely have been

  9. Subclinical Alterations of Cardiac Mechanics Present Early in the Course of Pediatric Type 1 Diabetes Mellitus: A Prospective Blinded Speckle Tracking Stress Echocardiography Study

    Directory of Open Access Journals (Sweden)

    Kai O. Hensel

    2016-01-01

    Full Text Available Diabetic cardiomyopathy substantially accounts for mortality in diabetes mellitus. The pathophysiological mechanism underlying diabetes-associated nonischemic heart failure is poorly understood and clinical data on myocardial mechanics in early stages of diabetes are lacking. In this study we utilize speckle tracking echocardiography combined with physical stress testing in order to evaluate whether left ventricular (LV myocardial performance is altered early in the course of uncomplicated type 1 diabetes mellitus (T1DM. 40 consecutive asymptomatic normotensive children and adolescents with T1DM (mean age 11.5±3.1 years and mean disease duration 4.3±3.5 years and 44 age- and gender-matched healthy controls were assessed using conventional and quantitative echocardiography (strain and strain rate during bicycle ergometer stress testing. Strikingly, T1DM patients had increased LV longitudinal (p=0.019 and circumferential (p=0.016 strain rate both at rest and during exercise (p=0.021. This was more pronounced in T1DM patients with a longer disease duration (p=0.038. T1DM patients with serum HbA1c>9% showed impaired longitudinal (p=0.008 and circumferential strain (p=0.005 and a reduced E/A-ratio (p=0.018. In conclusion, asymptomatic T1DM patients have signs of hyperdynamic LV contractility early in the course of the disease. Moreover, poor glycemic control is associated with early subclinical LV systolic and diastolic impairment.

  10. Subclinical Alterations of Cardiac Mechanics Present Early in the Course of Pediatric Type 1 Diabetes Mellitus: A Prospective Blinded Speckle Tracking Stress Echocardiography Study

    Science.gov (United States)

    Hensel, Kai O.; Grimmer, Franziska; Roskopf, Markus; Jenke, Andreas C.; Wirth, Stefan; Heusch, Andreas

    2016-01-01

    Diabetic cardiomyopathy substantially accounts for mortality in diabetes mellitus. The pathophysiological mechanism underlying diabetes-associated nonischemic heart failure is poorly understood and clinical data on myocardial mechanics in early stages of diabetes are lacking. In this study we utilize speckle tracking echocardiography combined with physical stress testing in order to evaluate whether left ventricular (LV) myocardial performance is altered early in the course of uncomplicated type 1 diabetes mellitus (T1DM). 40 consecutive asymptomatic normotensive children and adolescents with T1DM (mean age 11.5 ± 3.1 years and mean disease duration 4.3 ± 3.5 years) and 44 age- and gender-matched healthy controls were assessed using conventional and quantitative echocardiography (strain and strain rate) during bicycle ergometer stress testing. Strikingly, T1DM patients had increased LV longitudinal (p = 0.019) and circumferential (p = 0.016) strain rate both at rest and during exercise (p = 0.021). This was more pronounced in T1DM patients with a longer disease duration (p = 0.038). T1DM patients with serum HbA1c > 9% showed impaired longitudinal (p = 0.008) and circumferential strain (p = 0.005) and a reduced E/A-ratio (p = 0.018). In conclusion, asymptomatic T1DM patients have signs of hyperdynamic LV contractility early in the course of the disease. Moreover, poor glycemic control is associated with early subclinical LV systolic and diastolic impairment. PMID:26839891

  11. The Relationship between Teacher Qualification and the Quality of the Early Childhood Care and Learning Environment. Campbell Systematic Reviews 2017:1

    Science.gov (United States)

    Manning, Matthew; Garvis, Susanne; Fleming, Christopher; Wong, Gabriel T. W.

    2017-01-01

    Poor quality early childhood education and care (ECEC) can be detrimental to the development of children as it could lead to poor social, emotional, educational, health, economic, and behavioural outcomes. The lack of consensus as to the strength of the relationship between teacher qualification and the quality of the early childhood learning…

  12. Insulin gene mutations resulting in early-onset diabetes: marked differences in clinical presentation, metabolic status, and pathogenic effect through endoplasmic reticulum retention

    DEFF Research Database (Denmark)

    Meur, Gargi; Simon, Albane; Harun, Nasret

    2009-01-01

    the molecular mechanisms involved. RESEARCH DESIGN AND METHODS: The INS gene was sequenced in 16 French probands with unexplained MODY, 95 patients with nonautoimmune early-onset diabetes (diagnosed at ... quantitated by real-time PCR. RESULTS: A novel coding mutation, L30M, potentially affecting insulin multimerization, was identified in five diabetic individuals (diabetes onset 17-36 years) in a single family. L30M preproinsulin-GFP fluorescence largely associated with the endoplasmic reticulum (ER) in MIN6...

  13. Methodology 1: Systematic reviews for occupational safety and health: the PEROSH clearinghouse. Oral presentations: Day 1: Wednesday, September 7, 2011. 22nd International Conference on Epidemiology in Occupational Health EPICOH 2011 September 7-9, 2011, Oxford, UK

    NARCIS (Netherlands)

    Nold, A.; Blatter, B.; Euler, U.; Gagliardi, D.; Knardahl, S.; Lastowiecka-Moras, E.; Olsen, O.; Verbeek, J.

    2011-01-01

    Objectives Systematic reviews and meta-analysis of high quality offer combined results from epidemiological studies which can be very helpful for decision making in occupational safety and health (OSH). The Clearinghouse of Systematic Reviews, a joint project of seven European research institutes,

  14. Methodology 1: Systematic reviews for occupational safety and health: the PEROSH clearinghouse. Oral presentations: Day 1: Wednesday, September 7, 2011. 22nd International Conference on Epidemiology in Occupational Health EPICOH 2011 September 7-9, 2011, Oxford, UK

    NARCIS (Netherlands)

    Nold, A.; Blatter, B.; Euler, U.; Gagliardi, D.; Knardahl, S.; Lastowiecka-Moras, E.; Olsen, O.; Verbeek, J.

    2011-01-01

    Objectives Systematic reviews and meta-analysis of high quality offer combined results from epidemiological studies which can be very helpful for decision making in occupational safety and health (OSH). The Clearinghouse of Systematic Reviews, a joint project of seven European research institutes, a

  15. 中风后抑郁的早期预防现状%Present Situation of Early Prevention of Post-Stroke Depression

    Institute of Scientific and Technical Information of China (English)

    蔡金亚; 孙建华; 徐修竹

    2016-01-01

    中风后抑郁(PSD)是脑血管疾病常见的并发症之一,发生率、致残率和病死率高. 从发病机制、中西医早期预防方面将有关中风后抑郁的早期预防的研究及文献进行综述,并对目前西药治疗PSD存在的问题以及中医药疗法治疗本病的优势进行讨论,为寻求有效的预防中风后抑郁的方案提供新思路、新方法. 参考文献26篇.%Post-stroke depression(PSD) is one of the common complications of cerebrovascular disease,which has high incidence,morbidity and mortality. This article reviews the study of early prevention of post-stroke depression from the aspects of pathogenesis ,early prevention of Chinese and western medicine in recent years,and discusses the current problems of western medicine treatment of PSD and the advantages of the traditional Chinese medicine therapy for this disease ,to provide a new idea and new method for the effective prevention of post-stroke depression.

  16. Tumour necrosis factor-alpha receptors are present in the corpus luteum throughout the oestrous cycle and during the early gestation period in pigs.

    Science.gov (United States)

    Miyamoto, Y; Sakumoto, R; Sakabe, Y; Miyake, M; Okano, A; Okuda, K

    2002-04-01

    To determine the physiological significance of tumour necrosis factor-alpha (TNFalpha) in the regulation of luteal functions in pig, this study was conducted to identify the presence of functional TNFalpha receptors in porcine corpora lutea (CL) throughout the oestrous cycle and the early gestation. The CL were isolated from pigs on days 4, 6, 8, 12 or 15 of the oestrous cycle (n=3; day 0 = oestrus) and days 15, 20 or 25 of gestation (n=3; day 0 = mating). A Scatchard analysis revealed the presence of a high-affinity binding site for TNFalpha in all samples (dissociation constant; 2.7 +/- 0.51 to 5.8 +/- 0.50 nM). The concentration of TNFalpha receptors was higher on day 15 of the oestrous cycle than on days 4 and 8 of the oestrous cycle (p gestation period. In addition, TNFalpha receptor concentration in the CL of the late luteal stage (day 15) of the oestrous cycle was higher than on the respective day in the early pregnant pig, suggesting that TNFalpha plays a role in accomplishing luteolysis in the porcine CL.

  17. A Systematic Review of Bovine Respiratory Disease Diagnosis Focused on Diagnostic Confirmation, Early Detection, and Prediction of Unfavorable Outcomes in Feedlot Cattle.

    Science.gov (United States)

    Wolfger, Barbara; Timsit, Edouard; White, Brad J; Orsel, Karin

    2015-11-01

    A large proportion of newly arrived feedlot cattle are affected with bovine respiratory disease (BRD). Economic losses could be reduced by accurate, early detection. This review evaluates the available literature regarding BRD confirmatory diagnostic tests, early detection methods, and modalities to estimate post-therapeutic prognosis or predict unfavorable or fatal outcomes. Scientific evidence promotes the use of haptoglobin to confirm BRD status. Feeding behavior, infrared thermography, and reticulorumen boluses are promising methods. Retrospective analyses of routinely collected treatment and cohort data can be used to identify cattle at risk of unfavorable outcome. Other methods have been reviewed but require further study.

  18. Prevalence of early neurodevelopmental disabilities in Mexico: a systematic review Prevalencia de neuro-discapacidades tempranas en México: una revisión sistemática

    Directory of Open Access Journals (Sweden)

    Adrián Poblano

    2009-09-01

    Full Text Available OBJECTIVE: Early neurodevelopment disabilities (END such as cerebral palsy (CP, deafness, blindness, epilepsy, and mental retardation (MR are very important public health concerns. Although no strong data on END can be obtained in Mexico, the few papers concerning END epidemiology deserve systematic and critical review. Thus, this was the objective of the present paper. METHOD: We performed a systematic review of papers published reporting on the prevalence of END in Mexico. We performed a search in several medical data bases such as PubMed, Artemisa, ImBioMed, and LiLaCS. Each paper was downloaded, read and discussed. We only selected papers published between 1999 and 2008. RESULTS: No data on CP and epilepsy prevalence in infants have been found. Data on deafness prevalence report hearing loss in 0.65/1,000 healthy newborns, and in 2.6/100 in high-risk very premature infants. With regard to blindness, prevalence of retinopathy of premature infants in any stage was reported at ca 10.61 and 22.2/100 in high-risk premature infants. Congenital hypothyroidism (CH prevalence in infants was found in 4.2/10,000 live newborns after a national universal screening survey. CONCLUSION: No universal data regarding the prevalence of END in Mexico have been investigated, with the exception of CH. Mexico needs more research to determine epidemiologic data focused on designing actions to prevent, treat, and rehabilitate END.OBJETIVO: Las neuro-discapacidades tempranas (NDT como la parálisis cerebral (PC, hipoacusia, debilidad visual, epilepsia y retardo mental (RM son problemas muy importantes de salud pública. Aunque no existen suficientes datos sobre la prevalencia de NDT en México, el objetivo de este trabajo es hacer comentarios sistemáticos y críticos sobre los ya estudios existentes. MÉTODO: Realizamos una búsqueda sistemática de artículos publicados sobre NDT en México. La búsqueda comprendió las siguientes bases de publicaciones: Pub

  19. The added value of mifepristone to non-surgical treatment regimens for uterine evacuation in case of early pregnancy failure: a systematic review of the literature

    NARCIS (Netherlands)

    Berg, J. van den; Gordon, B.B.; Snijders, M.P.M.L.; Vandenbussche, F.P.H.A.; Coppus, S.F.P.J.

    2015-01-01

    OBJECTIVE(S): Early pregnancy failure (EPF) is a common complication of pregnancy. Surgical intervention carries a risk of complications and, therefore, medical treatment appears to be a safe alternative. Unfortunately, the current medical treatment with misoprostol alone has complete evacuation rat

  20. Unremarked or Unperformed? Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

    NARCIS (Netherlands)

    de Boer, Pieter T.; Frederix, G.W.J.; Feenstra, Talitha L.; Vemer, Pepijn

    2016-01-01

    BACKGROUND: Transparent reporting of validation efforts of health economic models give stakeholders better insight into the credibility of model outcomes. In this study we reviewed recently published studies on seasonal influenza and early breast cancer in order to gain insight into the reporting of

  1. Unremarked or Unperformed? : Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

    NARCIS (Netherlands)

    de Boer, Pieter T; Frederix, Geert W J; Feenstra, Talitha L; Vemer, Pepijn

    2016-01-01

    BACKGROUND: Transparent reporting of validation efforts of health economic models give stakeholders better insight into the credibility of model outcomes. In this study we reviewed recently published studies on seasonal influenza and early breast cancer in order to gain insight into the reporting of

  2. Unremarked or Unperformed? : Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer

    NARCIS (Netherlands)

    de Boer, Pieter T.; Frederix, Geert W. J.; Feenstra, Talitha L.; Vemer, Pepijn

    2016-01-01

    Background Transparent reporting of validation efforts of health economic models give stakeholders better insight into the credibility of model outcomes. In this study we reviewed recently published studies on seasonal influenza and early breast cancer in order to gain insight into the reporting of

  3. Systematic error revisited

    Energy Technology Data Exchange (ETDEWEB)

    Glosup, J.G.; Axelrod, M.C.

    1996-08-05

    The American National Standards Institute (ANSI) defines systematic error as An error which remains constant over replicative measurements. It would seem from the ANSI definition that a systematic error is not really an error at all; it is merely a failure to calibrate the measurement system properly because if error is constant why not simply correct for it? Yet systematic errors undoubtedly exist, and they differ in some fundamental way from the kind of errors we call random. Early papers by Eisenhart and by Youden discussed systematic versus random error with regard to measurements in the physical sciences, but not in a fundamental way, and the distinction remains clouded by controversy. The lack of a general agreement on definitions has led to a plethora of different and often confusing methods on how to quantify the total uncertainty of a measurement that incorporates both its systematic and random errors. Some assert that systematic error should be treated by non- statistical methods. We disagree with this approach, and we provide basic definitions based on entropy concepts, and a statistical methodology for combining errors and making statements of total measurement of uncertainty. We illustrate our methods with radiometric assay data.

  4. Measuring IPDE-SQ personality disorder prevalence in pre-sentence and early-stage prison populations, with sub-type estimates.

    Science.gov (United States)

    Slade, Karen; Forrester, Andrew

    2013-01-01

    Understanding the prevalence and type of personality disorder within prison systems allows for the effective targeting of resources to implement strategies to alleviate symptoms, manage behaviour and attempt to reduce re-offending. This study aimed to determine the prevalence of personality disorder (PD) traits within a local urban high-turnover adult male prison with a remand/recently sentenced population in London, UK. The International Personality Disorder Examination - Screening Questionnaire (IPDE-SQ) self-administered questionnaire (ICD-10 version) was completed by 283 prisoners (42% completion rate). 77% of respondents reached the threshold for one or more PDs. The most common PD types were Paranoid PD (44.5%), Anankastic PD (40.3%), Schizoid PD (35%) and Dissocial PD (25.8%). These results confirm and extend existing knowledge regarding the prevalence of PD in prison populations into a high-turnover, urban, remand population. The stark comparison with community samples indicates that a more equitable standard of service delivery within the criminal justice system, focussing on preventive and early intervention services, is now required.

  5. Comparison between Early-Onset and Late-Onset Alzheimer's Disease Patients with Amnestic Presentation: CSF and 18F-FDG PET Study

    Directory of Open Access Journals (Sweden)

    Agostino Chiaravalloti

    2016-04-01

    Full Text Available Background/Aims: To investigate the differences in brain glucose consumption between patients with early onset of Alzheimer's disease (EOAD, aged ≤65 years and patients with late onset of Alzheimer's disease (LOAD, aged >65 years. Methods: Differences in brain glucose consumption between the groups have been evaluated by means of Statistical Parametric Mapping version 8, with the use of age, sex, Mini-Mental State Examination and cerebrospinal fluid values of Aβ1-42, phosphorylated Tau and total Tau as covariates in the comparison between EOAD and LOAD. Results: As compared to LOAD, EOAD patients showed a significant decrease in glucose consumption in a wide portion of the left parietal lobe (BA7, BA31 and BA40. No significant differences were obtained when subtracting the EOAD from the LOAD group. Conclusions: The results of our study show that patients with EOAD show a different metabolic pattern as compared to those with LOAD that mainly involves the left parietal lobe.

  6. The Janus face of iron on anoxic worlds: iron oxides are both protective and destructive to life on the early Earth and present-day Mars.

    Science.gov (United States)

    Wadsworth, Jennifer; Cockell, Charles S

    2017-05-01

    The surface of the early Earth was probably subjected to a higher flux of ultraviolet (UV) radiation than today. UV radiation is known to severely damage DNA and other key molecules of life. Using a liquid culture and a rock analogue system, we investigated the interplay of protective and deleterious effects of iron oxides under UV radiation on the viability of the model organism, Bacillus subtilis. In the presence of hydrogen peroxide, there exists a fine balance between iron oxide's protective effects against this radiation and its deleterious effects caused by Photo-Fenton reactions. The maximum damage was caused by a concentration of hematite of ∼1 mg/mL. Concentrations above this confer increasing protection by physical blockage of the UV radiation, concentrations below this cause less effective UV radiation blockage, but also a correspondingly less effective Photo-Fenton reaction, providing an overall advantage. These results show that on anoxic worlds, surface habitability under a high UV flux leaves life precariously poised between the beneficial and deleterious effects of iron oxides. These results have relevance to the Archean Earth, but also the habitability of the Martian surface, where high levels of UV radiation in combination with iron oxides and hydrogen peroxide can be found. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Very Early Presentation of Extrahepatic Portal Vein Obstruction Causing Portal Hypertension in an Infant: Uncertainties in the Management and Therapeutic Limitations.

    Science.gov (United States)

    Khodayar-Pardo, Parisá; Peña Aldea, Andrés; Ramírez González, Ana; Meseguer Carrascosa, Adela; Calabuig Bayo, Cristina

    2016-01-01

    Extrahepatic portal vein obstruction, although rare in children, is a significant cause of portal hypertension (PHT) leading to life-threatening gastrointestinal bleeding in the pediatric age group. PHT may also lead to other complications such as hyperesplenism, cholangyopathy, ascites, and even hepatopulmonary syndrome and portopulmonary hypertension that may require organ transplantation. Herein we report the case of an asymptomatic 11-month-old infant wherein a hepatomegaly and cavernous transformation of the portal vein was detected by liver ultrasound. Neither signs of thrombosis in arteriovenous system, nor affectation of biliary tract were identified in the magnetic resonance imaging study. A significant enlargement of the caudate lobe of the liver was reported. No risk factors were detected. The differential diagnosis performed was extensive. Inherited thrombophilia and storage disorders were especially considered. Liver biopsy was normal. Upper gastrointestinal esophagogastroduodenoscopy detected two small varicose cords on the distal third of the esophagus. Finding a cavernous transformation of the portal vein with evidence of collateral circulation in such an early age is a challenging condition for professionals, since PHT may lead to severe complications during childhood and can compromise growth and development. Evidence-based guidelines for the management of PHT in adults have been published. However, follow-up and treatment of pediatric patients have not yet been standardized. Moreover, management of PHT in infants faces particular difficulties such as technical restrictions that could hinder their treatment.

  8. Very Early Presentation of Extrahepatic Portal Vein Obstruction Causing Portal Hypertension in an Infant: Uncertainties in the Management and Therapeutic Limitations

    Directory of Open Access Journals (Sweden)

    Parisá Khodayar-Pardo

    2016-07-01

    Full Text Available Extrahepatic portal vein obstruction, although rare in children, is a significant cause of portal hypertension (PHT leading to life-threatening gastrointestinal bleeding in the pediatric age group. PHT may also lead to other complications such as hyperesplenism, cholangyopathy, ascites, and even hepatopulmonary syndrome and portopulmonary hypertension that may require organ transplantation. Herein we report the case of an asymptomatic 11-month-old infant wherein a hepatomegaly and cavernous transformation of the portal vein was detected by liver ultrasound. Neither signs of thrombosis in arteriovenous system, nor affectation of biliary tract were identified in the magnetic resonance imaging study. A significant enlargement of the caudate lobe of the liver was reported. No risk factors were detected. The differential diagnosis performed was extensive. Inherited thrombophilia and storage disorders were especially considered. Liver biopsy was normal. Upper gastrointestinal esophagogastroduodenoscopy detected two small varicose cords on the distal third of the esophagus. Finding a cavernous transformation of the portal vein with evidence of collateral circulation in such an early age is a challenging condition for professionals, since PHT may lead to severe complications during childhood and can compromise growth and development. Evidence-based guidelines for the management of PHT in adults have been published. However, follow-up and treatment of pediatric patients have not yet been standardized. Moreover, management of PHT in infants faces particular difficulties such as technical restrictions that could hinder their treatment.

  9. Very Early Presentation of Extrahepatic Portal Vein Obstruction Causing Portal Hypertension in an Infant: Uncertainties in the Management and Therapeutic Limitations

    Science.gov (United States)

    Khodayar-Pardo, Parisá; Peña Aldea, Andrés; Ramírez González, Ana; Meseguer Carrascosa, Adela; Calabuig Bayo, Cristina

    2016-01-01

    Extrahepatic portal vein obstruction, although rare in children, is a significant cause of portal hypertension (PHT) leading to life-threatening gastrointestinal bleeding in the pediatric age group. PHT may also lead to other complications such as hyperesplenism, cholangyopathy, ascites, and even hepatopulmonary syndrome and portopulmonary hypertension that may require organ transplantation. Herein we report the case of an asymptomatic 11-month-old infant wherein a hepatomegaly and cavernous transformation of the portal vein was detected by liver ultrasound. Neither signs of thrombosis in arteriovenous system, nor affectation of biliary tract were identified in the magnetic resonance imaging study. A significant enlargement of the caudate lobe of the liver was reported. No risk factors were detected. The differential diagnosis performed was extensive. Inherited thrombophilia and storage disorders were especially considered. Liver biopsy was normal. Upper gastrointestinal esophagogastroduodenoscopy detected two small varicose cords on the distal third of the esophagus. Finding a cavernous transformation of the portal vein with evidence of collateral circulation in such an early age is a challenging condition for professionals, since PHT may lead to severe complications during childhood and can compromise growth and development. Evidence-based guidelines for the management of PHT in adults have been published. However, follow-up and treatment of pediatric patients have not yet been standardized. Moreover, management of PHT in infants faces particular difficulties such as technical restrictions that could hinder their treatment. PMID:27504083

  10. Female heterozygotes for the hypomorphic R40H mutation can have ornithine transcarbamylase deficiency and present in early adolescence: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Kirk Edwin P

    2010-11-01

    Full Text Available Abstract Introduction Ornithine transcarbamylase deficiency is the most common hereditary urea cycle defect. It is inherited in an X-linked manner and classically presents in neonates with encephalopathy and hyperammonemia in males. Females and males with hypomorphic mutations present later, sometimes in adulthood, with episodes that are frequently fatal. Case presentation A 13-year-old Caucasian girl presented with progressive encephalopathy, hyperammonemic coma and lactic acidosis. She had a history of intermittent regular episodes of nausea and vomiting from seven years of age, previously diagnosed as abdominal migraines. At presentation she was hyperammonemic (ammonia 477 μmol/L with no other biochemical indicators of hepatic dysfunction or damage and had grossly elevated urinary orotate (orotate/creatinine ratio 1.866 μmol/mmol creatinine, reference range A mutation was identified in the ornithine transcarbamylase gene (OTC in our patient confirming the first symptomatic female shown heterozygous for the R40H mutation. A review of the literature and correspondence with authors of patients with the R40H mutation identified one other symptomatic female patient who died of hyperammonemic coma in her late teens. Conclusions This report expands the clinical spectrum of presentation of ornithine transcarbamylase deficiency to female heterozygotes for the hypomorphic R40H OTC mutation. Although this mutation is usually associated with a mild phenotype, females with this mutation can present with acute decompensation, which can be fatal. Ornithine transcarbamylase deficiency should be considered in the differential diagnosis of unexplained acute confusion, even without a suggestive family history.

  11. Fungos Presentes em Acículas de Pinus taeda em Estágios Iniciais de Decomposição no Campo Fungi Present on Pinus taeda Needles in Early Stages of Decomposition in the Field

    Directory of Open Access Journals (Sweden)

    Angela Michelato Ghizelini

    2011-03-01

    of Pinus taeda in an experimental plantation with four years old, located at Três Barras, SC, Brazil. Senescent needles were collected from trees in november/2003 and putted in selective bags for microorganisms, which were left over the forest litter. The first sample was taken to the laboratory and the remaining ones were kept in situ so that the needles continue their natural decomposition process and were collected every three months. The collected needles were submitted at 20 successive washings. Fragments were taken off and inserted in Petri dishes containing malt extract agar 2% and were incubated at enviromental conditions. During fungi succession, 13 genera were identified: Acremonium sp., Alternaria sp., Cladosporium sp., Colletotrichum sp., Epicoccum sp., Fusarium sp., Gliocladium sp., Mucor sp., Penicillium sp., Pestalotia sp., Rhizoctonia sp., Trichoderma sp. and Verticillium sp. The most significant fungi were Trichoderma sp., Fusarium sp. and Verticillium sp. It was considered that the present fungal biodiversity is enough to start needle decomposition, by presence of cellulolitic fungi. 

  • Colloids versus crystalloids in objective-guided fluid therapy, systematic review and meta-analysis. Too early or too late to draw conclusions.

    Science.gov (United States)

    Ripollés, Javier; Espinosa, Ángel; Casans, Rubén; Tirado, Ana; Abad, Alfredo; Fernández, Cristina; Calvo, José

    2015-01-01

    Several clinical trials on Goal directed fluid therapy (GDFT) were carried out, many of those using colloids in order to optimize the preload. After the decision of European Medicines Agency, there is such controversy regarding its use, benefits, and possible contribution to renal failure. The objective of this systematic review and meta-analysis is to compare the use of last-generation colloids, derived from corn, with crystalloids in GDFT to determine associated complications and mortality. A bibliographic research was carried out in MEDLINE PubMed, EMBASE and Cochrane Library, corroborating randomized clinical trials where crystalloids are compared to colloids in GDFT for major non-cardiac surgery in adults. One hundred thirty references were found and among those 38 were selected and 29 analyzed; of these, six were included for systematic review and meta-analysis, including 390 patients. It was observed that the use of colloids is not associated with the increase of complications, but rather with a tendency to a higher mortality (RR [95% CI] 3.87 [1.121-13.38]; I(2)=0.0%; p=0.635). Because of the limitations of this meta-analysis due to the small number of randomized clinical trials and patients included, the results should be taken cautiously, and the performance of new randomized clinical trials is proposed, with enough statistical power, comparing balanced and unbalanced colloids to balanced and unbalanced crystalloids, following the protocols of GDFT, considering current guidelines and suggestions made by groups of experts. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  • Colloids versus crystalloids in objective-guided fluid therapy, systematic review and meta-analysis. Too early or too late to draw conclusions

    Directory of Open Access Journals (Sweden)

    Javier Ripollés

    2015-08-01

    Full Text Available INTRODUCTION: Several clinical trials on Goal directed fluid therapy (GDFT were carried out, many of those using colloids in order to optimize the preload. After the decision of European Medicines Agency, there is such controversy regarding its use, benefits, and possible contribution to renal failure. The objective of this systematic review and meta-analysis is to compare the use of last-generation colloids, derived from corn, with crystalloids in GDFT to determine associated complications and mortality.METHODS: A bibliographic research was carried out in MEDLINE PubMed, EMBASE and Cochrane Library, corroborating randomized clinical trials where crystalloids are compared to colloids in GDFT for major non-cardiac surgery in adults.RESULTS: One hundred thirty references were found and among those 38 were selected and 29 analyzed; of these, six were included for systematic review and meta-analysis, including 390 patients. It was observed that the use of colloids is not associated with the increase of complications, but rather with a tendency to a higher mortality (RR [95% CI] 3.87 [1.121-13.38]; I2 = 0.0%; p = 0.635.CONCLUSIONS: Because of the limitations of this meta-analysis due to the small number of randomized clinical trials and patients included, the results should be taken cautiously, and the performance of new randomized clinical trials is proposed, with enough statistical power, comparing balanced and unbalanced colloids to balanced and unbalanced crystalloids, following the protocols of GDFT, considering current guidelines and suggestions made by groups of experts.

  • [Colloids versus crystalloids in objective-guided fluid therapy, systematic review and meta-analysis. Too early or too late to draw conclusions].

    Science.gov (United States)

    Ripollés, Javier; Espinosa, Ángel; Casans, Rubén; Tirado, Ana; Abad, Alfredo; Fernández, Cristina; Calvo, José

    2015-01-01

    Several clinical trials on Goal directed fluid therapy (GDFT) were carried out, many of those using colloids in order to optimize the preload. After the decision of European Medicines Agency, there is such controversy regarding its use, benefits, and possible contribution to kidney failure. The objective of this systematic review and meta-analysis is to compare the use of last-generation colloids, derived from corn, with crystalloids, in GDFT, to determine complications and mortality associated associated. A bibliographic research was carried out in Medline, Pubmed, Embase and Cochrane Library, corroborating randomized clinical trials in those crystalloids are compared to colloids in GDFT for mayor non-cardiac surgery in adults. One hundred thirty references were found, among those 38 were selected, and 29 analyzed; of these, 6 were included for systematic review and meta-analysis, including 390 patients. It was perceived that the use of colloids it not associated with the increase of complications, but rather with a tendency to a higher mortality (RR [95% IC] 3.87 [1.121, 13, 38]); I(2)=0.0%; p=0.635). Due to this meta-analysis' limitations for small number of randomized clinical trials and patients included, the results should be taken cautiously, and it is proposed to carry out new randomized clinical trials, with enough statistical power, comparing balanced and non-balanced colloids to balanced and non-balanced crystalloids, following the protocols of GDFT, respecting current guidelines and suggestions made by groups of experts. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  • Pre-treatment differences and early response monitoring of neoadjuvant chemotherapy in breast cancer patients using magnetic resonance imaging: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Prevos, R.; Wildberger, J.E. [Maastricht University Medical Center, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands); Smidt, M.L. [Maastricht University Medical Center, Department of Surgery, Maastricht (Netherlands); Tjan-Heijnen, V.C.G. [Maastricht University Medical Center, Department of Medical Oncology, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Goethem, M. van [University Hospital of Antwerp, Department of Radiology, Antwerp (Belgium); Beets-Tan, R.G.; Lobbes, M.B.I. [Maastricht University Medical Center, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2012-12-15

    To assess whether magnetic resonance imaging (MRI) can identify pre-treatment differences or monitor early response in breast cancer patients receiving neoadjuvant chemotherapy. PubMed, Cochrane library, Medline and Embase databases were searched for publications until January 1, 2012. After primary selection, studies were selected based on predefined inclusion/exclusion criteria. Two reviewers assessed study contents using an extraction form. In 15 studies, which were mainly underpowered and of heterogeneous study design, 31 different parameters were studied. Most frequently studied parameters were tumour diameter or volume, K{sup trans}, K{sub ep}, V{sub e}, and apparent diffusion coefficient (ADC). Other parameters were analysed in only two or less studies. Tumour diameter, volume, and kinetic parameters did not show any pre-treatment differences between responders and non-responders. In two studies, pre-treatment differences in ADC were observed between study groups. At early response monitoring significant and non-significant changes for all parameters were observed for most of the imaging parameters. Evidence on distinguishing responders and non-responders to neoadjuvant chemotherapy using pre-treatment MRI, as well as using MRI for early response monitoring, is weak and based on underpowered study results and heterogeneous study design. Thus, the value of breast MRI for response evaluation has not yet been established. (orig.)

  • A handheld MEMS-based line-scanned dual-axis confocal microscope for early cancer detection and surgical guidance (Conference Presentation)

    Science.gov (United States)

    Chen, Ye; Yin, Chengbo; Wei, Linpeng; Glaser, Adam K.; Abeytunge, Sanjee; Peterson, Gary; Mandella, Michael J.; Sanai, Nader; Rajadhyaksha, Milind; Liu, Jonathan T.

    2017-02-01

    Considerable efforts have been recently undertaken to develop miniature optical-sectioning microscopes for in vivo microendoscopy and point-of-care pathology. These devices enable in vivo interrogation of disease as a real-time and noninvasive alternative to gold-standard histopathology, and therefore could have a transformative impact for the early detection of cancer as well as for guiding tumor-resection procedures. Regardless of the specific modality, various trade-offs in size, speed, field of view, resolution, contrast, and sensitivity are necessary to optimize a device for a particular application. Here, a miniature MEMS-based line-scanned dual-axis confocal (LS-DAC) microscope, with a 12-mm diameter distal tip, has been developed for point-of-care pathology. The dual-axis architecture has demonstrated superior rejection of out-of-focus and multiply scattered photons compared to a conventional single-axis confocal configuration. The use of line scanning enables fast frame rates (≥15 frames/sec), which mitigates motion artifacts of a handheld device during clinical use. We have developed a method to actively align the illumination and collection beams in this miniature LS-DAC microscope through the use of a pair of rotatable alignment mirrors. Incorporation of a custom objective lens, with a small form factor for in vivo application, enables the device to achieve an axial and lateral resolution of 2.0 and 1.1 microns, respectively. Validation measurements with reflective targets, as well as in vivo and ex vivo images of tissues, demonstrate that this high-speed LS-DAC microscope can achieve high-contrast imaging of fluorescently labeled tissues with sufficient sensitivity for applications such as oral cancer detection and guiding brain-tumor resections.

  • Early Cretaceous to present latitude of the central proto-Tibetan Plateau : A paleomagnetic synthesis with implications for Cenozoic tectonics, paleogeography, and climate of Asia

    NARCIS (Netherlands)

    Lippert, Peter C.; van Hinsbergen, D.J.J.; Dupont-Nivet, Guillaume

    2014-01-01

    Published paleomagnetic data from well-dated sedimentary rocks and lavas from the Lhasa terrane have been reevaluated in a statistically consistent framework to assess the latitude history of southern Tibet from ca. 110 Ma to the present. The resulting apparent polar wander path shows that the margi

  • Comparative Efficacy of Interventional Therapies for Early-stage Hepatocellular Carcinoma: A PRISMA-compliant Systematic Review and Network Meta-analysis.

    Science.gov (United States)

    Lan, Tian; Chang, Lei; Rahmathullah, M N; Wu, Long; Yuan, Yu-Feng

    2016-04-01

    There are several interventional therapies that improve the prognosis and increase the survival rate of early-stage hepatocellular carcinoma (early-stage HCC), but it is uncertain about whether one is superior to others, and available researches investigating the comparative effects of different treatments are limited. The main objective of this Bayesian network meta-analysis was to compare the efficacy of these different treatment strategies for early-stage HCC and rank these interventions for practical consideration. We performed an electronic search of PubMed, Embase, and Cochrane Library, and extracted data from randomized controlled trials that compared different interventional therapies for early-stage HCC. Direct comparison and network meta-analyses were conducted with Aggregate Data Drug Information System software. Consistency models were created to determine whether there was a significant difference between any 2 therapies, and cumulative probability was used to rank different treatments. Twenty-one randomized controlled trials involving 2691 patients were included. In our network meta-analysis, the combination therapy of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) was associated with better 1-year survival rate, as compared with hepatic resection alone (P < 0.05, odds ratio [OR] 0.25, 95% confidence interval [CI] 0.06-0.83), percutaneous ethanol injection (PEI) alone (P < 0.05, OR 0.13, 95% CI 0.03-0.45), and RFA alone (P < 0.05, OR 0.23, 95% CI 0.07-0.70). TACE + RFA had a higher 3-year survival rate than PEI alone (P < 0.05, OR 0.32, 95% CI 0.15-0.72) and RFA alone (P < 0.05, OR 0.45, 95% CI 0.24-0.87). And there was a statistical difference between RFA + PEI and PEI alone (P < 0.05, OR 0.33, 95% CI 0.12-0.93) for 3-year survival rate. The results of rank test and cumulative probability showed that TACE + RFA ranked highest on the evaluation of 1-year, 3-year, and 5-year

  • Early re-presentation to hospital after discharge from an acute medical unit: perspectives of older patients, their family caregivers and health professionals.

    Science.gov (United States)

    Slatyer, Susan; Toye, Christine; Popescu, Aurora; Young, Jeanne; Matthews, Anne; Hill, Andrew; Williamson, D James

    2013-02-01

    To explore the perceptions of older patients who re-presented to hospital within 28 days of discharge from an acute medical unit (AMU), their family caregivers and appropriately experienced health professionals. Hospitals are increasingly using AMUs to provide rapid assessment and treatment for medical patients. Evidence of efficacy is building, however in-depth exploration of the experiences of older patients who re-present to hospital soon after discharge from an AMU, and those who care for them, appears to be lacking. A qualitative, descriptive design was used. In 2007, our team purposively sampled older patients who re-presented to hospital within 28 days of discharge from an AMU (n = 12), family caregivers (n = 15), and health professionals (n = 35). Data were collected using semi-structured interviews and subjected to thematic content analysis. Four themes emerged: the health trajectory, communication challenges, discharge readiness and the decision to return. Re-presentation to hospital was seen as part of a declining health trajectory. The AMU was viewed as treating acute illness well, however patients and family caregivers left hospital with limited understanding of underlying health problems and, therefore, ill-prepared for future health crises. There are clear benefits for older patients from AMUs, which expedite treatment for acute health crises. However, AMU discharge planning needs to consider patients' overall health status and likely future needs to optimise outcomes. Such a requirement is problematic in the context of acute time pressures. To ensure prompt and expert attention to key aspects of discharge planning for older people leaving AMUs, there is a role for in-depth clinical expertise in the care of older people facing deteriorating life-limiting conditions. Therefore, a leadership role for nurses with geriatric and palliative care expertise, alongside medical and allied health professionals, merits attention in this context. © 2013

  • 早期综合干预对发育临界儿神经心理发育的影响%Effects of Early Systematical Intervention on Neuropsychological Development of Developmental Borderline Children

    Institute of Scientific and Technical Information of China (English)

    刘小英; 杨梅凤; 寇海燕; 刘文龙

    2014-01-01

    Objective: To explore effects of early systematical intervention on neuropsychological development of developmental borderline children (DBC).Method: 100 DBC aged from 0 to 6, whose developmental quotient(DQ) were from 70 to 85, were randomly grouped. There were 50 children in intervention group and control group respectively. Children from control group accepted only routine early education guidance while children from intervention group were educated by early systematical intervention training besides routine early education guidance. Their DQ were assessed after 6 months and were compared with DQ before intervention to evaluate educational training results.Result: The scores of DQ, gross motor, fine motor, adaptation, language and social behavior of children from intervention group were higher than those of children from control group and the difference was significant (P<0.01). The interventional effective rate of the intervention group was 92%, while that of the control group was 60%, and the difference was significant (P<0.01). Conclusion:Early systematical intervention can improve neuropsychological development of developmental borderline children (DBC).%目的:探究早期综合干预对发育临界儿神经心理发育的影响。方法:筛查出的总发育商为70~85分的0~6岁发育临界儿100例随机数字表法分为干预组和对照组,每组50例。对照组接受传统以体检为主的保健的基础上的常规早期教育指导,干预组在常规早期教育指导基础上,还进行了早期综合干预,采用0~6岁小儿神经心理发育检查表对两组患者分别在干预前和干预6个月后进行测查,比较两组发育临界儿干预效果。结果:干预6个月后干预组的发育商数、大运动、精细运动、适应能力、语言和社交行为的得分较对照组均有明显提高,差异有统计学意义(P<0.01);干预组总有效率达92%,明显高于对照组的总有效率60%,比较

    1. Impact of early psychosocial factors (childhood socioeconomic factors and adversities on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review

      Directory of Open Access Journals (Sweden)

      Tamayo Teresa

      2010-09-01

      Full Text Available Abstract Background Psychological factors and socioeconomic status (SES have a notable impact on health disparities, including type 2 diabetes risk. However, the link between childhood psychosocial factors, such as childhood adversities or parental SES, and metabolic disturbances is less well established. In addition, the lifetime perspective including adult socioeconomic factors remains of further interest. We carried out a systematic review with the main question if there is evidence in population- or community-based studies that childhood adversities (like neglect, traumata and deprivation have considerable impact on type 2 diabetes incidence and other metabolic disturbances. Also, parental SES was included in the search as risk factor for both, diabetes and adverse childhood experiences. Finally, we assumed that obesity might be a mediator for the association of childhood adversities with diabetes incidence. Therefore, we carried out a second review on obesity, applying a similar search strategy. Methods Two systematic reviews were carried out. Longitudinal, population- or community-based studies were included if they contained data on psychosocial factors in childhood and either diabetes incidence or obesity risk. Results We included ten studies comprising a total of 200,381 individuals. Eight out of ten studies indicated that low parental status was associated with type 2 diabetes incidence or the development of metabolic abnormalities. Adjustment for adult SES and obesity tended to attenuate the childhood SES-attributable risk but the association remained. For obesity, eleven studies were included with a total sample size of 70,420 participants. Four out of eleven studies observed an independent association of low childhood SES on the risk for overweight and obesity later in life. Conclusions Taken together, there is evidence that childhood SES is associated with type 2 diabetes and obesity in later life. The database on the role of

    2. Optimal Nutrition In Lactating Women And Its Effect On Later Health Of Offspring: A Systematic Review Of Current Evidence And Recommendations (Early Nutrition Project).

      Science.gov (United States)

      de Waard, Marita; Brands, Brigitte; Kouwenhoven, Stefanie M P; Lerma, Joaquim Calvo; Crespo-Escobar, Paula; Koletzko, Berthold; Zalewski, Bartlomiej M; van Goudoever, Johannes B

      2016-04-29

      Background EarlyNutrition ( www.project-earlynutrition.eu ) is an international research consortium investigating the effects of early nutrition on metabolic programming. Objective To summarize current evidence and standards, recommendations, guidelines, and regulations on nutrition or supplements in lactating women with emphasis placed on long-term health effects in offspring, including cardiovascular disease, hypertension, overweight/obesity, metabolic syndrome, diabetes, or glucose intolerance. Methods Medline, Embase, selected databases and websites were searched for documents published between 2010 and 2015. Results Thirteen documents met the inclusion criteria. Effects of maternal long-chain polyunsaturated fatty acid (LC-PUFA) supplementation on overweight/obesity or hypertension in offspring were assessed in 10 studies. One study described the effect of maternal vitamin D supplementation on overweight/obesity, and the remaining 2 studies assessed the effects of maternal probiotic/synbiotic supplementation during lactation on overweight/obesity or metabolic syndrome in their infants. Forty-one documents contained dietary recommendations on various macro- and micronutrients for lactating women, but without consideration of our long-term health outcomes in infants. Conclusion Literature on nutrition of lactating women and its effect on their infants/ later health with respect to metabolic programming outcomes appeared to be scarce, and focused mostly on supplementation of LC-PUFA's. No recent guidelines or recommendations were available, highlighting the significant research gaps regarding this topic.

    3. Does computer navigation system really improve early clinical outcomes after anterior cruciate ligament reconstruction? A meta-analysis and systematic review of randomized controlled trials.

      Science.gov (United States)

      Cheng, Tao; Zhang, Guo-You; Zhang, Xian-Long

      2012-03-01

      Inaccurate tunnel placement is an important cause of failure in conventional anterior cruciate ligament (ACL) reconstruction. Controversy currently exists over the usefulness of computer-assisted navigation systems in addressing this problem. Five randomized or quasi-randomized, controlled trials comparing computer-navigated versus conventional technique in ACL reconstructions until December 1, 2009 were identified through a systematical database search. The clinical outcomes of the trials were analyzed by Lachman test, pivot-shift test, International Knee Documentation Committee knee score, Lysholm score, and Tegner score. Mean difference or risk ratio with 95% confidence interval was calculated using a fixed-effects or random-effects model. Heterogeneity across the studies was also assessed. We found that the use of computer-assisted navigation systems led to additional operative time (8-17min). No significant differences between computer-navigated and conventional groups were found in terms of knee stability and functional assessment during short-term follow-up. The role of computer-assisted navigation systems on clinical performance and longevity needs further investigation in large sample, long-term randomized trials. Copyright © 2011 Elsevier B.V. All rights reserved.

    4. CERN Library | Cecilia Jarlskog presents "Portrait of Gunnar Källén: a physics shooting star and poet of early quantum field theory" | 16 September

      CERN Multimedia

      2014-01-01

      Wolfgang Pauli referred to him as 'my discovery', Robert Oppenheimer described him as 'one of the most gifted theorists' and Niels Bohr found him enormously stimulating. Who was the man in question, Gunnar Källén (1926-1968)?   His appearance in the physics sky was like a shooting star. His contributions to the scientific debate caused excitement among young and old. Similar to his friend and mentor, Wolfgang Pauli, he demanded honesty and rigour in physics - a distinct dividing line between fact and speculation. In his obituary, Arthur S. Wightman would write: "Gunnar Källén was a proud continuer of the tradition in quantum field theory established by Wolfgang Pauli. His papers on quantum electrodynamics in the period 1950-1954 carried the non-perturbative approach to quantum electrodynamics forward to a point beyond which very little essential progress has been made up to the present day. At the time I was trying ...

    5. High-sensitivity troponin assays for the early rule-out or diagnosis of acute myocardial infarction in people with acute chest pain: A systematic review and cost-effectiveness analysis

      NARCIS (Netherlands)

      M. Westwood (Marie); T. van Asselt (Thea); B.L.T. Ramaekers (Bram); P. Whiting (Penny); P. Thokala (Praveen); M.A. Joore (Manuela); N. Armstrong (Nigel); J. Ross (Janine); J.L. Severens (Hans); J. Kleijnen (Jos)

      2015-01-01

      textabstractBackground The primary indication for this assessment is the early rule-out of acute myocardial infarction (AMI) in people presenting with acute chest pain and suspected, but not confirmed, non-ST segment elevation myocardial infarction (NSTEMI). Cardiac troponins (cTns) I and T are used

    6. Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials.

      Science.gov (United States)

      Hutton, Eileen K; Hassan, Eman S

      2007-03-21

      With few exceptions, the umbilical cord of every newborn is clamped and cut at birth, yet the optimal timing for this intervention remains controversial. To compare the potential benefits and harms of late vs early cord clamping in term infants. Search of 6 electronic databases (on November 15, 2006, starting from the beginning of each): the Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Neonatal Group trials register, the Cochrane library, MEDLINE, EMBASE, and CINHAL; hand search of secondary references in relevant studies; and contact of investigators about relevant published research. Controlled trials comparing late vs early cord clamping following birth in infants born at 37 or more weeks' gestation. Two reviewers independently assessed eligibility and quality of trials and extracted data for outcomes of interest: infant hematologic status; iron status; and risk of adverse events such as jaundice, polycythemia, and respiratory distress. The meta-analysis included 15 controlled trials (1912 newborns). Late cord clamping was delayed for at least 2 minutes (n = 1001 newborns), while early clamping in most trials (n = 911 newborns) was performed immediately after birth. Benefits over ages 2 to 6 months associated with late cord clamping include improved hematologic status measured as hematocrit (weighted mean difference [WMD], 3.70%; 95% confidence interval [CI], 2.00%-5.40%); iron status as measured by ferritin concentration (WMD, 17.89; 95% CI, 16.58-19.21) and stored iron (WMD, 19.90; 95% CI, 7.67-32.13); and a clinically important reduction in the risk of anemia (relative risk (RR), 0.53; 95% CI, 0.40-0.70). Neonates with late clamping were at increased risk of experiencing asymptomatic polycythemia (7 studies [403 neonates]: RR, 3.82; 95% CI, 1.11-13.21; 2 high-quality studies only [281 infants]: RR, 3.91; 95% CI, 1.00-15.36). Delaying clamping of the umbilical cord in full-term neonates for a minimum of 2 minutes following birth is

    7. What Level of Bowel Prep Quality Requires Early Repeat Colonoscopy: Systematic Review and Meta-Analysis of the Impact of Preparation Quality on Adenoma Detection Rate

      Science.gov (United States)

      Clark, Brian T.; Rustagi, Tarun; Laine, Loren

      2015-01-01

      OBJECTIVES Current guidelines recommend early repeat colonoscopy when bowel preparation quality is inadequate, defined as inability to detect polyps > 5 mm, but no data link specific bowel preparation categories or scores to this definition. Nevertheless, most physicians use a shortened screening/surveillance interval in patients with intermediate-quality preparation. We determined whether different levels of bowel preparation quality are associated with differences in adenoma detection rates (ADRs: proportion of colonoscopies with ≥1 adenoma) to help guide decisions regarding early repeat colonoscopy—with primary focus on intermediate-quality preparation. METHODS MEDLINE and Embase were searched for studies with adenoma or polyp detection rate stratified by bowel preparation quality. Preparation quality definitions were standardized on the basis of Aronchick definitions (excellent/good/fair/poor/insufficient), and primary analyses of ADR trichotomized bowel preparation quality: high quality (excellent/good), intermediate quality (fair), and low quality (poor/insufficient). Dichotomized analyses of adequate (excellent/good/fair) vs. inadequate (poor/insufficient) were also performed. RESULTS Eleven studies met the inclusion criteria. The primary analysis, ADR with intermediate- vs. high-quality preparation, showed an odds ratio (OR) of 0.94 (0.80–1.10) and absolute risk difference of −1% (−3%, 2%). ADRs were significantly higher with both intermediate-quality and high-quality preparation vs. low-quality preparation: OR = 1.39 (1.08–1.79) and 1.41 (1.21–1.64), with absolute risk increases of 5% for both. ADR and advanced ADR were significantly higher with adequate vs. inadequate preparation: OR = 1.30 (1.19–1.42) and 1.30 (1.02–1.67). Studies did not report other relevant outcomes such as total adenomas per colonoscopy. CONCLUSIONS ADR is not significantly different with intermediate-quality vs. high-quality bowel preparation. Our results confirm

    8. Early Signaling in Primary T Cells Activated by Antigen Presenting Cells Is Associated with a Deep and Transient Lamellal Actin Network.

      Directory of Open Access Journals (Sweden)

      Kole T Roybal

      Full Text Available Cellular signaling transduction critically depends on molecular interactions that are in turn governed by dynamic subcellular distributions of the signaling system components. Comprehensive insight into signal transduction requires an understanding of such distributions and cellular structures driving them. To investigate the activation of primary murine T cells by antigen presenting cells (APC we have imaged more than 60 signaling intermediates during T cell stimulation with microscopy across resolution limits. A substantial number of signaling intermediates associated with a transient, wide, and actin-associated lamellum extending from an interdigitated T cell:APC interface several micrometers into the T cell, as characterized in detail here. By mapping the more than 60 signaling intermediates onto the spatiotemporal features of cell biological structures, the lamellum and other ones previously described, we also define distinct spatial and temporal characteristics of T cell signal initiation, amplification, and core signaling in the activation of primary T cells by APCs. These characteristics differ substantially from ones seen when T cells are activated using common reductionist approaches.

    9. Safety and effectiveness of stem cell therapies in early-phase clinical trials in stroke: a systematic review and meta-analysis.

      Science.gov (United States)

      Nagpal, Anjali; Choy, Fong Chan; Howell, Stuart; Hillier, Susan; Chan, Fiona; Hamilton-Bruce, Monica A; Koblar, Simon A

      2017-08-30

      Stem cells have demonstrated encouraging potential as reparative therapy for patients suffering from post-stroke disability. Reperfusion interventions in the acute phase of stroke have shown significant benefit but are limited by a narrow window of opportunity in which they are beneficial. Thereafter, rehabilitation is the only intervention available. The current review summarises the current evidence for use of stem cell therapies in stroke from early-phase clinical trials. The safety and feasibility of administering different types of stem cell therapies in stroke seem to be reasonably proven. However, the effectiveness needs still to be established through bigger clinical trials with more pragmatic clinical trial designs that address the challenges raised by the heterogeneous nature of stroke per se, as well those due to unique characteristics of stem cells as therapeutic agents.

    10. Early Stages of Yamamotozephyrus kwangtungensis (Forster)(Insecta,Lepidoptera,Lycaenidae) with Notes on Its Systematic Position%虎灰蝶幼期及分类地位

      Institute of Scientific and Technical Information of China (English)

      王敏; 李剑萍; 陈刘生; 范骁凌

      2009-01-01

      The genus Yamamotozephyrus Saigusa is a monobasic genus with Y.kwangtungensis (Forster) as the type species.Early stages of the genus are reported for the first time from the Nanling Mountains,S.China.The food plant of the species is Castanopsis sp.The species has one generation per year,with adults flying in May and June.%虎灰蝶属是基于虎灰蝶Yamamotozephyrus kwangtungensis而建立的单种属,报道了产自广东南岭的虎灰蝶幼期.该蝶寄主植物为壳斗科白锥Castanopsis sp.,年发生1个世代,成虫出现于5-6月.

    11. First results from the Goddard High-Resolution Spectrograph - Evidence for photospheric microturbulence in early O stars - Are surface gravities systematically underestimated?

      Science.gov (United States)

      Hubeny, I.; Heap, S. R.; Altner, B.

      1991-01-01

      GHRS spectra of two very hot stars provide evidence for the presence of microturbulence in their photospheres. In attempting to reproduce the observed spectra, theoretical models have been built in which the microturbulence is allowed to modify not only the Doppler line widths (classical 'spectroscopic' microturbulence), but also the turbulent pressure (thus mimicking a 'physical' turbulence). It is found that a corresponding modification of the temperature-pressure stratification influences the hydrogen and helium line profiles to the extent that the surface gravities of early O stars determined without considering microturbulence are too low by 0.1-0.15 dex. Thus, including microturbulence would reduce, or resolve completely, a long-standing discrepancy between evolutionary and spectroscopic stellar masses.

    12. Lu Hf systematics of the ultra-high temperature Napier Metamorphic Complex in Antarctica: Evidence for the early Archean differentiation of Earth's mantle

      Science.gov (United States)

      Choi, Sung Hi; Mukasa, Samuel B.; Andronikov, Alexandre V.; Osanai, Yasuhito; Harley, Simon L.; Kelly, Nigel M.

      2006-06-01

      The Napier Complex of the East Antarctic Craton comprises some of the oldest rocks on Earth (˜ 3.8 billion years old), overprinted by an ultra-high temperature (UHT) metamorphic event near the Archean-Proterozoic boundary. Garnet, orthopyroxene, sapphirine, osumilite, rutile and a whole rock representing a fully equilibrated assemblage from this UHT granulite belt have yielded a Lu-Hf isochron age of 2403 ± 43 Ma, the first ever determined on a UHT mineral assemblage. Preservation of the UHT mineral assemblage in the rock analyzed, without any significant retrogression, suggests rapid cooling with closure likely to have occurred for the Lu-Hf system at post-peak UHT conditions near a temperature of ˜ 800 °C. This mineral-whole rock isochron yields an initial 176Hf/ 177Hf ratio corresponding to an ɛHf value of - 14 ± 1, acquired during UHT metamorphism. Such a low value demonstrates that overall UHT granulites evolved in a low Lu/Hf environment, probably formed when the rocks were first extracted from a highly depleted mantle. Zircon ɛHf values we have measured "see through" the UHT metamorphism and show that the source materials for the magmas that formed the Napier Complex were extremely depleted (> + 5.6 ɛHf at 3.85 Ga) relative to the chondritic uniform reservoir (CHUR). These results also suggest significant depletion of the early Archean mantle, in agreement with the early differentiation of the Earth that the latest core formation models require.

    13. Probiotics for Prevention of Atopy and Food Hypersensitivity in Early Childhood: A PRISMA-Compliant Systematic Review and Meta-Analysis of Randomized Controlled Trials.

      Science.gov (United States)

      Zhang, Guo-Qiang; Hu, Hua-Jian; Liu, Chuan-Yang; Zhang, Qiao; Shakya, Shristi; Li, Zhong-Yue

      2016-02-01

      Most studies investigated probiotics on food hypersensitivity, not on oral food challenge confirmed food allergy in children. The authors systematically reviewed the literature to investigate whether probiotic supplementation prenatally and/or postnatally could reduce the risk of atopy and food hypersensitivity in young children.PubMed, Embase, the Cochrane Central Register of Controlled Trials, and 4 main Chinese literature databases (Wan Fang, VIP, China National Knowledge Infrastructure, and SinoMed) were searched for randomized controlled trials regarding the effect of probiotics on the prevention of allergy in children. The last search was conducted on July 11, 2015.Seventeen trials involving 2947 infants were included. The first follow-up studies were analyzed. Pooled analysis indicated that probiotics administered prenatally and postnatally could reduce the risk of atopy (relative risk [RR] 0.78; 95% confidence interval [CI] 0.66-0.92; I = 0%), especially when administered prenatally to pregnant mother and postnatally to child (RR 0.71; 95% CI 0.57-0.89; I = 0%), and the risk of food hypersensitivity (RR 0.77; 95% CI 0.61-0.98; I = 0%). When probiotics were administered either only prenatally or only postnatally, no effects of probiotics on atopy and food hypersensitivity were observed.Probiotics administered prenatally and postnatally appears to be a feasible way to prevent atopy and food hypersensitivity in young children. The long-term effects of probiotics, however, remain to be defined in the follow-up of existing trials. Still, studies on probiotics and confirmed food allergy, rather than surrogate measure of food hypersensitivity, are warranted.

    14. Third harmonic generation imaging of intact human cerebral organoids to assess key components of early neurogenesis in Rett Syndrome (Conference Presentation)

      Science.gov (United States)

      Yildirim, Murat; Feldman, Danielle; Wang, Tianyu; Ouzounov, Dimitre G.; Chou, Stephanie; Swaney, Justin; Chung, Kwanghun; Xu, Chris; So, Peter T. C.; Sur, Mriganka

      2017-02-01

      Rett Syndrome (RTT) is a pervasive, X-linked neurodevelopmental disorder that predominantly affects girls. It is mostly caused by a sporadic mutation in the gene encoding methyl CpG-binding protein 2 (MeCP2).The clinical features of RTT are most commonly reported to emerge between the ages of 6-18 months and implicating RTT as a disorder of postnatal development. However, a variety of recent evidence from our lab and others demonstrates that RTT phenotypes are present at the earliest stages of brain development including neurogenesis, migration, and patterning in addition to stages of synaptic and circuit development and plasticity. We have used RTT patient-derived induced pluripotent stem cells to generate 3D human cerebral organoids that can serve as a model for human neurogenesis in vitro. We aim to expand on our existing findings in order to determine aberrancies at individual stages of neurogenesis by performing structural and immunocytochemical staining in isogenic control and MeCP2-deficient organoids. In addition, we aim to use Third Harmonic Generation (THG) microscopy as a label-free, nondestructive 3D tissue visualization method in order to gain a complete understanding of the structural complexity that underlies human neurogenesis. As a proof of concept, we have performed THG imaging in healthy intact human cerebral organoids cleared with SWITCH. We acquired an intrinsic THG signal with the following laser configurations: 400 kHz repetition rate, 65 fs pulse width laser at 1350 nm wavelength. In these THG images, nuclei are clearly delineated and cross sections demonstrate the depth penetration capacity (Imaging control and MeCP2-deficient human cerebral organoids in 2D sections reveals structural and protein expression-based alterations that we expect will be clearly elucidated via both THG and three-photon fluorescence microscopy.

    15. Hepatic hydro thorax: patient with pleural effusion to the right presenting tracer migration to the contralateral thorax projection on early scintigraphic images

      Energy Technology Data Exchange (ETDEWEB)

      Ichiki, W.A.; Ribeiro, V.P.B.; Gusman, L.; Coura Filho, G.B.; Sapienza, M.T.; Ono, C.R; Watanabe, T.; Costa, P.L.A.; Hironaka, F.; Cerri, G.G.; Buchpiguel, C.A. [Universidade de Sao Paulo (FMUSP), SP (Brazil). Fac. de Medicina. Hospital das Clinicas

      2008-07-01

      Full text: Introduction: Hepatic hydrothorax is a significant pleural effusion, greater than 500 mL, that appears as a clinical manifestation of portal hypertension in patients with advanced cirrhosis, in the absence of cardiopulmonary disease. Its mechanisms may be explained by migration of ascitic fluid through diaphragm defects. Radioisotope scintigraphy may contribute for the diagnostic of hepatic hydrothorax. Case report: Female, 79 years old, with a history of hepatic cirrhosis due to hepatitis B virus, without primary pulmonary or heart disease. She presented worsening of clinical ascites and dyspnoea, and it was diagnosed an extensive right pleural effusion. She underwent a thoracocentesis with a drainage of 2000 mL of light yellow-citrine fluid with transudate features. The pleural effusion quickly relapsed, leading the hypothesis of a hepatic hydrothorax. A scintigraphy was requested to assess peritoneo-pleural shunt. A dose of 370 MBq (10 mCi) of {sup 99m}Tc sulfur colloid was instilled intraperitoneally. Static images involving the thorax and upper abdomen were acquired at 10, 20, 30 and 40 minutes and 4 hours after injection. At 10 minutes the radiotracer was seen on the left side of the thoracic region. The scintigraphy was repeated three days later, just after new thoracocentesis, due to the tracer progression to the left side of the thorax differed to the location of pleural effusion. Likewise, until 4 hours of the second study, the radiotracer was seen again on the left side of the thorax. However, a delayed image of 24 showed accumulation of the radiotracer in the right pleural cavity, confirming peritoneo-pleural shunt as cause of pleural effusion in this patient. Discussion: Hydrothorax is an uncommon complication in patients with decompensated hepatic cirrhosis. Its mechanisms are still not well elucidated, however, it is known that presence of defects in the diaphragm associated with the imbalance of ascitic fluid volume and the pleural

    16. A Guideline for Applying Systematic Reviews to Child Language Intervention

      Science.gov (United States)

      Hargrove, Patricia; Lund, Bonnie; Griffer, Mona

      2005-01-01

      This article focuses on applying systematic reviews to the Early Intervention (EI) literature. Systematic reviews are defined and differentiated from traditional, or narrative, reviews and from meta-analyses. In addition, the steps involved in critiquing systematic reviews and an illustration of a systematic review from the EI literature are…

    17. Evolution of U fractionation processes through geologic time : consequences for the variation of U deposit types from Early Earth to Present

      Science.gov (United States)

      Cuney, M.

      2009-12-01

      U deposits are known at nearly all stages of the geological cycle, but are not known prior to 2.95 Ga. Also, U deposit types vary greatly from Mesoarchean to Present. Most of these changes through time can be attributed to major modifications in the geodynamic evolution of the Earth, in magmatic fractionation processes, in the composition of the Atmosphere and in the nature of life. The first U-rich granites able to crystallize uraninite, appeared at about 3.1 Ga. They correspond to the most fractionated terms of high-K calcalkaline suites, resulting from crystal fractionation of magmas possibly derived from melting of mantle wedges enriched in K, U, Th. Highly fractionated peraluminous leucogranites, able to crystallize uraninite, appeared at about 2.6 Ga. Erosion of these two granite types led to the detrital accumulation of uraninite that formed the first U deposits on Earth: the Quartz Pebble Conglomerates from 2.95 to 2.4 Ga. From 2.3 Ga onwards, uprise of oxygen level in the atmosphere led to the oxidation of U(IV) to U(VI), U transport in solution, and exuberant development of marine algae in epicontinental platform sediments. From 2.3 to 1.8 Ga large amounts of U, previously accumulated as U(IV) minerals, were dissolved and trapped preferentially in passive margin settings, in organic-rich sediments, and which led to the formation of the world’s largest Paleoproterozoic U provinces, e.g. : the Wollaston belt, Canada and the Cahill Formation, Australia. During and after the worldwide 2.1-1.75 Ga orogenic events, responsible for the formation of the Nuna supercontinent, U trapped in these formations was the source for several types of mineralization: (i) metamorphosed U-mineralized graphitic schists, calcsilicates and meta-arkoses, (ii) diagenetic-hydrothermal remobilization with the formation of the first deposits related to redox processes at 2.0 Ga (Oklo, Gabon), (iii) partial melting of U-rich metasediments forming the uraninite disseminations in

    18. Writing a systematic review.

      Science.gov (United States)

      Ng, K H; Peh, W C

      2010-05-01

      Evidence-based medicine (EBM) aims to combine the best available scientific evidence with clinical experience and individual judgment of patient needs. In the hierarchy of scientific evidence, systematic reviews (along with meta-analyses) occupy the highest levels in terms of the quality of evidence. A systematic review is the process of searching, selecting, appraising, synthesising and reporting clinical evidence on a particular question or topic. It is currently considered the best, least biased and most rational way to organise, gather, evaluate and integrate scientific evidence from the rapidly-changing medical and healthcare literature. Systematic reviews could be used to present current concepts or serve as review articles and replace the traditional expert opinion or narrative review. This article explains the structure and content of a systematic review.

    19. Lu-Hf systematics of the ultra-high temperature Napier Complex, East Antarctica: evidence for the early Archean formation of continental crust

      Science.gov (United States)

      Choi, S.; Mukasa, S. B.; Andronikov, A. V.; Osanai, Y.; Harley, S. L.; Kelly, N. M.

      2009-12-01

      The Napier Complex in East Antarctica comprises some of the oldest rocks on earth (~3.8 billion years old), overprinted by an ultra-high temperature (UHT) metamorphic event near the Archean-Proterozoic boundary. Garnet, orthopyroxene, sapphirine, osumilite, rutile and a whole rock representing an equilibrated assemblage from this belt yield a Lu-Hf isochron age of 2,403 ± 43 Ma. Preservation of the UHT mineral assemblage in the rock analyzed suggests rapid cooling with closure likely to have occurred for the Lu-Hf system at post-peak UHT conditions near a temperature of ~800C. Individual zircon grains from Gage Ridge within the Napier Complex yielded a remarkably uniform range of 176Hf/177Hf values between 0.280433 ± 7 and 0.280505 ± 10, corresponding to ɛHf > +5.6 at 3.85 Ga relative to the chondritic uniform reservoir (CHUR). Because of their exceedingly low Lu/Hf values (<0.001), the grains are effectively recording the initial Hf isotope composition of the magmatic systems from which the gneiss protoliths crystallized. These results indicate that (1) the source of the crustal materials that formed the Napier Complex at 3.85 Ga were depleted relative to the CHUR. The extent of depletion involved is higher than has been predicted by extrapolation from the Lu-Hf isotopic evolution inferred for the source of Proterozoic and Phanerozoic basalts, judging from an fLu/Hf value of 0.51, (2) the depleted mantle reservoir has been in existence since very early in Earth’s history, in agreement with the early differentiation of the Earth that the latest core formation models require, and (3) an extremely depleted source also mean that the bulk of continental crust was extracted from the mantle by ~3.8 Ga. Moreover, the results demonstrate that even the oldest silicic rocks in the complex are not likely to have formed from remobilized older crustal materials, but were instead juvenile products of mantle melting. In addition, zircons with metamorphic rims have a similar

    20. Arthrofibrosis after ACL reconstruction is best treated in a step-wise approach with early recognition and intervention: a systematic review.

      Science.gov (United States)

      Ekhtiari, Seper; Horner, Nolan S; de Sa, Darren; Simunovic, Nicole; Hirschmann, Michael T; Ogilvie, Rick; Berardelli, Rebecca L; Whelan, Danny B; Ayeni, Olufemi R

      2017-03-04

      that used a step-wise approach to treating arthrofibrosis, more than half of patients were successfully treated without an operation. A more well-defined concept of arthrofibrosis, along with large, prospective studies will provide a clearer understanding of how to describe and manage this complication. The issue of arthrofibrosis following ACL reconstruction is clinically relevant as it represents a common complication of a commonly performed operation that nonetheless remains poorly defined and without clear treatment guidelines. Systematic Review of Level III and IV Studies, Level IV.

    1. The Efficacy of Bisphosphonates in Preventing Aromatase Inhibitor Induced Bone Loss for Postmenopausal Women with Early Breast Cancer: A Systematic Review and Meta-Analysis

      Directory of Open Access Journals (Sweden)

      Pooleriveetil Padikkal Anagha

      2014-01-01

      Full Text Available Objectives. We aim to determine the efficacy of bisphosphonates in preventing aromatase inhibitor induced bone loss (AIBL in postmenopausal women with early breast cancer. The secondary objective was to determine the safety of bisphosphonates. Materials and Methods. We searched electronic databases in a time period of 1995 January to 2013 June. Random effects meta-analytical models were used; between study heterogeneity and publication bias was assessed. Results. A total of six eligible studies reported the BMD T score of LS at 12 months and from that 3 trials of Zoledronic acid compared the change in BMD in immediate ZOL versus delayed ZOL done with subgroups like patients with normal BMD at baseline (OR = 5.402, 95% CI = 1.329–21.959, P value = 0.018 and osteopenic BMD at baseline (OR = 4.008, 95% CI = 2.249–7.143, P value = 0.0002. Both had a significant decrease in BMD that favoured the delayed ZOL; 3 trials of risedronate and ibandronate also had a significant decrease in BMD in AIs alone group. Immediate ZOL versus delayed ZOL also showed increased risk of getting an ADR in immediate group. Conclusion. Third generation bisphosphonates has an effect on BMD of patients who are on treatment of AIs in breast cancer. Furthermore, the patients treated with immediate ZOL had a significantly high risk of musculoskeletal ADR’s than patients with delayed ZOL.

    2. Early Onset of HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) and Adult T-cell Leukemia/Lymphoma (ATL): Systematic Search and Review.

      Science.gov (United States)

      Oliveira, Pedro D; Kachimarek, Amanda C; Bittencourt, Achiléa L

      2017-06-05

      Human T-cell lymphotropic virus type 1 (HTLV-1) is endemic in some regions and its vertical transmission occurs mainly through breastfeeding. About 10% of carriers develop associated diseases including HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP), adult T-cell leukemia/lymphoma (ATL) and infectious dermatitis associated with HTLV-1 (IDH). We searched for available case reports of early-onset HAM/TSP and ATL to evaluate demographic and disease aspects in infantile-juvenile patients. In the reviewed literature, 27 HAM/TSP and 31 ATL cases were found. In almost all of them, the most likely route of transmission was through breastfeeding. ATL is rarely reported, notwithstanding it may be underestimated because T-cell lymphomas are not investigated for HTLV-1 infection in this age group. IDH was frequently associated with HAM/TSP. The investigation of HTLV-1 infection in pregnant women is an important matter of public health and should be mandatory in endemic countries. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

    3. A Systematic Review and Meta-Analysis of a Measure of Staff/Child Interaction Quality (the Classroom Assessment Scoring System) in Early Childhood Education and Care Settings and Child Outcomes.

      Science.gov (United States)

      Perlman, Michal; Falenchuk, Olesya; Fletcher, Brooke; McMullen, Evelyn; Beyene, Joseph; Shah, Prakesh S

      2016-01-01

      The quality of staff/child interactions as measured by the Classroom Assessment Scoring System (CLASS) in Early Childhood Education and Care (ECEC) programs is thought to be important for children's outcomes. The CLASS is made of three domains that assess Emotional Support, Classroom Organization and Instructional Support. It is a relatively new measure that is being used increasingly for research, quality monitoring/accountability and other applied purposes. Our objective was to evaluate the association between the CLASS and child outcomes. Searches of Medline, PsycINFO, ERIC, websites of large datasets and reference sections of all retrieved articles were conducted up to July 3, 2015. Studies that measured association between the CLASS and child outcomes for preschool-aged children who attended ECEC programs were included after screening by two independent reviewers. Searches and data extraction were conducted by two independent reviewers. Thirty-five studies were systematically reviewed of which 19 provided data for meta-analyses. Most studies had moderate to high risk of bias. Of the 14 meta-analyses we conducted, associations between Classroom Organization and Pencil Tapping and between Instructional Support and SSRS Social Skills were significant with pooled correlations of .06 and .09 respectively. All associations were in the expected direction. In the systematic review, significant correlations were reported mainly from one large dataset. Substantial heterogeneity in use of the CLASS, its dimensions, child outcomes and statistical measures was identified. Greater consistency in study methodology is urgently needed. Given the multitude of factors that impact child development it is encouraging that our analyses revealed some, although small, associations between the CLASS and children's outcomes.

    4. Chinese Medicine and Western Medicine Systematic Rehabilitation in the Early Stage of Acute Myocardial Infarction%急性心肌梗死早期中西医结合系统化康复探讨

      Institute of Scientific and Technical Information of China (English)

      朱初麟; 杜廷海; 牛琳琳

      2015-01-01

      Objective To investigate the advantages and pathway of chinese medicine and western medicine systematic rehabilitation in theearly stage of acute myocardial infarction.MethodsExploring the effect of early rehabilitation on acute myocardial infarction and advantages of traditional Chinese medicine (TCM),then,proposing theidea and model of cardiac rehabilitation unit.Results An optimized,standardized rehabilitation treatment system were established after optimizing drug medication,physical therapy,psychological rehabili-tation,external TCM treatment through rehabilitation process and integrating effective TCM therapy and western therapy.Conclusion Itwas needed to exert the advantages of chinese medicine rehabilitation and improve the systematic management model of chinese medicine and western medicine. Applying integrative and optimized cardiac rehabil-itation in the early stage of acute myocardial infarction would be beneficial for health undoubtly.%目的:探讨急性心肌梗死早期中西医结合系统化康复的优势和途径。方法论述早期康复运动对急性心肌梗死的影响、中医心脏康复的特色优势,提出了心脏康复单元的理念和模式。结果通过康复流程,以优化药物、物理治疗、心理康复、中医外治等,把中医和西医有效的治疗方法重新进行整合,形成一个优化的、程序标准化的康复治疗系统。结论发挥中医康复学的优势,健全中西医心脏康复系统化管理模式,将整体、优化的中医心脏康复应用于急性心肌梗死早期,无疑有助于疗效的进一步提高。

    5. Ethics in systematic reviews.

      Science.gov (United States)

      Vergnes, Jean-Noel; Marchal-Sixou, Christine; Nabet, Cathy; Maret, Delphine; Hamel, Olivier

      2010-12-01

      Since its introduction by the Nuremberg Code and the Declaration of Helsinki, the place held by ethics in biomedical research has been continuously increasing in importance. The past 30 years have also seen exponential growth in the number of biomedical articles published. A systematic review of the literature is the scientific way of synthesising a plethora of information, by exhaustively searching out and objectively analysing the studies dealing with a given issue. However, the question of ethics in systematic reviews is rarely touched upon. This could lead to some drawbacks, as systematic reviews may contain studies with ethical insufficiencies, may be a possible way to publish unethical research and may also be prone to conflict of interest. Finally, informed consent given for an original study is not necessarily still valid at the systematic review level. There is no doubt that routine ethical assessment in systematic reviews would help to improve the ethical and methodological quality of studies in general. However, ethical issues change so much with time and location, and are so broad in scope and in context that it appears illusory to search for a universal, internationally accepted standard for ethical assessment in systematic reviews. Some simple suggestions could nevertheless be drawn from the present reflection and are discussed in the paper.

    6. The metallographic examination of sword no. 438 as part of a systematic survey of swords from the early medieval stronghold of Mikulčice, Czech Republic

      Directory of Open Access Journals (Sweden)

      Hošek, Jiří

      2012-12-01

      Full Text Available The paper deals with a metallographic examination of a sword from grave No. 438, which was uncovered at the site of Mikulčice (Hodonín county, a former early medieval stronghold in Moravia (Czech Republic. Mikulčice was one of the main power centres of the Great Moravia – the first state formed by Slavs north of the Danube River – which was created in the first third of the 9th century and ended at the beginning of the 10th century. The sword, provided with a single flattened hemispherical pommel (Petersen X type, has a blade bearing an inscription that is no longer legible. According to the results of metallographic examination, the blade was hardened and consists of steel cutting edges welded on a core, which was composed of steel side-plates and a middle strip of iron or low-carbon steel. It was an excellent sword, undoubtedly one of the best swords excavated in Mikulčice.

      El artículo trata de un examen metalográfico de una espada de la tumba número 438, que fue descubierta en el yacimiento de Mikulčice (Hodonín Condado, antiguo bastión bajomedieval en Moravia (República Checa. Mikulčice fue uno de los centros de poder principales del Gran Moravia - la primera agrupación estatal de los eslavos del norte del río Danubio - que se creó en el primer tercio del siglo IX y fue abolido al comienzo del siglo X. La espada, que cuenta con un pomo aplanado hemiesféri-co (Petersen tipo X, tiene una hoja con una inscripción que ya no es legible. De acuerdo con los resulta-dos del examen metalográfico, la hoja fue endurecida y se compone de filos de corte de acero, soldados a un núcleo. Éste está compuesto de placas laterales de acero y una franja central de hierro o de acero dulce. Era una espada excelente, sin duda, una de las mejores espadas jamás excavadas en Mikulčice.

    7. Early goal-directed therapy reduces mortality in adult patients with severe sepsis and septic shock: Systematic review and meta-analysis

      Directory of Open Access Journals (Sweden)

      Legese Chelkeba

      2015-01-01

      Full Text Available Introduction: Survival sepsis campaign guidelines have promoted early goal-directed therapy (EGDT as a means for reduction of mortality. On the other hand, there were conflicting results coming out of recently published meta-analyses on mortality benefits of EGDT in patients with severe sepsis and septic shock. On top of that, the findings of three recently done randomized clinical trials (RCTs showed no survival benefit by employing EGDT compared to usual care. Therefore, we aimed to do a meta-analysis to evaluate the effect of EGDT on mortality in severe sepsis and septic shock patients. Methodology: We included RCTs that compared EGDT with usual care in our meta-analysis. We searched in Hinari, PubMed, EMBASE, and Cochrane central register of controlled trials electronic databases and other articles manually from lists of references of extracted articles. Our primary end point was overall mortality. Results: A total of nine trails comprising 4783 patients included in our analysis. We found that EGDT significantly reduced mortality in a random-effect model (RR, 0.86; 95% confidence interval [CI], 0.72–0.94; P = 0.008;   I 2 =50%. We also did subgroup analysis stratifying the studies by the socioeconomic status of the country where studies were conducted, risk of bias, the number of sites where the trials were conducted, setting of trials, publication year, and sample size. Accordingly, trials carried out in low to middle economic income countries (RR, 0.078; 95% CI, 0.67–0.91; P = 0.002; I2 = 34% significantly reduced mortality compared to those in higher income countries (RR, 0.93; 95% CI, 0.33–1.06; P = 0.28; I2 = 29%. On the other hand, patients receiving EGDT had longer length of hospital stay compared to the usual care (mean difference, 0.49; 95% CI, –0.04–1.02; P = 0.07; I2 = 0%. Conclusion: The result of our study showed that EGDT significantly reduced mortality in patients with severe sepsis and septic shock. Paradoxically

    8. 早期系统的医院-家庭康复对早产儿发育的影响%The effects of early and systematic hospital-and-family rehabilitation on the growth of premature infants

      Institute of Scientific and Technical Information of China (English)

      温晓红; 黄金华; 潘家华; 朱蓉; 汪蕾蕾; 廖承琳; 吴万云

      2010-01-01

      Objective To explore the effects of early hospital-family comprehensive rehabilitation on the development of pretenn infants. Methods A total of 256 premature infants were chosen and divided into an early intervention group (n = 148) and a control group (n =108). Besides being given the conventional mothering instruction , the early intervention group was given early assessment, regular visits and hospital-family comprehensive rehabilitation treatment. The control group was only given the conventional mothering instruction. The fine and gross motor growth quotients, adaptation, verbalisation and social behavior and general growth quotient of all the premature infants were assessed periodically using the infant neuropsychology growth scale. Results The growth quotient assessment indicators of the infants receiving the intervention were obviously better at the 6th, 12th, 18th and 24th month after birth, and the differences between the two groups were statistically significant. The incidence of cerebral palsy in the early intervention group was 0.71% (1/148), with only one cerebral palsy infant in the early intervention group who was at level Ⅲ of the gross motor function classification system ( GMFCS) , while the incidence of cerebral palsy in the control group was 5.1% (5/98) , with 5 cerebral palsy infants, one of whom was at GMFCS level Ⅲ and 4 of whom were at level Ⅳ. Conclusions Early systematic hospital-family comprehensive rehabilitation can improve the general growth of premature infants, decrease the incidence of cerebral palsy, and neurobehavior deficits.%目的 探讨早期系统的医院-家庭综合康复模式对早产儿发育的影响.方法 将符合标准的早产儿256例分成早期干预组(148例)和常规对照组(108例).早期干预组除接受常规育儿指导外,还进行早期评估、定期随访和医院-家庭康复治疗;对照组只接受常规育儿指导.采用小儿神经心理发育量表定期对2组患儿的粗大运动

    9. Systematic review

      DEFF Research Database (Denmark)

      Lødrup, Anders Bergh; Reimer, Christina; Bytzer, Peter

      2013-01-01

      in getting off acid-suppressive medication and partly explain the increase in long-term use of PPI. A number of studies addressing this issue have been published recently. The authors aimed to systematically review the existing evidence of clinically relevant symptoms caused by acid rebound following PPI...

    10. Present time

      CERN Document Server

      Romero, Gustavo E

      2014-01-01

      The idea of a moving present or `now' seems to form part of our most basic beliefs about reality. Such a present, however, is not reflected in any of our theories of the physical world. I show in this article that presentism, the doctrine that only what is present exists, is in conflict with modern relativistic cosmology and recent advances in neurosciences. I argue for a tenseless view of time, where what we call `the present' is just an emergent secondary quality arising from the interaction of perceiving self-conscious individuals with their environment. I maintain that there is no flow of time, but just an ordered system of events.

    11. CATCHY PRESENTATIONS

      DEFF Research Database (Denmark)

      Eriksen, Kaare; Tollestrup, Christian; Ovesen, Nis

      2011-01-01

      An important competence for designers is the ability to communicate and present ideas and proposals for customers, partners, investors and colleagues. The Pecha Kucha principle, developed by Astrid Klein and Mark Dytham, has become a widely used and easy format for the presentation of new concepts...

    12. Systematic Avocating

      Directory of Open Access Journals (Sweden)

      Jan Green

      2014-12-01

      Full Text Available Feeling obliged to undertake complex research tasks outside core working hours is a common occurrence in academia. Detailed and timely research projects are expected; the creation and defence of sufficient intervals within a crowded working schedule is one concern explored in this short version paper. Merely working longer hours fails to provide a satisfactory solution for individuals experiencing concerns of this nature. Personal effort and drive are utilised and requires the application of mental mustering and systematic procedures. The attitude to research work is treating the task as a hobby conceptualised as avocating. Whilst this provides a personal solution through immersion in the task, this approach should raise concerns for employers. The flexibility of grounded theory is evident and the freedom to draw on various bodies of knowledge provides fresh insight into a problem that occurs in organizations in many sectors experiencing multiple priorities. The application of the core category, systematic avocating, may prove beneficial.

    13. Systematisches Innovationsmanagement / Systematic innovation management

      Directory of Open Access Journals (Sweden)

      Georgy, Ursula

      2011-12-01

      Full Text Available Public institutions (here libraries are in competition with each other in the same way like companies of the producing industra. Therefore it is crucial for libraries to identify trends early and to respond to customer needs focused and purposefully. This requires a systematic innovation management of libraries.

    14. Information Presentation

      Science.gov (United States)

      Holden, Kritina L.; Thompson, Shelby G.; Sandor, Aniko; McCann, Robert S.; Kaiser, Mary K.; Adelstein, Barnard D.; Begault, Durand R.; Beutter, Brent R.; Stone, Leland S.; Godfroy, Martine

      2009-01-01

      The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew. In addition to addressing display design issues associated with information formatting, style, layout, and interaction, the Information Presentation DRP is also working toward understanding the effects of extreme environments encountered in space travel on information processing. Work is also in progress to refine human factors-based design tools, such as human performance modeling, that will supplement traditional design techniques and help ensure that optimal information design is accomplished in the most cost-efficient manner. The major areas of work, or subtasks, within the Information Presentation DRP for FY10 are: 1) Displays, 2) Controls, 3) Procedures and Fault Management, and 4) Human Performance Modeling. The poster will highlight completed and planned work for each subtask.

    15. Information Presentation

      Science.gov (United States)

      Holden, K.L.; Boyer, J.L.; Sandor, A.; Thompson, S.G.; McCann, R.S.; Begault, D.R.; Adelstein, B.D.; Beutter, B.R.; Stone, L.S.

      2009-01-01

      The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew. The major areas of work, or subtasks, within this DRP are: 1) Displays, 2) Controls, 3) Electronic Procedures and Fault Management, and 4) Human Performance Modeling. This DRP is a collaborative effort between researchers at Johnson Space Center and Ames Research Center.

    16. Early functional, esthetic, and psychological rehabilitation of preschool child with nonsyndromic oligodontia and anodontia in mixed dentition stage through conservative systematic approach: A case report with 5-year follow-up

      Science.gov (United States)

      Rathee, Manu; Malik, Poonam; Dua, Madhuri; Yadav, Vikas

      2016-01-01

      Missing teeth are a common developmental abnormality in humans. It may manifest as absence of varying numbers of primary and/or secondary teeth. Early treatment and follow-up are the key to successful rehabilitation of young patients with congenitally missing teeth. It is critical that oral rehabilitation is started early to maintain and correct the oral functions. Mucosa borne removable prostheses are the commonly selected treatment options for the young patients who present with oligodontia or anodontia. This clinical report describes esthetic, functional, and psychological rehabilitation of a young boy with severe oligodontia in maxillary arch and anodontia in mandibular arch. The individualized conservative graded approach in prosthetic rehabilitation with removable acrylic prosthesis helped to achieve esthetics, functionality, and psychological benefits. PMID:27307674

    17. Voting Present

      Directory of Open Access Journals (Sweden)

      James Lo

      2013-12-01

      Full Text Available During his time as a state senator in Illinois, Barack Obama voted “Present” 129 times, a deliberate act of nonvoting that subsequently became an important campaign issue during the 2008 presidential elections. In this article, I examine the use of Present votes in the Illinois state senate. I find evidence that Present votes can largely be characterized as protest votes used as a legislative tool by the minority party. Incorporating information from Present votes into a Bayesian polytomous item-response model, I find that this information increases the efficiency of ideal point estimates by approximately 35%. There is little evidence of significant moderation by Obama when Present votes are accounted for, though my results suggest that Obama’s voting record may have moderated significantly before his subsequent election to the U.S. Senate. My results also suggest that because legislative nonvoting may occur for a variety of reasons, naive inclusion of nonvoting behavior into vote choice models may lead to biased results.

    18. Evolution of computational chemistry, the "launch pad" to scientific computational models: The early days from a personal account, the present status from the TACC-2012 congress, and eventual future applications from the global simulation approach

      Science.gov (United States)

      Clementi, Enrico

      2012-06-01

      This is the introductory chapter to the AIP Proceedings volume "Theory and Applications of Computational Chemistry: The First Decade of the Second Millennium" where we discuss the evolution of "computational chemistry". Very early variational computational chemistry developments are reported in Sections 1 to 7, and 11, 12 by recalling some of the computational chemistry contributions by the author and his collaborators (from late 1950 to mid 1990); perturbation techniques are not considered in this already extended work. Present day's computational chemistry is partly considered in Sections 8 to 10 where more recent studies by the author and his collaborators are discussed, including the Hartree-Fock-Heitler-London method; a more general discussion on present day computational chemistry is presented in Section 14. The following chapters of this AIP volume provide a view of modern computational chemistry. Future computational chemistry developments can be extrapolated from the chapters of this AIP volume; further, in Sections 13 and 15 present an overall analysis on computational chemistry, obtained from the Global Simulation approach, by considering the evolution of scientific knowledge confronted with the opportunities offered by modern computers.

    19. Science Technology Engineering and Math (STEM) Education MUST Begin in Early Childhood Education: A Systematic Analysis of Washington State Guidelines Used to Gauge the Development and Learning of Young Learners

      Science.gov (United States)

      Briseno, Luis Miguel

      This paper reflects future direction for early Science Technology Engineering and Mathematics (STEM) education, science in particular. Washington State stakeholders use guidelines including: standards, curriculums and assessments to gauge young children's development and learning, in early childhood education (ECE). Next Generation Science Standards (NGSS), and the Framework for K-12 programs (National Research Council, 2011) emphasizes the need for reconfiguration of standards: "Too often standards are a long list of detailed and disconnected facts... this approach alienates young people, it also leaves them with fragments of knowledge and little sense of the inherent logic and consistency of science and of its universality." NGSS' position elevates the concern and need for learners to experience teaching and learning from intentionally designed cohesive curriculum units, rather than as a series of unrelated and isolated lessons. To introduce the argument the present study seeks to examine Washington State early learning standards. To evaluate this need, I examined balance and coverage/depth. Analysis measures the level of continuum in high-quality guidelines from which Washington State operates to serve its youngest citizens and their families.

    20. Technical presentation

      CERN Multimedia

      FI Department

      2008-01-01

      RADIOSPARES, the leading catalogue distributor of components (electronic, electrical, automation, etc.) and industrial supplies will be at CERN on Friday 3 October 2008 (Main Building, Room B, from 9.00 a.m. to 3.00 p.m.) to introduce its new 2008/2009 catalogue. This will be the opportunity for us to present our complete range of products in more detail: 400 000 part numbers available on our web site (Radiospares France, RS International, extended range of components from other manufacturers); our new services: quotations, search for products not included in the catalogue, SBP products (Small Batch Production: packaging in quantities adapted to customers’ requirements); partnership with our focus manufacturers; demonstration of the on-line purchasing tool implemented on our web site in conjunction with CERN. RADIOSPARES will be accompanied by representatives of FLUKE and TYCO ELECTRONICS, who will make presentations, demonstrate materials and answer any technical questio...

    1. Overview Presentation

      Science.gov (United States)

      Lytle, John

      2001-01-01

      This report provides an overview presentation of the 2000 NPSS (Numerical Propulsion System Simulation) Review and Planning Meeting. Topics include: 1) a background of the program; 2) 1999 Industry Feedback; 3) FY00 Status, including resource distribution and major accomplishments; 4) FY01 Major Milestones; and 5) Future direction for the program. Specifically, simulation environment/production software and NPSS CORBA Security Development are discussed.

    2. Should weight loss and maintenance programmes be designed differently for men? A systematic review of long-term randomised controlled trials presenting data for men and women: The ROMEO project.

      Science.gov (United States)

      Robertson, Clare; Avenell, Alison; Boachie, Charles; Stewart, Fiona; Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Boyers, Dwayne

      2016-01-01

      We systematically reviewed the randomised controlled trial (RCT) evidence for long-term (≥12 months) weight management interventions for obese men in contrast to women to help understand whether programmes should be designed differently for men. We searched 11 databases up to October 2014. Twenty-two RCTs reported data separately for men and women in weight loss or weight maintenance interventions. We found men were under-represented in RCTs of weight loss interventions open to both sexes. Men comprised 36% of participants (4771 from 13,305 participants). Despite this, men were 11% (95% CI 8-14%, pmeta-analysis of 13 trials showed no significant difference in weight loss between men and women, either for weight loss in kg (p=0.90) or percentage weight loss (p=0.78), although men tended to lose more weight with intensive low fat reducing diets, with or without meal replacements, and structured physical activity/exercise programmes than women. Orlistat was less beneficial for men for weight maintenance. Individual support and tailoring appeared more helpful for men than women. We found evidence that men and women respond differently to, and have different preferences for, varying types of weight management programme. We suggest that it is important to understand men's views on weight loss, as this is likely to also improve the uptake and effectiveness of programmes for men.

    3. Neurosyphilis: Various Presentations

      Directory of Open Access Journals (Sweden)

      Kezban Aslan

      2012-12-01

      Full Text Available Neurosphylisis develops in about 5 % of untreated patients infected with Treponema pallidum. Spirocet, disseminates systemically hours to days after inoculation. Early invasion to central nervous system can be seen in infected patients without symptomatic. In these lecture we presented three patients with different complain. The patients have had; diplopia, headache and blurred vision, numness and slimming of legs.

    4. Autism Spectrum Disorder: the Present Perspective

      Directory of Open Access Journals (Sweden)

      S Chaudhuri

      2015-06-01

      Full Text Available The last decade has witnessed a surge of awareness about autism among the public and professionals. Much revealing research is being done on this issue and the knowledge base has improved substantially and a set of professionals are specializing on the subject, focusing on its causative factors and management. Autism being a disorder stemming from early childhood and the prevalence rate rising alarmingly over the years, Pediatricians are expected to play a vital role in early detection and early intervention in management of the problem. But, unfortunately, autism is not yet considered to be under the purview of pediatricians. As pediatricians, we are often perplexed when faced with such a different child in our office and either overlook the problem or hurry to hand him over to a psychiatrist, not trying to really identify and understand the problem as a medical entity ourselves. Hence better awareness among pediatricians is the need of the day. As specialists have worked with autism over the decades, it has become clear that: autism is a disorder that involves early development, presently there is no medical answer to autism, and the only management strategy hinges largely on effective training. The earlier the training begins the better it is for the child. It is of paramount importance to start training and bring about changes by the time the child is 18 months old. This throws up interesting new challenges to the profession of pediatrics. To identify the early warning signs of autism, it is important that Pediatricians are able to recognize the signs and symptoms of autistic spectrum disorders (ASD, have a strategy for assessing them systematically, be familiar with available tools for screening as well as developmental and educational resources.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12775 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 37-47

    5. Technical presentation

      CERN Multimedia

      FP Department

      2009-01-01

      07 April 2009 Technical presentation by Leuze Electronics: 14.00 – 15.00, Main Building, Room 61-1-017 (Room A) Photoelectric sensors, data identification and transmission systems, image processing systems. We at Leuze Electronics are "the sensor people": we have been specialising in optoelectronic sensors and safety technology for accident prevention for over 40 years. Our dedicated staff are all highly customer oriented. Customers of Leuze Electronics can always rely on one thing – on us! •\tFounded in 1963 •\t740 employees •\t115 MEUR turnover •\t20 subsidiaries •\t3 production facilities in southern Germany Product groups: •\tPhotoelectric sensors •\tIdentification and measurements •\tSafety devices

    6. Efficacy of standard (SLA) and modified sandblasted and acid-etched (SLActive) dental implants in promoting immediate and/or early occlusal loading protocols: a systematic review of prospective studies.

      Science.gov (United States)

      Chambrone, Leandro; Shibli, Jamil Awad; Mercúrio, Carlos Eduardo; Cardoso, Bruna; Preshaw, Philip M

      2015-04-01

      To assess the survival percentage, clinical and radiographic outcomes of sandblasted and acid-etched (SLA) dental implants and its modified surface (SLActive) in protocols involving immediate and early occlusal loading. MEDLINE, EMBASE and the Cochrane Oral Health Group's Trials Register CENTRAL were searched in duplicate up to, and including, June 2013 to include randomised controlled trials (RCTs) and prospective observational studies of at least 6-month duration published in all languages. Studies limited to patients treated with SLA and/or SLActive implants involving a treatment protocol describing immediate and early loading of these implants were eligible for inclusion. Data on clinical and/or radiographic outcomes following implant placement were considered for inclusion. Of the 447 potentially eligible publications identified by the search strategy, seven RCTs comprising a total of 853 implants (8% titanium plasma-sprayed, 41.5% SLA and 50.5% SLActive) and 12 prospective observational studies including 1394 SLA and 145 SLActive implants were included in this review. According to the Cochrane Collaboration's tool for assessing risk of bias, one of the studies was considered to be at a low risk of bias, whereas the remaining studies were considered to be at an unclear risk. Regarding the observational studies, all of them presented a medium methodological quality based on the Modified Newcastle-Ottawa scale. There were no significant differences reported in the studies in relation to implant loss or clinical parameters between the immediate/early loading and delayed loading protocols. Overall, 95% of SLA and 97% of SLActive implants still survive at the end of follow-up. Despite of the positive findings achieved by the included studies, few RCTs were available for analysis for SLActive implants. Study heterogeneity, scarcity of data and the lack of pooled estimates represent a limitation between studies' comparisons and should be considered when interpreting

    7. 老年脑出血患者早期康复治疗效果的系统评价%A systematic review of the effect of early rehabilitative therapy for patients with cerebral hemorrhage

      Institute of Scientific and Technical Information of China (English)

      周婷; 张莉; 贺建湘; 李大芬; 肖燕; 冯翼

      2015-01-01

      目的:系统评价老年脑出血患者早期康复的效果。方法计算机检索中国期刊全文数据库(CNKI)、维普信息资源系统(VIP)、万方数据资源系统、中国生物医学文献数据库(CBM )(均从建库至2014年10月),并手工检索同期老年脑出血患者早期康复效果的相关灰色文献。按纳入与排除标准独立筛选文献、提取资料,采用 Rev‐M an 5.1软件进行 M eta分析。结果纳入7个研究共711例患者,其中早期康复组369例,传统组342例。M eta分析结果显示:早期康复能提高老年脑出血患者日常生活能力[MD=10.64,95% CI(10.10,11.17),Z=39.13,P<0.00001],肢体运动功能[MD=10.77,95% CI(7.39,14.15),Z=6.25,P<0.00001]。结论老年脑出血患者通过早期康复,能促进日常生活能力,改善肢体运动功能,提高生活质量。%Objective To systematically review the effect of early rehabilitative therapy for patients with cerebral hemorrhage .Method we electronically searched in China National Knowledge Infrastruct‐ure (CNKI) ,Chinese Sci‐ence Technology Periodical Databases(VIP) ,WanFang Database ,China Biology Medicine disc(CBM) for studies the effect of early rehabilitative therapy for patients with cerebral hemorrhage from inception to October 2014 .The Rev‐Man 5 .1 software was used for meta analysis .Result 711 patients with cerebral hemorrhage were investigated .Meta analysis showed that the scores of Fugl‐Meyer[MD=10 .77 ,95% CI(7 .39 ,14 .15) ,Z=6 .25 ,P<0 .00001]and Bar‐thel MD= 10 .64 ,95% CI(10 .10 ,11 .17) ,Z= 39 .13 ,P< 0 .00001〗were significantly higher in the rehabilitation group than in control group .Conclusion Early rehabilitative intervention therapy can be effective in improving life a‐bility and motor function so that it enhances quality of life .

    8. Homologs of the Xenopus developmental gene DG42 are present in zebrafish and mouse and are involved in the synthesis of Nod-like chitin oligosaccharides during early embryogenesis.

      Science.gov (United States)

      Semino, C E; Specht, C A; Raimondi, A; Robbins, P W

      1996-05-14

      The Xenopus developmental gene DG42 is expressed during early embryonic development, between the midblastula and neurulation stages. The deduced protein sequence of Xenopus DG42 shows similarity to Rhizobium Nod C, Streptococcus Has A, and fungal chitin synthases. Previously, we found that the DG42 protein made in an in vitro transcription/translation system catalyzed synthesis of an array of chitin oligosaccharides. Here we show that cell extracts from early Xenopus and zebrafish embryos also synthesize chitooligosaccharides. cDNA fragments homologous to DG42 from zebrafish and mouse were also cloned and sequenced. Expression of these homologs was similar to that described for Xenopus based on Northern and Western blot analysis. The Xenopus anti-DG42 antibody recognized a 63-kDa protein in extracts from zebrafish embryos that followed a similar developmental expression pattern to that previously described for Xenopus. The chitin oligosaccharide synthase activity found in extracts was inactivated by a specific DG42 antibody; synthesis of hyaluronic acid (HA) was not affected under the conditions tested. Other experiments demonstrate that expression of DG42 under plasmid control in mouse 3T3 cells gives rise to chitooligosaccharide synthase activity without an increase in HA synthase level. A possible relationship between our results and those of other investigators, which show stimulation of HA synthesis by DG42 in mammalian cell culture systems, is provided by structural analyses to be published elsewhere that suggest that chitin oligosaccharides are present at the reducing ends of HA chains. Since in at least one vertebrate system hyaluronic acid formation can be inhibited by a pure chitinase, it seems possible that chitin oligosaccharides serve as primers for hyaluronic acid synthesis.

    9. Systematic review

      DEFF Research Database (Denmark)

      Borup, H; Kirkeskov, L; Hanskov, Dorte Jessing Agerby

      2017-01-01

      of airway obstruction among workers in the construction industry. The authors independently assessed studies to determine their eligibility and performed a quality assessment of the included papers. Results: Twelve studies were included. Nine studies found a statistically significant association between......: To assess the occurrence of COPD among construction workers. Methods: We performed a systematic search in PubMed and Embase between 1 January 1990 and 31 August 2016 in order to identify epidemiological studies with a risk estimate for either COPD morbidity/mortality or a spirometry-based definition......Background: Between 15 and 20% of prevalent cases of chronic obstructive pulmonary disease (COPD) have been attributed to occupational exposures to vapours, gases, dusts and fumes. Dust at construction sites is still a challenge, but no overview exists of COPD among construction workers. Aims...

    10. Parental Influences on the Diets of 2-5-Year-Old Children: Systematic Review of Interventions

      Science.gov (United States)

      Peters, Jacqueline; Sinn, Natalie; Campbell, Karen; Lynch, John

      2012-01-01

      During the early years, parents have a major influence on their children's diets, food choices and development of eating habits. However, research concerning the influence of parental feeding practices on young children's diets is limited. This paper presents a systematic review of intervention studies with parents of preschool children. The aim…

    11. Parental Influences on the Diets of 2-5-Year-Old Children: Systematic Review of Interventions

      Science.gov (United States)

      Peters, Jacqueline; Sinn, Natalie; Campbell, Karen; Lynch, John

      2012-01-01

      During the early years, parents have a major influence on their children's diets, food choices and development of eating habits. However, research concerning the influence of parental feeding practices on young children's diets is limited. This paper presents a systematic review of intervention studies with parents of preschool children. The aim…

    12. [The comparative effectiveness of high-intensity dynamic training with the use of exercise machines and therapeutic gymnastics for the joints in the patients presenting with early rheumatoid arthritis].

      Science.gov (United States)

      Orlova, E V; Karateev, D E; Kochetkov, A V; Mozhar, T E

      2013-01-01

      The objective of the present work was to compare the effectiveness of two therapeutic exercise programs for the patients presenting with early rheumatoid arthritis (RA). The study included 51 patients. Fifteen of them (group 1) were given conventional medicamental therapy in combination with high-intensity dynamic physical exercises with the use of the Enraf-Nonius training devices (45-60 min). Eighteen patients of group 2 were offered 10 sessions of remedial gymnastics for the joints (45 min each) under the guidance of an instructor that were continued under the domestic conditions (45 min each session thrice weekly for 3 months). Eighteen patients of group 3 were given medicamental therapy alone (control). The parameters estimated in the study included the mean strength of knee joint extension and ankle joint flexion measured with the use of En-TreeM devices, articular pain (100 mm BAHI), DAS28, HAQ, and RAPID3 indices. It was shown that both programs of therapeutic exercises reduced the severity of the disease, improved the functional and motor activity of the patients and their quality of life. The majority of these characteristics were significantly different from those documented in the control group (pexercise machines was higher than without them (articular pain was reduced by 57.9% (pexercises during 3 months was higher (83.3%) than with high-intensity dynamic training with the use of exercise machines (60%). It is concluded that the latter modality should be recommended to the younger patients with RA (below 40 years), a short history of the disease, and its low activity.

    13. Plasminogen activator inhibitor-1 5G/5G genotype is associated with early spontaneous recanalization of the infarct-related artery in patients presenting with acute ST-elevation myocardial infarction.

      Science.gov (United States)

      Cagliyan, Caglar E; Yuregir, Ozge O; Balli, Mehmet; Tekin, Kamuran; Akilli, Rabia E; Bozdogan, Sevcan T; Turkmen, Serdar; Deniz, Ali; Baykan, Oytun A; Aslan, Huseyin; Cayli, Murat

      2013-05-01

      We aimed to examine the association between plasminogen activator inhibitor-1 (PAI-1) genetic polymorphism and early spontaneous recanalization in patients presenting with acute ST-elevation myocardial infarction. Patients admitted to our emergency department with ST-elevation myocardial infarction in the first 6 h of symptom onset were included. An immediate primary percutaneous coronary intervention was performed. Patients were grouped according to the initial patency of the infarct-related artery (IRA) as follows: total occlusion (TO) group [Thrombolysis in Myocardial Infarction (TIMI) 0-1 flow in the IRA], partial recanalization group (TIMI 2 flow in the IRA), and complete recanalization (CR) group (TIMI 3 flow in the IRA). PAI-1 4G/5G polymorphism was detected using the real-time PCR method. There were 107 patients in the TO group, 30 patients in the partial recanalization group, and 45 patients in the CR group. When we evaluated degrees of patency according to the PAI-1 genotype, TO of the IRA was the highest in patients with the PAI 4G/4G genotype (PAI-1 4G/4G: 66.7%, PAI-1 4G/5G: 65.9%, PAI-1 5G/5G: 40.4%) and CR of the IRA was the highest in patients with the PAI 5G/5G genotype (PAI-1 5G/5G: 38.5%, PAI-1 4G/5G: 19.8%, PAI-1 4G/4G: 17.9%). The distribution of genotypes in different degrees of patency of IRA was statistically significant (P=0.029). In logistic regression analysis, the PAI-1 5G/5G genotype was associated independently with the spontaneous CR of the IRA (odds ratio: 2.875, 95% confidence interval [1.059-7.086], P=0.038). Patients with the PAI-1 5G/5G genotype seem to be luckier than others in terms of early spontaneous recanalization of the IRA. Further prospective studies with large patient populations are required for more precise results.

    14. STELLAR KINEMATICS AND STRUCTURAL PROPERTIES OF VIRGO CLUSTER DWARF EARLY-TYPE GALAXIES FROM THE SMAKCED PROJECT. II. THE SURVEY AND A SYSTEMATIC ANALYSIS OF KINEMATIC ANOMALIES AND ASYMMETRIES

      Energy Technology Data Exchange (ETDEWEB)

      Toloba, E.; Guhathakurta, P. [UCO/Lick Observatory, University of California, Santa Cruz, 1156 High Street, Santa Cruz, CA 95064 (United States); Peletier, R. F. [Kapteyn Astronomical Institute, Postbus 800, 9700 AV Groningen (Netherlands); Boselli, A. [Laboratoire d' Astrophysique de Marseille-LAM, Université d' Aix-Marseille and CNRS, UMR 7326, 38 rue F. Joliot-Curie, 13388 Marseille Cedex 13 (France); Lisker, T. [Astronomisches Rechen-Institut, Zentrum für Astronomie der Universität Heidelberg, Mönchhofstraße 12-14, D-69120 Heidelberg (Germany); Falcón-Barroso, J.; Ryś, A. [Instituto de Astrofísica de Canarias, Vía Láctea s/n, La Laguna, Tenerife (Spain); Simon, J. D. [Observatories of the Carnegie Institution for Science, 813 Santa Barbara Street, Pasadena, CA 91101 (United States); Van de Ven, G. [Max Planck Institute for Astronomy, Königstuhl 17, D-69117 Heidelberg (Germany); Paudel, S. [Korea Astronomy and Space Science Institute, Daejeon 305-348 (Korea, Republic of); Emsellem, E. [European Southern Observatory, Karl-Schwarzschild-Strasse 2, D-85748, Garching (Germany); Janz, J. [Centre for Astrophysics and Supercomputing, Swinburne University, Hawthorn, VIC 3122 (Australia); Den Brok, M. [Department of Physics and Astronomy, University of Utah, Salt Lake City, UT 84112 (United States); Gorgas, J. [Departamento de Astrofísica y Física de la Atmósfera, Universidad Complutense de Madrid, E-28040, Madrid (Spain); Hensler, G. [Department of Astrophysics, University of Vienna, Türkenschanzstraße 17, 1180 Vienna (Austria); Laurikainen, E.; Salo, H. [Division of Astronomy, Department of Physics, PO Box 3000, FI-90014 University of Oulu (Finland); Niemi, S.-M., E-mail: toloba@ucolick.org [Mullard Space Science Laboratory, University College London, Holmbury St. Mary, Dorking, Surrey RH5 6NT (United Kingdom)

      2015-01-01

      We present spatially resolved kinematics and global stellar populations and mass-to-light ratios for a sample of 39 dwarf early-type (dE) galaxies in the Virgo cluster studied as part of the SMAKCED stellar absorption-line spectroscopy and imaging survey. This sample is representative of the early-type population in the Virgo cluster in the absolute magnitude range –19.0 < M{sub r} < –16.0 and of all morphological subclasses found in this galaxy population. For each dE, we measure the rotation curve and velocity dispersion profile and fit an analytic function to the rotation curve. We study the significance of the departure of the rotation curve from the best-fit analytic function (poorly fit) and of the difference between the approaching and receding sides of the rotation curve (asymmetry). Our sample includes two dEs with kinematically decoupled cores that have been previously reported. We find that 62 ± 8% (23 out of the 39) of the dEs have a significant anomaly in their rotation curve. Analysis of the images reveals photometric anomalies for most galaxies. However, there is no clear correlation between the significance of the photometric and kinematic anomalies. We measure age-sensitive (H{sub β} and H{sub γA}) and metallicity sensitive (Fe4668 and Mgb) Lick spectral indices in the LIS-5 Å system. This population of galaxies exhibits a wide range of ages and metallicities; we also find that 4 dEs show clear evidence of emission partially filling in the Balmer absorption lines. Finally, we estimate the total masses and dark matter fractions of the dEs and plot them in the mass-size, the mass-velocity dispersion, and the fundamental plane scaling relations. The dEs seem to be the bridge between massive early-type galaxies and dSphs, and have a median total mass within the R{sub e} of log M{sub e} = 9.1 ± 0.2 and a median dark matter fraction within the R{sub e} of f {sub DM} = 46 ± 18%. Any formation model for the dE galaxy class must account for this

    15. Practice patterns and clinical outcomes among non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients presenting to primary and tertiary hospitals: insights from the EARLY glycoprotein IIb/IIIa inhibition in NSTE-ACS (EARLY-ACS) trial.

      Science.gov (United States)

      Toleva, Olga; Westerhout, Cynthia M; Senaratne, Manohara P J; Bode, Christoph; Lindroos, Magnus; Sulimov, Vitaly A; Montalescot, Gilles; Newby, L Kristin; Giugliano, Robert P; Van de Werf, Frans; Armstrong, Paul W

      2014-11-15

      We evaluated patients at tertiary [both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) capable] and primary hospitals in the EARLY-ACS trial. Early invasive management is recommended for high-risk non-ST-segment elevation acute coronary syndromes. We evaluated outcomes in 9,204 patients presenting to: tertiary sites, primary sites with transfer to tertiary sites ("transferred") and those who remained at primary sites ("non-transfer"). There were 348 tertiary (n = 7,455 patients) and 89 primary hospitals [n = 1,749 patients (729 transferred; 1,020 non-transfer)]. Significant delays occurred in time from symptom onset to angiography (49 hr), PCI (53h), and CABG (178 hr) for transferred patients (P HR): 0.64 (0.47-0.87), P = 0.005]: there was no difference between transferred and tertiary patients [5.2% vs. 6.3%; adjusted HR: 0.80 (0.58-1.12), P = 0.202]. Despite similar rates of catheterization, GUSTO severe/moderate bleeding within 120 hr was less in non-transfer [3.1% vs. 6.7% (tertiary); adjusted OR: 0.47 (0.32-0.68), P best long-term survival. © 2014 Wiley Periodicals, Inc.

    16. Effects of need supportive teaching on early adolescents' motivation and engagement : A review of the literature

      NARCIS (Netherlands)

      Stroet, Kim; Opdenakker, Marie; Minnaert, Alexander

      In the present paper we systematically review the corpus of evidence on the effects of need supportive teaching on early adolescents' motivation and engagement for school. Based on Self-Determination Theory, we define need supportive teaching in terms of teachers' provision of autonomy support,

    17. Effects of Need Supportive Teaching on Early Adolescents' Motivation and Engagement: A Review of the Literature

      Science.gov (United States)

      Stroet, Kim; Opdenakker, Marie-Christine; Minnaert, Alexander

      2013-01-01

      In the present paper we systematically review the corpus of evidence on the effects of need supportive teaching on early adolescents' motivation and engagement for school. Based on Self-Determination Theory, we define need supportive teaching in terms of teachers' provision of autonomy support, structure, and involvement. The results of an…

    18. Effects of need supportive teaching on early adolescents' motivation and engagement : A review of the literature

      NARCIS (Netherlands)

      Stroet, Kim; Opdenakker, Marie; Minnaert, Alexander

      2013-01-01

      In the present paper we systematically review the corpus of evidence on the effects of need supportive teaching on early adolescents' motivation and engagement for school. Based on Self-Determination Theory, we define need supportive teaching in terms of teachers' provision of autonomy support, stru

    19. In patients presenting to the emergency department with skin and soft tissue infections what is the diagnostic accuracy of point-of-care ultrasonography for the diagnosis of abscess compared to the current standard of care? A systematic review and meta-analysis

      Science.gov (United States)

      Chenkin, Jordan; Cho, Dennis D; Jelic, Tomislav; Scheuermeyer, Frank X

      2017-01-01

      Objectives The primary objective of this systematic review was to determine the accuracy of point-of-care ultrasonography (POCUS) in diagnosing abscess in emergency department (ED) patients with skin and soft tissue infections (SSTI). The secondary objective was the accuracy of POCUS in the paediatric population subgroup. Setting Prospective studies set in emergency departments. Participants Emergency department patients (adult and paediatric) presenting with SSTI and suspected abscess. Primary and secondary outcome measures This systematic review was conducted according to Cochrane Handbook guidelines, and the following databases were searched: PubMed, MEDLINE, EMBASE and the Cochrane database of systematic reviews (1946–2015). We included prospective cohort and case–control studies investigating ED patients with SSTI and abscess or cellulitis, a defined POCUS protocol, a clearly defined gold standard for abscess and a contingency table describing sensitivity and specificity. Two reviewers independently ascertained all potentially relevant citations for methodologic quality according to QUADAS-2 criteria. The primary outcome measure was the sensitivity and specificity of POCUS for abscess. A preplanned subgroup (secondary) analysis examined the effects in paediatric populations, and changes in management were explored post hoc. Results Of 3028 articles, 8 were identified meeting inclusion criteria; all were rated as good to excellent according to QUADAS-2 criteria. Combined test characteristics of POCUS on the ED diagnosis of abscess for patients with SSTI were as follows: sensitivity 96.2% (95% CI 91.1% to 98.4%), specificity 82.9% (95% CI 60.4% to 93.9%), positive likelihood ratio 5.63 (95% CI 2.2 to 14.6) and negative likelihood ratio 0.05 (95% CI 0.01 to 0.11). Conclusions A total of 8 studies of good-to-excellent quality were included in this review. The use of POCUS helps differentiate abscess from cellulitis in ED patients with SSTI. Trial registration

    20. Perceiving the Present and a Systematization of Illusions

      Science.gov (United States)

      Changizi, Mark A.; Hsieh, Andrew; Nijhawan, Romi; Kanai, Ryota; Shimojo, Shinsuke

      2008-01-01

      Over the history of the study of visual perception there has been great success at discovering countless visual illusions. There has been less success in organizing the overwhelming variety of illusions into empirical generalizations (much less explaining them all via a unifying theory). Here, this article shows that it is possible to…

    1. Meeting the Challenge: Effective Strategies for Challenging Behaviours in Early Childhood Environments = Relever le defi: Strategies efficaces aupres des enfants presentant des problemes de comportement dans les milieux de la petite enfance.

      Science.gov (United States)

      Kaiser, Barbara; Rasminsky, Judy Sklar

      Describing the frustration felt by early childhood educators when they encounter challenging behaviors that do not respond to their usual guidance and disciplinary measures, this guide, in English and French, is designed to give the information and skills needed to cope with children with challenging behaviors. The guide is based on the view that…

    2. A systematic method for search term selection in systematic reviews.

      Science.gov (United States)

      Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine

      2014-06-01

      The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a solution to this problem as they aim to synthesize all current information on a particular topic and present a balanced and unbiased summary of the findings. They are fast becoming an important method of research across a number of fields, yet only a small number of guidelines exist on how to define and select terms for a systematic search. This article presents a replicable method for selecting terms in a systematic search using the semantic concept recognition software called leximancer (Leximancer, University of Queensland, Brisbane, Australia). We use this software to construct a set of terms from a corpus of literature pertaining to transborder interventions for drug control and discuss the applicability of this method to systematic reviews in general. This method aims to contribute a more 'systematic' approach for selecting terms in a manner that is entirely replicable for any user.

    3. A systematic approach to an organization's sustainability.

      Science.gov (United States)

      Schalock, Robert L; Verdugo, Miguel; Lee, Tim

      2016-06-01

      This article integrates the concepts of sustainability and quality improvement into a systematic approach to an organization's sustainability. The article: (a) presents a literature-based model that incorporates the factors that drive an organization's sustainability; (b) describes how sustainability is operationalized through a systematic approach to quality improvement; (c) discusses the advantages of a systematic approach to sustainability; and (d) shares with the reader literature and experientially-based lessons learned about the approach.

    4. Early functional rehabilitation versus postoperative immobilization for acute achilles tendon ruptures:a systematic review%急性跟腱断裂术后早期功能锻炼与制动的Meta分析

      Institute of Scientific and Technical Information of China (English)

      陈江涛; 荀传辉; 宋兴华; 加莎热特·杰力勒; 霍建军

      2012-01-01

      tendon ruptures were identified from MEDLINE (from 1966 to 2011.1),EMBASE (from 1966 to 2011.1),Cochrane Library (Issue 1,2011),Cochrane Musculoskeletal Injuries Group Database (2011.1) and CBM disc (from 1979 to 2011.1).We hand-searched Chinese Journal of Orthopaedics (from the llrst issue to January issue,2011 ) and Chinese Journal of Orthopaedic Trauma (from the first issue to January issue,2011 ) for RCTs and CCTs of our interest.Data were extracted by 2 reviewers with designed extraction form.RevMan 4.2.8 software was used for data analysis.Results Four RCTs and 3 CCTs were included for the present meta analysis.Compared with postoperative immobilization,early functional rehabilitation significantly improved patients' subjective satisfaction [ RR =1.27,95% CI (1.01,1.61),P =0.04]and reduced the complication rate [ RR =0.43,95% CI (0.22,0.83),P =0.01 ]but did not significantly increase the rerupture rate [ RR =0.59,95% CI (0.20,1.80),P =0.92],the infection rate [ RR =0.70,95% CI (0.26,1.86),P =0.48],or the achilles elongation at either 6 weeks [SMD=1.50,95% CI(-3.40,6.40)]or at 12 weeks[SMD=-0.25,95% CI(-5.64,5.14)].Conclusions Compared with postoperative immobilization for acute achilles tendon ruptures,early functional rehabilitation can obviously increase patients' subjective satisfaction and reduce complications without increasing risks of rerupture and infection.There is no significant difference in achilles elongation,calf strength and range of motion of the ankle between the 2 treatments.

    5. Implementation of responsiveness to intervention in early education settings.

      Science.gov (United States)

      Justice, Laura M; McGinty, Anita; Guo, Ying; Moore, Douglas

      2009-05-01

      This article provides an overview of how response to intervention (RTI) may be used effectively within early childhood settings. Discussion is organized to address such issues regarding RTI implementation as (1) how to design and implement a high-quality Tier 1 learning environment that systematically improves children's language and literacy outcomes, (2) how to design and implement a high-quality Tier 2 supplemental learning intervention that systematically improves the language and literacy outcomes of children who are unresponsive to Tier 1, and (3) how to design and implement a comprehensive and cohesive assessment system that appropriately identifies children who show inadequate response to the Tier 1 and Tier 2 learning opportunities. A model for implementing RTI using the supplemental curriculum by Justice and McGinty, READ IT AGAIN-PREK! (2008), is presented. This tool was developed to meet the needs of early childhood programs as they seek to implement RIA in a cost-effective and scalable manner.

    6. Dissemination bias in systematic reviews of animal research: a systematic review.

      Science.gov (United States)

      Mueller, Katharina F; Briel, Matthias; Strech, Daniel; Meerpohl, Joerg J; Lang, Britta; Motschall, Edith; Gloy, Viktoria; Lamontagne, Francois; Bassler, Dirk

      2014-01-01

      Systematic reviews of preclinical studies, in vivo animal experiments in particular, can influence clinical research and thus even clinical care. Dissemination bias, selective dissemination of positive or significant results, is one of the major threats to validity in systematic reviews also in the realm of animal studies. We conducted a systematic review to determine the number of published systematic reviews of animal studies until present, to investigate their methodological features especially with respect to assessment of dissemination bias, and to investigate the citation of preclinical systematic reviews on clinical research. Eligible studies for this systematic review constitute systematic reviews that summarize in vivo animal experiments whose results could be interpreted as applicable to clinical care. We systematically searched Ovid Medline, Embase, ToxNet, and ScienceDirect from 1st January 2009 to 9th January 2013 for eligible systematic reviews without language restrictions. Furthermore we included articles from two previous systematic reviews by Peters et al. and Korevaar et al. The literature search and screening process resulted in 512 included full text articles. We found an increasing number of published preclinical systematic reviews over time. The methodological quality of preclinical systematic reviews was low. The majority of preclinical systematic reviews did not assess methodological quality of the included studies (71%), nor did they assess heterogeneity (81%) or dissemination bias (87%). Statistics quantifying the importance of clinical research citing systematic reviews of animal studies showed that clinical studies referred to the preclinical research mainly to justify their study or a future study (76%). Preclinical systematic reviews may have an influence on clinical research but their methodological quality frequently remains low. Therefore, systematic reviews of animal research should be critically appraised before translating them

    7. Dissemination bias in systematic reviews of animal research: a systematic review.

      Directory of Open Access Journals (Sweden)

      Katharina F Mueller

      Full Text Available Systematic reviews of preclinical studies, in vivo animal experiments in particular, can influence clinical research and thus even clinical care. Dissemination bias, selective dissemination of positive or significant results, is one of the major threats to validity in systematic reviews also in the realm of animal studies. We conducted a systematic review to determine the number of published systematic reviews of animal studies until present, to investigate their methodological features especially with respect to assessment of dissemination bias, and to investigate the citation of preclinical systematic reviews on clinical research.Eligible studies for this systematic review constitute systematic reviews that summarize in vivo animal experiments whose results could be interpreted as applicable to clinical care. We systematically searched Ovid Medline, Embase, ToxNet, and ScienceDirect from 1st January 2009 to 9th January 2013 for eligible systematic reviews without language restrictions. Furthermore we included articles from two previous systematic reviews by Peters et al. and Korevaar et al.The literature search and screening process resulted in 512 included full text articles. We found an increasing number of published preclinical systematic reviews over time. The methodological quality of preclinical systematic reviews was low. The majority of preclinical systematic reviews did not assess methodological quality of the included studies (71%, nor did they assess heterogeneity (81% or dissemination bias (87%. Statistics quantifying the importance of clinical research citing systematic reviews of animal studies showed that clinical studies referred to the preclinical research mainly to justify their study or a future study (76%.Preclinical systematic reviews may have an influence on clinical research but their methodological quality frequently remains low. Therefore, systematic reviews of animal research should be critically appraised before

    8. Systematic Software Development

      DEFF Research Database (Denmark)

      Kuhrmann, Marco; Méndez Fernández, Daniel

      2015-01-01

      The speed of innovation and the global allocation of resources to accelerate development or to reduce cost put pressure on the software industry. In the global competition, especially so-called high-price countries have to present arguments why the higher development cost is justified and what...... makes these countries an attractive host for software companies. Often, high-quality engineering and excellent quality of products, e.g., machinery and equipment, are mentioned. Yet, the question is: Can such arguments be also found for the software industry? We aim at investigating the degree...... of professionalism and systematization of software development to draw a map of strengths and weaknesses. To this end, we conducted as a first step an exploratory survey in Germany, presented in this paper. In this survey, we focused on the perceived importance of the two general software engineering process areas...

    9. [The systematization of the enzyme-linked immunosorbent assay (=ELISA)].

      Science.gov (United States)

      Gränzer, W

      1989-06-01

      Using the example of the detectability of immunological methods the study shows the considerable influence exerted by this detectability on the quantitative and qualitative parameters and the necessity of a systematization of the methods. This systematization already starts with the product labeling: A sufficient description of antibodies has to contain five qualities. The profitability of the experimental research is improved by optimized product and method systematization. ELISA is presented in a systematized form as a modular system optimizing the comparability of these methods. In order to detect the gain of information transparency obtained by systematization, an ELISA, described in the literature, is presented in the original and in the systematized form.

    10. Error correction in adders using systematic subcodes.

      Science.gov (United States)

      Rao, T. R. N.

      1972-01-01

      A generalized theory is presented for the construction of a systematic subcode for a given AN code in such a way that error control properties of the AN code are preserved in this new code. The 'systematic weight' and 'systematic distance' functions in this new code depend not only on its number representation system but also on its addition structure. Finally, to illustrate this theory, a simple error-correcting adder organization using a systematic subcode of 29 N code is sketched in some detail.

    11. Advances and trends in the molecular systematics of the parasitic Platyhelminthes.

      Science.gov (United States)

      Olson, Peter D; Tkach, Vasyl V

      2005-01-01

      The application of molecular systematics to the parasitic Platyhelminthes (Cestoda, Digenea and Monogenea) over the last decade has advanced our understanding of their interrelationships and evolution substantially. Here we review the current state of play and the early works that led to the molecular-based hypotheses that now predominate in the field; advances in their systematics, taxonomy, classification and phylogeny, as well as trends in species circumscription, molecular targets and analytical methods are discussed for each of the three major parasitic groups. A by-product of this effort has been an ever increasing number of parasitic flatworms characterized genetically, and the useful application of these data to the diagnosis of animal and human pathogens, and to the elucidation of life histories are presented. The final section considers future directions in the field, including taxon sampling, molecular targets of choice, and the current and future utility of mitochondrial and nuclear genomics in systematic study.

    12. Investigation of systematic errors of metastable "atomic pair" number

      CERN Document Server

      Yazkov, V

      2015-01-01

      Sources of systematic errors in analysis of data, collected in 2012, are analysed. Esti- mations of systematic errors in a number of “atomic pairs” fr om metastable π + π − atoms are presented.

    13. Interventions for Adolescent Mental Health: An Overview of Systematic Reviews

      OpenAIRE

      2016-01-01

      Many mental health disorders emerge in late childhood and early adolescence and contribute to the burden of these disorders among young people and later in life. We systematically reviewed literature published up to December 2015 to identify systematic reviews on mental health interventions in adolescent population. A total of 38 systematic reviews were included. We classified the included reviews into the following categories for reporting the findings: school-based interventions (n = 12); c...

    14. Systematic Review on Bailing Capsule Combined Conventional Treatment for Treating Early Disbetic Nephropathy%百令胶囊联合常规治疗早期糖尿病肾病的系统评价

      Institute of Scientific and Technical Information of China (English)

      唐榕; 陈路佳; 黄玲; 向帆; 胡正波

      2013-01-01

      Objective To evaluate the effect and safety of Bailing Capsule combined with the conventional treatment for treating early disbetic nephropathy.Methods The Cochrane Library (Issue 1,2012),EMbase,PubMed,CBM,CNKI and VIP(from their establishment to October 2012) were retrieved by computer for collecting the randomized controlled trials(RCTs) of Bailing Capsule combined with the conventional treatment for treating early disbetic nephropathy.The data were performed the meta analysis by RevMan 5.14 software.Results Twenty-nine RCTs involving 1 601 patients were ultimately identified.The Results of meta-analyses showed that,compared with the control group,the urinary albumin excretion rate(UAER) of the Bailing Capsule group was lower than that of the control group [MD =-27.41,95% CI(-32.82,-21.99),P < 0.000 01];the 24h UMA of the Bailing Capsule group was lower than that of the control group,[MD =-48.95,95% CI(-67.66,-30.25),P < 0.000 01] ;the serum SCr of the Bailing Capsule group was lower than that of the control group,[MD =-6.34,95% CI(-10.94,-1.75),P < 0.000 01] ; the BUN of the Bailing Capsule group was lower than that of the control group,[MD =-0.49,95% CI(-0.97,-0.01),P =0.04];the effective rate of the Bailing Capsule group was higher than that of the control group,[OR=4.98,95% CI(3.12,7.95),P < 0.000 01].The fasting plasma glucose(FPG) of the Bailing Capsule group was lower than that of the control group without statistically significant difference between them [MD =-0.02,95% CI(-0.28,0.23),P =0.86].No serious adverse reactions were found in the two groups.Conclusion Based on the present clinical evidences,Bailing Capsule combined with the conventional treatment for treating early disbetic nephropathy is effective with good safety.Howerver,due to the quality disunity of the included studies,this Conclusion need more large sample size,high-quality RCTs to confirm.%目的 系统评价百令胶囊联合常规治疗对早期糖尿病肾

    15. The Reported Effects of a Systematic Professional Learning Program on the Knowledge, Skills, and Concerns of Australian Early Childhood Educators Who Support Young Children Displaying or at Risk of Challenging Behaviours

      Science.gov (United States)

      Arthur-Kelly, Michael; Farrell, Genevieve; De Bortoli, Tania; Lyons, Gordon; Hinchey, Frank; Ho, Fuk Chuen; Opartkiattikul, Watinee; Baker, Fran; Fairfax, Warren

      2017-01-01

      High-quality early childhood education is a vital experience for young children with and without disabilities. Social and communication experiences in the context of play represent a core curriculum that sets a foundation for later learning and participation. Using a new self-report instrument, this article describes data collected in a…

    16. High-sensitivity troponin assays for the early rule-out or diagnosis of acute myocardial infarction in people eith acute chest pain: a systematic review and cost-effectiveness analysis

      NARCIS (Netherlands)

      M. Westwood (Marie); T. van Asselt (Thea); B. Ramaekers (Bram); P. Whiting (Penny); P. Tokala (Praveen); M.A. Joore (Manuela); N. Armstrong (Nigel); J. Ross (Janine); J.L. Severens (Hans); J. Kleijnen (Jos)

      2015-01-01

      textabstractBackground: Early diagnosis of acute myocardial infarction (AMI) can ensure quick and effective treatment but only 20% of adults with emergency admissions for chest pain have an AMI. High-sensitivity cardiac troponin (hs-cTn) assays may allow rapid rule-out of AMI and avoidance of unnece

    17. High-sensitivity troponin assays for the early rule-out or diagnosis of acute myocardial infarction in people with acute chest pain : a systematic review and cost-effectiveness analysis

      NARCIS (Netherlands)

      Westwood, Marie; van Asselt, Thea; Ramaekers, Bram; Whiting, Penny; Thokala, Praveen; Joore, Manuela; Armstrong, Nigel; Ross, Janine; Severens, Johan; Kleijnen, Jos

      2015-01-01

      BACKGROUND: Early diagnosis of acute myocardial infarction (AMI) can ensure quick and effective treatment but only 20% of adults with emergency admissions for chest pain have an AMI. High-sensitivity cardiac troponin (hs-cTn) assays may allow rapid rule-out of AMI and avoidance of unnecessary hospit

    18. Re-systematizing Pragmatics

      Institute of Scientific and Technical Information of China (English)

      2012-01-01

      The publication of Levinson's celebrated Pragmatics in 1983 systematized the field of pragmatics and marked the coming of age of pragmatics as a linguistic discipline in its own right. Today pragmaties is one of the most vibrant and rapidly growing fields in linguistics and the philosophy of language. It is also a particularly complex subject with all kinds of disciplinary influence, and few, if any, clear boundaries. The aim of this article is to survey the representative research areas in contemporary pragmatics and present an authoritative and up-to-date description of the contemporary landscape of pragmatics, in the hope that it will help shape the development of the discipline in the next decade or so.

    19. A clinician's guide to systematic reviews.

      Science.gov (United States)

      Crowther, David M

      2013-08-01

      The purpose of this article is to discuss systematic reviews, how they are performed, and their associated strengths and limitations. A systematic review is an assessment of evidence involving exact methods to systematically identify, select, and critically evaluate all available literature on a particular topic. Unlike most narrative reviews, systematic reviews have defined methods established a priori for searching, evaluating, extracting, synthesizing, and reporting available evidence. Key characteristics differentiating systematic reviews from most narrative reviews include: clearly stated objectives, pre-defined inclusion/exclusion criteria, an explicit reproducible methodology, systematic exhaustive searches to identify all sources of evidence, an assessment of the validity for each included study, and a systematic presentation of the study characteristics/results. Though there are significant advantages to systematic reviews, there are also clear limitations such as: the quality of included evidence; heterogeneity and homogeneity of included studies; and publication bias. Even with these limitations, systematic reviews are beneficial to front line clinicians when the quantity of evidence is so substantial that reviewing and synthesizing it is not feasible, available evidence is conflicting, or when the robustness of available evidence is unknown.

    20. Systematic review automation technologies

      Science.gov (United States)

      2014-01-01

      Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects. We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time. PMID:25005128

    1. Bicep2. III. INSTRUMENTAL SYSTEMATICS

      Energy Technology Data Exchange (ETDEWEB)

      Ade, P. A. R. [School of Physics and Astronomy, Cardiff University, Cardiff, CF24 3AA (United Kingdom); Aikin, R. W.; Bock, J. J.; Brevik, J. A.; Filippini, J. P.; Golwala, S. R.; Hildebrandt, S. R. [Department of Physics, California Institute of Technology, Pasadena, CA 91125 (United States); Barkats, D. [Joint ALMA Observatory, ESO, Santiago (Chile); Benton, S. J. [Department of Physics, University of Toronto, Toronto, ON (Canada); Bischoff, C. A.; Buder, I.; Karkare, K. S. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, MA 02138 (United States); Bullock, E. [Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455 (United States); Dowell, C. D. [Jet Propulsion Laboratory, Pasadena, CA 91109 (United States); Duband, L. [SBT, Commissariat à l’Energie Atomique, Grenoble (France); Fliescher, S. [Department of Physics, University of Minnesota, Minneapolis, MN 55455 (United States); Halpern, M.; Hasselfield, M. [Department of Physics and Astronomy, University of British Columbia, Vancouver, BC (Canada); Hilton, G. C.; Irwin, K. D., E-mail: csheehy@uchicago.edu [National Institute of Standards and Technology, Boulder, CO 80305 (United States); Collaboration: Bicep2 Collaboration; and others

      2015-12-01

      In a companion paper, we have reported a >5σ detection of degree scale B-mode polarization at 150 GHz by the Bicep2 experiment. Here we provide a detailed study of potential instrumental systematic contamination to that measurement. We focus extensively on spurious polarization that can potentially arise from beam imperfections. We present a heuristic classification of beam imperfections according to their symmetries and uniformities, and discuss how resulting contamination adds or cancels in maps that combine observations made at multiple orientations of the telescope about its boresight axis. We introduce a technique, which we call “deprojection,” for filtering the leading order beam-induced contamination from time-ordered data, and show that it reduces power in Bicep2's actual and null-test BB spectra consistent with predictions using high signal-to-noise beam shape measurements. We detail the simulation pipeline that we use to directly simulate instrumental systematics and the calibration data used as input to that pipeline. Finally, we present the constraints on BB contamination from individual sources of potential systematics. We find that systematics contribute BB power that is a factor of ∼10× below Bicep2's three-year statistical uncertainty, and negligible compared to the observed BB signal. The contribution to the best-fit tensor/scalar ratio is at a level equivalent to r = (3–6) × 10{sup −3}.

    2. Systematic Review of Clozapine Cardiotoxicity.

      Science.gov (United States)

      Curto, Martina; Girardi, Nicoletta; Lionetto, Luana; Ciavarella, Giuseppino M; Ferracuti, Stefano; Baldessarini, Ross J

      2016-07-01

      Clozapine is exceptionally effective in psychotic disorders and can reduce suicidal risk. Nevertheless, its use is limited due to potentially life-threatening adverse effects, including myocarditis and cardiomyopathy. Given their clinical importance, we systematically reviewed research on adverse cardiac effects of clozapine, aiming to improve estimates of their incidence, summarize features supporting their diagnosis, and evaluate proposed monitoring procedures. Incidence of early (≤2 months) myocarditis ranges from <0.1 to 1.0 % and later (3-12 months) cardiomyopathy about 10 times less. Diagnosis rests on relatively nonspecific symptoms, ECG changes, elevated indices of myocardial damage, cardiac MRI findings, and importantly, echocardiographic evidence of developing ventricular failure. Treatment involves stopping clozapine and empirical applications of steroids, diuretics, beta-blockers, and antiangiotensin agents. Mortality averages approximately 25 %. Safety of clozapine reuse remains uncertain. Systematic studies are needed to improve knowledge of the epidemiology, avoidance, early identification, and treatment of these adverse effects, with effective and practicable monitoring protocols.

    3. Early aquatic physical therapy improves function and does not increase risk of wound-related adverse events for adults after orthopedic surgery: a systematic review and meta-analysis.

      Science.gov (United States)

      Villalta, Elizabeth M; Peiris, Casey L

      2013-01-01

      To investigate whether early postoperative aquatic physical therapy is a low-risk and effective form of physical therapy to improve functional outcomes after orthopedic surgery. Databases MEDLINE, CINAHL, AMED, Embase, and PEDro were searched from the earliest date available until October 2011. Additional trials were identified by searching reference lists and citation tracking. Controlled trials evaluating the effects of aquatic physical therapy on adverse events for adults therapy, early aquatic physical therapy does not increase the risk of wound-related adverse events (risk difference=.01, 95% CI -.05 to .07) and results in improved performance of activities of daily living (SMD=.33, 95% CI=.07-.58, I(2)=0%). There were no significant differences in edema (SMD=-.27, 95% CI=-.81 to .27, I(2)=58%) or pain (SMD=-.06, 95% CI=-.50 to .38, I(2)=32%). After orthopedic surgery aquatic physical therapy improves function and does not increase the risk of wound-related adverse events and is as effective as land-based therapy in terms of pain, edema, strength, and range of motion in the early postoperative period. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

    4. 幼儿音乐教学中情感体验现状及对策研究%The present situation and countermeasure of emotional experience in the early childhood music teaching

      Institute of Scientific and Technical Information of China (English)

      苏立

      2012-01-01

        Music education is an important part in the course of early childhood education, and let childhood get emotional experience is the value of music education, also the orientation of kindergarten art curriculum. Through the analysis of the problems in children's emotional experience in children's music teaching, and put forward improvement measures, to offer relevant personage as a reference.%  音乐教学是幼儿教育课程重要组成部分,而让幼儿从中获得情感体验是音乐教育的价值所在,也是幼儿艺术课程的定位。通过分析幼儿音乐教学中儿童情感体验中存在的问题,并针对性的提出改进措施,以供相关人士作为参考。

    5. The Present Situation of the Early Parent-Child Reading Analysis and Strategy Analysis%早期亲子阅读的现状分析及策略探析

      Institute of Scientific and Technical Information of China (English)

      印英

      2014-01-01

      Early parent-child reading education is a system engineering,the parents of the children’s independent reading ability training,the formation of good reading habits bear the important responsibility. Parent-child reading not only focus on the process of parent-child interaction,pay more attention to the emotional communication between parents and children,promote children’s physical and mental health development,improve the quality of family education.%早期亲子阅读是一项系统的教育工程,家长对幼儿自主阅读能力的培养、良好阅读习惯的形成承担着重要的职责。亲子阅读的过程不仅关注亲子间的互动,更关注家长与幼儿间的情感沟通,促进幼儿身心的健康发展,提高家庭教育的质量。

    6. Product-related Environmental Performance Indicators: a systematic literature review

      DEFF Research Database (Denmark)

      Issa, Isabela I.; Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.

      2013-01-01

      structured approach to support EPIs selection is still lacking. This paper presents the efforts made in order to identify, classify and systematize the existing EPIs based on the systematic literature review. From the review, 261 EPIs were identified, classified, and then systematized in a digital database...

    7. Planck 2015 results. III. LFI systematic uncertainties

      CERN Document Server

      Ade, P A R; Baccigalupi, C; Banday, A J; Barreiro, R B; Bartolo, N; Basak, S; Battaglia, P; Battaner, E; Benabed, K; Benoit-Lévy, A; Bernard, J -P; Bersanelli, M; Bielewicz, P; Bonaldi, A; Bonavera, L; Bond, J R; Borrill, J; Burigana, C; Butler, R C; Calabrese, E; Catalano, A; Christensen, P R; Colombo, L P L; Cruz, M; Curto, A; Cuttaia, F; Danese, L; Davies, R D; Davis, R J; de Bernardis, P; de Rosa, A; de Zotti, G; Delabrouille, J; Dickinson, C; Diego, J M; Doré, O; Ducout, A; Dupac, X; Elsner, F; Enßlin, T A; Eriksen, H K; Finelli, F; Frailis, M; Franceschet, C; Franceschi, E; Galeotta, S; Galli, S; Ganga, K; Ghosh, T; Giard, M; Giraud-Héraud, Y; Gjerløw, E; González-Nuevo, J; Górski, K M; Gregorio, A; Gruppuso, A; Hansen, F K; Harrison, D L; Hernández-Monteagudo, C; Herranz, D; Hildebrandt, S R; Hivon, E; Hobson, M; Hornstrup, A; Hovest, W; Huffenberger, K M; Hurier, G; Jaffe, A H; Jaffe, T R; Keihäen, E; Keskitalo, R; Kiiveri, K; Kisner, T S; Knoche, J; Krachmalnicoff, N; Kunz, M; Kurki-Suonio, H; Lagache, G; Lamarre, J -M; Lattanzi, M; Lawrence, C R; Leahy, J P; Leonardi, R; Levrier, F; Lilje, P B; Linden-Vørnle, M; Lindholm, V; López-Caniego, M; Lubin, P M; Macías-Pérez, J F; Maffei, B; Maggio, G; Maino, D; Mandolesi, N; Mangilli, A; Maris, M; Martin, P G; Martínez-González, E; Masi, S; Matarrese, S; Meinhold, P R; Mennella, A; Migliaccio, M; Mitra, S; Montier, L; Morgante, G; Mortlock, D; Munshi, D; Murphy, J A; Nati, F; Natoli, P; Noviello, F; Paci, F; Pagano, L; Pajot, F; Paoletti, D; Partridge, B; Pasian, F; Pearson, T J; Perdereau, O; Pettorino, V; Piacentini, F; Pointecouteau, E; Polenta, G; Pratt, G W; Puget, J -L; Rachen, J P; Reinecke, M; Remazeilles, M; Renzi, A; Ristorcelli, I; Rocha, G; Rosset, C; Rossetti, M; Roudier, G; Rubiño-Martín, J A; Rusholme, B; Sandri, M; Santos, D; Savelainen, M; Scott, D; Stolyarov, V; Stompor, R; Suur-Uski, A -S; Sygnet, J -F; Tauber, J A; Tavagnacco, D; Terenzi, L; Toffolatti, L; Tomasi, M; Tristram, M; Tucci, M; Umana, G; Valenziano, L; Valiviita, J; Van Tent, B; Vassallo, T; Vielva, P; Villa, F; Wade, L A; Wandelt, B D; Watson, R; Wehus, I K; Yvon, D; Zacchei, A; Zibin, J P; Zonca, A

      2015-01-01

      We present the current accounting of systematic effect uncertainties for the Low Frequency Instrument (LFI) that are relevant to the 2015 release of the Planck cosmological results, showing the robustness and consistency of our data set, especially for polarization analysis. We use two complementary approaches: (i) simulations based on measured data and physical models of the known systematic effects; and (ii) analysis of difference maps containing the same sky signal ("null-maps"). The LFI temperature data are limited by instrumental noise. At large angular scales the systematic effects are below the cosmic microwave background (CMB) temperature power spectrum by several orders of magnitude. In polarization the systematic uncertainties are dominated by calibration uncertainties and compete with the CMB $E$-modes in the multipole range 10-20. Based on our model of all known systematic effects, we show that these effects introduce a slight bias of around $0.2\\,\\sigma$ on the reionization optical depth derived ...

    8. Assessment of early child development: what, why, and how?

      Directory of Open Access Journals (Sweden)

      Tajana Brajović

      2010-05-01

      Full Text Available Motor skills, language, social and personal development as well as cognitive abilities are often the focus of early child development assessment and monitoring. The article presents some of the developmental milestones in these areas of child development. At the same time the article demonstrates that early child development assessment surpasses merely the orientation acording to developmental milestones. As a part of primary health prevention in Slovenia, identification of children with potential developmental delays is performed with the Denver developmental screening test II and the Systematical psychological examination of the three-year-old procedure. The purpose of applying developmental screening tests is early identification of children with developmental problems, as well as preparation of effective early interventions. By applying an appropriate psychological test material, a psychologist is able to assess the type and the stage of child' s psychological problems and delays in different developmental domains. Only psychometrically sound, and standardized tests should be applied in the process of early child development assessment. The work presents some of the practical and theoretical difficulties which practitioners are facing in the process of early child development assessment. Some feasible solutions are provided as well.

    9. [The systematization of epilepsy remissions].

      Science.gov (United States)

      Gromov, S A; Fedotenkova, T N

      1995-01-01

      Problems of systematization of remissions of epileptic seizures and epilepsy are discussed on the basis of clinical examination of 341 epileptic patients with seizures suppressed for many years and international classifications of epilepsy. A classification, developed by the authors, is presented. It reflects stages of regress of the disease in achievement of prolonged (for years) control of seizures. The possibility of drug dependence development in these therapeutic remissions is also taken into consideration.

    10. From Systematic Errors to Cosmology Using Large-Scale Structure

      Science.gov (United States)

      Hunterer, Dragan

      We propose to carry out a two-pronged program to significantly improve links between galaxy surveys and constraints on primordial cosmology and fundamental physics. We will first develop the methodology to self-calibrate the survey, that is, determine the large-angle calibration systematics internally from the survey. We will use this information to correct biases that propagate from the largest to smaller angular scales. Our approach for tackling the systematics is very complementary to existing ones, in particular in the sense that it does not assume knowledge of specific systematic maps or templates. It is timely to undertake these analyses, since none of the currently known methods addresses the multiplicative effects of large-angle calibration errors that contaminate the small-scale signal and present one of the most significant sources of error in the large-scale structure. The second part of the proposal is to precisely quantify the statistical and systematic errors in the reconstruction of the Integrated Sachs-Wolfe (ISW) contribution to the cosmic microwave background (CMB) sky map using information from galaxy surveys. Unlike the ISW contributions to CMB power, the ISW map reconstruction has not been studied in detail to date. We will create a nimble plug-and-play pipeline to ascertain how reliably a map from an arbitrary LSS survey can be used to separate the late-time and early-time contributions to CMB anisotropy at large angular scales. We will pay particular attention to partial sky coverage, incomplete redshift information, finite redshift range, and imperfect knowledge of the selection function for the galaxy survey. Our work should serve as the departure point for a variety of implications in cosmology, including the physical origin of the large-angle CMB "anomalies".

    11. Early Fives Program Evaluation: Farmington Public Schools.

      Science.gov (United States)

      Peper, H. Robert

      An evaluation of the Early Fives program of the Farmington (Michigan) Public Schools is reported. This extra-year program began in the 1980-81 school year. By the 1982-83 school year, tuition was no longer charged, and a systematic screening effort was implemented. Each Early Fives classroom contains a maximum of 15 children with a certified…

    12. Preschool Teachers' Constructions of Early Reading

      Science.gov (United States)

      Walker, Karen E.

      2015-01-01

      Research concerning preschool teachers' constructions of early reading has potential to influence teachers' curricular decisions and classroom practice. Six preschool teachers in North Texas were interviewed in regard to what they think about early reading and how they develop these understandings or constructions. The systematic, inductive…

    13. A Short History Regarding the Taxonomy and Systematic Researches of Platygastroidea (Hymenoptera

      Directory of Open Access Journals (Sweden)

      O. A. Popovici

      2011-10-01

      Full Text Available This paper presents an overview of the most important and best-known works that were the subject of taxonomy or systematics Platygastroidea superfamily. The paper is divided into three parts. In the first part of the research surprised the early period can be placed throughout the XIXth century between Latreille and Dalla Torre. Before this period, references about platygastrids and scelionids were made by Linnaeus and Schrank, they are the ones who described the first platygastrid and scelionid respectively. In this the first period work entomologists as: Haliday, Westwood, Walker, Forster, Ashmead, Thomson, Howard, etc., the result of their work being the description of 699 scelionids species which are found quoted in Dalla Torre's catalogue. The second part of the paper is devoted to early 20th century. This vibrant work is marked by the work of two great entomologists: Kieffer and Dodd. In this period one publish the first and only global monograph of platygastrids and scelionids until now. In this monograph are twice the number of species than in Dalla Torre's catalogue which shows the magnitude of the systematic research of those moments. The third part of the paper refers to the late 20th and early 21st century. This period, which continues today, is the period of modern systematics and taxonomy research about platygastrids and scelionids. During this period these two families become a distinct Superfamily which differs by Proctotrupoidea Superfamily. A great contribution in taxonomic and systematic Platygastroidea Superfamily brought Masner and Kozlov, the presentation of their work occupying the largest space of this 3rd party.

    14. Abstract Presentations: What Do SGIM Presenters Prefer?

      OpenAIRE

      Tulsky, Asher A.; Kouides, Ruth W

      1998-01-01

      We surveyed physicians presenting abstracts at the 1995 Society of General Internal Medicine annual meeting to determine whether the oral or poster format better achieved their presentation goals. Poster presentations better met respondents' objectives for feedback and criticism and for networking and developing collaborative projects, while oral presentations better met their objectives for national visibility and sharing knowledge within one's field. Sixty-nine percent of respondents prefer...

    15. Systematic error mitigation in multiple field astrometry

      CERN Document Server

      Gai, Mario

      2011-01-01

      Combination of more than two fields provides constraints on the systematic error of simultaneous observations. The concept is investigated in the context of the Gravitation Astrometric Measurement Experiment (GAME), which aims at measurement of the PPN parameter $\\gamma$ at the $10^{-7}-10^{-8}$ level. Robust self-calibration and control of systematic error is crucial to the achievement of the precision goal. The present work is focused on the concept investigation and practical implementation strategy of systematic error control over four simultaneously observed fields, implementing a "double differential" measurement technique. Some basic requirements on geometry, observing and calibration strategy are derived, discussing the fundamental characteristics of the proposed concept.

    16. Enhanced recovery after vascular surgery: protocol for a systematic review

      Directory of Open Access Journals (Sweden)

      Gotlib Conn Lesley

      2012-11-01

      Full Text Available Abstract Background The enhanced recovery after surgery (ERAS programme is a multimodal evidence-based approach to surgical care which begins in the preoperative setting and extends through to patient discharge in the postoperative period. The primary components of ERAS include the introduction of preoperative patient education; reduction in perioperative use of nasogastric tubes and drains; the use of multimodal analgesia; goal-directed fluid management; early removal of Foley catheter; early mobilization, and early oral nutrition. The ERAS approach has gradually evolved to become the standard of care in colorectal surgery and is presently being used in other specialty areas such as vascular surgery. Currently there is little evidence available for the implementation of ERAS in this field. We plan to conduct a systematic review of this literature with a view to incorporating ERAS principles into the management of major elective vascular surgery procedures. Methods We will search EMBASE (OVID, 1947 to June 2012, Medline (OVID, 1948 to June 2012, and Cochrane Central Register of Controlled Trials (Wiley, Issue 1, 2012. Searches will be performed with no year or language restrictions. For inclusion, studies must look at adult patients over 18 years. Major elective vascular surgery includes carotid, bypass, aneurysm and amputation procedures. Studies must have evaluated usual care against an ERAS intervention in the preoperative, perioperative or postoperative period of care. Primary outcome measures are length of stay, decreased complication rate, and patient satisfaction or expectations. Only randomized controlled trials will be included. Discussion Most ERAS approaches have been considered in the context of colorectal surgery. Given the increasing use of multiple yet different aspects of this pathway in vascular surgery, it is timely to systematically review the evidence for their independent or combined outcomes, with a view to implementing

    17. Early Childhood Caries

      Directory of Open Access Journals (Sweden)

      Yumiko Kawashita

      2011-01-01

      Full Text Available Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional preventive program that includes oral hygiene instructions for mothers or caregivers, along with fluoride and diet counseling. However, these strategies alone are not sufficient to prevent dental caries in high-risk children; prevention of ECC also requires addressing the socioeconomic factors that face many families in which ECC is endemic. The aim of this paper is to systematically review information about ECC and to describe why many children are suffering from dental caries.

    18. Presentation rubric: improving faculty professional presentations.

      Science.gov (United States)

      Hayne, Arlene N; McDaniel, Gretchen S

      2013-01-01

      This article describes the content of a presentation evaluation rubric for use in the development and improvement in faculty performance to enhance learning. Lectures or professional presentations require skills that can be learned through the use of evidence-based practices for all forms of public speaking. A core competency of nursing faculty is to serve as a role model in skilled oral communication. The use of an evaluation presentation rubric can increase faculty competency in this area. © 2013 Wiley Periodicals, Inc.

    19. WMAP Detection of Early Reionization

      Science.gov (United States)

      Kogut, A.

      2003-01-01

      The Wilkinson Microwave Anisotropy Probe (WMAP) has mapped the full sky in Stokes I, Q, and U parameters at frequencies 23, 33, 41, 61, and 94 GHz. We detect correlations between the temperature and polarization maps significant at more than 10 standard deviations. The correlations are inconsistent with instrument noise and are significantly larger than the upper limits established for potential systematic errors. The correlations are present in all WMAP frequency bands with similar amplitude from 23 to 94 GHz, and are consistent with a superposition of a CMB signal with a weak foreground. The fitted CMB component is robust against different data combinations and fitting techniques. On small angular scales the WMAP data show the temperature-polarization correlation expected from adiabatic density perturbations. The data for $\\ell > 20$ agree well with the signal predicted solely from the temperature power spectra, with no additional free parameters. The existence of correlations on super-horizon scales provides significant support for inflationary cosmologies. We detect excess power on large angular scales compared to predictions based on the temperature power spectra alone. The excess power is well described by reionization at redshift $11 reionization optical depth yields results consistent with the best-fit $\\Lambda$CDM model, with best fit value $\\tau = 0.17 \\pm 0.04$ at 68\\% confidence, including systematic and foreground uncertainties. This trough in the absorption spectra of distant quasars, and implies that the universe has a complex ionization history. I will discuss the WMAP data and its implications for reionization in the early universe.

    20. Making your presentation fun: creative presentation techniques

      Energy Technology Data Exchange (ETDEWEB)

      KEENEN,MARTHA JANE

      2000-05-18

      What possesses someone to volunteer and go through hoops and red tape to make a presentation at a conference? For that matter, why does anyone ever present anything to anyone? Actually, presentations are a fact of life and there are many reasons for doing a presentation and doing it well. New and existing staff need training and orientation to the way things are done here. Handing all of them a manual and hoping they read it is pretty much a waste of paper. On the other hand, an effective, entertaining and upbeat presentation on the relevant topics is more likely to stick with those people. They will even have a name and face to remember and seek out when they have an issue on or with that topic. This can be a very effective beginning for networking with new peers. The presenter is seen as knowledgeable, as a source of information on company topics and possibly evaluated as a potential mentor or future manager. Project staff and/or peers benefit from clear, concise, presentations of topical knowledge. This is one way that a group working on various aspects of the same project or program can stay in touch and in step with each other. Most importantly, presentations may be the best or only door into the minds (and budgets) of management and customers. These presentations are a wonderful opportunity to address legal and compliance issues, budget, staffing, and services. Here is a chance, maybe the only one, to demonstrate and explain the wonderfulness of a program and the benefit they get by using the services offered most effectively. An interactive presentation on legal and compliance issues can be an effective tool in helping customers and/or management make good risk management decisions.

    1. Nocardial mycetoma: Diverse clinical presentations

      Directory of Open Access Journals (Sweden)

      Sharma Nand

      2008-01-01

      Full Text Available Nocardia spp are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia spp occur as a result of local trauma and contamination of the wound. Clinically, it presents as acute infection (abscesses or cellulitis, mycetoma, or sporotrichoid infection. Differential diagnosis includes eumycetoma, chromomycosis, blastomycosis, coccidioidomycosis, sporotrichosis, tuberculosis, botryomycosis, syphilis, yaws, and neoplasia. Its diagnosis is confirmed by demonstrating the causative organism in exudates (as granules, tissue specimens, or cultures. Early diagnosis will obviate need for drastic surgical measures as early institution of chemotherapy is effective in most patients. However, its diagnosis is often delayed due to diverse clinical presentations and for want of clinical suspicion, particularly in non-endemic areas. This paper presents 4 clinical forms of this not so uncommon disease, emphasizing the importance of high index of clinical suspicion, especially in non-endemic regions; and the significance of repeated examination of exudates for Nocardia granules for an early diagnosis.

    2. Nudibranch Systematic Index

      OpenAIRE

      2006-01-01

      This is an index of my approximately 6,200 nudibranch reprints and books. I have indexed them only for information concerning systematics, taxonomy, nomenclature, & description of taxa. This list should allow you to quickly find information concerning the description, taxonomy, or systematics of almost any species of nudibranch. The full citation for any of the authors and dates listed may be found in the nudibranch bibliography at http://repositories.cdlib.org/ims/Bibliographia_Nudibranch...

    3. Clinical Linguistics: Its Past, Present and Future

      Science.gov (United States)

      Perkins, Michael R.

      2011-01-01

      Historiography is a growing area of research within the discipline of linguistics, but so far the subfield of clinical linguistics has received virtually no systematic attention. This article attempts to rectify this by tracing the development of the discipline from its pre-scientific days up to the present time. As part of this, I include the…

    4. CO2激光治疗早期声门型喉癌的meta分析%Local recurrence of CO2 laser surgery for patients with early glottic carcinoma: a systematic review and meta-analysis

      Institute of Scientific and Technical Information of China (English)

      王颖; 周佳青

      2012-01-01

      Objective: Using meta analysis to assess the local recurrence of CO2 laser surgery for patients with early glottic carcinoma(Tis,T1 N0 M0 ,T2N0M0 ). Method:The Chinese data librarydike Wanfang, Weipu, Chinese Periodicals library)、PubMed、EMBASE、OVID and Proquest Medical Library were searched according to including and excluding standard. The reference was screened, quality evaluated and information extracted. Meta analysis was processed by RevMan 5. 0. Data including local recurrence after CO2 laser surgery for patients with stage Tis, T1 N0 M0 ,T2N0M0 glottic carcinoma was pulled using appropriate model according to their homogeneity or hetero geneity. Result: A total of 27 studies were included in this meta analysis. Group Tis versus Ti :P=0. 08, no statis tical significance; Group T1a, versus Tjb, :P<0. 01, great statistical significance; Group T; versus T2 : P=0. 09, no statistical significance; Group anterior commissure+ versus anterior commissure" :P<0. 01, great statistical significance. Conclusion:The local recurrence varies from different kinds of TNM classification of early glottic carcinoma after CO2 laser surgery. There is no statistical significance between group Tis versus T1 and group Tj versus T2. The local recurrence in T1a, is lower than in T1b. The local recurrence in group anterior commissure+ is higher than in group anterior commissure .%目的:应用meta分析的方法对CO2激光治疗早期声门型喉癌不同分期(Tis、T1N0M0、T2N0M0)的疗效进行评价.方法:检索万方期刊库、中国期刊网(清华同方)、中国科技期刊库(重庆维普)、PubMed、EMBASE、OVID、PML(Proquest Medical Library)数据库中的杂志、学位论文等.制定严格的纳入和排除标准,对相关文献进行筛查、质量评价和资料提取.对符合入选标准的资料运用RevMan 5.0软件进行meta分析.在进行异质性检验后选择适当的统计模型,进行资料合并,以Tis、T1N0M0、T2N0M0期声门型喉癌CO2激光

    5. Deiodinase activity is present in Xenopus laevis during early embryogenesis

      NARCIS (Netherlands)

      G.M. Dubois (Ghislaine Morvan); A. Sebillot (Anthony); G.G.J.M. Kuiper (George); C.H.J. Verhoelst (Carla H.); V.M. Darras (Veerle); T.J. Visser (Theo); B.A. Demeneix (Barbara)

      2006-01-01

      textabstractThyroid hormones orchestrate amphibian metamorphosis. The type 2 and type 3 deiodinases make vital contributions to this process by controlling levels of the thyroid hormones T4 and T3 available to different tissues. Because the tadpole thyroid gland is not functional until stage NF44, i

    6. Moral Questions and Dilemmas: Early Times to Present Day Issues

      Directory of Open Access Journals (Sweden)

      Michael W. Small

      2014-09-01

      Full Text Available The purpose of this paper was to look at developments which have occurred in ethical behaviour in a nation’s armed forces. The paper begins with the Greeks and their concept of arête ‘manly virtue’, and concludes with reference to courses in ethics conducted in various military academies. In Australia, the Department of Defence and the RAN have played a role in developing codes of conduct for all ranks, from senior officer to junior recruit. The paper suggests that developing an understanding of ethics in a military/naval context should be addressed at four levels. Criteria should be identified for identifying relevant ethical behaviour; agreement should be reached about what constitutes ethical behaviour; programs should be developed at recruit and officer cadet level; and finally, curricula in military/naval ethics should be an integral part of the program in military training establishments.

    7. Investigations on pests, diseases and present early warning system ...

      African Journals Online (AJOL)

      USER

      2010-02-08

      Feb 8, 2010 ... belonging to 4 orders were determined and it was found that the main pest was codling moth. ... develop resistance against some pesticides as a result of ... leaves and fruits of the randomly selected trees were examined for.

    8. Early puberty and thoracic mass: presentation of a case

      OpenAIRE

      Laredo Reyna, María Nataly; Instituto Nacional de Salud del Niño. Lima, Perú. Médico pediatra; Falen Bogio, Juan Manuel; Facultad de Medicina, Universidad Nacional Federico Villareal. Lima, Perú. médico endocrinólogo; Lipa Chancolla, Roxana; Instituto Nacional de Salud del Niño. Lima, Perú. médico patólogo clínico; Núñez Almache, Oswaldo; Instituto Nacional de Salud del Niño. Lima, Perú. médico endocrinologo pediatra; Pinto, Paola; Instituto Nacional de Salud del Niño. Lima, Perú. Médico pediatra; Espinoza Robles, Oscar; Instituto Nacional de Salud del Niño. Lima, Perú. Médico pediatra; Chávez, Eliana; Instituto Nacional de Salud del Niño. Lima, Perú. Médico pediatra; Rojas Gabulli, María Isabel; Instituto Nacional de Salud del Niño. Lima, Perú. Facultad de Medicina, Universidad Nacional Federico Villareal. Lima, Perú. médico endocrinólogo; Del Aguila Villar, Carlos; Instituto Nacional de Salud del Niño. Lima, Perú. Facultad de Medicina, Universidad Nacional Federico Villareal. Lima, Perú. Médico pediatra

      2014-01-01

      A case is reported of a 7 year old patient with progressive dyspnea and genital development according to Marshall and Tanner criteria at the G2 VP3 stage. A mass of regular and well-defined borders was found in the chest, with calcifications and cystic areas of heterogeneous content. Basal measurements of FSH, LH and testosterone were <10 mIU/mL, 12.2 mIU/mL and 724 ng/dL, respectively. α-fetoprotein was 145.1 ng/mL. Excising the tumor improved respiratory symptoms, diminished hormone leve...

    9. Early clerkships

      NARCIS (Netherlands)

      Kamalski, Digna M. A.; Ter Braak, Edith W. M. T.; Ten Cate, Olle Th. J.; Borleffs, Jan C. C.

      2007-01-01

      Background: Early clinical experience is being introduced in innovative, vertically integrated undergraduate medical curricula. While in many cases, this early clinical experience is limited to the presence of patients during lectures, in Utrecht students gain 'hands on' experience of daily clinical

    10. Adolf naef (1883-1949): on foundational concepts and principles of systematic morphology.

      Science.gov (United States)

      Rieppel, Olivier; Williams, David M; Ebach, Malte C

      2013-01-01

      During the early twentieth century, the Swiss Zoologist Adolf Naef (1883-1949) established himself as a leader in German comparative anatomy and higher level systematics. He is generally labeled an 'idealistic morphologist', although he himself called his research program 'systematic morphology'. The idealistic morphology that flourished in German biology during the first half of the twentieth century was a rather heterogeneous movement, within which Adolf Naef worked out a special theoretical system of his own. Following a biographical sketch, we present an English translation of a previously unpublished typescript from Naef's estate, which Naef intended as the introduction to a textbook on Comparative Anatomy for which he was unable to find a publisher before his sudden death in 1949. The typescript contains Naef's mature thoughts with unprecedented conciseness, focus, and clarity. The density of Naef's text warrants a historical and contextual explication of its content.

    11. Determinantes nutricionais precoces da massa livre de gordura no início da vida adulta: revisão sistemática da literatura Determinantes nutricionales tempranos de la masa libre de grasa en el comienzo de la edad adulta: una revisión sistemática de la literatura Early nutritional determinants of fat-free mass in early adulthood: a systematic review

      Directory of Open Access Journals (Sweden)

      Maria Cecilia Formoso Assunção

      2013-04-01

      edades posteriores. Los estudios muestran que cuanto mayor es el peso al nacer y se gana peso durante los primeros años de vida, mayor será la masa libre de grasa en la vida adulta. Sin embargo, los datos disponibles son pocos e inconclusos en relación con la alimentación en los primeros años de vida como predictor de la masa libre de grasa en edades posteriores.Early childhood nutritional factors can play a crucial role in the development of body composition in later phases of life. A systematic literature review was conducted to identify studies on the association between early nutritional determinants and fat-free mass in adulthood. The PubMed and Virtual Health Library electronic databases were used. Nine articles were included after a peer review of the 576 references initially found, published from 2003 to 2009, with healthy subjects and longitudinal analysis. Birth weight and birth length and variations across childhood were strong predictors of fat-free mass at later ages. The studies showed that higher birth weight and greater weight gain in early childhood were associated with greater fat-free mass in adulthood. However, the available data are limited and inconclusive in relation to eating in early childhood as a predictor of fat-free mass at later ages.

    12. Prenatal diagnosis of isolated right pulmonary agenesis using sonography alone: case study and systematic literature review.

      Science.gov (United States)

      Meller, Cesar H; Morris, R Katie; Desai, Tarak; Kilby, Mark D

      2012-12-01

      Pulmonary agenesis is a rare congenital anomaly, estimated to complicate around 1 per 15,000 pregnancies, in which there is complete absence or severe hypoplasia of one or both lungs, frequently associated with other abnormalities. A prospective prenatal diagnosis is a challenge, and a substantial proportion of cases are diagnosed by fetal magnetic resonance imaging, postnatal computed tomography, or postmortem. Thus, there are only a few reported cases of prenatal diagnosis in the literature. We report the prenatal diagnosis of isolated right lung agenesis diagnosed with sonography alone at a relatively early gestational age. We also present a systematic review of the literature for this condition to accompany this case study.

    13. Planck 2013 results. III. LFI systematic uncertainties

      CERN Document Server

      Aghanim, N; Arnaud, M; Ashdown, M; Atrio-Barandela, F; Aumont, J; Baccigalupi, C; Banday, A J; Barreiro, R B; Battaner, E; Benabed, K; Benoît, A; Benoit-Lévy, A; Bernard, J -P; Bersanelli, M; Bielewicz, P; Bobin, J; Bock, J J; Bonaldi, A; Bonavera, L; Bond, J R; Borrill, J; Bouchet, F R; Bridges, M; Bucher, M; Burigana, C; Butler, R C; Cardoso, J -F; Catalano, A; Chamballu, A; Chiang, L -Y; Christensen, P R; Church, S; Colombi, S; Colombo, L P L; Crill, B P; Cruz, M; Curto, A; Cuttaia, F; Danese, L; Davies, R D; Davis, R J; de Bernardis, P; de Rosa, A; de Zotti, G; Delabrouille, J; Dick, J; Dickinson, C; Diego, J M; Dole, H; Donzelli, S; Doré, O; Douspis, M; Dupac, X; Efstathiou, G; Enßlin, T A; Eriksen, H K; Finelli, F; Forni, O; Frailis, M; Franceschi, E; Gaier, T C; Galeotta, S; Ganga, K; Giard, M; Giraud-Héraud, Y; Gjerløw, E; González-Nuevo, J; Górski, K M; Gratton, S; Gregorio, A; Gruppuso, A; Hansen, F K; Hanson, D; Harrison, D; Henrot-Versillé, S; Hernández-Monteagudo, C; Herranz, D; Hildebrandt, S R; Hivon, E; Hobson, M; Holmes, W A; Hornstrup, A; Hovest, W; Huffenberger, K M; Jaffe, T R; Jaffe, A H; Jewell, J; Jones, W C; Juvela, M; Kangaslahti, P; Keihänen, E; Keskitalo, R; Kiiveri, K; Kisner, T S; Knoche, J; Knox, L; Kunz, M; Kurki-Suonio, H; Lagache, G; Lähteenmäki, A; Lamarre, J -M; Lasenby, A; Laureijs, R J; Lawrence, C R; Leahy, J P; Leonardi, R; Lesgourgues, J; Liguori, M; Lilje, P B; Lindholm, V; Linden-Vørnle, M; López-Caniego, M; Lubin, P M; Macías-Pérez, J F; Maino, D; Mandolesi, N; Maris, M; Marshall, D J; Martin, P G; Martínez-González, E; Masi, S; Matarrese, S; Matthai, F; Mazzotta, P; Meinhold, P R; Melchiorri, A; Mendes, L; Mennella, A; Migliaccio, M; Mitra, S; Moneti, A; Montier, L; Morgante, G; Mortlock, D; Moss, A; Munshi, D; Naselsky, P; Natoli, P; Netterfield, C B; Nørgaard-Nielsen, H U; Novikov, D; Novikov, I; O'Dwyer, I J; Osborne, S; Paci, F; Pagano, L; Paladini, R; Paoletti, D; Partridge, B; Pasian, F; Patanchon, G; Pearson, D; Peel, M; Perdereau, O; Perotto, L; Perrotta, F; Pierpaoli, E; Pietrobon, D; Plaszczynski, S; Platania, P; Pointecouteau, E; Polenta, G; Ponthieu, N; Popa, L; Poutanen, T; Pratt, G W; Prézeau, G; Prunet, S; Puget, J -L; Rachen, J P; Rebolo, R; Reinecke, M; Remazeilles, M; Ricciardi, S; Riller, T; Rocha, G; Rosset, C; Rossetti, M; Roudier, G; Rubiño-Martín, J A; Rusholme, B; Sandri, M; Santos, D; Scott, D; Seiffert, M D; Shellard, E P S; Spencer, L D; Starck, J -L; Stolyarov, V; Stompor, R; Sureau, F; Sutton, D; Suur-Uski, A -S; Sygnet, J -F; Tauber, J A; Tavagnacco, D; Terenzi, L; Toffolatti, L; Tomasi, M; Tristram, M; Tucci, M; Tuovinen, J; Türler, M; Umana, G; Valenziano, L; Valiviita, J; Van Tent, B; Varis, J; Vielva, P; Villa, F; Vittorio, N; Wade, L A; Wandelt, B D; Watson, R; Wilkinson, A; Yvon, D; Zacchei, A; Zonca, A

      2014-01-01

      We present the current estimate of instrumental and systematic effect uncertainties for the Planck-Low Frequency Instrument relevant to the first release of the Planck cosmological results. We give an overview of the main effects and of the tools and methods applied to assess residuals in maps and power spectra. We also present an overall budget of known systematic effect uncertainties, which are dominated sidelobe straylight pick-up and imperfect calibration. However, even these two effects are at least two orders of magnitude weaker than the cosmic microwave background (CMB) fluctuations as measured in terms of the angular temperature power spectrum. A residual signal above the noise level is present in the multipole range $\\ell<20$, most notably at 30 GHz, and is likely caused by residual Galactic straylight contamination. Current analysis aims to further reduce the level of spurious signals in the data and to improve the systematic effects modelling, in particular with respect to straylight and calibra...

    14. Systematic variations in divergence angle

      CERN Document Server

      Okabe, Takuya

      2012-01-01

      Practical methods for quantitative analysis of radial and angular coordinates of leafy organs of vascular plants are presented and applied to published phyllotactic patterns of various real systems from young leaves on a shoot tip to florets on a flower head. The constancy of divergence angle is borne out with accuracy of less than a degree. It is shown that apparent fluctuations in divergence angle are in large part systematic variations caused by the invalid assumption of a fixed center and/or by secondary deformations, while random fluctuations are of minor importance.

    15. Relationship between frontostriatal morphology and executive function deficits in bipolar I disorder following a first manic episode: data from the Systematic Treatment Optimization Program for Early Mania (STOP-EM).

      Science.gov (United States)

      Kozicky, Jan-Marie; Ha, Tae Hyon; Torres, Ivan J; Bond, David J; Honer, William G; Lam, Raymond W; Yatham, Lakshmi N

      2013-09-01

      Executive function impairments are a core feature of bipolar I disorder (BD-I), not only present during acute episodes but also persisting following remission of mood symptoms. Despite advances in knowledge regarding the neural basis of executive functions in healthy subjects, research into morphological abnormalities underlying the deficits in BD-I is lacking. Patients with BD-I within three months of sustained remission from their first manic episode (n = 41) underwent neuropsychological testing and a 3T magnetic resonance imaging scan and were compared to healthy subjects matched for age, sex, and premorbid IQ (n = 30). Group dorsolateral prefrontal cortex (DLPFC; Brodmann areas 9 and 46) and caudate volumes were examined and analyzed for relationships with the average score from three computerized tests of executive function: Spatial Working Memory, Stockings of Cambridge, and Intradimensional/Extradimensional Shift. Right caudate volumes were enlarged in patients (z = 3.57, p executive function relative to healthy subjects (d = -0.92, p executive function score, in patients, larger right (r = -0.36, p executive function impairments during remission in patients with BD-I. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

    16. The Economic Impact of Managing Late Presentation of Developmental Dysplasia of Hip (DDH

      Directory of Open Access Journals (Sweden)

      Anuar RIM

      2015-12-01

      Full Text Available Delayed presentation of Developmental Dysplasia of Hip (DDH comes with challenges in treatment as well as high surgical cost. Therefore the objective of this study is to quantify the economic impact of management of late presentation of DDH during a last 3-year period. We conducted a retrospective study with analysis of DDH cases managed between years 2012 to 2014. Early and late presentations of DDH were identified and cost management for both was estimated. Out of twenty-four DDH cases, thirteen cases fulfilled the inclusion criteria. All were female with majority of them presenting with unilateral DDH predominantly of the left hip. Most patients presented after age of six months and the principal complaint was abnormal or limping gait. The grand total cost for managing DDH during the three years period was USD 12,385.51, with 86% of the amount having been used to manage late presentation of DDH that was mostly contributed by the cost of surgery. We concluded that delayed presentation of DDH contributes heavily to high national expenditure. Early detection of DDH cases with systematic neonatal screening may help to minimize the incidence of the late presenting DDH and subsequently reduce the economic burden to the government.

    17. Develop your presentation skills

      CERN Document Server

      Theobald, Theo

      2016-01-01

      Going beyond handling nerves and presenting PowerPoint slides, the third edition of "Develop Your Presentation Skills "offers practical advice on developing a captivating presentation, constructing compelling content, and boosting self-confidence. The book includes three new chapters on delivering a "stripped down"presentation, using new media to engage with the audience, and handling being asked to present on short notice."

    18. Teaching Presentation Skills

      Science.gov (United States)

      Baker, William H.; Thompson, Michael P.

      2004-01-01

      Effective teaching of presentation skills focuses on the most important element of the presentation--the message itself. Some instructors place the heaviest emphasis on the messenger (the presenter) and focus their presentation feedback on all the presenter is doing wrong--saying "um," gesturing awkwardly, and so forth. When students receive this…

    19. Early literacy

      DEFF Research Database (Denmark)

      Jensen, Anders Skriver

      2012-01-01

      This paper discusses findings from the Danish contribution to the EASE project, a European research project running from 2008 to 2010 on early literacy in relation to the transition from childcare to school. It explores a holistic, inclusive approach to early literacy that resists a narrow...... and schools. The paper also draws on Gee’s (2001, 2003, 2004, 2008) sociocultural approach to literacy, and Honneth’s (2003, 2006) concept of recognition. Emphasizing participation and recognition as key elements, it claims that stakeholders in early liter- acy must pay attention to how diverse early literacy...... opportunities empower children, especially when these opportunities are employed in a project-based learning environ- ment in which each child is able to contribute to the shared literacy events....

    20. [Systematization of regional maternal and child health care].

      Science.gov (United States)

      Kitamura, K

      1983-08-01

      Systematization of regional maternal and child health care is discussed. At present regional maternal and child health care is mainly carried out by public health nurses, midwives, and maternal/child health promotor volunteers. Administrative measures taken so far in connection with maternal and child care are: early notification of pregnancy, issuance of mother/child health memo book, frequent check-ups during pregnancy, expectant mothers' education, baby check-ups, inoculation, and a special care of premature babies. 2 models for the systematization are proposed. According to the 1st model, a public health nurse starts to function whenever one or more of the following occurs. Birth registration and request for counseling from a nursing mother have been filed at the public health office. The notice of release of a nursing mother and request for home visiting from the medical institution arrive. Maternal and child health promotors advise guidance through home visiting. Midwives will play an important role among the patients with postpartum complications. Another model emphasizes the importance of the patient's continuing relationship with the medical institution where the birth took place. A midwife and a public health nurse interested in regional maternal and child care will be placed in the medical institution to engage in home visiting after the release of the patients. In addition to the usual 1 month baby check-up, one at 2 weeks is given for the benefit of nursing mothers. Regional public health nurses concentrate on the care of high risk patients, premarital pregnancy, and family planning. As systematization progresses, it becomes necessary to have a liason department of obstetrics and an information exchange system to achieve better communication between medical institutions and an administrative body.

    1. Systematic unenhanced CT for acute abdominal symptoms in the elderly patients improves both emergency department diagnosis and prompt clinical management

      Energy Technology Data Exchange (ETDEWEB)

      Millet, Ingrid; Pages-Bouic, Emma; Curros-Doyon, Fernanda; Taourel, Patrice [CHU Lapeyronie, Department of Medical Imaging, Montpellier Cedex 5 (France); Sebbane, Mustapha [Department of Emergency Medicine, CHU Lapeyronie, Montpellier (France); Molinari, Nicolas [Department of Medical Information and Statistics, CHU Montpellier (France); Riou, Bruno [GH Pitie-Salpetriere, APHP, Department of Emergency Medicine and Surgery, Paris (France)

      2017-02-15

      To assess the added-value of systematic