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Sample records for general adaptation syndrome

  1. [Hemodynamics, the autonomic nervous system and water metabolism as criteria for developing the general adaptation syndrome in pregnant women].

    Science.gov (United States)

    Gur'ianov, V A; Shepetovskaia, N L; Pivovarova, G M; Tolmachev, G N; Volodin, A V

    2007-01-01

    By taking into account the fact that the autonomic nervous and cardiovascular systems (ANS and CVS) are the major links of development of the general adaptation syndrome in pregnancy, which are affected by all the processes involved in the development of the syndrome, the author analyzed the state of these systems in healthy non-pregnant and pregnant women (HNPW and HPW) and in pregnant women with gestosis. HNPW were found to have already a prerequisite for impairing pregnancy adaptive processes as ANS and CVS dysfunction. In HPW, these impairments were more pronounced. In the pregnant women, impaired adaptive processes manifested themselves as excess sympathicotonia in 72% and parasympathicotonia in 23% of cases despite the treatment performed, which was accompanied by hypokinetic hemodynamics in 53 and 50%, respectively. In hyper- and eukinetic hemodynamics, there were no physiologically required decreases in total peripheral vascular resistance while in hypokinetic hemodynamics, there was its pathological increase. Such disorders enhance the significance of abdominal compartment syndrome, aortocaval compression, ischemia-reperfusion, hydrodynamic and membranogenic (capillary leakage) factors of impaired water metabolism, which contributes to adaptation derangement. Based on the findings, the authors have created a developmental modulation algorithm for the general adaptation syndrome by completed pregnancy and surgical delivery.

  2. [Postvagotomy adaptation syndrome].

    Science.gov (United States)

    Shapovalov, V A

    1998-01-01

    It was established in experiment, that the changes of the natural resistance of organism indexes and of the peritoneal cavity cytology has compensatory-adaptational character while the denervation-adaptational syndrome occurrence and progress, which may be assessed as eustress. Vagotomy and operative trauma cause qualitatively different reactions of an organism.

  3. Climateric: fatigue or third stage of the general adaptation syndrome Climaterio: fatiga o tercera etapa del síndrome de adaptación general

    OpenAIRE

    William Alvarez Gaviria

    2004-01-01

    The origin of climacteric has been subject of debate. Most opinions agree in that it arises exclusively from natural selection. In this paper the author argues that, besides this reason there is another, even more important; for him, climacteric is the final response to fatigue or the third stage of the general adaptation syndrome, just as in elderly people there is a loss of the capacity of proliferation of fibroblasts and lack of response to insulin. From a genetic point of view, this corre...

  4. Climateric: fatigue or third stage of the general adaptation syndrome Climaterio: fatiga o tercera etapa del síndrome de adaptación general

    Directory of Open Access Journals (Sweden)

    William Alvarez Gaviria

    2004-09-01

    Full Text Available The origin of climacteric has been subject of debate. Most opinions agree in that it arises exclusively from natural selection. In this paper the author argues that, besides this reason there is another, even more important; for him, climacteric is the final response to fatigue or the third stage of the general adaptation syndrome, just as in elderly people there is a loss of the capacity of proliferation of fibroblasts and lack of response to insulin. From a genetic point of view, this corresponds to an antagonic pleiotropy: the genetic program that has made the human adrenergic and corticotropic systems hyperactive, has also caused that they do not reach senescence intact. High concentrations of stress hormones during youth and adulthood in humans, as compared to chimpanzees, gorillas and orangutans, and the hormonal cascade reactions elicited by them are meaningfully related to our most conspicuous illnesses, our genotype/phenotype and, in the long term, with climacteric. Se ha conjeturado a menudo sobre las razones del climaterio y la mayoría de los autores sostiene que es un fenómeno que surge exclusivamente de la selección natural. Aquí asumimos que, aunque esa sea parte de la explicación, no es la razón primordial. Así como con la edad se da la pérdida, por ejemplo, de la capacidad proliferativa de los fibroblastos y de la sensibilidad a la insulina, el climaterio podría corresponder no más que a la fatiga o tercera etapa del Síndrome de Adaptación General. En un enfoque genético correspondería, pues, a una pleiotropía antagónica: el programa genético que ha hecho hiperactivos a los sistemas adrenérgico y corticotrópico del ser humano, evitaría también que llegara incólume al punto final de senescencia. Las altas concentraciones de hormonas de estrés en la juventud y la edad adulta que distinguen a nuestra especie, comparada con el chimpancé, el gorila y el orangután, y las reacciones hormonales en cascada que

  5. Intestinal adaptation in short bowel syndrome

    NARCIS (Netherlands)

    Welters, C.F.M.; Dejong, C.H.C.; Deutz, N.E.P.; Heineman, E.

    2002-01-01

    Intestinal adaptation in short bowel syndrome. Welters CF, Dejong CH, Deutz NE, Heineman E. Department of Surgery, Academic Hospital and University of Maastricht, The Netherlands. Regaining enteral autonomy after extensive small bowel resection is dependent on intestinal adaptation. This adaptationa

  6. Generalized Adaptive Artificial Neural Networks

    Science.gov (United States)

    Tawel, Raoul

    1993-01-01

    Mathematical model of supervised learning by artificial neural network provides for simultaneous adjustments of both temperatures of neurons and synaptic weights, and includes feedback as well as feedforward synaptic connections. Extension of mathematical model described in "Adaptive Neurons For Artificial Neural Networks" (NPO-17803). Dynamics of neural network represented in new model by less-restrictive continuous formalism.

  7. ADAPTIVE GENERALIZED PREDICTIVE CONTROL OF SWITCHED SYSTEMS

    Institute of Scientific and Technical Information of China (English)

    WANG Yi-jing; WANG Long

    2005-01-01

    The problem of adaptive generalized predictive control which consists of output prediction errors for a class of switched systems is studied. The switching law is determined by the output predictive errors of a finite number of subsystems. For the single subsystem and multiple subsystems cases, it is proved that the given direct algorithm of generalized predictive control guarantees the global convergence of the system. This algorithm overcomes the inherent drawbacks of the slow convergence and large transient errors for the conventional adaptive control.

  8. Rapid, generalized adaptation to asynchronous audiovisual speech.

    Science.gov (United States)

    Van der Burg, Erik; Goodbourn, Patrick T

    2015-04-01

    The brain is adaptive. The speed of propagation through air, and of low-level sensory processing, differs markedly between auditory and visual stimuli; yet the brain can adapt to compensate for the resulting cross-modal delays. Studies investigating temporal recalibration to audiovisual speech have used prolonged adaptation procedures, suggesting that adaptation is sluggish. Here, we show that adaptation to asynchronous audiovisual speech occurs rapidly. Participants viewed a brief clip of an actor pronouncing a single syllable. The voice was either advanced or delayed relative to the corresponding lip movements, and participants were asked to make a synchrony judgement. Although we did not use an explicit adaptation procedure, we demonstrate rapid recalibration based on a single audiovisual event. We find that the point of subjective simultaneity on each trial is highly contingent upon the modality order of the preceding trial. We find compelling evidence that rapid recalibration generalizes across different stimuli, and different actors. Finally, we demonstrate that rapid recalibration occurs even when auditory and visual events clearly belong to different actors. These results suggest that rapid temporal recalibration to audiovisual speech is primarily mediated by basic temporal factors, rather than higher-order factors such as perceived simultaneity and source identity.

  9. Instructional Accommodations for Students with Asperger Syndrome in the General High School Classroom

    Science.gov (United States)

    Baylis, Myrna

    2011-01-01

    General education teachers in the secondary sector are held responsible for adapting their lessons and classroom environment for students with Asperger Syndrome. With the growing number of students with Autism Spectrum Disorder being placed in general education classrooms, teachers are faced with yet another challenge in making their curriculum…

  10. Longitudinal profiles of adaptive behavior in fragile X syndrome.

    Science.gov (United States)

    Klaiman, Cheryl; Quintin, Eve-Marie; Jo, Booil; Lightbody, Amy A; Hazlett, Heather Cody; Piven, Joseph; Hall, Scott S; Chromik, Lindsay C; Reiss, Allan L

    2014-08-01

    To examine longitudinally the adaptive behavior patterns in fragile X syndrome. Caregivers of 275 children and adolescents with fragile X syndrome and 225 typically developing children and adolescents (2-18 years) were interviewed with the Vineland Adaptive Behavior Scales every 2 to 4 years as part of a prospective longitudinal study. Standard scores of adaptive behavior in people with fragile X syndrome are marked by a significant decline over time in all domains for males and in communication for females. Socialization skills are a relative strength as compared with the other domains for males with fragile X syndrome. Females with fragile X syndrome did not show a discernible pattern of developmental strengths and weaknesses. This is the first large-scale longitudinal study to show that the acquisition of adaptive behavior slows as individuals with fragile X syndrome age. It is imperative to ensure that assessments of adaptive behavior skills are part of intervention programs focusing on childhood and adolescence in this condition. Copyright © 2014 by the American Academy of Pediatrics.

  11. General Information about Mycosis Fungoides and the Sezary Syndrome

    Science.gov (United States)

    ... Childhood Hodgkin Lymphoma Treatment Childhood NHL Treatment Research Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)–Patient Version General Information About Mycosis Fungoides and the Sézary Syndrome Go to Health ...

  12. Generalized Anxiety and Major Depressive syndrome ...

    Science.gov (United States)

    Objective: Environmental exposure to manganese (Mn) may cause generalized anxiety (GA) and major depression (MD) in residents living in Mn-exposed areas. Marietta and East Liverpool are two Ohio towns identified as having elevated levels of Mn. The objective was to determine if levels of Mn exposure were associated with levels of GA and MD.Participants and methods: 186 participants (Mean age: 55.0 ± 10.80) were examined. Levels of air-Mn were assessed over a period of ten years using U.S. EPA’s AERMOD dispersion model. Average air-Mn exposure was 0.53 μg/m3 in the two towns. The GA syndrome was comprised of anxiety, obsessive-compulsive, and phobic scales from the Symptom Checklist (SCL-90-R). The MD syndrome was comprised of depression, anxiety, and psychoticism scales also from the SCL-90-R. Linear regression models were used to determine the relationship between Mn and GA, MD and the specific components of each.Results: Elevated air-Mn was associated with GA (β= 0.240, p=0.002), and MD (β= 0.202, p=0.011). Air-Mn was associated with specific components of GA anxiety (β= 0.255, p=0.001), phobic anxiety (β= 0.159, p=0.046), and obsessive-compulsive (β= 0.197, p=0.013). Similarly, components of MD syndrome suggested an association as well: depression (β= 0.180, p=0.023), anxiety (β= 0.255, p=0.001), and psychoticism (β= 0.188, p=0.018). Conclusions: The results suggest that residents with elevated exposure to environmental Mn have elevated levels of

  13. Intestinal adaptation in short bowel syndrome: A case report.

    Science.gov (United States)

    Palla, Viktoria-Varvara; Karaolanis, Georgios; Pentazos, Panagiotis; Ladopoulos, Alexios; Papageorgiou, Evaggelos

    2015-06-01

    Short bowel syndrome is a clinical entity that includes loss of energy, fluid, electrolytes or micronutrient balance because of inadequate functional intestinal length. This case report demonstrates the case of a woman who compensated for short bowel syndrome through intestinal adaptation, which is a complex process worthy of further investigation for the avoidance of dependence on total parenteral nutrition and of intestinal transplantation in such patients.

  14. Adolescent adaptive behavior profiles in Williams–Beuren syndrome, Down syndrome, and autism spectrum disorder

    OpenAIRE

    Del Cole, Carolina Grego; Caetano, Sheila Cavalcante; Ribeiro, Wagner; Kümmer, Arthur Melo E. e.; Jackowski,Andrea Parolin

    2017-01-01

    Background Adaptive behavior can be impaired in different neurodevelopmental disorders and may be influenced by confounding factors, such as intelligence quotient (IQ) and socioeconomic classification. Our main objective was to verify whether adaptive behavior profiles differ in three conditions—Williams Beuren syndrome (WBS), Down syndrome (DS), and autism spectrum disorder (ASD), as compared with healthy controls (HC) and with each other. Although the literature points towards each disorder...

  15. Cardiac involvement in total generalized lipodystrophy (Berardinelli- Seip syndrome

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    Viégas Ruy Felipe Melo

    2000-01-01

    Full Text Available Total generalized lipodystrophy (Berardinelli--Seip Syndrome is a rare hereditary disease characterized by insulin-resistant diabetes mellitus and a small quantity of adipose tissue and is of unknown origin. Common cardiovascular alterations related to this syndrome are cardiac hypertrophy and arterial hypertension. This article reports a case of Berardinelli--Seip syndrome and reviews the literature with special emphasis on the cardiovascular manifestations of this syndrome.

  16. Anomalous brain functional connectivity contributing to poor adaptive behavior in Down syndrome.

    Science.gov (United States)

    Pujol, Jesus; del Hoyo, Laura; Blanco-Hinojo, Laura; de Sola, Susana; Macià, Dídac; Martínez-Vilavella, Gerard; Amor, Marta; Deus, Joan; Rodríguez, Joan; Farré, Magí; Dierssen, Mara; de la Torre, Rafael

    2015-03-01

    Research in Down syndrome has substantially progressed in the understanding of the effect of gene overexpression at the molecular level, but there is a paucity of information on the ultimate consequences on overall brain functional organization. We have assessed the brain functional status in Down syndrome using functional connectivity MRI. Resting-state whole-brain connectivity degree maps were generated in 20 Down syndrome individuals and 20 control subjects to identify sites showing anomalous synchrony with other areas. A subsequent region-of-interest mapping served to detail the anomalies and to assess their potential contribution to poor adaptive behavior. Down syndrome individuals showed higher regional connectivity in a ventral brain system involving the amygdala/anterior temporal region and the ventral aspect of both the anterior cingulate and frontal cortices. By contrast, lower functional connectivity was identified in dorsal executive networks involving dorsal prefrontal and anterior cingulate cortices and posterior insula. Both functional connectivity increases and decreases contributed to account for patient scoring on adaptive behavior related to communication skills. The data overall suggest a distinctive functional organization with system-specific anomalies associated with reduced adaptive efficiency. Opposite effects were identified on distinct frontal and anterior temporal structures and relative sparing of posterior brain areas, which is generally consistent with Down syndrome cognitive profile. Relevantly, measurable connectivity changes, as a marker of the brain functional anomaly, could have a role in the development of therapeutic strategies addressed to improve the quality of life in Down syndrome individuals.

  17. Plasticity-rigidity cycles: A general adaptation mechanism

    OpenAIRE

    Csermely, Peter

    2015-01-01

    Successful adaptation helped the emergence of complexity. Alternating plastic- and rigid-like states were recurrently considered to play a role in adaptive processes. However, this extensive knowledge remained fragmented. In this paper I describe plasticity-rigidity cycles as a general adaptation mechanism operating in molecular assemblies, assisted protein folding, cellular differentiation, learning, memory formation, creative thinking, as well as the organization of social groups and ecosys...

  18. General Intelligence as a Domain-Specific Adaptation

    Science.gov (United States)

    Kanazawa, Satoshi

    2004-01-01

    General intelligence (g) poses a problem for evolutionary psychology's modular view of the human brain. The author advances a new evolutionary psychological theory of the evolution of general intelligence and argues that general intelligence evolved as a domain-specific adaptation for the originally limited sphere of evolutionary novelty in the…

  19. Greater Trochanteric Pain Syndrome in general Practice

    NARCIS (Netherlands)

    A. Brinks (Tineke)

    2011-01-01

    textabstractThis thesis focuses on patients with greater trochanteric pain syndrome. These patients suffer from local pain at the lateral side of the hip. The syndrome is characterized by chronic intermittent or continuous pain at and around the greater trochanter, sometimes radiating to the lateral

  20. Dual adaptation and adaptive generalization of the human vestibulo-ocular reflex

    Science.gov (United States)

    Welch, R. B.; Bridgeman, B.; Williams, J. A.; Semmler, R.

    1998-01-01

    In two experiments, we examined the possibility that the human vestibulo-ocular reflex (VOR) is subject to dual adaptation (the ability to adapt to a sensory rearrangement more rapidly and/or more completely after repeated experience with it) and adaptive generalization (the ability to adapt more readily to a novel sensory rearrangement as a result of prior dual adaptation training). In Experiment 1, the subjects actively turned the head during alternating exposure to a visual-vestibular rearrangement (target/head gain = 0.5) and the normal situation (target/head gain = 0.0). These conditions produced both adaptation and dual adaptation of the VOR but no evidence of adaptive generalization when tested with a target/head gain of 1.0. Experiment 2, in which exposure to the 0.5 gain entailed externally controlled (i.e., passive) whole body rotation, resulted in VOR adaptation but no dual adaptation. As in Experiment 1, no evidence of adaptive generalization was found.

  1. Polycystic ovary syndrome: a transgenerational evolutionary adaptation.

    Science.gov (United States)

    Shaw, L M A; Elton, S

    2008-01-01

    Polycystic ovary syndrome has a common association with anovulatory infertility, while the physical symptoms are often associated with the increased androgens that are part of the endocrine profile. There is a well-recognised association with lipid and glucose metabolism anomalies and, when undergoing ovulation induction, ovarian hyperstimulation syndrome. This common condition is familial, but a contributory gene has yet to be found. The question of why a gene that predisposes to anovulation, diabetes and heart disease might have perpetuated so frequently is addressed. Three hypotheses for evolutionary advantage are discussed. The food deprivation hypothesis considers the role of the observed increase in ovulation when women with the condition lose weight in relation to seasonality. The refeeding hypothesis considers the androgenic and slightly enhanced anabolic metabolism in relation to periods of privation and the advantage of preferential early ovulation when refeeding after a period of privation. The transgenerational privation hypothesis considers the effect of persistent, severe, yet subfatal privation on individuals both in utero and throughout life. While an androgenic, anabolic state would improve efficiency in the use of food for protein synthesis and fat storage, benefiting the fetus both in relation to its in utero development and neonatal survival, survival and reproductive capacity as an adult benefits by a genotype expressing itself in women of successive generations.

  2. OPPORTUNITIES FOR PSYCHO-MOTOR SKILLS DEVELOPMENT IN CHILDREN WITH DOWN SYNDROME - ADAPTED SWIMMING -

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    Chera-Ferrario B.

    2012-12-01

    Full Text Available Sport activities have a beneficial effect on the mind and body of any type of person. The benefits of sport are even more evident in children with Down Syndrome, who exhibit a general delay in neuro-motor structures. Our aim was to develop the psycho-motor skills in children with Down Syndrome through adapted swimming exercises. We believe that our involvement in adapted swimming for children with Down Syndrome may help develop certain aspects of psycho-motor abilities. The swimming took place with 6 Down Syndrome children from the Special Needs School in Targoviste, for a period of six months and the children being assisted by volunteer students from the Valahia University Department of Sport in Targoviste.The most important result was the children's delight in coming to the pool and taking part in the swimming lessons. Through the methods and exercises used and the devoted involvement of the volunteers, the children developed great levels of trust and courage and learned to swim using only aids. After performing motor skill tests on the children, we observed a general growth in the motor skills monitored.Continuation of the adapted swimming is very important in order to mobilize the skills obtained and continue development of psycho-motor abilities.

  3. Synchronization of generalized Henon map by using adaptive fuzzy controller

    CERN Document Server

    Xue Yue Ju

    2003-01-01

    In this paper, an adaptive fuzzy control method is presented to synchronize model-unknown discrete-time generalized Henon map. The proposed method is robust to approximate errors and disturbances, because it integrates the merits of adaptive fuzzy and the variable structure control. Moreover, it can realize the synchronizations of non-identical chaotic systems. The simulation results of synchronization of generalized Henon map show that it not only can synchronize model-unknown generalized Henon map but also is robust against the noise of the systems. These merits are advantageous for engineering realization.

  4. Intellectual and Adaptive Functioning in Sturge-Weber Syndrome

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    Kavanaugh, Brian; Sreenivasan, Aditya; Bachur, Catherine; Papazoglou, Aimilia; Comi, Anne; Zabel, T. Andrew

    2015-01-01

    The present study examined the intellectual and adaptive functioning in a sample of children and young adults with Sturge-Weber Syndrome. A total of 80 research participants from a SWS study database underwent full neurological evaluation as part of their participation or concurrent medical care. Twenty-nine of the participants received neuropsychological evaluations. Analyses indicated no significant demographic or neurological differences between those who did and did not receive neuropsychological evaluations. Overall, the neuropsychological evaluation sample displayed significantly lower functioning relative to published normative data across domains of intellectual and adaptive functioning. 32% of the sample displayed impaired performance (standard score ≤ 75) in intellectual functioning and 58% displayed impaired performance in adaptive functioning. Hemiparesis status independently predicted overall adaptive functioning while seizure frequency independently predicted overall intellectual functioning. Younger participants displayed significantly higher (more intact) ratings in adaptive functioning compared to older participants, specifically in overall adaptive functioning, motor skills, and community living skills. A composite measure of neurological status (SWS-NRS) incorporating seizure and hemiparesis status effectively distinguished between individuals with impaired or non-impaired adaptive and intellectual functioning, and showed promise as a screening method for identifying individuals with more involved intellectual and/or adaptive needs. PMID:25952468

  5. [Effect of vitamin sufficiency on adaptation syndrome in growing rats].

    Science.gov (United States)

    Sidorova, Iu S; Beketova, N A; Vrzhesinskaia, O A; Kodentsova, V M; Kosheleva, O V; Zorin, S N; Selifanov, A V; Mazo, V K

    2014-01-01

    The influence of vitamin supply of growing male -Wistar rats (n=21) with an initial body weight 53,5±0,9 g on their resistance to a single distress induced by the electric shock has been investigated. Control rats within 21 days received a complete semisynthetic diet,providingadequate amounts of vitamins. Combined vitamin deficiency in experimental rats was caused by 5-fold decrease of vitamin mixture amount in the feed and the total vitamin E exclusion from the mixture. On the 21st day, one day before the end of the experiment, both groups of rats were subjected to stress impact (electrocutaneous irritation on paws, 0,4 mA for 8 sec) and then animals were placed in metabolic cages to collect urine. By the end of the experiment, the animals with the combined vitamin deficiency lag behind in growth. Vitamin B2, A, B1 and E liver content decreased in experimental rats by 1,6, 2,3, 4,4 and 15 fold accordingly. Retinol plasma concentration was significantly reduced by 18%, α-tocopherol level - by 5 fold, urinary excretionof riboflavin and 4-pyridoxic acid (vitamin B6 metabolite) was significantly reduced by 6,5 and 2,46 times accordingly. MDA blood plasma concentration and the urinary ratio of oxidized and not oxidized form of 8-hydroxy-2'-deoxy-guanosine did not differ in both groups of rats. Urinary excretion of stress biomarker corticosterone in rats with combined vitamin deficit was 2,5-fold higher than in control rats. Thus, reducing of vitamins supply resulted in an increase of urine corticosterone in stressed rats, that characterized the intensity of general adaptation syndrome. This fact shows the importance of optimal sufficiency with vitamins in nonspecific (general) resistance to stress.

  6. Synchronization of general complex networks via adaptive control schemes

    Indian Academy of Sciences (India)

    Ping He; Chun-Guo Jing; Chang-Zhong Chen; Tao Fan; Hassan Saberi Nik

    2014-03-01

    In this paper, the synchronization problem of general complex networks is investigated by using adaptive control schemes. Time-delay coupling, derivative coupling, nonlinear coupling etc. exist universally in real-world complex networks. The adaptive synchronization scheme is designed for the complex network with multiple class of coupling terms. A criterion guaranteeing synchronization of such complex networks is established by employing the Lyapunov stability theorem and adaptive control schemes. Finally, an illustrative example with numerical simulation is given to show the feasibility and efficiency of theoretical results.

  7. Cognitive and adaptive behavior profiles of children with Angelman syndrome.

    Science.gov (United States)

    Peters, Sarika U; Goddard-Finegold, Jan; Beaudet, Arthur L; Madduri, Niru; Turcich, Marie; Bacino, Carlos A

    2004-07-15

    Angelman syndrome (AS) is a neurodevelopmental disorder caused by maternal deficiency of the UBE3A gene that encodes E6-AP ubiquitin-protein ligase. Expression of the UBE3A gene from the maternal chromosome is essential to prevent AS. AS is characterized by severe mental retardation, ataxia, and a defined behavioral pattern characterized mainly by happy/sociable disposition. This study used the Bayley Scales of Infant Development and the Vineland Adaptive Behavior Scales to examine the cognitive abilities and adaptive behavior of children (n = 20) with the four known molecular classes of AS, including patterns of strengths and weaknesses across adaptive behavior domains, and the relationship between adaptive behavior and overall cognitive abilities. Cognitive skills fell within the severe to profound range of mental deficiency. Differences in cognitive skills according to genetic subtype only partially supported previous research and suggest that there is overlap in abilities across genetic subtypes of AS. Adaptive behavior skills were also significantly delayed, with participants demonstrating a significant strength in socialization, and a weakness in motor skills. Strong, positive correlations emerge between cognitive ability scores and adaptive behaviors scores. These results provide further delineation of a cognitive/behavioral phenotype in AS.

  8. The Development of Adaptive Skills in Young People with Down Syndrome

    Science.gov (United States)

    Van Duijn, G.; Dijkxhoorn, Y.; Scholte, E. M.; Van Berckelaer-Onnes, I. A.

    2010-01-01

    Background: To help children with Down syndrome reach optimum levels of adaptive behaviour, caretakers need to know how and to what extent children with Down syndrome acquire adaptive skills. Method: The adaptive levels of motor, daily living, communicative and social behavioural skills were determined in a group of 984 Dutch children with Down…

  9. The Development of Adaptive Skills in Young People with Down Syndrome

    Science.gov (United States)

    Van Duijn, G.; Dijkxhoorn, Y.; Scholte, E. M.; Van Berckelaer-Onnes, I. A.

    2010-01-01

    Background: To help children with Down syndrome reach optimum levels of adaptive behaviour, caretakers need to know how and to what extent children with Down syndrome acquire adaptive skills. Method: The adaptive levels of motor, daily living, communicative and social behavioural skills were determined in a group of 984 Dutch children with Down…

  10. On Self-Adaptive Method for General Mixed Variational Inequalities

    Directory of Open Access Journals (Sweden)

    Abdellah Bnouhachem

    2008-01-01

    Full Text Available We suggest and analyze a new self-adaptive method for solving general mixed variational inequalities, which can be viewed as an improvement of the method of (Noor 2003. Global convergence of the new method is proved under the same assumptions as Noor's method. Some preliminary computational results are given to illustrate the efficiency of the proposed method. Since the general mixed variational inequalities include general variational inequalities, quasivariational inequalities, and nonlinear (implicit complementarity problems as special cases, results proved in this paper continue to hold for these problems.

  11. Adaptive generalized functional synchronization of Chaotic systems with unknown parameters

    Institute of Scientific and Technical Information of China (English)

    Wang Dong-Feng; Han Pu

    2008-01-01

    A universal adaptive generalized functional synchronization approach to any two different or identical chaotic systems with unknown parameters is proposed,based on a unified mathematical expression of a large class of chaotic system.Self-adaptive parameter law and control law are given in the form of a theorem.The synchronization between the three-dimensional R(o)ssler chaotic system and the four-dimensional Chen's hyper-chaotic system is studied as an example for illustration.The computer simulation results demonstrate the feasibility of the method proposed.

  12. Adaptive quasi-likelihood estimate in generalized linear models

    Institute of Scientific and Technical Information of China (English)

    CHEN Xia; CHEN Xiru

    2005-01-01

    This paper gives a thorough theoretical treatment on the adaptive quasilikelihood estimate of the parameters in the generalized linear models. The unknown covariance matrix of the response variable is estimated by the sample. It is shown that the adaptive estimator defined in this paper is asymptotically most efficient in the sense that it is asymptotic normal, and the covariance matrix of the limit distribution coincides with the one for the quasi-likelihood estimator for the case that the covariance matrix of the response variable is completely known.

  13. Generalization in adaptation to stable and unstable dynamics.

    Directory of Open Access Journals (Sweden)

    Abdelhamid Kadiallah

    Full Text Available Humans skillfully manipulate objects and tools despite the inherent instability. In order to succeed at these tasks, the sensorimotor control system must build an internal representation of both the force and mechanical impedance. As it is not practical to either learn or store motor commands for every possible future action, the sensorimotor control system generalizes a control strategy for a range of movements based on learning performed over a set of movements. Here, we introduce a computational model for this learning and generalization, which specifies how to learn feedforward muscle activity in a function of the state space. Specifically, by incorporating co-activation as a function of error into the feedback command, we are able to derive an algorithm from a gradient descent minimization of motion error and effort, subject to maintaining a stability margin. This algorithm can be used to learn to coordinate any of a variety of motor primitives such as force fields, muscle synergies, physical models or artificial neural networks. This model for human learning and generalization is able to adapt to both stable and unstable dynamics, and provides a controller for generating efficient adaptive motor behavior in robots. Simulation results exhibit predictions consistent with all experiments on learning of novel dynamics requiring adaptation of force and impedance, and enable us to re-examine some of the previous interpretations of experiments on generalization.

  14. Extended generalized Lagrangian multipliers for magnetohydrodynamics using adaptive multiresolution methods

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    Domingues M. O.

    2013-12-01

    Full Text Available We present a new adaptive multiresoltion method for the numerical simulation of ideal magnetohydrodynamics. The governing equations, i.e., the compressible Euler equations coupled with the Maxwell equations are discretized using a finite volume scheme on a two-dimensional Cartesian mesh. Adaptivity in space is obtained via Harten’s cell average multiresolution analysis, which allows the reliable introduction of a locally refined mesh while controlling the error. The explicit time discretization uses a compact Runge–Kutta method for local time stepping and an embedded Runge-Kutta scheme for automatic time step control. An extended generalized Lagrangian multiplier approach with the mixed hyperbolic-parabolic correction type is used to control the incompressibility of the magnetic field. Applications to a two-dimensional problem illustrate the properties of the method. Memory savings and numerical divergences of magnetic field are reported and the accuracy of the adaptive computations is assessed by comparing with the available exact solution.

  15. [Hypoplastic left heart syndrome (general review)].

    Science.gov (United States)

    Tláskal, T; Povýsilová, V; Vondrys, D; Skovránek, J

    1999-05-01

    The hypoplastic left heart syndrome (HLHS) is a critical congenital heart lesion with a small left ventricle in combination with stenosis or atresia of the aortic and the mitral valve. This heart disease is associated with a nearly 100% mortality at neonatal age. Until recently, this heart lesion was considered inoperable because of extremely unfavourable morphology. Introduction of the Norwood three-step reconstructive operation on one hand, and heart transplantation in neonates, on the other hand, improved the prognosis of patients with this complex heart lesion. In our country, however, this heart disease, if found during the first months of pregnancy, represents an indication for its termination, and neonates with HLHS are offered only symptomatic medical treatment. On basis of good experience from several most experienced cardiac centres we believe that it is necessary to reassess the statement considering HLHS as an inoperable disease. The main change from this aspect necessitates, however, a detailed analysis of the whole problem not only from the morphological, clinical and surgical point of view but also from philosophical, psychological, socio-economic and health care organisation aspects.

  16. QUEST+: A general multidimensional Bayesian adaptive psychometric method.

    Science.gov (United States)

    Watson, Andrew B

    2017-03-01

    QUEST+ is a Bayesian adaptive psychometric testing method that allows an arbitrary number of stimulus dimensions, psychometric function parameters, and trial outcomes. It is a generalization and extension of the original QUEST procedure and incorporates many subsequent developments in the area of parametric adaptive testing. With a single procedure, it is possible to implement a wide variety of experimental designs, including conventional threshold measurement; measurement of psychometric function parameters, such as slope and lapse; estimation of the contrast sensitivity function; measurement of increment threshold functions; measurement of noise-masking functions; Thurstone scale estimation using pair comparisons; and categorical ratings on linear and circular stimulus dimensions. QUEST+ provides a general method to accelerate data collection in many areas of cognitive and perceptual science.

  17. [Burnout syndrome in general practitioners of Avila].

    Science.gov (United States)

    Frutos-Llanes, R; Jiménez-Blanco, S; Blanco-Montagut, L E

    2014-10-01

    To determine the level of burnout in general practitioners of Avila and the influence of social, occupational and health factors. A descriptive cross-sectional epidemiological study was conducted and aimed at all Primary Care medical staff of Avila during the first half of 2011, using two questionnaires: the Maslach Burnout Inventory and other sociodemographic, health and occupational variables. A response rate of 51.8% was obtained. The mean age was 48.55±8.16, and 52% were male, 77% married, 45% with tenure, 78% worked in rural centres, and, 82% performed out of hours home visits plus clinics. The prevalence of severe burn out was low (16%) in our study was low. A high prevalence (68%) of moderate/severe level of the condition was found. Being married (P=.012), do not guards (Pburnout in severe or moderate/severe burnout. A moderate level of burnout was found. Contrary to what many doctors thought, the prevalence of the condition in its severe form was low, but was high when taking the severe and moderate/severe forms together. Therefore, measures should be extended to reduce occupational stress of doctors, in order to improve working practices and professional efficiency. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  18. Adolescent adaptive behavior profiles in Williams-Beuren syndrome, Down syndrome, and autism spectrum disorder.

    Science.gov (United States)

    Del Cole, Carolina Grego; Caetano, Sheila Cavalcante; Ribeiro, Wagner; Kümmer, Arthur Melo E E; Jackowski, Andrea Parolin

    2017-01-01

    Adaptive behavior can be impaired in different neurodevelopmental disorders and may be influenced by confounding factors, such as intelligence quotient (IQ) and socioeconomic classification. Our main objective was to verify whether adaptive behavior profiles differ in three conditions-Williams Beuren syndrome (WBS), Down syndrome (DS), and autism spectrum disorder (ASD), as compared with healthy controls (HC) and with each other. Although the literature points towards each disorder having a characteristic profile, no study has compared profiles to establish the specificity of each one. A secondary objective was to explore potential interactions between the conditions and socioeconomic status, and whether this had any effect on adaptive behavior profiles. One hundred and five adolescents were included in the study. All adolescents underwent the following evaluations: the Vineland Adaptive Behavior Scale (VABS), the Wechsler Intelligence Scale for Children (WISC), and the Brazilian Economic Classification Criteria. Our results demonstrated that the WBS group performed better than the DS group in the communication domain, β = -15.08, t(3.45), p = .005, and better than the ASD group in the socialization domain, β = 8.92, t(-2.08), p = .013. The DS group also performed better than the ASD group in socialization, β = 16.98, t(-2.32), p = .024. IQ was an important confounding factor, and socioeconomic status had an important effect on the adaptive behavior of all groups. There is a heterogeneity regarding adaptive behavior profiles in WBS, DS, and ASD. These data are important to better design specific strategies related to the health and social care of each particular group.

  19. Adaptive Skills, Behavior Problems, and Parenting Stress in Mothers of Boys with Fragile X Syndrome

    Science.gov (United States)

    Sarimski, Klaus

    2010-01-01

    The relationship of temperament, atypical behaviors, and adaptive behavior of young boys with Fragile X syndrome on mothers' parenting stress was analyzed. Twenty-six boys with Fragile X syndrome (30-88 months of age) participated. The overall development of the participants was significantly delayed with a specific profile of adaptive behaviors…

  20. Decentralized adaptive generalized predictive control for structural vibration

    Institute of Scientific and Technical Information of China (English)

    LU Minyue; GU Zhongquan

    2005-01-01

    A decentralized generalized predictive control (GPC) algorithm is developed for strongly coupled multi-input multi-output systems with parallel computation. The algorithm is applied to adaptive control of structural vibration. The key steps in this algorithm are to group the actuators and the sensors and then to pair these groups into subsystems. It is important that the on-line identification and the control law design can be a parallel process for all these subsystems. It avoids the high computation cost in ordinary predictive control,and is of great advantage especially for large-scale systems.

  1. Generalized pattern search algorithms with adaptive precision function evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Polak, Elijah; Wetter, Michael

    2003-05-14

    In the literature on generalized pattern search algorithms, convergence to a stationary point of a once continuously differentiable cost function is established under the assumption that the cost function can be evaluated exactly. However, there is a large class of engineering problems where the numerical evaluation of the cost function involves the solution of systems of differential algebraic equations. Since the termination criteria of the numerical solvers often depend on the design parameters, computer code for solving these systems usually defines a numerical approximation to the cost function that is discontinuous with respect to the design parameters. Standard generalized pattern search algorithms have been applied heuristically to such problems, but no convergence properties have been stated. In this paper we extend a class of generalized pattern search algorithms to a form that uses adaptive precision approximations to the cost function. These numerical approximations need not define a continuous function. Our algorithms can be used for solving linearly constrained problems with cost functions that are at least locally Lipschitz continuous. Assuming that the cost function is smooth, we prove that our algorithms converge to a stationary point. Under the weaker assumption that the cost function is only locally Lipschitz continuous, we show that our algorithms converge to points at which the Clarke generalized directional derivatives are nonnegative in predefined directions. An important feature of our adaptive precision scheme is the use of coarse approximations in the early iterations, with the approximation precision controlled by a test. Such an approach leads to substantial time savings in minimizing computationally expensive functions.

  2. Psychiatric syndromes comorbid with mental retardation: differences in cognitive and adaptive skills.

    Science.gov (United States)

    Di Nuovo, Santo F; Buono, Serafino

    2007-11-01

    The study concerns the specific cognitive and adaptive skills of persons dually diagnosed with mental retardation (MR) and comorbid pathologies, as schizophrenia, personality and mood disorders, pervasive developmental disorders, epilepsy and ADHD. The sample was composed of 182 subjects, diagnosed as mild or moderate MR level, age range from 6 years 8 months to 50 years 2 months, mean age 17.1 (standard deviation 7.9). All the subjects were inpatients in a specialized structure for the diagnosis and the treatment of MR. The instruments of the study were Wechsler Intelligence Scale (WAIS-R or WISC-R according to the chronological age of subjects) and Vineland Adaptive Behavior Scale (VABS). Results confirm that comorbidity is a factor differentiating among mentally retarded subjects. Both verbal processes requiring memory retrieval and visuo-spatial processes are involved as differentiating features. ADHD strongly increases the impairment of cognitive skills, while behavioral disorders are less damaging in MR performance. In adult samples, the differentiating role of comorbid syndromes in MR individuals is reduced for cognitive skills, and limited to some basic verbal abilities, more impaired in mood disorder, less in schizophrenic disorder. The areas of adaptation and socialization, motor and daily living skills, are impaired more in generalized development disturbances than in comorbid schizophrenic and personality and mood disorders. An accurate psychological assessment of dual diagnoses is useful in detecting the specific underlying processes differentiating the comorbid syndromes, and in planning an appropriate rehabilitative treatment.

  3. Adaptive and Maladaptive Behavior in Children with Smith-Magenis Syndrome

    Science.gov (United States)

    Martin, Staci C.; Wolters, Pamela L.; Smith, Ann C. M.

    2006-01-01

    Children with Smith-Magenis Syndrome (SMS) exhibit deficits in adaptive behavior but systematic studies using objective measures are lacking. This descriptive study assessed adaptive functioning in 19 children with SMS using the Vineland Adaptive Behavior Scales (VABS). Maladaptive behavior was examined through parent questionnaires and the…

  4. Adaptive and Maladaptive Behavior in Children with Smith-Magenis Syndrome

    Science.gov (United States)

    Martin, Staci C.; Wolters, Pamela L.; Smith, Ann C. M.

    2006-01-01

    Children with Smith-Magenis Syndrome (SMS) exhibit deficits in adaptive behavior but systematic studies using objective measures are lacking. This descriptive study assessed adaptive functioning in 19 children with SMS using the Vineland Adaptive Behavior Scales (VABS). Maladaptive behavior was examined through parent questionnaires and the…

  5. Adaptive Behavior and Problem Behavior in Young Children with Williams Syndrome

    Science.gov (United States)

    Hahn, Laura J.; Fidler, Deborah J.; Hepburn, Susan L.

    2014-01-01

    The present study compares the adaptive behavior profile of 18 young children with Williams syndrome (WS) and a developmentally matched group of 19 children with developmental disabilities and examines the relationship between adaptive behavior and problem behaviors in WS. Parents completed the Vineland Adaptive Behavioral Scales--Interview…

  6. Behavioral phenotypes of genetic syndromes with intellectual disability: comparison of adaptive profiles.

    Science.gov (United States)

    Di Nuovo, Santo; Buono, Serafino

    2011-10-30

    The study of distinctive and consistent behaviors in the most common genetic syndromes with intellectual disability is useful to explain abnormalities or associated psychiatric disorders. The behavioral phenotypes revealed outcomes totally or partially specific for each syndrome. The aim of our study was to compare similarities and differences in the adaptive profiles of the five most frequent genetic syndromes, i.e. Down syndrome, Williams syndrome, Angelman syndrome, Prader-Willi syndrome, and Fragile-X syndrome (fully mutated), taking into account the relation with chronological age and the overall IQ level. The research was carried out using the Vineland Adaptive Behavior Scale (beside the Wechsler Intelligence scales to obtain IQ) with a sample of 181 persons (107 males and 74 females) showing genetic syndromes and mental retardation. Syndrome-based groups were matched for chronological age and mental age (excluding the Angelman group, presenting with severe mental retardation). Similarities and differences in the adaptive profiles are described, relating them to IQs and maladaptive behaviors. The results might be useful in obtaining a global index of adjustment for the assessment of intellectual disability level as well as for educational guidance and rehabilitative plans. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. Therapeutic modalities for the short bowel syndrome : improvement of adaptation and small-bowel transplantation

    NARCIS (Netherlands)

    M.C.J. Wolvekamp

    1994-01-01

    textabstractThis thesis deals with two therapeutic modalities for patients with an irreversible short bowel syndrome: improvement of adaptation and small-bowel transplantation. Thereby, emphasis is put on the role of these therapeutic modalities for children.

  8. General Situation of Acupuncture and Tuina for Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    韩晶; 胡幼平

    2009-01-01

    @@ Chronic fatigue syndrome(CFS)refers to a poor adaptation in physiology,psychology and social activities.It iS a critical status between health and sickness,also known as sub.health,and becomes a hot point in the medical study in the twenty first century,and its incidence is about 70%in the population of China[1-4].Its main manifestations Can be divided into four major categories:first psychological symptoms,manifested by low spirit,low emotion,depression and unhappiness,or frustration and easy anger,anxiety and stress,susplctousness and jealousy,poor sicep,poor memory,poor concentration.

  9. Adaptive Elastic Net for Generalized Methods of Moments.

    Science.gov (United States)

    Caner, Mehmet; Zhang, Hao Helen

    2014-01-30

    Model selection and estimation are crucial parts of econometrics. This paper introduces a new technique that can simultaneously estimate and select the model in generalized method of moments (GMM) context. The GMM is particularly powerful for analyzing complex data sets such as longitudinal and panel data, and it has wide applications in econometrics. This paper extends the least squares based adaptive elastic net estimator of Zou and Zhang (2009) to nonlinear equation systems with endogenous variables. The extension is not trivial and involves a new proof technique due to estimators lack of closed form solutions. Compared to Bridge-GMM of Caner (2009), we allow for the number of parameters to diverge to infinity as well as collinearity among a large number of variables, also the redundant parameters set to zero via a data dependent technique. This method has the oracle property, meaning that we can estimate nonzero parameters with their standard limit and the redundant parameters are dropped from the equations simultaneously. Numerical examples are used to illustrate the performance of the new method.

  10. Generalization of visuomotor adaptation depends on the spatial characteristic of visual workspace.

    Science.gov (United States)

    Wang, Lei; Müsseler, Jochen

    2012-11-01

    The present study aims to address a novel aspect of visuomotor adaptation and its generalization. It is based on the assumption that the spatial structure of the distal action space is crucial for generalization. In the experiments, the distal action spaces could manifest either a symmetric or parallel structure. The imposed visuomotor rotations in the adaptation and the following generalization were either the same or opposing each other. In the generalization phase, motor bias resulting from prior adaptation was observed, and it turned out to substantially depend on the property of the workspace. In Experiment 1 with a parallel workspace, preceding adaptation to the same rotation was more advantageous than adaptation to an opposing rotation. This observation was reversed in Experiment 2 with the symmetrical workspace: prior adaptation to an opposing rotation was more advantageous for the generalization than prior adaptation to the same rotation. Mechanisms possibly underlying the observed influence of the workspace configuration were discussed.

  11. Profiles and Development of Adaptive Behavior in Children with Down Syndrome

    Science.gov (United States)

    Dykens, Elisabeth; Hodapp, Robert; Evans, David

    2006-01-01

    The profiles and developmental trajectories of adaptive behavior were cross-sectionally examined in 80 children with Down syndrome ages 1 to 11.5 years using the Vineland Adaptive Behavior Scales. Profile findings indicated a significant weakness in communication relative to daily living and socialization skills. Within communication itself,…

  12. Generalized synchronization with uncertain parameters of nonlinear dynamic system via adaptive control.

    Science.gov (United States)

    Yang, Cheng-Hsiung; Wu, Cheng-Lin

    2014-01-01

    An adaptive control scheme is developed to study the generalized adaptive chaos synchronization with uncertain chaotic parameters behavior between two identical chaotic dynamic systems. This generalized adaptive chaos synchronization controller is designed based on Lyapunov stability theory and an analytic expression of the adaptive controller with its update laws of uncertain chaotic parameters is shown. The generalized adaptive synchronization with uncertain parameters between two identical new Lorenz-Stenflo systems is taken as three examples to show the effectiveness of the proposed method. The numerical simulations are shown to verify the results.

  13. Adaptive behavior of institutionalized individuals with Down syndrome.

    Science.gov (United States)

    Silverstein, A B; Ageno, D; Alleman, A C; Derecho, K T; Gray, S B; White, J F

    1985-03-01

    Institutional residents with Down syndrome (N = 413) were matched with an equal number of residents in other diagnostic categories with respect to sex, age, length of hospitalization, and IQ. The two groups were compared on 62 items of the Client Development Evaluation Report, and significant differences were found on 19 of these items. The subjects with Down syndrome tended to show greater social competence (except in the clarity of their speech) and less maladaptive behavior. To account for these differences, we offer the speculative hypothesis that the favorable expectations of service providers for their clients with Down syndrome may come to serve as self-fulfilling prophecies.

  14. Adaptive Error Estimation in Linearized Ocean General Circulation Models

    Science.gov (United States)

    Chechelnitsky, Michael Y.

    1999-01-01

    Data assimilation methods are routinely used in oceanography. The statistics of the model and measurement errors need to be specified a priori. This study addresses the problem of estimating model and measurement error statistics from observations. We start by testing innovation based methods of adaptive error estimation with low-dimensional models in the North Pacific (5-60 deg N, 132-252 deg E) to TOPEX/POSEIDON (TIP) sea level anomaly data, acoustic tomography data from the ATOC project, and the MIT General Circulation Model (GCM). A reduced state linear model that describes large scale internal (baroclinic) error dynamics is used. The methods are shown to be sensitive to the initial guess for the error statistics and the type of observations. A new off-line approach is developed, the covariance matching approach (CMA), where covariance matrices of model-data residuals are "matched" to their theoretical expectations using familiar least squares methods. This method uses observations directly instead of the innovations sequence and is shown to be related to the MT method and the method of Fu et al. (1993). Twin experiments using the same linearized MIT GCM suggest that altimetric data are ill-suited to the estimation of internal GCM errors, but that such estimates can in theory be obtained using acoustic data. The CMA is then applied to T/P sea level anomaly data and a linearization of a global GFDL GCM which uses two vertical modes. We show that the CMA method can be used with a global model and a global data set, and that the estimates of the error statistics are robust. We show that the fraction of the GCM-T/P residual variance explained by the model error is larger than that derived in Fukumori et al.(1999) with the method of Fu et al.(1993). Most of the model error is explained by the barotropic mode. However, we find that impact of the change in the error statistics on the data assimilation estimates is very small. This is explained by the large

  15. Generalization of visuomotor adaptation depends on the spatial characteristic of visual workspace

    OpenAIRE

    2012-01-01

    The present study aims to address a novel aspect of visuomotor adaptation and its generalization. It is based on the assumption that the spatial structure of the distal action space is crucial for generalization. In the experiments, the distal action spaces could manifest either a symmetric or parallel structure. The imposed visuomotor rotations in the adaptation and the following generalization were either the same or opposing each other. In the generalization phase, motor bias resulting fro...

  16. The hyperventilation syndrome in panic disorder, agoraphobia and generalized anxiety disorder

    NARCIS (Netherlands)

    de Ruiter, C.; Garssen, B.; Rijken, H.; Kraaimaat, F.

    1989-01-01

    The symptom complex of panic disorder and generalized anxiety disorder suggests an etiological role for hyperventilation. The present study investigates the overlap between DSM-III-R panic disorder, panic disorder with agoraphobia and generalized anxiety disorder with hyperventilation syndrome

  17. A Qualitative Analysis of General Receptive Vocabulary of Adolescents with Down Syndrome

    Science.gov (United States)

    Facon, Bruno; Nuchadee, Marie-Laure; Bollengier, Therese

    2012-01-01

    This study aimed to discover whether general receptive vocabulary is qualitatively phenotypical in Down syndrome. Sixty-two participants with Down syndrome (M age = 16.74 years, SD = 3.28) were individually matched on general vocabulary raw total score with 62 participants with intellectual disability of undifferentiated etiology (M age = 16.20…

  18. A Qualitative Analysis of General Receptive Vocabulary of Adolescents with Down Syndrome

    Science.gov (United States)

    Facon, Bruno; Nuchadee, Marie-Laure; Bollengier, Therese

    2012-01-01

    This study aimed to discover whether general receptive vocabulary is qualitatively phenotypical in Down syndrome. Sixty-two participants with Down syndrome (M age = 16.74 years, SD = 3.28) were individually matched on general vocabulary raw total score with 62 participants with intellectual disability of undifferentiated etiology (M age = 16.20…

  19. Ramsay hunt syndrome: A diagnostic challenge for general dental practitioners

    Directory of Open Access Journals (Sweden)

    Gautham Singh

    2017-01-01

    Full Text Available Ramsay hunt syndrome is not just a syndrome but it's rather an infectious disease caused by reactivation of latent varicella-zoster virus in geniculate ganglion. This was first explained by J. Ramsay Hunt as a triad of complications like otalgia, mucosal and cutaneous rashes with or without trigeminal facial palsy. The facial palsy can occur with characteristic vesicles along the path of nerve. We present a case of Ramsay Hunt syndrome in a 48-year-old male. The unilateral pattern of facial involvement and presence of vesicles assisted us for early diagnosis, distinguishing the syndrome with diseases mimicking other severe neurological illnesses and prompt treatment.

  20. [General anesthesia for a pregnant patient with PAPA syndrome].

    Science.gov (United States)

    Ohno, Seika; Ariyama, Jun; Tsujita, Miki; Ueshima, Hironobu; Imanishi, Hirokazu; Terao, Kazuhisa; Mieda, Tsutomu; Kitamura, Akira

    2014-08-01

    A 31-year-old female, with 22 weeks of pregnancy, presented with sudden onset of severe headache. CT scan showed diffuse subarachnoid hemorrhage. A cerebral angiogram showed dissecting aneurysm of right cerebral artery. To obliterate the aneurysm and prevent rupture, the patient underwent coil embolization via an endovascular approach under general anesthesia because the procedure under sedation with local anesthesia was too risky for re-bleeding. The patient has been diagnosed as PAPA syndrome. Although the arthritis was now stable and she was taking no drug, remarkable osteoarthritis was observed. The cervical spine X ray demonstrated no cervical ankylosis. As patient was sedated with propofol, airway examination could not be done except noticing thyromental distance of seven centimeters. Patient's trachea was intubated using Macintosh size #3 laryngoscope blade and a 7.0 non-styletted tracheal tube at the first attempt without any problems (Cormack grade I). Anesthesia was maintained with sevoflurane, fentanyl and remifentanil. After the end of endovascular surgery, the patient was transferred to the intensive care unit under mechanical ventilation. She was weaned from mechanical ventilation 2 days later but consciousness was unclear. Right incomplete paralysis was also observed. MRI revealed vasospasm on the bilateral internal carotid artery. The patient underwent percutaneous tansluminalangioplasty coil and intraarterial injection of fasudil hydrochloride under local anesthesia. The consciousness recovered fully and the paralysis was improved. The patient delivered the baby by Caesarean sections under combined spinal and epidural anesthesia at 36 weeks without any problems with both the mother and baby.

  1. Adaptive and maladaptive functioning in Kleefstra syndrome compared to other rare genetic disorders with intellectual disabilities.

    Science.gov (United States)

    Vermeulen, Karlijn; de Boer, Anneke; Janzing, Joost G E; Koolen, David A; Ockeloen, Charlotte W; Willemsen, Marjolein H; Verhoef, Floor M; van Deurzen, Patricia A M; van Dongen, Linde; van Bokhoven, Hans; Egger, Jos I M; Staal, Wouter G; Kleefstra, Tjitske

    2017-05-12

    Detailed neurobehavioural profiles are of major value for specific clinical management, but have remained underexposed in the population with intellectual disabilities (ID). This was traditionally classified based on IQ level only. Rapid advances in genetics enable etiology based stratification in the majority of patients, which reduces clinical heterogeneity. This paper illustrates that specific profiles can be obtained for rare syndromes with ID. Our main aim was to study (mal)adaptive functioning in Kleefstra Syndrome (KS) by comparing and contrasting our findings to three other subgroups: Koolen-de Vries Syndrome, GATAD2B-related syndrome, and a mixed control group of individuals with ID. In total, we studied 58 individuals (28 males, 30 females) with ID; 24 were diagnosed with KS, 13 with Koolen-de Vries Syndrome, 6 with the GATAD2B-related syndrome, and 15 individuals with undefined neurodevelopmental disorders. All individuals were examined with a Vineland Adaptive Behavior Scale, mini PAS-ADD interview, and an Autism Diagnostic Observation Schedule to obtain measures of adaptive and maladaptive functioning. Each of the three distinctive genetic disorders showed its own specific profile of adaptive and maladaptive functioning, while being contrasted mutually. However, when data of the subgroups altogether are contrasted to the data of KS, such differences could not be demonstrated. Based on our findings, specific management recommendations were discussed for each of the three syndromes. It is strongly suggested to consider the genetic origin in individuals with congenital neurodevelopmental disorders for individual based psychiatric and behavioral management. © 2017 Wiley Periodicals, Inc.

  2. Dravet syndrome or genetic (generalized) epilepsy with febrile seizures plus?

    NARCIS (Netherlands)

    Scheffer, Ingrid E.; Zhang, Yue-Hua; Jansen, Floor E.; Dibbens, Leanne

    2009-01-01

    Dravet syndrome and genetic epilepsy with febrile seizures plus (GEFS+) can both arise due 10 mutations of SCN1A. the gene encoding the alpha 1 pore-forming subunit of the sodium channel. GEFS+ refers to a familial epilepsy syndrome where at least two family members have phenotypes that fit within t

  3. Dravet syndrome or genetic (generalized) epilepsy with febrile seizures plus?

    NARCIS (Netherlands)

    Scheffer, Ingrid E.; Zhang, Yue-Hua; Jansen, Floor E.; Dibbens, Leanne

    Dravet syndrome and genetic epilepsy with febrile seizures plus (GEFS+) can both arise due 10 mutations of SCN1A. the gene encoding the alpha 1 pore-forming subunit of the sodium channel. GEFS+ refers to a familial epilepsy syndrome where at least two family members have phenotypes that fit within

  4. Behavior and Adaptive Functioning in Adolescents with Down Syndrome: Specifying Targets for Intervention

    Science.gov (United States)

    Jacola, Lisa M.; Hickey, Francis; Howe, Steven R.; Esbensen, Anna; Shear, Paula K.

    2014-01-01

    Adolescents with Down syndrome can demonstrate increased behavior problems as compared with typical peers. Few studies have explored whether behavior impacts adaptive functioning. Caregiver report from the Behavioral Assessment System for Children, 2nd Edition (BASC-2; Reynolds & Kamphaus, 2004) and the Child Behavioral Checklist (CBCL;…

  5. Adaptation in families of children with Down syndrome in East Asian countries: an integrative review.

    Science.gov (United States)

    Choi, Hyunkyung; Van Riper, Marcia

    2017-08-01

    The purpose of this integrative literature review was to understand the experiences of East Asian families of children with Down syndrome and identify factors affecting their adaptation in the Resiliency Model of Family Stress, Adjustment and Adaptation. Socio-cultural factors influence how well families adapt following the birth of a child with Down syndrome. Existing literature in this area has focused primarily on families from Western cultures. This is problematic because nurses care for families from all over the world. Therefore, the focus of this review is on families of children with Down syndrome living in East Asia, where Confucianism is dominant. Integrative literature review. Online databases (i.e. PubMed, CINAHL and PsycINFO) and a public search engine (i.e. Google Scholar) were used along with manual searches of reference lists and major journals. Studies were limited to original publications written in English and published between 1990-2014. Two authors independently performed integrative review processes proposed by Whittemore and Knafl and a quality assessment using the Mixed Methods Appraisal Tool. Like families in Western cultures, some East Asian families of children with Down syndrome adapted well and even thrived while others struggled. Various socio-cultural factors, including some associated with Confucianism, played a role in how individuals, dyads and families adapted. An understanding of socio-cultural influences can help nurses implement culturally sensitive family-centred interventions with families of children with Down syndrome. It may also facilitate policy changes concerning resources for these families. © 2016 John Wiley & Sons Ltd.

  6. Adaptation of a general circulation model to ocean dynamics

    Science.gov (United States)

    Turner, R. E.; Rees, T. H.; Woodbury, G. E.

    1976-01-01

    A primitive-variable general circulation model of the ocean was formulated in which fast external gravity waves are suppressed with rigid-lid surface constraint pressires which also provide a means for simulating the effects of large-scale free-surface topography. The surface pressure method is simpler to apply than the conventional stream function models, and the resulting model can be applied to both global ocean and limited region situations. Strengths and weaknesses of the model are also presented.

  7. The autistic phenotype in Down syndrome: differences in adaptive behaviour versus Down syndrome alone and autistic disorder alone.

    Science.gov (United States)

    Dressler, Anastasia; Perelli, Valentina; Bozza, Margherita; Bargagna, Stefania

    2011-01-01

    The autistic phenotype in Down syndrome (DS) is marked by a characteristic pattern of stereotypies, anxiety and social withdrawal. Our aim was to study adaptive behaviour in DS with and without autistic comorbidity using the Vineland Adaptive Behaviour Scales (VABS), the Childhood Autism Rating Scales (CARS) and the DSM IV-TR criteria. We assessed 24 individuals and established three groups: Down syndrome (DS), DS and autistic disorder (DS-AD), and autistic disorder (AD). The DS and DS-AD groups showed statistically significantly similar strengths on the VABS (in receptive and domestic skills). The DS and DS-AD subjects also showed similar strengths on the CARS (in imitation and relating), differing significantly from the AD group. The profile of adaptive functioning and symptoms in DS-AD seemed to be more similar to that found in DS than to the profile emerging in AD. We suggest that the comorbidity of austistic symptoms in DS hampered the acquisition of adaptive skills more than did the presence of DS alone.

  8. Family influences on adaptive development in young children with Down syndrome.

    Science.gov (United States)

    Hauser-Cram, P; Warfield, M E; Shonkoff, J P; Krauss, M W; Upshur, C C; Sayer, A

    1999-01-01

    In this study we investigated the extent to which the family environment predicted differences in trajectories of adaptive development in young children with Down syndrome. The sample was comprised of 54 children with Down syndrome and their families who were studied from infancy through the age of 5 years as part of a longitudinal study of children with disabilities. Hierarchical linear modeling (HLM) was used to estimate the parameters of hierarchical growth models in domains of adaptive development. Results indicated that growth in communication, daily living skills, and socialization domains were predicted by measures of the family environment (i.e., family cohesion and mother-child interaction) above and beyond that predicted by maternal education. Further, Bayley MDI measures during infancy did not predict changes in adaptive development in any of the domains. The results are discussed in terms of implications for service provision and for expanding theoretical frameworks to include the development of children with disabilities.

  9. Automated Clutch of AMT Vehicle Based on Adaptive Generalized Minimum Variance Controller

    National Research Council Canada - National Science Library

    Ze Li; Xinhao Yang

    2014-01-01

    ... of the automated clutch of automatic mechanical transmission vehicle. In this paper, an adaptive generalized minimum variance controller is applied to the automated clutch, which is driven by a brushless DC motor...

  10. Generalization of Hindi OCR Using Adaptive Segmentation and Font Files

    Science.gov (United States)

    Agrawal, Mudit; Ma, Huanfeng; Doermann, David

    In this chapter, we describe an adaptive Indic OCR system implemented as part of a rapidly retargetable language tool effort and extend work found in [20, 2]. The system includes script identification, character segmentation, training sample creation, and character recognition. For script identification, Hindi words are identified in bilingual or multilingual document images using features of the Devanagari script and support vector machine (SVM). Identified words are then segmented into individual characters, using a font-model-based intelligent character segmentation and recognition system. Using characteristics of structurally similar TrueType fonts, our system automatically builds a model to be used for the segmentation and recognition of the new script, independent of glyph composition. The key is a reliance on known font attributes. In our recognition system three feature extraction methods are used to demonstrate the importance of appropriate features for classification. The methods are tested on both Latin and non-Latin scripts. Results show that the character-level recognition accuracy exceeds 92% for non-Latin and 96% for Latin text on degraded documents. This work is a step toward the recognition of scripts of low-density languages which typically do not warrant the development of commercial OCR, yet often have complete TrueType font descriptions.

  11. An Adaptive Multialphabet Arithmetic Coding Based on Generalized Virtual Sliding Window

    DEFF Research Database (Denmark)

    Belyaev, Evgeny; Forchhammer, Søren; Liu, Kai

    2017-01-01

    We propose a novel efficient multialphabet multiplication-free adaptive arithmetic coder. First, we generalize probability estimation via virtual sliding window for the multialphabet case and show that it does not require multiplications and provides a tradeoff between the probability adaptation...... speed and the precision of the probability estimation. Second, we show how the generalized virtual sliding window can be used to eliminate multiplications and divisions. Finally, we demonstrate that the proposed arithmetic coder provides better compression performance than existing implementations based...

  12. Global Convergence of Adaptive Generalized Predictive Controller Based on Least Squares Algorithm

    Institute of Scientific and Technical Information of China (English)

    张兴会; 陈增强; 袁著祉

    2003-01-01

    Some papers on stochastic adaptive control schemes have established convergence algorithm using a leastsquares parameters. With the popular application of GPC, global convergence has become a key problem in automatic control theory. However, now global convergence of GPC has not been established for algorithms in computing a least squares iteration. A generalized model of adaptive generalized predictive control is presented. The global convergebce is also given on the basis of estimating the parameters of GPC by least squares algorithm.

  13. A non-traditional model of the metabolic syndrome: the adaptive significance of insulin resistance in fasting-adapted seals

    Directory of Open Access Journals (Sweden)

    Dorian S Houser

    2013-11-01

    Full Text Available Insulin resistance in modern society is perceived as a pathological consequence of excess energy consumption and reduced physical activity. Its presence in relation to the development of cardiovascular risk factors has been termed the metabolic syndrome, which produces increased mortality and morbidity and which is rapidly increasing in human populations. Ironically, insulin resistance likely evolved to assist animals during food shortages by increasing the availability of endogenous lipid for catabolism while protecting protein from use in gluconeogenesis and eventual oxidation. Some species that incorporate fasting as a predictable component of their life history demonstrate physiological traits similar to the metabolic syndrome during prolonged fasts. One such species is the northern elephant seal (Mirounga angustirostris, which fasts from food and water for periods of up to three months. During this time, ~90% of the seals metabolic demands are met through fat oxidation and circulating non-esterified fatty acids are high (0.7-3.2 mM. All life history stages of elephant seal studied to date demonstrate insulin resistance and fasting hyperglycemia as well as variations in hormones and adipocytokines that reflect the metabolic syndrome to some degree. Elephant seals demonstrate some intriguing adaptations with the potential for medical advancement; for example, ketosis is negligible despite significant and prolonged fatty acid oxidation and investigation of this feature might provide insight into the treatment of diabetic ketoacidosis. The parallels to the metabolic syndrome are likely reflected to varying degrees in other marine mammals, most of which evolved on diets high in lipid and protein content but essentially devoid of carbohydrate. Utilization of these natural models of insulin resistance may further our understanding of the pathophysiology of the metabolic syndrome in humans and better assist the development of preventative measures

  14. Sotos syndrome: An unusual presentation with intrauterine growth restriction, generalized lymphedema, and intention tremor.

    Science.gov (United States)

    McClelland, Jessie; Burgess, Bronwyn; Crock, Patricia; Goel, Himanshu

    2016-04-01

    Sotos syndrome is a childhood overgrowth syndrome characterized clinically by a distinctive facial gestalt, advanced bone age, childhood overgrowth, and non-progressive developmental delay; and genetically by haploinsufficiency of the Nuclear receptor binding SET Domain 1 (NSD1) gene. Generalized lymphedema has not previously been associated with Sotos syndrome. Generalized lymphedema has been associated with mutations in several genes including FLT4. This gene is involved in the regulation of VEGFR3, a key governor of lymphatic-endothelial cell development and function. We report on a 28-year-old Caucasian female with a de novo NSD1 intragenic mutation, c.5841_5848dup: p.Leu1950Serfs*22, who presented with characteristic clinical features of Sotos syndrome. Unusually this case includes atypical features of intrauterine growth retardation and post-pubertal onset of primary lymphedema. To our knowledge, no link between Sotos syndrome and generalized lymphedema has previously been described in the literature. We propose a mechanism by which disruptions in NSD1 gene may lead to generalized lymphedema. Aberrations of the mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK)-signaling pathway has been identified in both Sotos syndrome and lymphedema. This finding extends the known phenotype of Sotos syndrome through the inclusion of lymphedema. This case also indicates that presence of low birth weight does not exclude the possibility of Sotos syndrome.

  15. Lack of consensus on tests and criteria for generalized joint hypermobility, Ehlers-Danlos syndrome

    DEFF Research Database (Denmark)

    Remvig, Lars; Flycht, Lise; Christensen, Karl B;

    2014-01-01

    The objectives of this study were to register clinicians performance and opinion of importance of clinical tests for generalized joint hypermobility (GJH), Ehlers-Danlos syndrome, hypermobility type (EDS-HT) and joint hypermobility syndrome (JHS), and to reach a consensus among clinicians on crit...

  16. Vowel generalization and its relation to adaptation during perturbations of auditory feedback.

    Science.gov (United States)

    Reilly, Kevin J; Pettibone, Chelsea

    2017-08-23

    Repeated perturbations of auditory feedback during vowel production elicit changes not only in the production of the perturbed vowel (adaptation) but also in the production of nearby vowels that were not perturbed (generalization). The finding that adaptation generalizes to other, non-perturbed vowels suggest that sensorimotor representations for vowels are not independent; instead the goals for producing any one vowel may depend in part on the goals for other vowels. The present study investigated the dependence or independence of vowel representations by evaluating adaptation and generalization in two groups of speakers exposed to auditory perturbations of their first formant (F1) during different vowels. The speakers in both groups who adapted to the perturbation exhibited generalization in two non-perturbed vowels that were produced under masking noise. Correlation testing was performed to evaluate the relations between adaptation and generalization as well as between the generalization in the two non-perturbed vowels. These tests identified significant coupling between the F1 changes of adjacent vowels but not non-adjacent vowels. The pattern of correlation findings indicates that generalization was due in part to feedforward representations that are partly shared across adjacent vowels, possibly to maintain their acoustic contrast. Copyright © 2016, Journal of Neurophysiology.

  17. EEG features of absence seizures in idiopathic generalized epilepsy: Impact of syndrome, age, and state

    DEFF Research Database (Denmark)

    Sadleir, L.G.; Scheffer, I.E.; Smith, S.

    2009-01-01

    Purpose: Factors influencing the electroencephalography (EEG) features of absence seizures in newly presenting children with idiopathic generalized epilepsy (IGE) have not been rigorously studied. We examined how specific factors such as state, provocation, age, and epilepsy syndrome affect the E...

  18. [Formula: see text]Intellectual and adaptive functioning in Sturge-Weber Syndrome.

    Science.gov (United States)

    Kavanaugh, Brian; Sreenivasan, Aditya; Bachur, Catherine; Papazoglou, Aimilia; Comi, Anne; Zabel, T Andrew

    2016-01-01

    The present study examined the intellectual and adaptive functioning in a sample of children and young adults with Sturge-Weber Syndrome (SWS). A total of 80 research participants from a SWS study database underwent full neurological evaluation as part of their participation or concurrent medical care. Twenty-nine of the participants received neuropsychological evaluations. Analyses indicated no significant demographic or neurological differences between those who did and did not receive neuropsychological evaluations. Overall, the neuropsychological evaluation sample displayed significantly lower functioning relative to published normative data across domains of intellectual and adaptive functioning. Thirty-two percent of the sample displayed impaired performance (standard score ≤ 75) in intellectual functioning and 58% displayed impaired performance in adaptive functioning. Hemiparesis status independently predicted overall adaptive functioning while seizure frequency independently predicted overall intellectual functioning. Younger participants displayed significantly higher (more intact) ratings in adaptive functioning compared to older participants, specifically in overall adaptive functioning, motor skills, and community living skills. A composite measure of neurological status (SWS-NRS) incorporating seizure and hemiparesis status effectively distinguished between individuals with impaired or nonimpaired adaptive and intellectual functioning and showed promise as a screening method for identifying individuals with more involved intellectual and/or adaptive needs.

  19. Family functioning mediates adaptation in caregivers of individuals with Rett syndrome.

    Science.gov (United States)

    Lamb, Amanda E; Biesecker, Barbara B; Umstead, Kendall L; Muratori, Michelle; Biesecker, Leslie G; Erby, Lori H

    2016-11-01

    The objective of this study was to investigate factors related to family functioning and adaptation in caregivers of individuals with Rett syndrome (RS). A cross-sectional quantitative survey explored the relationships between demographics, parental self-efficacy, coping methods, family functioning and adaptation. A forward-backward, step-wise model selection procedure was used to evaluate variables associated with both family functioning and adaptation. Analyses also explored family functioning as a mediator of the relationship between other variables and adaptation. Bivariate analyses (N=400) revealed that greater parental self-efficacy, a greater proportion of problem-focused coping, and a lesser proportion of emotion-focused coping were associated with more effective family functioning. In addition, these key variables were significantly associated with greater adaptation, as was family functioning, while controlling for confounders. Finally, regression analyses suggest family functioning as a mediator of the relationships between three variables (parental self-efficacy, problem-focused coping, and emotion-focused coping) with adaptation. This study demonstrates the potentially predictive roles of expectations and coping methods and the mediator role of family functioning in adaptation among caregivers of individuals with RS, a chronic developmental disorder. A potential target for intervention is strengthening of caregiver competence in the parenting role to enhance caregiver adaptation. Published by Elsevier Ireland Ltd.

  20. DO CHILDREN WITH FRAGILE X SYNDROME SHOW DECLINES OR PLATEAUS IN ADAPTIVE BEHAVIOR?

    Science.gov (United States)

    Hahn, Laura J.; Brady, Nancy C.; Warren, Steven F.; Fleming, Kandace K.

    2014-01-01

    This study explores if children with fragile X syndrome (FXS) show advances, declines, or plateaus in adaptive behavior over time and the relationship of nonverbal cognitive abilities and autistic behavior on these trajectories. Parents of 55 children with FXS completed the Vineland Adaptive Behavior Scales between 3 and 6 times from 2 to 10 years of age. Using raw scores, results indicate that about half of the sample showed advances in adaptive behavior, while the other half showed declines, indicating a regression in skills. Children who were more cognitively advanced and had less autistic behaviors had higher trajectories. Understanding the developmental course of adaptive behavior in FXS has implications for educational planning and intervention, especially for those children showing declines. PMID:26322389

  1. Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome.

    Science.gov (United States)

    Glauser, T; Kluger, G; Sachdeo, R; Krauss, G; Perdomo, C; Arroyo, S

    2008-05-20

    Lennox-Gastaut syndrome is a catastrophic pediatric epilepsy syndrome characterized by multiple types of treatment-resistant seizures and high rates of seizure-related injury. Current available treatments are inadequate, leaving patients with few treatment options and opportunities. We conducted a double-blind, randomized, placebo-controlled trial of the antiepileptic drug rufinamide in patients with Lennox-Gastaut syndrome. Eligible patients between 4 and 30 years of age had multiple types of seizures (including tonic-atonic and atypical absence seizures) with a minimum of 90 seizures in the month before baseline and a recent history of a slow spike-and-wave pattern on EEG. After a 28-day baseline period, 139 eligible patients were randomized; 138 patients received either rufinamide (n = 74) or placebo (n = 64) in addition to their other antiepileptic drugs. The median percentage reduction in total seizure frequency was greater in the rufinamide therapy group than in the placebo group (32.7% vs 11.7%, p = 0.0015). There was a difference (p or=10% of patients receiving rufinamide) were somnolence (24.3% with rufinamide vs 12.5% with placebo) and vomiting (21.6% vs 6.3%). Rufinamide was an effective and well-tolerated treatment for seizures associated with Lennox-Gastaut syndrome.

  2. Supporting Students with Asperger's Syndrome in General Education.

    Science.gov (United States)

    Safran, Joan S.

    2002-01-01

    This article discusses social difficulties of children with Asperger's syndrome and provides strategies for helping children practice and learn the classroom and life rules that many students naturally acquire. Suggestions include: carefully structure seating arrangements and group work, provide a safe haven, prepare for changes in routine, and…

  3. A general review of the otolaryngologic manifestations of Down Syndrome.

    Science.gov (United States)

    Chin, Christopher J; Khami, Maria M; Husein, Murad

    2014-06-01

    Down Syndrome (DS) is the most common chromosome abnormality in liveborn children. Otolaryngologists frequently encounter these patients in their practice; in one survey, 50% of DS patients had been seen by Otolaryngology at least once. As such, it is essential that the practicing Otolaryngologist is aware of the otologic, rhinologic, and laryngologic manifestations of this complex disease and comfortable in the management and treatment of these unique patients. Our goal was to provide this information in a concise and definitive document. A comprehensive literature review using PubMed was completed. The terms "Otolaryngology", "Head and neck", "Ear, nose, throat", "Down Syndrome", and "Trisomy 21" were searched in various combinations. Applicable articles that discussed the Otolaryngologic manifestations of Down Syndrome were included. In total, fifty articles were included for review. The Down Syndrome child tends to have smaller external ear canals, have higher rates of chronic ear disease, and may present with conductive, sensorineural, or mixed hearing loss. As such, DS patients should receive behaviouralaudiological testing every 6 monthsand annually after the age of three in addition to closer follow-up by an Otolaryngologist if tympanic membranes cannot be visualized or if the external auditory canals are significantly stenosed. Management should involve close follow-up and a low threshold for PE tube placement to reduce the risks for speech and language delay. Chronic rhinitis in the Down Syndrome patient is common. Retrognathia, hypotonia, and macroglossia can all cause obstructive sleep apnea (OSA) in this population and therefore each DS patient should get an overnight polysomnograph. Subglottic stenosis, vocal cord paralysis and laryngomalacia are not infrequently seen in the Down Syndrome patient. To reduce acquired subglottic stenosis, endotracheal tubes that are at least two sizes smaller than what is appropriate for the patient's age should be used

  4. An adaptive prediction and detection algorithm for multistream syndromic surveillance

    Directory of Open Access Journals (Sweden)

    Magruder Steve F

    2005-10-01

    Full Text Available Abstract Background Surveillance of Over-the-Counter pharmaceutical (OTC sales as a potential early indicator of developing public health conditions, in particular in cases of interest to biosurvellance, has been suggested in the literature. This paper is a continuation of a previous study in which we formulated the problem of estimating clinical data from OTC sales in terms of optimal LMS linear and Finite Impulse Response (FIR filters. In this paper we extend our results to predict clinical data multiple steps ahead using OTC sales as well as the clinical data itself. Methods The OTC data are grouped into a few categories and we predict the clinical data using a multichannel filter that encompasses all the past OTC categories as well as the past clinical data itself. The prediction is performed using FIR (Finite Impulse Response filters and the recursive least squares method in order to adapt rapidly to nonstationary behaviour. In addition, we inject simulated events in both clinical and OTC data streams to evaluate the predictions by computing the Receiver Operating Characteristic curves of a threshold detector based on predicted outputs. Results We present all prediction results showing the effectiveness of the combined filtering operation. In addition, we compute and present the performance of a detector using the prediction output. Conclusion Multichannel adaptive FIR least squares filtering provides a viable method of predicting public health conditions, as represented by clinical data, from OTC sales, and/or the clinical data. The potential value to a biosurveillance system cannot, however, be determined without studying this approach in the presence of transient events (nonstationary events of relatively short duration and fast rise times. Our simulated events superimposed on actual OTC and clinical data allow us to provide an upper bound on that potential value under some restricted conditions. Based on our ROC curves we argue that a

  5. Generalization patterns for reach adaptation and proprioceptive recalibration differ after visuomotor learning.

    Science.gov (United States)

    Cressman, Erin K; Henriques, Denise Y P

    2015-07-01

    Visuomotor learning results in changes in both motor and sensory systems (Cressman EK, Henriques DY. J Neurophysiol 102: 3505-3518, 2009), such that reaches are adapted and sense of felt hand position recalibrated after reaching with altered visual feedback of the hand. Moreover, visuomotor learning has been shown to generalize such that reach adaptation achieved at a trained target location can influence reaches to novel target directions (Krakauer JW, Pine ZM, Ghilardi MF, Ghez C. J Neurosci 20: 8916-8924, 2000). We looked to determine whether proprioceptive recalibration also generalizes to novel locations. Moreover, we looked to establish the relationship between reach adaptation and changes in sense of felt hand position by determining whether proprioceptive recalibration generalizes to novel targets in a similar manner as reach adaptation. On training trials, subjects reached to a single target with aligned or misaligned cursor-hand feedback, in which the cursor was either rotated or scaled in extent relative to hand movement. After reach training, subjects reached to the training target and novel targets (including targets from a second start position) without visual feedback to assess generalization of reach adaptation. Subjects then performed a proprioceptive estimation task, in which they indicated the position of their hand relative to visual reference markers placed at similar locations as the trained and novel reach targets. Results indicated that shifts in hand position generalized across novel locations, independent of reach adaptation. Thus these distinct sensory and motor generalization patterns suggest that reach adaptation and proprioceptive recalibration arise from independent error signals and that changes in one system cannot guide adjustments in the other.

  6. Adaptive generalized projective synchronization of two different chaotic systems with unknown parameters

    Institute of Scientific and Technical Information of China (English)

    Zhang Ruo-Xun; Yang Shi-Ping

    2008-01-01

    This paper presents a general method of the generalized projective synchronization and the parameter identification between two different chaotic systems with unknown parameters.This approach is based on Lyapunov stability theory,and employs a combination of feedback control and adaptive control.With this method one can achieve the generalized projective synchronization and realize the parameter identifications between almost all chaotic (hyperchaotic) systems with unknown parameters.Numerical simulations results are presented to demonstrate the effectiveness of the method.

  7. Pediatric acute respiratory distress syndrome: Host factors in Down syndrome and the general population

    NARCIS (Netherlands)

    M. Bruijn

    2013-01-01

    We find that Down syndrome is an important risk factor for developing acute respiratory distress syndrome (ARDS) in children, but the reason why remains to be elucidated. In addition, we find several differences between adult and pediatric ARDS. The association between C-reactive protein (CRP) level

  8. Adaptive lag synchronization based topology identification scheme of uncertain general complex dynamical networks

    Science.gov (United States)

    Che, Y.; Li, R. X.; Han, C. X.; Wang, J.; Cui, S. G.; Deng, B.; Wei, X.

    2012-08-01

    This paper presents an adaptive lag synchronization based method for simultaneous identification of topology and parameters of uncertain general complex dynamical networks with and without time delays. Based on Lyapunov stability theorem and LaSalle's invariance principle, an adaptive controller is designed to realize lag synchronization between drive and response systems, meanwhile, identification criteria of network topology and system parameters are obtained. Numerical simulations illustrate the effectiveness of the proposed method.

  9. Semantic verbal fluency pattern, dementia rating scores and adaptive behavior correlate with plasma Aβ42 concentrations in Down syndrome young adults

    Directory of Open Access Journals (Sweden)

    Laura eDel Hoyo

    2015-11-01

    Full Text Available Down syndrome is an intellectual disability disorder in which language and, specifically, verbal fluency are strongly impaired domains; nearly all adults show neuropathology of Alzheimer’s disease, including amyloid deposition by their fifth decade of life. In the general population, verbal fluency deficits are considered a strong Alzheimer’s disease predictor being the Semantic Verbal Fluency Task (SVFT a useful tool for enhancing early diagnostic. However, there is a lack of information about the association between the semantic verbal fluency pattern (SVFP and the biological amyloidosis markers in Down syndrome. In the current study, we used the SVFT in young adults with Down syndrome to characterize their SVFP, assessing total generated words, clustering, and switching. We then explored its association with early indicators of dementia, adaptive behavior and amyloidosis biomarkers, using the Dementia Questionnaire for Persons with Intellectual Disability (DMR, the Adaptive Behavior Assessment System-Second Edition (ABAS-II, and plasma levels of Aβ peptides (Aβ40 and Aβ42, as a potent biomarker of Alzheimer's disease. In Down syndrome, worse performance in SVFT and poorer communication skills were associated with higher plasma Aβ42 concentrations, a higher DMR score and impaired communication skills (ABAS–II. The total word production and switching ability in SVFT were good indicators of plasma Aβ42 concentration. In conclusion, we propose the SVFT as a good screening test for early detection of dementia and amyloidosis in young adults with Down syndrome.

  10. Generalized Likelihood Ratio Statistics and Uncertainty Adjustments in Efficient Adaptive Design of Clinical Trials

    CERN Document Server

    Bartroff, Jay

    2011-01-01

    A new approach to adaptive design of clinical trials is proposed in a general multiparameter exponential family setting, based on generalized likelihood ratio statistics and optimal sequential testing theory. These designs are easy to implement, maintain the prescribed Type I error probability, and are asymptotically efficient. Practical issues involved in clinical trials allowing mid-course adaptation and the large literature on this subject are discussed, and comparisons between the proposed and existing designs are presented in extensive simulation studies of their finite-sample performance, measured in terms of the expected sample size and power functions.

  11. Adaptive global synchronization of a general complex dynamical network with non-delayed and delayed coupling

    Science.gov (United States)

    Wen, Sun; Chen, Shihua; Guo, Wanli

    2008-10-01

    This Letter investigates the global synchronization of a general complex dynamical network with non-delayed and delayed coupling. Based on Lasalle's invariance principle, adaptive global synchronization criteria is obtained. Analytical result shows that under the designed adaptive controllers, a general complex dynamical network with non-delayed and delayed coupling can globally asymptotically synchronize to a given trajectory. What is more, the node dynamic need not satisfy the very strong and conservative uniformly Lipschitz condition and the coupling matrix is not assumed to be symmetric or irreducible. Finally, numerical simulations are presented to verify the effectiveness of the proposed synchronization criteria.

  12. Adaptive global synchronization of a general complex dynamical network with non-delayed and delayed coupling

    Energy Technology Data Exchange (ETDEWEB)

    Wen Sun [College of Mathematics and Statistics, Wuhan University, Wuhan 430072 (China)], E-mail: sunwen_2201@163.com; Chen Shihua; Guo Wanli [College of Mathematics and Statistics, Wuhan University, Wuhan 430072 (China)

    2008-10-13

    This Letter investigates the global synchronization of a general complex dynamical network with non-delayed and delayed coupling. Based on Lasalle's invariance principle, adaptive global synchronization criteria is obtained. Analytical result shows that under the designed adaptive controllers, a general complex dynamical network with non-delayed and delayed coupling can globally asymptotically synchronize to a given trajectory. What is more, the node dynamic need not satisfy the very strong and conservative uniformly Lipschitz condition and the coupling matrix is not assumed to be symmetric or irreducible. Finally, numerical simulations are presented to verify the effectiveness of the proposed synchronization criteria.

  13. The Adapted Ordering Method for the Representation Theory of Lie Algebras and Superalgebras and their Generalizations

    CERN Document Server

    Gato-Rivera, Beatriz

    2008-01-01

    In 1998 the Adapted Ordering Method was developed for the study of the representation theory of the superconformal algebras in two dimensions. It allows: to determine the maximal dimension for a given type of space of singular vectors, to identify all singular vectors by only a few coefficients, to spot subsingular vectors and to set the basis for constructing embedding diagrams. In this talk I introduce the present version of the Adapted Ordering Method, published in J. Phys. A: Math. Theor. 41 (2008) 045201, which can be applied to general Lie algebras and superalgebras and their generalizations, provided they can be triangulated.

  14. The Adapted Ordering Method for Lie Algebras and Superalgebras and their Generalizations

    CERN Document Server

    Gato-Rivera, Beatriz

    2007-01-01

    In 1998 the Adapted Ordering Method was developed for the representation theory of the superconformal algebras in two dimensions. It allows: to determine maximal dimensions for a given type of space of singular vectors, to identify all singular vectors by only a few coefficients, to spot subsingular vectors and to set the basis for constructing embedding diagrams. In this article we present the Adapted Ordering Method for general Lie algebras and superalgebras, and their generalizations, provided they can be triangulated. We also review briefly the results obtained for the Virasoro algebra and for the N=2 and Ramond N=1 superconformal algebras.

  15. High School General Education English Teachers' Perception of IEP Accommodations for Students with Asperger Syndrome

    Science.gov (United States)

    Krones, Mary Patricia

    2016-01-01

    The purpose of this qualitative design study was to better understand the experiences of high school general education English teachers who have students with Asperger Syndrome in their classes. More specifically, this researcher wanted to better understand the teacher's perception of the IEP-denoted accommodations the general education teachers…

  16. The hyperventilation syndrome in panic disorder, agoraphobia and generalized anxiety disorder

    NARCIS (Netherlands)

    de Ruiter, C.; Garssen, B.; Rijken, H.; Kraaimaat, F.

    1989-01-01

    The symptom complex of panic disorder and generalized anxiety disorder suggests an etiological role for hyperventilation. The present study investigates the overlap between DSM-III-R panic disorder, panic disorder with agoraphobia and generalized anxiety disorder with hyperventilation syndrome (HVS)

  17. High School General Education English Teachers' Perception of IEP Accommodations for Students with Asperger Syndrome

    Science.gov (United States)

    Krones, Mary Patricia

    2016-01-01

    The purpose of this qualitative design study was to better understand the experiences of high school general education English teachers who have students with Asperger Syndrome in their classes. More specifically, this researcher wanted to better understand the teacher's perception of the IEP-denoted accommodations the general education teachers…

  18. General anesthesia in patients with syndrome of Poland.

    Science.gov (United States)

    Díaz-Crespo, J; Vázquez-Mambrilla, Y; García-Herrera, F

    2017-02-01

    The increased use of surgery as a treatment or as an alternative for improvement means that we have a larger number of patients in the operating theatre, including those who suffer from rare diseases. Poland Syndrome is a rare congenital disease associated with muscle development. These patients may have a broad spectrum of abnormalities, which include thoracic anomalies, which can alter the ventilatory management at the level of the airway; the possible onset of malignant hyperthermia. This leads the anaesthetist to take certain preventive measures. We report the case of a patient with Poland syndrome operated for the placement of a breast prosthesis. We avoid halogenated agents, and use a Total Intravenous Anaesthesia with propofol. The appearance of muscle spasms as a result of the use of propofol, forced us into a second anaesthesia to perform total intravenous anaesthesia with Midazolam. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. More adaptive versus less maladaptive coping: What is more predictive of symptom severity? Development of a new scale to investigate coping profiles across different psychopathological syndromes.

    Science.gov (United States)

    Moritz, Steffen; Jahns, Anna Katharina; Schröder, Johanna; Berger, Thomas; Lincoln, Tania M; Klein, Jan Philipp; Göritz, Anja S

    2016-02-01

    Lack of adaptive and enhanced maladaptive coping with stress and negative emotions are implicated in many psychopathological disorders. We describe the development of a new scale to investigate the relative contribution of different coping styles to psychopathology in a large population sample. We hypothesized that the magnitude of the supposed positive correlation between maladaptive coping and psychopathology would be stronger than the supposed negative correlation between adaptive coping and psychopathology. We also examined whether distinct coping style patterns emerge for different psychopathological syndromes. A total of 2200 individuals from the general population participated in an online survey. The Patient Health Questionnaire-9 (PHQ-9), the Obsessive-Compulsive Inventory revised (OCI-R) and the Paranoia Checklist were administered along with a novel instrument called Maladaptive and Adaptive Coping Styles (MAX) questionnaire. Participants were reassessed six months later. MAX consists of three dimensions representing adaptive coping, maladaptive coping and avoidance. Across all psychopathological syndromes, similar response patterns emerged. Maladaptive coping was more strongly related to psychopathology than adaptive coping both cross-sectionally and longitudinally. The overall number of coping styles adopted by an individual predicted greater psychopathology. Mediation analysis suggests that a mild positive relationship between adaptive and certain maladaptive styles (emotional suppression) partially accounts for the attenuated relationship between adaptive coping and depressive symptoms. Results should be replicated in a clinical population. Results suggest that maladaptive and adaptive coping styles are not reciprocal. Reducing maladaptive coping seems to be more important for outcome than enhancing adaptive coping. The study supports transdiagnostic approaches advocating that maladaptive coping is a common factor across different psychopathologies

  20. Dental Treatments under the General Anesthesia in a Child with Keratitis, Ichthyosis, and Deafness Syndrome

    Directory of Open Access Journals (Sweden)

    Sera Sımsek Derelioglu

    2013-01-01

    Full Text Available KID syndrome is a rare genodermatosis characterized by keratitis, ichthyosis, and sensorineural deafness. Although the dermatological, ophthalmologic, and sensorineural defects are emphasized in the literature, oral and dental evaluations are so superficial. In this case report, dental and oral symptoms of a three year and five months old boy with KID syndrome, suffering severe Early Childhood Caries (s-ECC and dental treatments done under General Anesthesia (GA were reported.

  1. A Description of Adaptive and Maladaptive Behaviour in Children and Adolescents with Cri-du-Chat Syndrome

    Science.gov (United States)

    Teixeira, M. C. T. V.; Emerich, D. R.; Orsati, F. T.; Rimerio, R. C.; Gatto, K. R.; Chappaz, I. O.; Kim, C. A.

    2011-01-01

    Background: Psychological tests can be useful to record adaptive and maladaptive behaviours of children with intellectual disability. The objective of this study was to describe the adaptive and maladaptive behaviour of children and adolescents with Cri-du-chat syndrome. Methods: The sample consisted of 10 children and adolescents with Cri-du-chat…

  2. A Description of Adaptive and Maladaptive Behaviour in Children and Adolescents with Cri-du-Chat Syndrome

    Science.gov (United States)

    Teixeira, M. C. T. V.; Emerich, D. R.; Orsati, F. T.; Rimerio, R. C.; Gatto, K. R.; Chappaz, I. O.; Kim, C. A.

    2011-01-01

    Background: Psychological tests can be useful to record adaptive and maladaptive behaviours of children with intellectual disability. The objective of this study was to describe the adaptive and maladaptive behaviour of children and adolescents with Cri-du-chat syndrome. Methods: The sample consisted of 10 children and adolescents with Cri-du-chat…

  3. Structure identification and adaptive synchronization of uncertain general complex dynamical networks

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yuhua, E-mail: yuhuaxu2004@163.co [College of Information Science and Technology, Donghua University, Shanghai 201620 (China) and Department of Maths, Yunyang Teacher' s College, Hubei 442000 (China); Zhou Wuneng, E-mail: wnzhou@163.co [College of Information Science and Technology, Donghua University, Shanghai 201620 (China); Fang Jian' an [College of Information Science and Technology, Donghua University, Shanghai 201620 (China); Lu Hongqian [Shandong Institute of Light Industry, Shandong Jinan 250353 (China)

    2009-12-28

    This Letter proposes an approach to identify the topological structure and unknown parameters for uncertain general complex networks simultaneously. By designing effective adaptive controllers, we achieve synchronization between two complex networks. The unknown network topological structure and system parameters of uncertain general complex dynamical networks are identified simultaneously in the process of synchronization. Several useful criteria for synchronization are given. Finally, an illustrative example is presented to demonstrate the application of the theoretical results.

  4. Robust adaptive synchronization of general dynamical networks with multiple delays and uncertainties

    Indian Academy of Sciences (India)

    LU YIMING; HE PING; MA SHU-HUA; LI GUO-ZHI; MOBAYBEN SALEH

    2016-06-01

    In this article, a general complex dynamical network which contains multiple delays and uncertainties is introduced, which contains time-varying coupling delays, time-varying node delay, and uncertainties of both the inner- and outer-coupling matrices. A robust adaptive synchronization scheme for these general complex networks with multiple delays and uncertainties is established and raised by employing the robust adaptive control principle and the Lyapunov stability theory. We choose some suitable adaptive synchronization controllers to ensure the robust synchronization of this dynamical network. The numerical simulations of the time-delay Lorenz chaotic system as local dynamical node are provided to observe and verify the viability and productivity of the theoretical research in this paper. Compared to the achievement of previous research, theresearch in this paper seems quite comprehensive and universal.

  5. Adaptive generalized combination complex synchronization of uncertain real and complex nonlinear systems

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Shi-bing, E-mail: wang-shibing@dlut.edu.cn, E-mail: wangxy@dlut.edu.cn [School of Computer and Information Engineering, Fuyang Normal University, Fuyang 236041 (China); Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian 116024 (China); Wang, Xing-yuan, E-mail: wang-shibing@dlut.edu.cn, E-mail: wangxy@dlut.edu.cn [Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian 116024 (China); Wang, Xiu-you [School of Computer and Information Engineering, Fuyang Normal University, Fuyang 236041 (China); Zhou, Yu-fei [College of Electrical Engineering and Automation, Anhui University, Hefei 230601 (China)

    2016-04-15

    With comprehensive consideration of generalized synchronization, combination synchronization and adaptive control, this paper investigates a novel adaptive generalized combination complex synchronization (AGCCS) scheme for different real and complex nonlinear systems with unknown parameters. On the basis of Lyapunov stability theory and adaptive control, an AGCCS controller and parameter update laws are derived to achieve synchronization and parameter identification of two real drive systems and a complex response system, as well as two complex drive systems and a real response system. Two simulation examples, namely, ACGCS for chaotic real Lorenz and Chen systems driving a hyperchaotic complex Lü system, and hyperchaotic complex Lorenz and Chen systems driving a real chaotic Lü system, are presented to verify the feasibility and effectiveness of the proposed scheme.

  6. Multichannel Speech Enhancement Based on Generalized Gamma Prior Distribution with Its Online Adaptive Estimation

    Science.gov (United States)

    Dat, Tran Huy; Takeda, Kazuya; Itakura, Fumitada

    We present a multichannel speech enhancement method based on MAP speech spectral magnitude estimation using a generalized gamma model of speech prior distribution, where the model parameters are adapted from actual noisy speech in a frame-by-frame manner. The utilization of a more general prior distribution with its online adaptive estimation is shown to be effective for speech spectral estimation in noisy environments. Furthermore, the multi-channel information in terms of cross-channel statistics are shown to be useful to better adapt the prior distribution parameters to the actual observation, resulting in better performance of speech enhancement algorithm. We tested the proposed algorithm in an in-car speech database and obtained significant improvements of the speech recognition performance, particularly under non-stationary noise conditions such as music, air-conditioner and open window.

  7. Considering the Use of General and Modified Assessment Items in Computerized Adaptive Testing

    Science.gov (United States)

    Wyse, Adam E.; Albano, Anthony D.

    2015-01-01

    This article used several data sets from a large-scale state testing program to examine the feasibility of combining general and modified assessment items in computerized adaptive testing (CAT) for different groups of students. Results suggested that several of the assumptions made when employing this type of mixed-item CAT may not be met for…

  8. An overview of short bowel syndrome management: adherence, adaptation, and practical recommendations.

    Science.gov (United States)

    Wall, Elizabeth A

    2013-09-01

    Short bowel syndrome (SBS) refers to the clinical consequences resulting from loss of small bowel absorptive surface area due to surgical resection or bypass. The syndrome is characterized by maldigestion, malabsorption, and malnutrition. Survival of patients with SBS is dependent on adaptation in the remaining bowel and a combination of pharmacologic and nutrition therapies. Individual plans of care are developed based on the length and sites of remaining bowel, the degree of intestinal adaptation, and the patient's ability to adhere to the medication and dietary regimens. Antisecretory and antidiarrheal medications are prescribed to slow intestinal transit times and optimize fluid and nutrient absorption. Based on postsurgical anatomy, enteral feedings, parenteral infusions, complex diet plans, and vitamin and mineral supplementation are used in various combinations to nourish patients with SBS. In the acute care setting, registered dietitians (RDs) assist with infusion therapy, diet education, and discharge planning. Long-term, as the small intestine adapts, RDs revise the nutrition care plan and monitor for nutrient deficiencies, metabolic bone disease, and anemia. The frequent monitoring and revision of care plans, plus the appreciable benefits from proper medical nutrition therapy, make this patient population extremely challenging and rewarding for RDs to manage. This article provides a brief, case study-based overview of the medical and nutrition management of SBS.

  9. Genetics, Evolution, and Adaptive Significance of the Selfing Syndrome in the Genus Capsella[C][W

    Science.gov (United States)

    Sicard, Adrien; Stacey, Nicola; Hermann, Katrin; Dessoly, Jimmy; Neuffer, Barbara; Bäurle, Isabel; Lenhard, Michael

    2011-01-01

    The change from outbreeding to selfing is one of the most frequent evolutionary transitions in flowering plants. It is often accompanied by characteristic morphological and functional changes to the flowers (the selfing syndrome), including reduced flower size and opening. Little is known about the developmental and genetic basis of the selfing syndrome, as well as its adaptive significance. Here, we address these issues using the two closely related species Capsella grandiflora (the ancestral outbreeder) and red shepherd’s purse (Capsella rubella, the derived selfer). In C. rubella, petal size has been decreased by shortening the period of proliferative growth. Using interspecific recombinant inbred lines, we show that differences in petal size and flower opening between the two species each have a complex genetic basis involving allelic differences at multiple loci. An intraspecific cross within C. rubella suggests that flower size and opening have been decreased in the C. rubella lineage before its extensive geographical spread. Lastly, by generating plants that likely resemble the earliest ancestors of the C. rubella lineage, we provide evidence that evolution of the selfing syndrome was at least partly driven by selection for efficient self-pollination. Thus, our studies pave the way for a molecular dissection of selfing-syndrome evolution. PMID:21954462

  10. Genetics, evolution, and adaptive significance of the selfing syndrome in the genus Capsella.

    Science.gov (United States)

    Sicard, Adrien; Stacey, Nicola; Hermann, Katrin; Dessoly, Jimmy; Neuffer, Barbara; Bäurle, Isabel; Lenhard, Michael

    2011-09-01

    The change from outbreeding to selfing is one of the most frequent evolutionary transitions in flowering plants. It is often accompanied by characteristic morphological and functional changes to the flowers (the selfing syndrome), including reduced flower size and opening. Little is known about the developmental and genetic basis of the selfing syndrome, as well as its adaptive significance. Here, we address these issues using the two closely related species Capsella grandiflora (the ancestral outbreeder) and red shepherd's purse (Capsella rubella, the derived selfer). In C. rubella, petal size has been decreased by shortening the period of proliferative growth. Using interspecific recombinant inbred lines, we show that differences in petal size and flower opening between the two species each have a complex genetic basis involving allelic differences at multiple loci. An intraspecific cross within C. rubella suggests that flower size and opening have been decreased in the C. rubella lineage before its extensive geographical spread. Lastly, by generating plants that likely resemble the earliest ancestors of the C. rubella lineage, we provide evidence that evolution of the selfing syndrome was at least partly driven by selection for efficient self-pollination. Thus, our studies pave the way for a molecular dissection of selfing-syndrome evolution.

  11. Beneficial Effects of Long-Term Growth Hormone Treatment on Adaptive Functioning in Infants With Prader-Willi Syndrome.

    Science.gov (United States)

    Lo, Sin T; Festen, Dederieke A M; Tummers-de Lind van Wijngaarden, Roderick F A; Collin, Philippe J L; Hokken-Koelega, Anita C S

    2015-07-01

    The aim of this study was to investigate the effect of growth hormone treatment on adaptive functioning in children with Prader-Willi syndrome. Vineland Adaptive Behavior Scale (VABS) was assessed during a randomized controlled trial (RCT) and after 7 years of growth hormone treatment. In the RCT, 75 children (42 infants and 33 prepubertal children) with Prader-Willi syndrome were included. Subsequently, 53 children were treated with long-term growth hormone. Our study demonstrates a marked delay in adaptive functioning in infants and children with Prader-Willi syndrome, which was associated with older age and lower intelligence. Results of the repeated measurements show that the earlier growth hormone treatment was started during infancy, the better the adaptive skills were on the long-term.

  12. Chiari malformation and central sleep apnea syndrome: efficacy of treatment with adaptive servo-ventilation

    Directory of Open Access Journals (Sweden)

    Jorge Marques do Vale

    2014-10-01

    Full Text Available The Chiari malformation type I (CM-I has been associated with sleep-disordered breathing, especially central sleep apnea syndrome. We report the case of a 44-year-old female with CM-I who was referred to our sleep laboratory for suspected sleep apnea. The patient had undergone decompressive surgery 3 years prior. An arterial blood gas analysis showed hypercapnia. Polysomnography showed a respiratory disturbance index of 108 events/h, and all were central apnea events. Treatment with adaptive servo-ventilation was initiated, and central apnea was resolved. This report demonstrates the efficacy of servo-ventilation in the treatment of central sleep apnea syndrome associated with alveolar hypoventilation in a CM-I patient with a history of decompressive surgery.

  13. Motor adaptation and generalization of reaching movements using motor primitives based on spatial coordinates.

    Science.gov (United States)

    Tanaka, Hirokazu; Sejnowski, Terrence J

    2015-02-15

    The brain processes sensory and motor information in a wide range of coordinate systems, ranging from retinal coordinates in vision to body-centered coordinates in areas that control musculature. Here we focus on the coordinate system used in the motor cortex to guide actions and examine physiological and psychophysical evidence for an allocentric reference frame based on spatial coordinates. When the equations of motion governing reaching dynamics are expressed as spatial vectors, each term is a vector cross product between a limb-segment position and a velocity or acceleration. We extend this computational framework to motor adaptation, in which the cross-product terms form adaptive bases for canceling imposed perturbations. Coefficients of the velocity- and acceleration-dependent cross products are assumed to undergo plastic changes to compensate the force-field or visuomotor perturbations. Consistent with experimental findings, each of the cross products had a distinct reference frame, which predicted how an acquired remapping generalized to untrained location in the workspace. In response to force field or visual rotation, mainly the coefficients of the velocity- or acceleration-dependent cross products adapted, leading to transfer in an intrinsic or extrinsic reference frame, respectively. The model further predicted that remapping of visuomotor rotation should under- or overgeneralize in a distal or proximal workspace. The cross-product bases can explain the distinct patterns of generalization in visuomotor and force-field adaptation in a unified way, showing that kinematic and dynamic motor adaptation need not arise through separate neural substrates.

  14. A NEW SELF-ADAPTIVE ITERATIVE METHOD FOR GENERAL MIXED QUASI VARIATIONAL INEQUALITIES

    Institute of Scientific and Technical Information of China (English)

    Abdellah Bnouhachem; Mohamed Khalfaoui; Hafida Benazza

    2008-01-01

    The general mixed quasi variational inequality containing a nonlinear term ψ is a useful and an important generalization of variational inequalities. The projection method can not be applied to solve this problem due to the presence of nonlinear term. It is well known that the variational inequalities involving the nonlinear term ψ are equivalent to the fixed point problems and re, solvent equations. In this article, the authors use these alternative equivalent formulations to suggest and analyze a new self-adaptive iterative method for solving general mixed quasi variational inequalities. Global convergence of the new method is proved. An example is given to illustrate the efficiency of the proposed method.

  15. An Adaptive Total Generalized Variation Model with Augmented Lagrangian Method for Image Denoising

    Directory of Open Access Journals (Sweden)

    Chuan He

    2014-01-01

    Full Text Available We propose an adaptive total generalized variation (TGV based model, aiming at achieving a balance between edge preservation and region smoothness for image denoising. The variable splitting (VS and the classical augmented Lagrangian method (ALM are used to solve the proposed model. With the proposed adaptive model and ALM, the regularization parameter, which balances the data fidelity and the regularizer, is refreshed with a closed form in each iterate, and the image denoising can be accomplished without manual interference. Numerical results indicate that our method is effective in staircasing effect suppression and holds superiority over some other state-of-the-art methods both in quantitative and in qualitative assessment.

  16. A General Framework for Sequential and Adaptive Methods in Survival Studies

    CERN Document Server

    Luo, Xiaolong; Ying, Zhiliang

    2011-01-01

    Adaptive treatment allocation schemes based on interim responses have generated a great deal of recent interest in clinical trials and other follow-up studies. An important application of such schemes is in survival studies, where the response variable of interest is time to the occurrence of a certain event. Due to possible dependency structures inherited from the enrollment and allocation schemes, existing approaches to survival models, including those that handle staggered entry, cannot be applied directly. This paper develops a new general framework with its theoretical foundation for handling such adaptive designs. The new approach is based on marked point processes and differs from existing approaches in that it considers entry and calender times rather than survival and calender times. Large sample properties, which are essential for statistical inference, are established. Special attention is given to the Cox model and related score processes. Applications to adaptive and sequential designs are discus...

  17. Adaptive Behavior and Development of Infants and Toddlers with Williams Syndrome

    Directory of Open Access Journals (Sweden)

    Rebecca M. Kirchner

    2016-04-01

    Full Text Available Williams syndrome (WS is a neurodevelopmental disorder that causes deficits in adaptive behavior, difficulties eating and sleeping, cognitive delays, and delayed development. Although researchers have conducted characterizations of children and adults with WS, less is known about young children with this disorder. This study characterizes the developmental and adaptive behavior features of 16 infants and toddlers with WS aged 3 months - 5 years. Data for this project was obtained from 2007-2014, and includes parent report data and standardized developmental testing. Thirty-one percent (31.3% of parents reported that their infant/toddler with WS had sleeping problems and 58.3% reported feeding difficulties. Levels of adaptive behavior were in the Mildly Delayed range as measured by the Adaptive Behavior Assessment System, Second Edition. Self care skills such as feeding or dressing oneself were significantly weaker than skills needed to function in the community, such as recognizing his/her home or throwing away trash. The difficulty with self-care skills is hypothesized to be related to the reported difficulties with eating and sleeping. Motor skills were significantly lower than both cognitive and language skills on the Bayley Scales of Infant and Toddler Development, Third Edition. The current study highlights the need for early intervention in these young children across all areas of development, particularly in self-care skills.

  18. Anesthetic and airway management of general anesthesia in a patient with Meckel-Gruber syndrome.

    Science.gov (United States)

    Miyazu, Mitsunori; Sobue, Kazuya; Ito, Hiroaki; Azami, Takafumi; Ito, Shoji; Takeuchi, Akinori; Sasano, Hiroshi; Tsuda, Takako; Katsuya, Hirotada

    2005-01-01

    Meckel-Gruber syndrome, characterized by occipital encephalocele, microcephaly, polydactyly, cleft lip or palate, mandibular micrognathism, and anatomical abnormality of the larynx and tongue, along with other associated malformations, is in the list of diseases associated with difficult airway. However, there has been no report on the management of general anesthesia and airway management for such patients. A 2-year-old girl with Meckel-Gruber syndrome was scheduled for cardioplasty and gastrostomy for gastroesophageal reflux under general anesthesia. Preoperative examination revealed obesity, microgenia, dysspondylism, proteinuria, hypoplastic kidneys, and stenosis of the anal canal. Although we anticipated some difficulty with the intubation and prepared several alternative methods for intubation, such as a bronchofiberscope and a laryngeal mask airway, tracheal intubation was completed without difficulty using conventional laryngoscopy after inhalational induction with sevoflurane. Because most patients with this syndrome die before and shortly after delivery, those who survive to some age might have less severe deformities.

  19. Lin-Kernighan Heuristic Adaptation for the Generalized Traveling Salesman Problem

    CERN Document Server

    Karapetyan, Daniel

    2010-01-01

    Lin-Kernighan heuristic is known to be one of the most successful heuristics for the Traveling Salesman Problem (TSP). It has also proven its efficiency in application to some other problems. However, it was never applied to the the Generalized Traveling Salesman Problem (GTSP) though it has the same nature as TSP. In this paper we discuss possible adaptations of TSP heuristics for GTSP and focus on the case of Lin-Kernighan algorithm. At first, we provide an easy-to-understand description of the original Lin-Kernighan heuristic. Then we propose several adaptations, both trivial and complicated ones. Finally, we conduct a fair competition between all the variations of Lin-Kernighan adaptation and some other GTSP heuristics. It appears that our adaptation of Lin-Kernighan algorithm for GTSP reproduces the success of the original heuristic. Different variations of our adaptation outperform all other heuristics in a wide range of tradeoffs between solution quality and running time, making Lin-Kernighan the state...

  20. Impact of co-channel interference on the performance of adaptive generalized transmit beamforming

    KAUST Repository

    Radaydeh, Redha Mahmoud Mesleh

    2011-08-01

    The impact of co-channel interference on the performance of adaptive generalized transmit beamforming for low-complexity multiple-input single-output (MISO) configuration is investigated. The transmit channels are assumed to be sufficiently separated and undergo Rayleigh fading conditions. Due to the limited space, a single receive antenna is employed to capture desired user transmission. The number of active transmit channels is adjusted adaptively based on statistically unordered and/or ordered instantaneous signal-to-noise ratios (SNRs), where the transmitter has no information about the statistics of undesired signals. The adaptation thresholds are identified to guarantee a target performance level, and the adaptation schemes with enhanced spectral efficiency or power efficiency are studied and their performance are compared under various channels conditions. To facilitate comparison studies, results for the statistics of instantaneous combined signal-to-interference-plus-noise ratio (SINR) are derived, which can be applied for different fading conditions of interfering signals. The statistics for combined SNR and combined SINR are then used to quantify various performance measures, considering the impact of non-ideal estimation of the desired user channel state information (CSI) and the randomness in the number of active interferers. Numerical and simulation comparisons for the achieved performance of the adaptation schemes are presented. © 2006 IEEE.

  1. Adaptive-Anisotropic Wavelet Collocation Method on general curvilinear coordinate systems

    Science.gov (United States)

    Brown-Dymkoski, Eric; Vasilyev, Oleg V.

    2017-03-01

    A new general framework for an Adaptive-Anisotropic Wavelet Collocation Method (A-AWCM) for the solution of partial differential equations is developed. This proposed framework addresses two major shortcomings of existing wavelet-based adaptive numerical methodologies, namely the reliance on a rectangular domain and the "curse of anisotropy", i.e. drastic over-resolution of sheet- and filament-like features arising from the inability of the wavelet refinement mechanism to distinguish highly correlated directional information in the solution. The A-AWCM addresses both of these challenges by incorporating coordinate transforms into the Adaptive Wavelet Collocation Method for the solution of PDEs. The resulting integrated framework leverages the advantages of both the curvilinear anisotropic meshes and wavelet-based adaptive refinement in a complimentary fashion, resulting in greatly reduced cost of resolution for anisotropic features. The proposed Adaptive-Anisotropic Wavelet Collocation Method retains the a priori error control of the solution and fully automated mesh refinement, while offering new abilities through the flexible mesh geometry, including body-fitting. The new A-AWCM is demonstrated for a variety of cases, including parabolic diffusion, acoustic scattering, and unsteady external flow.

  2. Biohybrid Control of General Linear Systems Using the Adaptive Filter Model of Cerebellum.

    Science.gov (United States)

    Wilson, Emma D; Assaf, Tareq; Pearson, Martin J; Rossiter, Jonathan M; Dean, Paul; Anderson, Sean R; Porrill, John

    2015-01-01

    The adaptive filter model of the cerebellar microcircuit has been successfully applied to biological motor control problems, such as the vestibulo-ocular reflex (VOR), and to sensory processing problems, such as the adaptive cancelation of reafferent noise. It has also been successfully applied to problems in robotics, such as adaptive camera stabilization and sensor noise cancelation. In previous applications to inverse control problems, the algorithm was applied to the velocity control of a plant dominated by viscous and elastic elements. Naive application of the adaptive filter model to the displacement (as opposed to velocity) control of this plant results in unstable learning and control. To be more generally useful in engineering problems, it is essential to remove this restriction to enable the stable control of plants of any order. We address this problem here by developing a biohybrid model reference adaptive control (MRAC) scheme, which stabilizes the control algorithm for strictly proper plants. We evaluate the performance of this novel cerebellar-inspired algorithm with MRAC scheme in the experimental control of a dielectric electroactive polymer, a class of artificial muscle. The results show that the augmented cerebellar algorithm is able to accurately control the displacement response of the artificial muscle. The proposed solution not only greatly extends the practical applicability of the cerebellar-inspired algorithm, but may also shed light on cerebellar involvement in a wider range of biological control tasks.

  3. Biohybrid control of general linear systems using the adaptive filter model of cerebellum

    Directory of Open Access Journals (Sweden)

    Emma D. Wilson

    2015-07-01

    Full Text Available The adaptive filter model of the cerebellar microcircuit has been successfully applied to biological motor control problems such as the vestibulo-ocular reflex (VOR and to sensory processing problems such as the adaptive cancellation of reafferent noise. It has also been successfully applied to problems in robotics such as adaptive camera stabilisation and sensor noise cancellation. In previous applications to inverse control problems the algorithm was applied to the velocity control of a plant dominated by viscous and elastic elements. Naive application of the adaptive filter model to the displacement (as opposed to velocity control of this plant results in unstable learning and control. To be more generally useful in engineering problems it is essential to remove this restriction to enable the stable control of plants of any order. We address this problem here by developing a biohybrid model reference adaptive control (MRAC scheme, which stabilises the control algorithm for strictly proper plants. We evaluate the performance of this novel cerebellar inspired algorithm with MRAC scheme in the experimental control of a dielectric electroactive polymer, a class of artificial muscle. The results show that the augmented cerebellar algorithm is able to accurately control the displacement response of the artificial muscle. The proposed solution not only greatly extends the practical applicability of the cerebellar-inspired algorithm, but may also shed light on cerebellar involvement in a wider range of biological control tasks.

  4. Toward a general theory of adaptive radiation: insights from microbial experimental evolution.

    Science.gov (United States)

    Kassen, Rees

    2009-06-01

    The history of life has been punctuated by unusually spectacular periods of evolutionary diversification called adaptive radiation. Darwin's finches in the Galapagos, cichlid fishes in African Rift and Nicaraguan crater lakes, and the emergence of mammals at the end of the Cretaceous are hallmark examples. Although we have learned much from these and other case studies about the mechanisms thought to drive adaptive radiations, convincing experimental tests of theory are often lacking for the simple reason that it is usually impossible to "rewind the tape of life," as Stephen Jay Gould was fond of saying, and run it again. This situation has changed dramatically in recent years with the increasing emphasis on the use of microbial populations which, because of their small size and rapid generation times, make possible the construction of replicated, manipulative experiments to study evolution in the laboratory. Here I review the contributions that microbial experimental evolution has made to our understanding of the ecological and genetic mechanisms underlying adaptive radiation. I focus on three major gaps in the theory of adaptive radiation--the paucity of direct tests of mechanism, the genetics of diversification, and the limits and constraints on the progress of radiations--with the aim of pointing the way toward the development of a more general theory of adaptive radiation.

  5. A Memristor-Based Hyperchaotic Complex Lü System and Its Adaptive Complex Generalized Synchronization

    Directory of Open Access Journals (Sweden)

    Shibing Wang

    2016-02-01

    Full Text Available This paper introduces a new memristor-based hyperchaotic complex Lü system (MHCLS and investigates its adaptive complex generalized synchronization (ACGS. Firstly, the complex system is constructed based on a memristor-based hyperchaotic real Lü system, and its properties are analyzed theoretically. Secondly, its dynamical behaviors, including hyperchaos, chaos, transient phenomena, as well as periodic behaviors, are explored numerically by means of bifurcation diagrams, Lyapunov exponents, phase portraits, and time history diagrams. Thirdly, an adaptive controller and a parameter estimator are proposed to realize complex generalized synchronization and parameter identification of two identical MHCLSs with unknown parameters based on Lyapunov stability theory. Finally, the numerical simulation results of ACGS and its applications to secure communication are presented to verify the feasibility and effectiveness of the proposed method.

  6. Adapting Phonological Awareness Interventions for Children With Down Syndrome Based on the Behavioral Phenotype: A Promising Approach?

    Science.gov (United States)

    Lemons, Christopher J; King, Seth A; Davidson, Kimberly A; Puranik, Cynthia S; Fulmer, Deborah; Mrachko, Alicia A; Partanen, Jane; Al Otaiba, Stephanie; Fidler, Deborah J

    2015-08-01

    Many children with Down syndrome demonstrate deficits in phonological awareness, a prerequisite to learning to read in an alphabetic language. The purpose of this study was to determine whether adapting a commercially available phonological awareness program to better align with characteristics associated with the behavioral phenotype of Down syndrome would increase children's learning of phonological awareness, letter sounds, and words. Five children with Down syndrome, ages 6 to 8 years, participated in a multiple baseline across participants single case design experiment in which response to an adapted phonological awareness intervention was compared with response to the nonadapted program. Results indicate a functional relation between the adapted program and phonological awareness. Suggestions for future research and implications for practice are provided.

  7. Adaptive adjustment of the generalization-discrimination balance in larval Drosophila.

    Science.gov (United States)

    Mishra, Dushyant; Louis, Matthieu; Gerber, Bertram

    2010-09-01

    Learnt predictive behavior faces a dilemma: predictive stimuli will never 'replay' exactly as during the learning event, requiring generalization. In turn, minute differences can become meaningful, prompting discrimination. To provide a study case for an adaptive adjustment of this generalization-discrimination balance, the authors ask whether Drosophila melanogaster larvae are able to either generalize or discriminate between two odors (1-octen-3-ol and 3-octanol), depending on the task. The authors find that after discriminatively rewarding one but not the other odor, larvae show conditioned preference for the rewarded odor. On the other hand, no odor specificity is observed after nondiscriminative training, even if the test involves a choice between both odors. Thus, for this odor pair at least, discrimination training is required to confer an odor-specific memory trace. This requires that there is at least some difference in processing between the two odors already at the beginning of the training. Therefore, as a default, there is a small yet salient difference in processing between 1-octen-3-ol and 3-octanol; this difference is ignored after nondiscriminative training (generalization), whereas it is accentuated by odor-specific reinforcement (discrimination). Given that, as the authors show, both faculties are lost in anosmic Or83b(1) mutants, this indicates an adaptive adjustment of the generalization-discrimination balance in larval Drosophila, taking place downstream of Or83b-expressing sensory neurons.

  8. Administration of a dipeptidyl peptidase IV inhibitor enhances the intestinal adaptation in a mouse model of short bowel syndrome

    DEFF Research Database (Denmark)

    Okawada, Manabu; Holst, Jens Juul; Teitelbaum, Daniel H

    2011-01-01

    Glucagon-like peptide-2 induces small intestine mucosal epithelial cell proliferation and may have benefit for patients who suffer from short bowel syndrome. However, glucagon-like peptide-2 is inactivated rapidly in vivo by dipeptidyl peptidase IV. Therefore, we hypothesized that selectively...... inhibiting dipeptidyl peptidase IV would prolong the circulating life of glucagon-like peptide-2 and lead to increased intestinal adaptation after development of short bowel syndrome....

  9. Mechanisms of Host Receptor Adaptation by Severe Acute Respiratory Syndrome Coronavirus

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Kailang; Peng, Guiqing; Wilken, Matthew; Geraghty, Robert J.; Li, Fang (UMMC)

    2012-12-10

    The severe acute respiratory syndrome coronavirus (SARS-CoV) from palm civets has twice evolved the capacity to infect humans by gaining binding affinity for human receptor angiotensin-converting enzyme 2 (ACE2). Numerous mutations have been identified in the receptor-binding domain (RBD) of different SARS-CoV strains isolated from humans or civets. Why these mutations were naturally selected or how SARS-CoV evolved to adapt to different host receptors has been poorly understood, presenting evolutionary and epidemic conundrums. In this study, we investigated the impact of these mutations on receptor recognition, an important determinant of SARS-CoV infection and pathogenesis. Using a combination of biochemical, functional, and crystallographic approaches, we elucidated the molecular and structural mechanisms of each of these naturally selected RBD mutations. These mutations either strengthen favorable interactions or reduce unfavorable interactions with two virus-binding hot spots on ACE2, and by doing so, they enhance viral interactions with either human (hACE2) or civet (cACE2) ACE2. Therefore, these mutations were viral adaptations to either hACE2 or cACE2. To corroborate the above analysis, we designed and characterized two optimized RBDs. The human-optimized RBD contains all of the hACE2-adapted residues (Phe-442, Phe-472, Asn-479, Asp-480, and Thr-487) and possesses exceptionally high affinity for hACE2 but relative low affinity for cACE2. The civet-optimized RBD contains all of the cACE2-adapted residues (Tyr-442, Pro-472, Arg-479, Gly-480, and Thr-487) and possesses exceptionally high affinity for cACE2 and also substantial affinity for hACE2. These results not only illustrate the detailed mechanisms of host receptor adaptation by SARS-CoV but also provide a molecular and structural basis for tracking future SARS-CoV evolution in animals.

  10. School Administrator Assessment of the Personality Traits of General Education Teachers for Suitability to Teach a Student with Asperger's Syndrome

    Science.gov (United States)

    Bernard, Arthur Ellis

    2011-01-01

    Most students with Asperger's syndrome are taught in general education classes by teachers who do not have special education training and it is the usually the administrator's responsibility to determine which general education teacher will teach a child with Asperger's syndrome. It is likely that most such decisions rely heavily on the…

  11. Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature

    DEFF Research Database (Denmark)

    Remvig, Lars; Jensen, Dorte V; Ward, Robert C

    2007-01-01

    This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria.......This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria....

  12. School Administrator Assessment of the Personality Traits of General Education Teachers for Suitability to Teach a Student with Asperger's Syndrome

    Science.gov (United States)

    Bernard, Arthur Ellis

    2011-01-01

    Most students with Asperger's syndrome are taught in general education classes by teachers who do not have special education training and it is the usually the administrator's responsibility to determine which general education teacher will teach a child with Asperger's syndrome. It is likely that most such decisions rely heavily on the…

  13. Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature

    DEFF Research Database (Denmark)

    Remvig, Lars; Jensen, Dorte V; Ward, Robert C

    2007-01-01

    This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria.......This literature review of generalized joint hypermobility (GJH) syndromes discusses information regarding sex-, age-, and race-related factors from publications that specifically document validated GJH criteria....

  14. β-Cell adaptation in a mouse model of glucocorticoid-induced metabolic syndrome.

    Science.gov (United States)

    Fransson, Liselotte; Franzén, Stephanie; Rosengren, Victoria; Wolbert, Petra; Sjöholm, Åke; Ortsäter, Henrik

    2013-12-01

    Glucocorticoids (GCs) are stress hormones primarily responsible for mobilizing glucose to the circulation. Due to this effect, insulin resistance and glucose intolerance are concerns in patients with endogenous overproduction of GCs and in patients prescribed GC-based therapy. In addition, hypercortisolemic conditions share many characteristics with the metabolic syndrome. This study reports on a thorough characterization, in terms of glucose control and lipid handling, of a mouse model where corticosterone is given via the drinking water. C57BL/6J mice were treated with corticosterone (100 or 25 μg/ml) or vehicle in their drinking water for 5 weeks after which they were subjected to insulin or glucose tolerance tests. GC-treated mice displayed increased food intake, body weight gain, and central fat deposit accumulations. In addition, the GC treatment led to dyslipidemia as well as accumulation of ectopic fat in the liver and skeletal muscle, having a substantial negative effect on insulin sensitivity. Also glucose intolerance and hypertension, both part of the metabolic syndrome, were evident in the GC-treated mice. However, the observed effects of corticosterone were reversed after drug removal. Furthermore, this study reveals insights into β-cell adaptation to the GC-induced insulin resistance. Increased pancreatic islet volume due to cell proliferation, increased insulin secretion capacity, and increased islet chaperone expression were found in GC-treated animals. This model mimics the human metabolic syndrome. It could be a valuable model for studying the complex mechanisms behind the development of the metabolic syndrome and type 2 diabetes, as well as the multifaceted relations between GC excess and disease.

  15. Age-related changes of adaptive and neuropsychological features in persons with Down Syndrome.

    Directory of Open Access Journals (Sweden)

    Alessandro Ghezzo

    Full Text Available Down Syndrome (DS is characterised by premature aging and an accelerated decline of cognitive functions in the vast majority of cases. As the life expectancy of DS persons is rapidly increasing, this decline is becoming a dramatic health problem. The aim of this study was to thoroughly evaluate a group of 67 non-demented persons with DS of different ages (11 to 66 years, from a neuropsychological, neuropsychiatric and psychomotor point of view in order to evaluate in a cross-sectional study the age-related adaptive and neuropsychological features, and to possibly identify early signs predictive of cognitive decline. The main finding of this study is that both neuropsychological functions and adaptive skills are lower in adult DS persons over 40 years old, compared to younger ones. In particular, language and short memory skills, frontal lobe functions, visuo-spatial abilities and adaptive behaviour appear to be the more affected domains. A growing deficit in verbal comprehension, along with social isolation, loss of interest and greater fatigue in daily tasks, are the main features found in older, non demented DS persons evaluated in our study. It is proposed that these signs can be alarm bells for incipient dementia, and that neuro-cognitive rehabilitation and psycho-pharmacological interventions must start as soon as the fourth decade (or even earlier in DS persons, i.e. at an age where interventions can have the greatest efficacy.

  16. Cognitive and adaptive evaluation of 21 consecutive patients with Dravet syndrome.

    Science.gov (United States)

    Villeneuve, Nathalie; Laguitton, Virginie; Viellard, Marine; Lépine, Anne; Chabrol, Brigitte; Dravet, Charlotte; Milh, Mathieu

    2014-02-01

    In order to assess the cognitive and adaptive profiles of school-aged patients with Dravet syndrome (DS), we proposed to evaluate the intelligence and adaptive scores in twenty-one 6- to 10-year-old patients with DS followed in our institution between 1997 and 2013. Fourteen patients were tested using the Wechsler Intelligence Scale for Children (WISC) and the Vineland Adaptive Behavioral Scales (VABS); 6 patients could not be tested with the WISC and were tested with the VABS only, and one was tested with the WISC only. Data regarding the epilepsy were retrospectively collected. Statistical analysis (Spearman rank order and Pearson correlation coefficient) was used to correlate early epilepsy characteristics with the cognitive and adaptive scores. Sodium channel, neuronal alpha-subunit type 1 (SCN1A) was mutated in 19 out of 21 patients. After the age of 6years, none of the DS patients had a normal intelligence quotient (IQ) using WISC (age at the testing period: mean=100±5; median=105months; mean total IQ=47±3; n=15). Only five patients had a verbal and/or a non verbal IQ of more than 60 (points). Their cognitive profile was characterized by an attention deficit, an inability to inhibit impulsive responses, perseverative responses and deficit in planning function. Administering the Vineland Adaptive Behavioral Scales in the same period, we showed that socialization skills were significantly higher than communication and autonomy skills (age at the testing period: mean=100±4; median=100months; n=20). We did not find any significant correlation between the IQ or developmental quotient assessed between 6 and 10years of age and the quantitative and qualitative parameters of epilepsy during the first two years of life in this small group of patients. Despite an overall moderate cognitive deficit in this group of patients, the Vineland Adaptive Behavioral Scales described an adaptive/behavioral profile with low communication and autonomy capacities, whereas the

  17. Non-syndromic occurrence of true generalized microdontia with mandibular mesiodens - a rare case.

    Science.gov (United States)

    Bargale, Seema D; Kiran, Shital D P

    2011-10-28

    Abnormalities in size of teeth and number of teeth are occasionally recorded in clinical cases. True generalized microdontia is rare case in which all the teeth are smaller than normal. Mesiodens is commonly located in maxilary central incisor region and uncommon in the mandible. In the present case a 12 year-old boy was healthy; normal in appearance and the medical history was noncontributory. The patient was examined and found to have permanent teeth that were smaller than those of the average adult teeth. The true generalized microdontia was accompanied by mandibular mesiodens. This is a unique case report of non-syndromic association of mandibular hyperdontia with true generalized microdontia.

  18. Generalized Monge-Kantorovich optimization for grid generation and adaptation in LP

    Energy Technology Data Exchange (ETDEWEB)

    Delzanno, G L [Los Alamos National Laboratory; Finn, J M [Los Alamos National Laboratory

    2009-01-01

    The Monge-Kantorovich grid generation and adaptation scheme of is generalized from a variational principle based on L{sub 2} to a variational principle based on L{sub p}. A generalized Monge-Ampere (MA) equation is derived and its properties are discussed. Results for p > 1 are obtained and compared in terms of the quality of the resulting grid. We conclude that for the grid generation application, the formulation based on L{sub p} for p close to unity leads to serious problems associated with the boundary. Results for 1.5 {approx}< p {approx}< 2.5 are quite good, but there is a fairly narrow range around p = 2 where the results are close to optimal with respect to grid distortion. Furthermore, the Newton-Krylov methods used to solve the generalized MA equation perform best for p = 2.

  19. Generalized in situ adaptive tabulation for constitutive model evaluation in plasticity

    Energy Technology Data Exchange (ETDEWEB)

    Arsenlis, A; Barton, N; Becker, R; Rudd, R

    2005-04-28

    A database storage, search and retrieval method of constitutive model responses for use in plasticity simulations is developed to increase the computational efficiency of finite element simulations employing complex non-linear material models. The method is based in the in situ adaptive tabulation method that has been successfully applied in the field of combustion chemistry, but is significantly modified to better handle the system of equations in plasticity. When using the database, the material response is estimated by a linear extrapolation from an appropriate database entry. This is shown to provide a response with an acceptable error tolerance. Two different example problems are chosen to demonstrate the behavior of the constitutive model estimation technique: a dynamic shock simulation, and a quasi-static inhomogeneous deformation simulation. This generalized in situ adaptive tabulation method shows promise for enabling simulations with complex multi-physics and multi-length scale constitutive descriptions.

  20. [Prevalence and Comorbidity of Self-Reported Diagnosis of Burnout Syndrome in the General Population].

    Science.gov (United States)

    Maske, Ulrike E; Riedel-Heller, Steffi G; Seiffert, Ingeburg; Jacobi, Frank; Hapke, Ulfert

    2016-01-01

    To determine the prevalence and comorbid mental disorders of self-reported diagnosis of burnout syndrome in the general population of Germany. In the German Health Interview and Examination Survey (DEGS1) self-reported diagnosis of a burnout syndrome made by a physician or psychotherapist was assessed in a standardized interview (N = 7987). For N = 4483 mental disorders were determined with the Composite International Diagnostic Interview (CIDI). Weighted lifetime and 12-month prevalences were calculated. Lifetime prevalence of diagnosed burnout syndrome was 4.2 % (women 5.2 %, men 3.3 %), 12-month prevalence was 1.5 % (women 1.9 %, men 1.1 %). Highest prevalences were found in 40 - 59 year olds, in people with middle and high socio economic status and in women with low and men with high social support. Among the 12-month cases, 70.9 % had at least one DSM-IV disorder. Associations were found for the diagnosis of burnout syndrome with somatoform, affective and anxiety disorders. The diagnosis of burnout syndrome is less frequently given and reported than expected. People with a burnout diagnosis often have a manifest mental disorder. © Georg Thieme Verlag KG Stuttgart · New York.

  1. MRSA model of learning and adaptation: a qualitative study among the general public

    Directory of Open Access Journals (Sweden)

    Rohde Rodney E

    2012-04-01

    Full Text Available Abstract Background More people in the US now die from Methicillin Resistant Staphylococcus aureus (MRSA infections than from HIV/AIDS. Often acquired in healthcare facilities or during healthcare procedures, the extremely high incidence of MRSA infections and the dangerously low levels of literacy regarding antibiotic resistance in the general public are on a collision course. Traditional medical approaches to infection control and the conventional attitude healthcare practitioners adopt toward public education are no longer adequate to avoid this collision. This study helps us understand how people acquire and process new information and then adapt behaviours based on learning. Methods Using constructivist theory, semi-structured face-to-face and phone interviews were conducted to gather pertinent data. This allowed participants to tell their stories so their experiences could deepen our understanding of this crucial health issue. Interview transcripts were analysed using grounded theory and sensitizing concepts. Results Our findings were classified into two main categories, each of which in turn included three subthemes. First, in the category of Learning, we identified how individuals used their Experiences with MRSA, to answer the questions: What was learned? and, How did learning occur? The second category, Adaptation gave us insights into Self-reliance, Reliance on others, and Reflections on the MRSA journey. Conclusions This study underscores the critical importance of educational programs for patients, and improved continuing education for healthcare providers. Five specific results of this study can reduce the vacuum that currently exists between the knowledge and information available to healthcare professionals, and how that information is conveyed to the public. These points include: 1 a common model of MRSA learning and adaptation; 2 the self-directed nature of adult learning; 3 the focus on general MRSA information, care and

  2. Peripheral vasodilators and the management of peripheral vascular disease and Raynaud's syndrome in general practice.

    Science.gov (United States)

    Connolly, J P; McGavock, H; Wilson-Davis, K

    1998-05-01

    There is no convincing evidence that peripheral vasodilators produce any significant improvement in exercise tolerance in patients with peripheral vascular disease, and these drugs may do more harm than good. In the treatment of severe Raynaud's syndrome, however, thymoxamine, prazosin or nifedipine is recommended. A descriptive study was carried out, firstly, to determine why these drugs are prescribed in general practice, and secondly, to describe the drug choices in the treatment of both Raynaud's syndrome and peripheral vascular disease in a representative sample of 22 practices in Northern Ireland. Of those patients prescribed peripheral vasodilators 69.6% were diagnosed as peripheral vascular disease, claudication or atherosclerosis. Over three-quarters of peripheral vasodilators prescribed were repeat prescriptions. Of those with Raynaud's syndrome only half were treated appropriately, and certainty of diagnosis did not guarantee appropriate treatment. Peripheral vasodilators accounted for the majority (51.5%) of items prescribed for peripheral vascular disease. A minority of patients with peripheral vascular disease (20.3%) were prescribed aspirin, and a smaller minority (4.4%) had undergone amputation. Peripheral vasodilators were prescribed unnecessarily and inappropriately. Measures to promote evidence-based treatment of both Raynaud's syndrome and peripheral vascular disease in general practice need to be taken. Copyright 1998 John Wiley & Sons, Ltd.

  3. No evidence for adaptation of current egg drop syndrome 1976 viruses to chickens.

    Science.gov (United States)

    Tsukamoto, K; Kuwabara, M; Kaneko, M; Mase, M; Imai, K

    2004-01-01

    In order to determine whether the current field strains of egg drop syndrome (EDS) 1976 viruses adapt to chickens, we compared the growth efficiency of three Japanese field strains (PA-1/79, AWI/98, Gifu/01) in chicken and duck embryo liver cells. The growth efficiency in chicken or duck embryo liver cells was almost similar in these strains. The fiber protein may carry the type-specific antigen and the hemagglutination activity, and hexon protein may contain the subgroup-specific antigenic determinants. Therefore, the fiber head and hexon loop 1 DNA domain sequences of the six Japanese field strains UPA-1/79, ME/80, 44/81, Kyoto/91, AWI/98, Gifu/01) were compared, but these DNA domains were identical among the six field strains. Our data suggested that the EDS virus was maintained without discernible changes for the last two decades in the field.

  4. Effects of generalized and specialized adaptive defense by shared prey on intra-guild predation.

    Science.gov (United States)

    Ikegawa, Yusuke; Ezoe, Hideo; Namba, Toshiyuki

    2015-01-07

    Intra-guild predation (IGP), predation on consumers which share common prey with the predators, is an important community module to understand a mechanism for persistence of complex food webs. However, classical theory suggests that persistence of an IGP system is unlikely particularly at high productivity, while empirical data do not support the prediction. Recently, adaptive defense by shared prey has been recognized to enhance coexistence of species and stability of the system. Some organisms having multiple predators in IGP systems employ two types of defenses; generalized defense that is effective against multiple predators and specialized one that is effective against only a specific predator species. We consider an IGP model including shared prey that can use the two types of defenses in combination against the consumer or omnivore. Assuming that the shared prey can change the allocation of defensive effort to increase its fitness, we show that the joint use of two types of adaptive defenses promotes three species coexistence and enhances stability of the IGP system when the specialized defense is more effective than the generalized one. When the system is unstable, a variety of oscillations appear and both the population densities and defensive efforts or only the population densities oscillate. Joint use of defenses against the consumer tends to increase the equilibrium population density of the shared prey with the defense efficiencies. In contrast, efficient generalized and specialized defenses against the omnivore often decrease the prey population. Consequently, adaptive defense by shared prey may not necessarily heighten the population size of the defender but sometimes increases densities of both the attackers and defender in IGP systems. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Adapting Phonological Awareness Interventions for Children with Down Syndrome Based on the Behavioral Phenotype: A Promising Approach?

    Science.gov (United States)

    Lemons, Christopher J.; King, Seth A.; Davidson, Kimberly A.; Puranik, Cynthia S.; Fulmer, Deborah; Mrachko, Alicia A.; Partanen, Jane; Al Otaiba, Stephanie; Fidler, Deborah J.

    2015-01-01

    Many children with Down syndrome demonstrate deficits in phonological awareness, a prerequisite to learning to read in an alphabetic language. The purpose of this study was to determine whether adapting a commercially available phonological awareness program to better align with characteristics associated with the behavioral phenotype of Down…

  6. Adapting Phonological Awareness Interventions for Children with Down Syndrome Based on the Behavioral Phenotype: A Promising Approach?

    Science.gov (United States)

    Lemons, Christopher J.; King, Seth A.; Davidson, Kimberly A.; Puranik, Cynthia S.; Fulmer, Deborah; Mrachko, Alicia A.; Partanen, Jane; Al Otaiba, Stephanie; Fidler, Deborah J.

    2015-01-01

    Many children with Down syndrome demonstrate deficits in phonological awareness, a prerequisite to learning to read in an alphabetic language. The purpose of this study was to determine whether adapting a commercially available phonological awareness program to better align with characteristics associated with the behavioral phenotype of Down…

  7. Patients taking medications for bipolar disorder are more prone to metabolic syndrome than Korea's general population.

    Science.gov (United States)

    Lee, Nam Young; Kim, Se Hyun; Cho, Belong; Lee, Yeon Ji; Chang, Jae Seung; Kang, Ung Gu; Kim, Yong Sik; Ahn, Yong Min

    2010-10-01

    Despite growing concerns about the co-morbidity of metabolic syndrome (MetS) and bipolar disorder, few studies have been conducted on this topic in Asian populations. This study examined Korean patients with bipolar disorder to assess its co-morbidity with MetS and to compare the prevalence of MetS in patients with medication for bipolar disorder with that of healthy patients. We used cross-sectional data from the medical records of patients with bipolar disorder who presented to the psychiatric clinic in Seoul National University Hospital between June 2007 and June 2008. The control group, matched for age and gender, was randomly drawn from visitors to the Health Promotion Center at the same hospital during the same period. We compared the prevalence of MetS between these two groups with independent sample t-tests and chi-squared tests. We also calculated the indirectly standardized prevalence ratio (ISPR) with a standardization that used the Fourth Korean National Health and Nutrition Examination Survey (KNHNES, 2007). The prevalence of MetS in patients who took medication for bipolar disorder (N=152) was 27.0%, 25.0% and 25.7%, based on the definitions of the American Heart Association and the National Heart, Lung and Blood Institute's adaptation of the Adult Treatment Panel III (AHA), the National Cholesterol Education Program for Adult Treatment Panel III (ATPIII) and the International Diabetes Federation (IDF), respectively. The present study determined that the prevalence of MetS was significantly higher in patients with bipolar disorder than in the control group; the odds ratios (OR) (95% CI) were 2.44 (1.35-4.40), 2.48 (1.34-4.59) and 2.57 (1.40-4.74), based on the definition of the AHA, ATPIII and IDF, respectively. The ISPR (95% CI) was 1.48 (1.02-1.93), 1.54 (1.05-2.03) and 1.98 (1.36-2.60), respectively. Patients with medications for bipolar disorder showed a significantly higher prevalence of increased waist circumference, elevated triglycerides, and

  8. General up regulation of Spodoptera frugiperda trypsins and chymotrypsins allows its adaptation to soybean proteinase inhibitor.

    Science.gov (United States)

    Brioschi, Daniela; Nadalini, Larissa D; Bengtson, Mario H; Sogayar, Mari Cleide; Moura, Daniel S; Silva-Filho, Marcio C

    2007-12-01

    The existence of a diverse serine proteinase gene family in lepidopteran insects suggests they play a significant role in the insect adaptation to plant proteinase inhibitors. These proteinases have been shown to be involved in the process of proteolytic digestion in insect larvae. We carried out a selective transcriptome study of midguts from Spodoptera frugiperda larvae fed on a diet supplemented with soybean proteinase inhibitor (SPI). Using subtracted cDNA libraries made of gut-expressed transcripts, a total of 2100 partial sequences were obtained, of those 38% were related to digestive process. Two large and diverse groups of chymotrypsins and trypsins were obtained, and some of these proteinase-encoding genes were further characterized by quantitative RT-PCR. The transcription analyses revealed two groups: one group of genes constitutively expressed in the control larvae that is up regulated by introducing SPI to the diet, and a second group that is absent in the control but is induced by the SPI-rich diet. This observation suggests that adaptation of S. frugiperda to SPI involves de novo synthesis and also up regulation of existing enzymes. Proteases from intestines of larvae reared on a diet with SPI showed insensitivity to the inhibitor. The proteases were also insensitive to a broad-spectrum potato proteinase inhibitor preparation. We propose that adaptation of S. frugiperda to SPI follows a "shotgun" approach, based on a general up regulation of a large set of endoproteinases.

  9. Adaptive finite element modeling of direct current resistivity in 2-D generally anisotropic structures

    Science.gov (United States)

    Yan, Bo; Li, Yuguo; Liu, Ying

    2016-07-01

    In this paper, we present an adaptive finite element (FE) algorithm for direct current (DC) resistivity modeling in 2-D generally anisotropic conductivity structures. Our algorithm is implemented on an unstructured triangular mesh that readily accommodates complex structures such as topography and dipping layers and so on. We implement a self-adaptive, goal-oriented grid refinement algorithm in which the finite element analysis is performed on a sequence of refined grids. The grid refinement process is guided by an a posteriori error estimator. The problem is formulated in terms of total potentials where mixed boundary conditions are incorporated. This type of boundary condition is superior to the Dirichlet type of conditions and improves numerical accuracy considerably according to model calculations. We have verified the adaptive finite element algorithm using a two-layered earth with azimuthal anisotropy. The FE algorithm with incorporation of mixed boundary conditions achieves high accuracy. The relative error between the numerical and analytical solutions is less than 1% except in the vicinity of the current source location, where the relative error is up to 2.4%. A 2-D anisotropic model is used to demonstrate the effects of anisotropy upon the apparent resistivity in DC soundings.

  10. Major depressive disorder in the general hospital: adaptation of clinical practice guidelines.

    Science.gov (United States)

    Voellinger, Rachel; Berney, Alexandre; Baumann, Pierre; Annoni, Jean Marie; Bryois, Christian; Buclin, Thierry; Büla, Christophe; Camus, Vincent; Christin, Laurent; Cornuz, Jacques; de Goumoëns, Pierre; Lamy, Olivier; Strnad, Jindrich; Burnand, Bernard; Stiefel, Frederic

    2003-01-01

    Major Depressive Disorder is particularly frequent among physically ill inpatients. Despite the considerable human burden and financial costs, Major Depressive Disorder remains under-detected and under-treated. To improve this situation, clinical practice guidelines for the management of Major Depressive Disorder were developed for patients in the general hospital. They were adapted from existing good quality guidelines. A literature search has been conducted to identify guidelines and systematic reviews about the management of Major Depressive Disorder. The quality of the existing guidelines was evaluated by means of the AGREE instrument (Appraisal of Guidelines for Research and Evaluation). Complementary literature searches were necessary to answer questions such as "depression and physical illness" or "antidepressants and somatic medication". The guidelines were discussed by a multidisciplinary internal panel. The final version was reviewed by an external panel. This paper presents the development process and a summary of these guidelines for the management of Major Depressive Disorder. The adaptation of good quality guidelines to local needs requires much time, effort and skills. Easier ways for the adaptation and use of high quality guidelines at the local level may result from better coordination, organization and updating of guidelines at a national or supranational level.

  11. Consistent Classification of Landsat Time Series with an Improved Automatic Adaptive Signature Generalization Algorithm

    Directory of Open Access Journals (Sweden)

    Matthew P. Dannenberg

    2016-08-01

    Full Text Available Classifying land cover is perhaps the most common application of remote sensing, yet classification at frequent temporal intervals remains a challenging task due to radiometric differences among scenes, time and budget constraints, and semantic differences among class definitions from different dates. The automatic adaptive signature generalization (AASG algorithm overcomes many of these limitations by locating stable sites between two images and using them to adapt class spectral signatures from a high-quality reference classification to a new image, which mitigates the impacts of radiometric and phenological differences between images and ensures that class definitions remain consistent between the two classifications. We refined AASG to adapt stable site identification parameters to each individual land cover class, while also incorporating improved input data and a random forest classifier. In the Research Triangle region of North Carolina, our new version of AASG demonstrated an improved ability to update existing land cover classifications compared to the initial version of AASG, particularly for low intensity developed, mixed forest, and woody wetland classes. Topographic indices were particularly important for distinguishing woody wetlands from other forest types, while multi-seasonal imagery contributed to improved classification of water, developed, forest, and hay/pasture classes. These results demonstrate both the flexibility of the AASG algorithm and the potential for using it to produce high-quality land cover classifications that can utilize the entire temporal range of the Landsat archive in an automated fashion while maintaining consistent class definitions through time.

  12. The Association of Intelligence, Visual-Motor Functioning, and Personality Characteristics With Adaptive Behavior in Individuals With Williams Syndrome.

    Science.gov (United States)

    Fu, Trista J; Lincoln, Alan J; Bellugi, Ursula; Searcy, Yvonne M

    2015-07-01

    Williams syndrome (WS) is associated with deficits in adaptive behavior and an uneven adaptive profile. This study investigated the association of intelligence, visual-motor functioning, and personality characteristics with the adaptive behavior in individuals with WS. One hundred individuals with WS and 25 individuals with developmental disabilities of other etiologies were included in this study. This study found that IQ and visual-motor functioning significantly predicted adaptive behavior in individuals of WS. Visual-motor functioning especially predicted the most amount of unique variance in overall adaptive behavior and contributed to the variance above and beyond that of IQ. Present study highlights the need for interventions that address visual-motor and motor functioning in individuals with WS.

  13. Profile of Hand Compartment Syndrome in Dr. Hasan Sadikin General Hospital, West Java, 2008−2012

    Directory of Open Access Journals (Sweden)

    Kajendaran Manogaran

    2015-12-01

    Full Text Available Background: Compartment syndrome is a serious disorder caused by elevated pressure in a muscle compartment that can progress to muscle and nerve damage. This disorder can happen to anyone but more frequently in young adults. The occurrence frequency of hand compartment syndrome is relatively low. The aim of this study is to identify the profile of compartment syndrome in patients hand Methods: A descriptive study was perfomed to 15 cases that were collected from medical records from 2008-2012, in Dr. Hasan Sadikin General Hospital. The profile of the case consisted of age, sex, symptoms and signs, etiology, facsiotomy schedule after admission, length of stay and patient’s outcome. The collected data were presented using tables. Results: The study showed that 12 out of 15 cases were males and 7 out of 15 cases were 20−39 years old patients. The common clinical findings were swelling, pain, limited range of motion and normal sensibility. The faciotomy procedure was conducted 1 day after the admission with length of stay more than 1 week. The patients condition were improved after operation. Conclusions: Hand compartment syndrome is a rare case, mostly affects younger adults and male. Most of the symptoms and signs are swelling, limitation of movement, pain in the location area with normal sensibility. The faciotomy procedure is conducted 1 day after admission. The length of stay is more than 1 week with an improved outcome.

  14. Carpal tunnel syndrome in general practice 1987 and 2001: incidence and the role of occupational and non-occupational factors.

    NARCIS (Netherlands)

    Bongers, F.J.M.; Schellevis, F.G.; Bosch, W.J.H.M. van den; Zee, J. van der

    2007-01-01

    Most studies on the incidence of the carpal tunnel syndrome and the relation of this disorder with occupation are population-based. In this study we present data from general practice. Aim: to compare incidence rates of carpal tunnel syndrome in 1987 and 2001, and to study the relationship between c

  15. GENERAL OVERGROWTH IN THE FRAGILE-X SYNDROME - VARIABILITY IN THE PHENOTYPIC-EXPRESSION OF THE FMR1 GENE MUTATION

    NARCIS (Netherlands)

    DEVRIES, BBA; ROBINSON, H; STOLTEDIJKSTRA, [No Value; GI, CVTP; DIJKSTRA, PF; VANDOOM, J; HALLEY, DJJ; OOSTRA, BA; TURNER, G; NIERMEIJER, MF

    1995-01-01

    The fragile X syndrome, which often presents in childhood with overgrowth, may in some cases show some diagnostic overlap with classical Sotos syndrome. We describe four fragile X patients with general overgrowth, all of whom are from families with other affected relatives who show the classic Marti

  16. Adiposopathy, metabolic syndrome, quantum physics, general relativity, chaos and the Theory of Everything.

    Science.gov (United States)

    Bays, Harold

    2005-05-01

    Excessive fat (adiposity) and dysfunctional fat (adiposopathy) constitute the most common worldwide epidemics of our time -- and perhaps of all time. Ongoing efforts to explain how the micro (adipocyte) and macro (body organ) biologic systems interact through function and dysfunction in promoting Type 2 diabetes mellitus, hypertension and dyslipidemia are not unlike the mechanistic and philosophical thinking processes involved in reconciling the micro (quantum physics) and macro (general relativity) theories in physics. Currently, the term metabolic syndrome refers to a constellation of consequences often associated with excess body fat and is an attempt to unify the associations known to exist between the four fundamental metabolic diseases of obesity, hyperglycemia (including Type 2 diabetes mellitus), hypertension and dyslipidemia. However, the association of adiposity with these metabolic disorders is not absolute and the metabolic syndrome does not describe underlying causality, nor does the metabolic syndrome necessarily reflect any reasonably related pathophysiologic process. Just as with quantum physics, general relativity and the four fundamental forces of the universe, the lack of an adequate unifying theory of micro causality and macro consequence is unsatisfying, and in medicine, impairs the development of agents that may globally improve both obesity and obesity-related metabolic disease. Emerging scientific and clinical evidence strongly supports the novel concept that it is not adiposity alone, but rather it is adiposopathy that is the underlying cause of most cases of Type 2 diabetes mellitus, hypertension and dyslipidemia. Adiposopathy is a plausible Theory of Everything for mankind's greatest metabolic epidemics.

  17. A cross-cultural study of the structure of comorbidity among common psychopathological syndromes in the general health care setting

    NARCIS (Netherlands)

    Krueger, RF; Chentsova-Dutton, YE; Markon, KE; Goldberg, D; Ormel, J

    2003-01-01

    This study presents analyses of 7 common psychopathological syndromes in the World Health Organization (WHO) Collaborative Study of Psychological Problems in General Health Care (T. B. Ustun & N. Sartorius, 1995). Data on depression, somatization, hypochondriasis, neurasthenia, anxious worry, anxiou

  18. Down Syndrome: General Information. Fact Sheet Number 4 = El Sindrome de Down: Informacion General. Fact Sheet Number 15.

    Science.gov (United States)

    Interstate Research Associates, McLean, VA.

    This fact sheet on Down Syndrome is offered in both English and Spanish. First it provides a definition and description of this syndrome, noting its etiology in a chromosomal abnormality. Incidence figures are then given. Typical characteristics of people with Down Syndrome are listed. Commonly associated health-related problems are noted,…

  19. Down Syndrome: General Information. Fact Sheet Number 4 = El Sindrome de Down: Informacion General. Fact Sheet Number 15.

    Science.gov (United States)

    Interstate Research Associates, McLean, VA.

    This fact sheet on Down Syndrome is offered in both English and Spanish. First it provides a definition and description of this syndrome, noting its etiology in a chromosomal abnormality. Incidence figures are then given. Typical characteristics of people with Down Syndrome are listed. Commonly associated health-related problems are noted,…

  20. Ellis-van Creveld syndrome: a generalized dysplasia of enchondral ossification

    Energy Technology Data Exchange (ETDEWEB)

    Sergi, C.; Otto, H.F. [Inst. of Pathology, University of Heidelberg, Heidelberg (Germany); Voigtlaender, T.; Hentze, S.; Tariverdian, G. [Inst. of Human Genetics, Univ. Hospital, Heidelberg (Germany); Zoubaa, S. [Dept. of Neuropathology, University Hospital, Heidelberg (Germany); Meyberg-Solomeyer, G.; Schiesser, M. [Ultrasonography Section, Obstetrical Clinics, University Hospital, Heidelberg (Germany); Troeger, J. [Department of Paediatric Radiology, University Hospital, Heidelberg (Germany)

    2001-04-01

    We report a 25-week fetus with lethal Ellis-van Creveld syndrome who was diagnosed prenatally from the US detection of a narrow chest, postaxial polydactyly of the hands, short acro-/mesomelic limbs and a ventricular septal defect. The postnatal radiographic features of the skeleton confirmed the diagnosis. Literature review of the histopathology of the physeal growth plate is contradictory, varying between retardation of the hypertrophic chondrocytes without disorganization and marked disorganization of the proliferating chondrocytes. We investigated numerous sites of the enchondral ossification and observed retardation of the physeal growth plate in all sites and retardation with pronounced disorganization of the physeal growth plate in the upper mesomelic bone segments only. These data support the concept that Ellis-van Creveld syndrome is mainly a generalized disorder of the maturation of enchondral ossification. (orig.)

  1. [Difficult airway management for general anesthesia in two patients with Kartagener syndrome].

    Science.gov (United States)

    Andoh, Taiki; Momota, Yoshihiro; Murata, Kenji; Kotani, Junichiro

    2010-05-01

    Two patients with Kartagener syndrome were managed under general anesthesia by nasal intubation for sagital split ramus osteotomy. Many episodes of expectoration were encountered in the former patient's perioperative period and the expectoration discharge was inadequate by postoperative nausea, leading to trouble in airway management. In the second patient, tube collapse was caused after intubation by serious nasal cavity strangulation, and re-intubation was necessary. Expectoration is seen resulting from decreased ciliary function with bronchiectasis during anesthetic management of patients with Kartagener syndrome. It is important to prevent lung complications by nausea prevention and pain killing in the postoperative period, in addition to proper suctioning in the perioperative period. Furthermore, there is nasal cavity narrowing by chronic sinusitis. When performing nasal intubation, the difficult airway management is required.

  2. Content-adaptive pentary steganography using the multivariate generalized Gaussian cover model

    Science.gov (United States)

    Sedighi, Vahid; Fridrich, Jessica; Cogranne, Rémi

    2015-03-01

    The vast majority of steganographic schemes for digital images stored in the raster format limit the amplitude of embedding changes to the smallest possible value. In this paper, we investigate the possibility to further improve the empirical security by allowing the embedding changes in highly textured areas to have a larger amplitude and thus embedding there a larger payload. Our approach is entirely model driven in the sense that the probabilities with which the cover pixels should be changed by a certain amount are derived from the cover model to minimize the power of an optimal statistical test. The embedding consists of two steps. First, the sender estimates the cover model parameters, the pixel variances, when modeling the pixels as a sequence of independent but not identically distributed generalized Gaussian random variables. Then, the embedding change probabilities for changing each pixel by 1 or 2, which can be transformed to costs for practical embedding using syndrome-trellis codes, are computed by solving a pair of non-linear algebraic equations. Using rich models and selection-channel-aware features, we compare the security of our scheme based on the generalized Gaussian model with pentary versions of two popular embedding algorithms: HILL and S-UNIWARD.

  3. Exploration of burnout syndrome in nurses of general hospital in Larnaka of Cyprus

    Directory of Open Access Journals (Sweden)

    Maritsa Gourni

    2012-10-01

    Full Text Available Health professionals belong to the group of high risk to develop burn out syndrome. According to Maslach & Jackson, "emotional exhaustion", "depersonalization" and the "reduced feeling of personal accomplishment" are the three parameters that consist the burn out syndrome. The aim of the present study was to explore burn out syndrome among nursing workforce in General Hospital of Larnaka in Cyprus. Method and material: The sample studied consisted of 100 nurses coming from 10 different departments of the hospital. Data were collected by the completion of a specially designed questionnaire for the needs of the research which apart from the socio-demographic variables included Maslach burn out questionnaire. Data analysis was conducted by the statistical package SPSS 16 and the statistical method was t-test and Anova. Results: From the 100 participants, 76% were women and 24% men. The mean age of the participants was 35,8 years old. The results showed that the participants experienced median level of burnout syndrome. Men of the sample studied experienced higher level of "emotional exhaustion" with average value 19,4 and "depersonalization" with average value 7,5 whereas reduced feeling of personal accomplishment with average 39,7. Married participants had "emotional exhaustion" with average value 20,2, "depersonalization" with average 7,6 and "feeling of personal accomplishment" with average 38,5. Presence of children had positive relation with all subscales and more specifically those who had 3 and more children had 21,1 average value of "emotional disturbance", 7,9 average "depersonalization" and 40,5 average value of "feeling of personal accomplishment". Nurses with 1-5 years previous experience had 19,9 average value of "emotional exhaustion", 7,7 of "depersonalization" and 38,7 of "feeling of personal accomplishment". Statistical analysis showed no relation with socio-demographic variables of nurses with burn out syndrome.Conclusions: It is

  4. General relativistic hydrodynamics with Adaptive-Mesh Refinement (AMR) and modeling of accretion disks

    Science.gov (United States)

    Donmez, Orhan

    We present a general procedure to solve the General Relativistic Hydrodynamical (GRH) equations with Adaptive-Mesh Refinement (AMR) and model of an accretion disk around a black hole. To do this, the GRH equations are written in a conservative form to exploit their hyperbolic character. The numerical solutions of the general relativistic hydrodynamic equations is done by High Resolution Shock Capturing schemes (HRSC), specifically designed to solve non-linear hyperbolic systems of conservation laws. These schemes depend on the characteristic information of the system. We use Marquina fluxes with MUSCL left and right states to solve GRH equations. First, we carry out different test problems with uniform and AMR grids on the special relativistic hydrodynamics equations to verify the second order convergence of the code in 1D, 2 D and 3D. Second, we solve the GRH equations and use the general relativistic test problems to compare the numerical solutions with analytic ones. In order to this, we couple the flux part of general relativistic hydrodynamic equation with a source part using Strang splitting. The coupling of the GRH equations is carried out in a treatment which gives second order accurate solutions in space and time. The test problems examined include shock tubes, geodesic flows, and circular motion of particle around the black hole. Finally, we apply this code to the accretion disk problems around the black hole using the Schwarzschild metric at the background of the computational domain. We find spiral shocks on the accretion disk. They are observationally expected results. We also examine the star-disk interaction near a massive black hole. We find that when stars are grounded down or a hole is punched on the accretion disk, they create shock waves which destroy the accretion disk.

  5. Adaptive Stacked Generalization for Multiclass Motor Imagery-Based Brain Computer Interfaces.

    Science.gov (United States)

    Nicolas-Alonso, Luis F; Corralejo, Rebeca; Gomez-Pilar, Javier; Álvarez, Daniel; Hornero, Roberto

    2015-07-01

    Practical motor imagery-based brain computer interface (MI-BCI) applications are limited by the difficult to decode brain signals in a reliable way. In this paper, we propose a processing framework to address non-stationarity, as well as handle spectral, temporal, and spatial characteristics associated with execution of motor tasks. Stacked generalization is used to exploit the power of classifier ensembles for combining information coming from multiple sources and reducing the existing uncertainty in EEG signals. The outputs of several regularized linear discriminant analysis (RLDA) models are combined to account for temporal, spatial, and spectral information. The resultant algorithm is called stacked RLDA (SRLDA). Additionally, an adaptive processing stage is introduced before classification to reduce the harmful effect of intersession non-stationarity. The benefits of the proposed method are evaluated on the BCI Competition IV dataset 2a. We demonstrate its effectiveness in binary and multiclass settings with four different motor imagery tasks: left-hand, right-hand, both feet, and tongue movements. The results show that adaptive SRLDA outperforms the winner of the competition and other approaches tested on this multiclass dataset.

  6. Strain Mediated Adaptation Is Key for Myosin Mechanochemistry: Discovering General Rules for Motor Activity.

    Science.gov (United States)

    Jana, Biman; Onuchic, José N

    2016-08-01

    A structure-based model of myosin motor is built in the same spirit of our early work for kinesin-1 and Ncd towards physical understanding of its mechanochemical cycle. We find a structural adaptation of the motor head domain in post-powerstroke state that signals faster ADP release from it compared to the same from the motor head in the pre-powerstroke state. For dimeric myosin, an additional forward strain on the trailing head, originating from the postponed powerstroke state of the leading head in the waiting state of myosin, further increases the rate of ADP release. This coordination between the two heads is the essence of the processivity of the cycle. Our model provides a structural description of the powerstroke step of the cycle as an allosteric transition of the converter domain in response to the Pi release. Additionally, the variation in structural elements peripheral to catalytic motor domain is the deciding factor behind diverse directionalities of myosin motors (myosin V & VI). Finally, we observe that there are general rules for functional molecular motors across the different families. Allosteric structural adaptation of the catalytic motor head in different nucleotide states is crucial for mechanochemistry. Strain-mediated coordination between motor heads is essential for processivity and the variation of peripheral structural elements is essential for their diverse functionalities.

  7. A general hybrid radiation transport scheme for star formation simulations on an adaptive grid

    CERN Document Server

    Klassen, Mikhail; Pudritz, Ralph E; Peters, Thomas; Banerjee, Robi; Buntemeyer, Lars

    2014-01-01

    Radiation feedback plays a crucial role in the process of star formation. In order to simulate the thermodynamic evolution of disks, filaments, and the molecular gas surrounding clusters of young stars, we require an efficient and accurate method for solving the radiation transfer problem. We describe the implementation of a hybrid radiation transport scheme in the adaptive grid-based FLASH general magnetohydrodynamics code. The hybrid scheme splits the radiative transport problem into a raytracing step and a diffusion step. The raytracer captures the first absorption event, as stars irradiate their environments, while the evolution of the diffuse component of the radiation field is handled by a flux-limited diffusion (FLD) solver. We demonstrate the accuracy of our method through a variety of benchmark tests including the irradiation of a static disk, subcritical and supercritical radiative shocks, and thermal energy equilibration. We also demonstrate the capability of our method for casting shadows and calc...

  8. Non-syndromic occurrence of true generalized microdontia with mandibular mesiodens - a rare case

    Directory of Open Access Journals (Sweden)

    Kiran Shital DP

    2011-10-01

    Full Text Available Abstract Abnormalities in size of teeth and number of teeth are occasionally recorded in clinical cases. True generalized microdontia is rare case in which all the teeth are smaller than normal. Mesiodens is commonly located in maxilary central incisor region and uncommon in the mandible. In the present case a 12 year-old boy was healthy; normal in appearance and the medical history was noncontributory. The patient was examined and found to have permanent teeth that were smaller than those of the average adult teeth. The true generalized microdontia was accompanied by mandibular mesiodens. This is a unique case report of non-syndromic association of mandibular hyperdontia with true generalized microdontia.

  9. Cross-Cultural adaptation of the General Functioning Scale of the Family

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    Thiago Pires

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To describe the process of cross-cultural adaptation of the General Functioning Scale of the Family, a subscale of the McMaster Family Assessment Device, for the Brazilian population. METHODS The General Functioning Scale of the Family was translated into Portuguese and administered to 500 guardians of children in the second grade of elementary school in public schools of Sao Gonçalo, Rio de Janeiro, Southeastern Brazil. The types of equivalences investigated were: conceptual and of items, semantic, operational, and measurement. The study involved discussions with experts, translations and back-translations of the instrument, and psychometric assessment. Reliability and validity studies were carried out by internal consistency testing (Cronbach’s alpha, Guttman split-half correlation model, Pearson correlation coefficient, and confirmatory factor analysis. Associations between General Functioning of the Family and variables theoretically associated with the theme (father’s or mother’s drunkenness and violence between parents were estimated by odds ratio. RESULTS Semantic equivalence was between 90.0% and 100%. Cronbach’s alpha ranged from 0.79 to 0.81, indicating good internal consistency of the instrument. Pearson correlation coefficient ranged between 0.303 and 0.549. Statistical association was found between the general functioning of the family score and the theoretically related variables, as well as good fit quality of the confirmatory analysis model. CONCLUSIONS The results indicate the feasibility of administering the instrument to the Brazilian population, as it is easy to understand and a good measurement of the construct of interest.

  10. Effects of microalgae chlorella species crude extracts on intestinal adaptation in experimental short bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Mustafa Kerem; Bulent Salman; Hatice Pasaoglu; Abdulkadir Bedirli; Murat Alper; Hikmet Katircioglu; Tahir Atici; E Ferda Pertoin; Ebru Ofluoglu

    2008-01-01

    AIM: To evaluate the effects of chlorella crude extract (CCE) on intestinal adaptation in rats subjected to short bowel syndrome (SBS).METHODS: Wistar rats weighing 230-260 g were used in the study. After anesthesia a 75% small bowel resection was performed. Rats were randomized and divided into groups. Control group (n = 10): where 5% dextrose was given through a gastrostomy tube, Enteral nutrition (EN) group (n = 10): Isocaloric and isonitrogen EN (Alitraq, Abbott, USA), study group (/7 = 10): CCE was administrated through a gastrostomy tube. Rats were sacrificed on the fifteenth postoperative day and blood and tissue samples were taken. Histopathologic evaluation, intestinal mucosal protein and DNA levels,intestinal proliferation and apoptosis were determined in intestinal tissues, and total protein, albumin and citrulline levels in blood were studied.RESULTS: In rats receiving CCE, villus lengthening,crypt depth, mucosal DNA and protein levels, intestinal proliferation, and serum citrulline, protein and albumin levels were found to be significantly higher than those in control group. Apoptosis in CCE treated rats was significantly reduced when compared to EN group rats.CONCLUSION: CCE has beneficial effects on intestinala daptation in experimental SBS.

  11. Code Development of Three-Dimensional General Relativistic Hydrodynamics with AMR(Adaptive-Mesh Refinement) and Results From Special and General Relativistic Hydrodynamic

    CERN Document Server

    Donmez, O

    2004-01-01

    In this paper, the general procedure to solve the General Relativistic Hydrodynamical(GRH) equations with Adaptive-Mesh Refinement (AMR) is presented. In order to achieve, the GRH equations are written in the conservation form to exploit their hyperbolic character. The numerical solutions of general relativistic hydrodynamic equations are done by High Resolution Shock Capturing schemes (HRSC), specifically designed to solve non-linear hyperbolic systems of conservation laws. These schemes depend on the characteristic information of the system. The Marquina fluxes with MUSCL left and right states are used to solve GRH equations. First, different test problems with uniform and AMR grids on the special relativistic hydrodynamics equations are carried out to verify the second order convergence of the code in 1D, 2D and 3D. Results from uniform and AMR grid are compared. It is found that adaptive grid does a better job when the number of resolution is increased. Second, the general relativistic hydrodynamical equa...

  12. [Abdominal compartment syndrome: survey on the awareness of Portuguese general surgeons].

    Science.gov (United States)

    Costa, Sílvia; Gomes, Aline; Graça, Susana; Ferreira, António; Fernandes, Gonçalo; Esteves, Joana; Costa, Alexandre; Fernandes, Paula; Castelões, Paula; Maciel, Jorge

    2011-12-01

    The Abdominal Compartment Syndrome (ACS) is a clinical entity recognized for over a century, but only recently its risk criteria, monitorization and treatment have been defined by the World Society of the Abdominal Compartment Syndrome (WSACS). The general surgeon's involvement is vital since this syndrome is common in surgical patients and because its treatment may culminate in a laparostomy. 250 questionnaires of 17 questions were distributed among general surgeons attending the XXVIII Portuguese Congress of Surgery. The data were analyzed using SPSS® v16. We received 36,4% (91) of the delivered questionnaires, most of which from male surgeons (63,7%), from central hospitals (75,8%), working 42 h per week (70.3%), whose average of age was 38 years. About half of the respondents received training in Intensive Care Units. All surgeons had already heard about measuring the Intra- abdominal Pressure (IAP), which was being performed at 89% of their hospitals. About 40% of surgeons only admitted intra-abdominal hypertension above 20 mmHg (only 22% indicated the correct value of 12 mmHg). 36,3% of surgeons suggested that a decompressive laparostomy must be carried out for primary ACS if IAP greater then 20 mmHg with new organ failure; 36.3% favoured the "Vacuum-pack"-like system, and 56% only re-operate the patients "as needed". 48,4% of surgeons had already performed decompressive laparostomy, 66% of which had residence training in a ICU (p = 0,005). Respondents also pointed an average mortality related to ACS of 81% without laparostomy, and a reduction to 38,5% after performing that procedure. Only 26% of the surgeons were aware of the WSACS consensus definitions and recommendations, of those, 83% had already performed a laparostomy (Pdivulgation.

  13. Robust Adaptive Sliding Mode Control for Generalized Function Projective Synchronization of Different Chaotic Systems with Unknown Parameters

    Directory of Open Access Journals (Sweden)

    Xiuchun Li

    2013-01-01

    Full Text Available When the parameters of both drive and response systems are all unknown, an adaptive sliding mode controller, strongly robust to exotic perturbations, is designed for realizing generalized function projective synchronization. Sliding mode surface is given and the controlled system is asymptotically stable on this surface with the passage of time. Based on the adaptation laws and Lyapunov stability theory, an adaptive sliding controller is designed to ensure the occurrence of the sliding motion. Finally, numerical simulations are presented to verify the effectiveness and robustness of the proposed method even when both drive and response systems are perturbed with external disturbances.

  14. [Burnout syndrome in medical residents at the General Hospital of Durango, México].

    Science.gov (United States)

    Terrones-Rodríguez, Jovany Francisco; Cisneros-Pérez, Vicente; Arreola-Rocha, José Jesús

    2016-01-01

    The burnout syndrome is commonly spread among health workers and students, due to the excessive demands they feel on their workspaces. Depersonalization, emotional exhaustion and personal accomplishment are the areas assessed. To determine the prevalence of burnout syndrome in medical residents at the General Hospital of Durango; a descriptive, prolective, cross-sectional study was designed and applied to residents of different specialties of the General Hospital of Durango who agreed to participate, the "Maslach Burnout Inventory" was applied. We surveyed 116 residents, 43.1 % (50) women and 56.89 % (66) men. The overall prevalence was 89.66 % (95 % CI: 82.63- 94.54). Affected in a single area the 48.28 % (95 % CI: 38.90-57.74), in two areas the 35.34 % (95 % CI: 26.69-44.76) and in the three areas 6.03 % (95 % CI: 2.46-12.04). Stratified by areas, high emotional exhaustion was 41.38 % (95 % CI: 32.31-50.90), high depersonalization in 54.31 % (95 % CI: 44.81-63.59), and low personal accomplishment 41.38 % (95 % CI: 32.31-50.90). The prevalence is higher than the reported. The most frequently affected is depersonalization, followed by emotional exhaustion and finally the personal accomplishment. In the areas of Gynecology and obstetrics, Internal medicine, Pediatrics and Orthopedics, the 100 % of the residents are affected.

  15. Adult zebrafish intestine resection: a novel model of short bowel syndrome, adaptation, and intestinal stem cell regeneration.

    Science.gov (United States)

    Schall, K A; Holoyda, K A; Grant, C N; Levin, D E; Torres, E R; Maxwell, A; Pollack, H A; Moats, R A; Frey, M R; Darehzereshki, A; Al Alam, D; Lien, C; Grikscheit, T C

    2015-08-01

    Loss of significant intestinal length from congenital anomaly or disease may lead to short bowel syndrome (SBS); intestinal failure may be partially offset by a gain in epithelial surface area, termed adaptation. Current in vivo models of SBS are costly and technically challenging. Operative times and survival rates have slowed extension to transgenic models. We created a new reproducible in vivo model of SBS in zebrafish, a tractable vertebrate model, to facilitate investigation of the mechanisms of intestinal adaptation. Proximal intestinal diversion at segment 1 (S1, equivalent to jejunum) was performed in adult male zebrafish. SBS fish emptied distal intestinal contents via stoma as in the human disease. After 2 wk, S1 was dilated compared with controls and villus ridges had increased complexity, contributing to greater villus epithelial perimeter. The number of intervillus pockets, the intestinal stem cell zone of the zebrafish increased and contained a higher number of bromodeoxyuridine (BrdU)-labeled cells after 2 wk of SBS. Egf receptor and a subset of its ligands, also drivers of adaptation, were upregulated in SBS fish. Igf has been reported as a driver of intestinal adaptation in other animal models, and SBS fish exposed to a pharmacological inhibitor of the Igf receptor failed to demonstrate signs of intestinal adaptation, such as increased inner epithelial perimeter and BrdU incorporation. We describe a technically feasible model of human SBS in the zebrafish, a faster and less expensive tool to investigate intestinal stem cell plasticity as well as the mechanisms that drive intestinal adaptation.

  16. The comparison of the intestinal adaptation effects of subcutaneous and oral insulin in a rats with short bowel syndrome

    Directory of Open Access Journals (Sweden)

    Unal Bicakci

    2013-01-01

    Full Text Available Aim: Insulin has been reported to have positive effects on intestinal adaptation after short bowel syndrome when applicated oral or subcutaneously. The purpose of this study is to compare the intestinal adaptation effects of subcutaneous and oral routes of insulin in rats with short bowel syndrome. Materials and Methods: The short bowel syndrome (SBS was performed through 70-75% of small intestinal resection and an end-to-end anastomosis. The control group rats underwent SBS only. In the second group, oral insulin (1 U/ml was administrated twice-daily. In the last group, the insulin was administrated subcutaneously (1 U/kg as in the control group. All rats were killed on day 15. Outcome parameters were weight of small intestine, the crypt length, villous depth, the blood levels of vascular endothelial growth factor (VEGF, and granolocyt-monocyst colony-stimulating factor (GMCSF. Results: Intestinal weight was significantly more in oral insulin group and subcutaneous insulin group than in the control group (72.6 ± 4.3, 78.6 ± 4.8 and 59.7 ± 4.8 (P 0.05. VEGF values were not statistically significant between the groups (200.3 ± 41.6, 178.9 ± 30.7 and 184.3 ± 52.2 (P > 0.05. GMCSF was statistically higher in the control group than in other groups (3.34 ± 1.34, 1.56 ± 0.44 and 1.56 ± 0.44 (P < 0.05. Conclusion: Insulin has positive effects on intestinal adaptation in short bowel syndrome. Subcutaneous administration is slightly more effective than the oral route.

  17. A General, Adaptive, Roadmap-Based Algorithm for Protein Motion Computation.

    Science.gov (United States)

    Molloy, Kevin; Shehu, Amarda

    2016-03-01

    Precious information on protein function can be extracted from a detailed characterization of protein equilibrium dynamics. This remains elusive in wet and dry laboratories, as function-modulating transitions of a protein between functionally-relevant, thermodynamically-stable and meta-stable structural states often span disparate time scales. In this paper we propose a novel, robotics-inspired algorithm that circumvents time-scale challenges by drawing analogies between protein motion and robot motion. The algorithm adapts the popular roadmap-based framework in robot motion computation to handle the more complex protein conformation space and its underlying rugged energy surface. Given known structures representing stable and meta-stable states of a protein, the algorithm yields a time- and energy-prioritized list of transition paths between the structures, with each path represented as a series of conformations. The algorithm balances computational resources between a global search aimed at obtaining a global view of the network of protein conformations and their connectivity and a detailed local search focused on realizing such connections with physically-realistic models. Promising results are presented on a variety of proteins that demonstrate the general utility of the algorithm and its capability to improve the state of the art without employing system-specific insight.

  18. A 3-D Novel Conservative Chaotic System and its Generalized Projective Synchronization via Adaptive Control

    Directory of Open Access Journals (Sweden)

    S. Vaidyanathan

    2014-11-01

    Full Text Available This research work proposes a five-term 3-D novel conservative chaotic system with a quadratic nonlinearity and a quartic nonlinearity. The conservative chaotic systems have the important property that they are volume conserving. The Lyapunov exponents of the 3-D novel chaotic system are obtained as �! = 0.0836, �! = 0 and �! = −0.0836. Since the sum of the Lyapunov exponents is zero, the 3-D novel chaotic system is conservative. Thus, the Kaplan-Yorke dimension of the 3-D novel chaotic system is easily seen as 3.0000. The phase portraits of the novel chaotic system simulated using MATLAB depict the chaotic attractor of the novel system. This research work also discusses other qualitative properties of the system. Next, an adaptive controller is designed to achieve Generalized Projective Synchronization (GPS of two identical novel chaotic systems with unknown system parameters. MATLAB simulations are shown to validate and demonstrate the GPS results derived in this work.

  19. Foam Multi-Dimensional General Purpose Monte Carlo Generator With Self-Adapting Symplectic Grid

    CERN Document Server

    Jadach, Stanislaw

    2000-01-01

    A new general purpose Monte Carlo event generator with self-adapting grid consisting of simplices is described. In the process of initialization, the simplex-shaped cells divide into daughter subcells in such a way that: (a) cell density is biggest in areas where integrand is peaked, (b) cells elongate themselves along hyperspaces where integrand is enhanced/singular. The grid is anisotropic, i.e. memory of the axes directions of the primary reference frame is lost. In particular, the algorithm is capable of dealing with distributions featuring strong correlation among variables (like ridge along diagonal). The presented algorithm is complementary to others known and commonly used in the Monte Carlo event generators. It is, in principle, more effective then any other one for distributions with very complicated patterns of singularities - the price to pay is that it is memory-hungry. It is therefore aimed at a small number of integration dimensions (<10). It should be combined with other methods for higher ...

  20. Image classification with densely sampled image windows and generalized adaptive multiple kernel learning.

    Science.gov (United States)

    Yan, Shengye; Xu, Xinxing; Xu, Dong; Lin, Stephen; Li, Xuelong

    2015-03-01

    We present a framework for image classification that extends beyond the window sampling of fixed spatial pyramids and is supported by a new learning algorithm. Based on the observation that fixed spatial pyramids sample a rather limited subset of the possible image windows, we propose a method that accounts for a comprehensive set of windows densely sampled over location, size, and aspect ratio. A concise high-level image feature is derived to effectively deal with this large set of windows, and this higher level of abstraction offers both efficient handling of the dense samples and reduced sensitivity to misalignment. In addition to dense window sampling, we introduce generalized adaptive l(p)-norm multiple kernel learning (GA-MKL) to learn a robust classifier based on multiple base kernels constructed from the new image features and multiple sets of prelearned classifiers from other classes. With GA-MKL, multiple levels of image features are effectively fused, and information is shared among different classifiers. Extensive evaluation on benchmark datasets for object recognition (Caltech256 and Caltech101) and scene recognition (15Scenes) demonstrate that the proposed method outperforms the state-of-the-art under a broad range of settings.

  1. What do we call Adaptive Management? A general characterization from a global sample

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    T. Espigares

    2008-03-01

    Full Text Available This study presents a characterisation of the implementation of Adaptive Management (AM from the analysis of 35 projects around the world. Our results reveal that AM projects are usually aimed at ecosystem management, conservation and restoration. Also, they mainly act upon forest or epicontinental water ecosystems and their goal is generally species exploitation and in most cases these projects act at a local scale. From a methodological point of view, most AM cases use an active approach and monitoring programs and were at the phase of problem identification. We found differences in the implementation of AM between developed and developing countries that were present in our samples in the following way: AM projects in developed countries were typically carried out by state agencies, and focused on solving problems concerning epicontinental waters and the public use of ecosystems. They had the support of national funds and used modelling techniques. In contrast, the AM projects from developing countries were mainly aimed at the conservation of natural protected areas and at the mitigation of environmental impacts derived from mining activities. The financial support of these projects was frequently provided by international organizations, and the use of modelling techniques was uncommon. For a better exploitation of all the possibilities of AM, we suggest the use of criteria to be customized to the specific needs of the socio-economic reality of every country and to monitor the results at a global scale to continuously improve this practice.

  2. A general hybrid radiation transport scheme for star formation simulations on an adaptive grid

    Energy Technology Data Exchange (ETDEWEB)

    Klassen, Mikhail; Pudritz, Ralph E. [Department of Physics and Astronomy, McMaster University 1280 Main Street W, Hamilton, ON L8S 4M1 (Canada); Kuiper, Rolf [Max Planck Institute for Astronomy Königstuhl 17, D-69117 Heidelberg (Germany); Peters, Thomas [Institut für Computergestützte Wissenschaften, Universität Zürich Winterthurerstrasse 190, CH-8057 Zürich (Switzerland); Banerjee, Robi; Buntemeyer, Lars, E-mail: klassm@mcmaster.ca [Hamburger Sternwarte, Universität Hamburg Gojenbergsweg 112, D-21029 Hamburg (Germany)

    2014-12-10

    Radiation feedback plays a crucial role in the process of star formation. In order to simulate the thermodynamic evolution of disks, filaments, and the molecular gas surrounding clusters of young stars, we require an efficient and accurate method for solving the radiation transfer problem. We describe the implementation of a hybrid radiation transport scheme in the adaptive grid-based FLASH general magnetohydrodyanmics code. The hybrid scheme splits the radiative transport problem into a raytracing step and a diffusion step. The raytracer captures the first absorption event, as stars irradiate their environments, while the evolution of the diffuse component of the radiation field is handled by a flux-limited diffusion solver. We demonstrate the accuracy of our method through a variety of benchmark tests including the irradiation of a static disk, subcritical and supercritical radiative shocks, and thermal energy equilibration. We also demonstrate the capability of our method for casting shadows and calculating gas and dust temperatures in the presence of multiple stellar sources. Our method enables radiation-hydrodynamic studies of young stellar objects, protostellar disks, and clustered star formation in magnetized, filamentary environments.

  3. A General Hybrid Radiation Transport Scheme for Star Formation Simulations on an Adaptive Grid

    Science.gov (United States)

    Klassen, Mikhail; Kuiper, Rolf; Pudritz, Ralph E.; Peters, Thomas; Banerjee, Robi; Buntemeyer, Lars

    2014-12-01

    Radiation feedback plays a crucial role in the process of star formation. In order to simulate the thermodynamic evolution of disks, filaments, and the molecular gas surrounding clusters of young stars, we require an efficient and accurate method for solving the radiation transfer problem. We describe the implementation of a hybrid radiation transport scheme in the adaptive grid-based FLASH general magnetohydrodyanmics code. The hybrid scheme splits the radiative transport problem into a raytracing step and a diffusion step. The raytracer captures the first absorption event, as stars irradiate their environments, while the evolution of the diffuse component of the radiation field is handled by a flux-limited diffusion solver. We demonstrate the accuracy of our method through a variety of benchmark tests including the irradiation of a static disk, subcritical and supercritical radiative shocks, and thermal energy equilibration. We also demonstrate the capability of our method for casting shadows and calculating gas and dust temperatures in the presence of multiple stellar sources. Our method enables radiation-hydrodynamic studies of young stellar objects, protostellar disks, and clustered star formation in magnetized, filamentary environments.

  4. Gender Differences in Lifestyle Factors Associated with Metabolic Syndrome and Preliminary Metabolic Syndrome in the General Population: The Watari Study.

    Science.gov (United States)

    Hattori, Tomomi; Konno, Satoshi; Munakata, Masanori

    2017-09-01

    Objective In Japan, metabolic syndrome (MetS) and preliminary metabolic syndrome (preMetS) are more prevalent in men; however, it remains unclear whether the relationship between these metabolic disorders and lifestyle factors is similar between genders. Methods We examined waist circumference, blood pressure, fasting blood, and various lifestyle factors in 3,166 individuals aged from 30-79 years of age from the Japanese general population. MetS was diagnosed on the basis of central obesity - assessed by waist circumference - plus two or more of the following cardio-metabolic risks according to Japanese criteria: high blood pressure, hyperglycemia, and lipid abnormality. Central obesity plus one of the risks was defined as preMetS. Results Men had a significantly higher prevalence of MetS (23.3% vs. 8.7%, p<0.001) and preMetS (21.2% vs. 10.2%, p<0.001) than women. An age-adjusted logistic regression analysis revealed that heavy drinkers were associated with an increased probability of MetS (odds ratio, 1.91: 95% confidence interval, 1.29-2.83) and preMetS (1.69: 1.11-2.58); fast eaters were also related to preMetS (1.83: 1.33-2.55) and MetS (1.55: 1.12-2.15) in men. Lacking regular exercise was significantly associated with preMetS (1.38: 1.03-1.85), but not MetS. In women, preMetS was significantly associated with fast eaters and lacking regular exercise (1.44: 1.01-2.07 and 1.41: 1.02-1.96, respectively); a stepwise increase in each odds ratio (2.02: 1.40-2.91 and 1.47: 1.03-2.09, respectively) was also observed for MetS. Conclusion The relationships between lifestyle factors and MetS or preMetS differed between men and women, which suggests the need for gender-specific lifestyle modification to effectively prevent MetS.

  5. A multichannel nonlinear adaptive noise canceller based on generalized FLANN for fetal ECG extraction

    Science.gov (United States)

    Ma, Yaping; Xiao, Yegui; Wei, Guo; Sun, Jinwei

    2016-01-01

    In this paper, a multichannel nonlinear adaptive noise canceller (ANC) based on the generalized functional link artificial neural network (FLANN, GFLANN) is proposed for fetal electrocardiogram (FECG) extraction. A FIR filter and a GFLANN are equipped in parallel in each reference channel to respectively approximate the linearity and nonlinearity between the maternal ECG (MECG) and the composite abdominal ECG (AECG). A fast scheme is also introduced to reduce the computational cost of the FLANN and the GFLANN. Two (2) sets of ECG time sequences, one synthetic and one real, are utilized to demonstrate the improved effectiveness of the proposed nonlinear ANC. The real dataset is derived from the Physionet non-invasive FECG database (PNIFECGDB) including 55 multichannel recordings taken from a pregnant woman. It contains two subdatasets that consist of 14 and 8 recordings, respectively, with each recording being 90 s long. Simulation results based on these two datasets reveal, on the whole, that the proposed ANC does enjoy higher capability to deal with nonlinearity between MECG and AECG as compared with previous ANCs in terms of fetal QRS (FQRS)-related statistics and morphology of the extracted FECG waveforms. In particular, for the second real subdataset, the F1-measure results produced by the PCA-based template subtraction (TSpca) technique and six (6) single-reference channel ANCs using LMS- and RLS-based FIR filters, Volterra filter, FLANN, GFLANN, and adaptive echo state neural network (ESN a ) are 92.47%, 93.70%, 94.07%, 94.22%, 94.90%, 94.90%, and 95.46%, respectively. The same F1-measure statistical results from five (5) multi-reference channel ANCs (LMS- and RLS-based FIR filters, Volterra filter, FLANN, and GFLANN) for the second real subdataset turn out to be 94.08%, 94.29%, 94.68%, 94.91%, and 94.96%, respectively. These results indicate that the ESN a and GFLANN perform best, with the ESN a being slightly better than the GFLANN but about four times more

  6. Impact of co-channel interference on the performance of adaptive non-ideal generalized transmit diversity

    KAUST Repository

    Radaydeh, Redha Mahmoud Mesleh

    2010-09-01

    The impact of co-channel interference and nonideal estimation of the desired user channel state information (CSI) on the performance of an adaptive threshold-based generalized transmit diversity for low-complexity multiple-input single-output configuration is investigated. The adaptation to channel conditions is assumed to be based on the desired user CSI, and the number of active transmit antennas is adjusted accordingly to guarantee predetermined target performance. To facilitate comparisons between different adaptation schemes, new analytical results for the statistics of combined signal-to-interference-plus-noise ratio (SINR) are derived, which can be applied for different fading conditions of interfering signals. Selected numerical results are presented to validate the analytical development and to compare the outage performance of the considered adaptation schemes. © 2010 IEEE.

  7. Adaptive generalized matrix projective lag synchronization between two different complex networks with non-identical nodes and different dimensions

    Institute of Scientific and Technical Information of China (English)

    Dai Hao; Jia Li-Xin; Zhang Yan-Bin

    2012-01-01

    The adaptive generalized matrix projective lag synchronization between two different complex networks with non-identical nodes and different dimensions is investigated in this paper.Based on Lyapunov stability theory and Barbalat's lemma,generalized matrix projective lag synchronization criteria are derived by using the adaptive control method.Furthermore,each network can be undirected or directed,connected or disconnected,and nodes in either network may have identical or different dynamics.The proposed strategy is applicable to almost all kinds of complex networks.In addition,numerical simulation results are presented to illustrate the effectiveness of this method,showing that the synchronization speed is sensitively influenced by the adaptive law strength,the network size,and the network topological structure.

  8. Generalized lymphedema associated with neurologic signs (GLANS) syndrome: a new entity?

    Science.gov (United States)

    Berton, Marine; Lorette, Gérard; Baulieu, Françoise; Lagrue, Emmanuelle; Blesson, Sophie; Cambazard, Frédéric; Vaillant, Loïc; Maruani, Annabel

    2015-02-01

    Primary lymphedema in children, especially generalized disease with facial involvement, is rare. We sought to report 3 childhood cases of lymphedema with associated neurologic findings and to provide a pathophysiologic explanation for this association. Clinical observations, electroencephalography, and neuroimaging studies were evaluated. Microcomparative genomic hybridization was performed in 1 case. The 3 children had primary lymphedema of all 4 limbs and the face. This was confirmed by lymphoscintigraphy, which showed hypoplasia of vessels and hypofixation of lymph nodes. They had nonspecific neurologic disorders and electroencephalography abnormalities, without intellectual deficit. Neuroimaging revealed normal findings. Microcomparative genomic hybridization in 1 patient revealed no cytogenetic anomaly. The outcome was fatal in 1 case with development of visceral lymphedema and coma. Genetic studies were performed in only 1 case. These observations suggest that neurologic assessment and electroencephalography are indicated for patients with lymphedema of the limbs and face to identify this syndrome. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Neuroleptic Malignant Syndrome After the Use of Venlafaxine in a Patient with Generalized Anxiety Disorder

    Directory of Open Access Journals (Sweden)

    Tsung-Chien Lu

    2006-01-01

    Full Text Available Neuroleptic malignant syndrome (NMS is a potentially lethal adverse reaction to neuroleptics, which is characterized by hyperthermia, extrapyramidal symptoms, altered consciousness and autonomic dysfunction. Although NMS is most commonly induced by the high-potency neuroleptics, its development has also been associated with the use of non-neuroleptic agents that block central dopamine pathways. A 68-year-old man with generalized anxiety disorder and depressive symptoms presented at the emergency department (ED with high fever, tremor, muscle rigidity, rhabdomyolysis and altered mental status. NMS was considered to have been caused by the recent addition and subsequent dose increase in his treatment regimen of venlafaxine, a serotonin norepinephrine reuptake inhibitor. He was successfully treated with bromocriptine, lorazepam, and fluid hydration in the ED and intensive care unit.

  10. Generalized avian dispersal syndrome contributes to Chinese tallow tree (Sapium sebiferum, Euphorbiaceae) invasiveness

    Science.gov (United States)

    Renne, I.J.; Barrow, W.C.; Johnson, Randall L.A.; Bridges, W.C.

    2002-01-01

    Plants possessing generalized dispersal syndromes are likely to be more invasive than those relying on specialist dispersal agents. To address this issue on a local and regional scale, avian seed dispersal of the invasive alien Chinese tallow tree (Sapium sebiferum (L.) Roxb.) was assessed in forests and spoil areas of South Carolina and along forest edges in Louisiana during the 1997-99 fruiting seasons. Tallow trees in these floristically distinct habitats had a few common and many casual visitors, and considerable species overlap among habitats was found. However, bird species differed in the importance of dispersing and dropping seeds among habitats. Important dispersal agents common to forests and spoil areas of South Carolina included Northern Flicker, American Robin and Redwinged Blackbird, whereas Red-bellied Woodpecker and European Starling were important in the former and latter habitat, respectively. In Louisiana, Red-bellied Woodpecker, American Robin, Northern Cardinal and Eastern Bluebird dispersed many seeds. Nearly all species foraging on seeds were winter residents. Estimated numbers of seeds dispersed and dropped were higher in spoil areas of South Carolina than in Louisiana because of higher numbers of individuals per visit, higher seed consumption and seed dropping rates, and longer foraging durations. Within South Carolina, more seeds were dispersed and dropped in spoil areas than in forests because of higher numbers of birds per visit. These findings show that among habitats, tallow tree attracts diverse but variable coteries of dispersal agents that are qualitatively similar in seed usage patterns. We suggest that its generalized dispersal syndrome contributes to effective seed dispersal by many bird species throughout its range. Effects of differential avian use among locales may include changes in local bird communities, and differing tallow tree demographics and invasion patterns.

  11. A Context-Aware Self-Adaptive Fractal Based Generalized Pedagogical Agent Framework for Mobile Learning

    Science.gov (United States)

    Boulehouache, Soufiane; Maamri, Ramdane; Sahnoun, Zaidi

    2015-01-01

    The Pedagogical Agents (PAs) for Mobile Learning (m-learning) must be able not only to adapt the teaching to the learner knowledge level and profile but also to ensure the pedagogical efficiency within unpredictable changing runtime contexts. Therefore, to deal with this issue, this paper proposes a Context-aware Self-Adaptive Fractal Component…

  12. [Corrective surgery of thoracic anomalies in Poland syndrome. General review of 20 patients].

    Science.gov (United States)

    Glicenstein, J

    2001-12-01

    Breast and thoracic anomalies in Poland's syndrome, whether associated or not with hypoplasia of the upper limb, have no functional impairment. They present an important cosmetic disgrace. Several methods for correction were proposed: muscular transfer with or without implants. Each one has its advantages and drawbacks. We operated 20 adolescents and adults with this deformity: 13 females and 7 males. If the inferior bundle of the pectoralis major was always absent, other muscular anomalies such as aplasia of the latissimus dorsi may complicate the corrective procedure. The choice of the treatment depends upon the importance of the muscular and sometimes associated costal aplasia, in the young girl, the breast development and in both sexes the position of the nipple. The latissimus dorsi transfer may be considered as the most adapted technique for the pestoralis major replacement. The results are often disappointing due to the secondary muscular atrophy. A composite implant with a part for breast reconstruction and another to fill the subclavicular gap gives satisfactory results but it has the hazards of implants.

  13. Cross-Cultural adaptation of the General Functioning Scale of the Family.

    Science.gov (United States)

    Pires, Thiago; Assis, Simone Gonçalves de; Avanci, Joviana Quintes; Pesce, Renata Pires

    2016-06-27

    To describe the process of cross-cultural adaptation of the General Functioning Scale of the Family, a subscale of the McMaster Family Assessment Device, for the Brazilian population. The General Functioning Scale of the Family was translated into Portuguese and administered to 500 guardians of children in the second grade of elementary school in public schools of Sao Gonçalo, Rio de Janeiro, Southeastern Brazil. The types of equivalences investigated were: conceptual and of items, semantic, operational, and measurement. The study involved discussions with experts, translations and back-translations of the instrument, and psychometric assessment. Reliability and validity studies were carried out by internal consistency testing (Cronbach's alpha), Guttman split-half correlation model, Pearson correlation coefficient, and confirmatory factor analysis. Associations between General Functioning of the Family and variables theoretically associated with the theme (father's or mother's drunkenness and violence between parents) were estimated by odds ratio. Semantic equivalence was between 90.0% and 100%. Cronbach's alpha ranged from 0.79 to 0.81, indicating good internal consistency of the instrument. Pearson correlation coefficient ranged between 0.303 and 0.549. Statistical association was found between the general functioning of the family score and the theoretically related variables, as well as good fit quality of the confirmatory analysis model. The results indicate the feasibility of administering the instrument to the Brazilian population, as it is easy to understand and a good measurement of the construct of interest. Descrever o processo de adaptação transcultural da escala de Funcionamento Geral da Família, subescala da McMaster Family Assessment Device, para a população brasileira. A escala de Funcionamento Geral da Família, original no idioma inglês, foi traduzida para o português e aplicada a 500 responsáveis de crianças do segundo ano do ensino

  14. Adaptive Immunity Dysregulation in Acute Coronary Syndromes: From Cellular and Molecular Basis to Clinical Implications.

    Science.gov (United States)

    Flego, Davide; Liuzzo, Giovanna; Weyand, Cornelia M; Crea, Filippo

    2016-11-08

    Although the early outcome of acute coronary syndrome (ACS) has considerably improved in the last decade, cardiovascular diseases still represent the main cause of morbidity and mortality worldwide. This is mainly because recurrence of ACS eventually leads to the pandemics of heart failure and sudden cardiac death, thus calling for a reappraisal of the mechanisms responsible for coronary instability. This review discusses recent advances in our understanding of how adaptive immunity contributes to the pathogenesis of ACS and the clinical implications that arise from these new pathogenic concepts. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Physiological adaptation after a 12-week physical activity program for patients with Prader-Willi syndrome: two case reports.

    Science.gov (United States)

    Amaro, Alexandre Slowetzky; Teixeira, Maria Cristina Triguero Veloz; de Mesquita, Maria Luiza Guedes; Rodrigues, Graciele Massoli; Rubin, Daniela Andrea; Carreiro, Luiz Renato Rodrigues

    2016-06-23

    Physical activity programs are a powerful tool against several diseases including obesity and their comorbidities. Prader-Willi syndrome is the most common genetic disease associated with obesity, and brings with it behavioral and emotional problems that need complex management. Research into the effect of physical activity programs on Prader-Willi syndrome is limited and it is frequently argued that if a physical activity program is too complex, the participants are more likely to drop out. Therefore, in this study, we assessed the physiological adaptation effect of a physical activity program with increasing complexity and load, in a boy and a girl with Prader-Willi syndrome by assessing changes in lipid profile, body composition, and physical fitness parameters. Case 1 was an 11-year-old girl, mixed race (brown), with an intelligence quotient of 68, 52.0 % body fat, and a body mass index of 45.3 kg/m(2). The Prader-Willi syndrome diagnosis was made when she was 5-years old and was found to be due to an imprinting genomic defect. Case 2 was a 14-year-old boy, mixed race (brown), with an intelligence quotient of 74, 48.8 % body fat, and a body mass index of 37.3 kg/m(2). The diagnosis was made when he was 10-years old and was found to be caused by gene deletion. Both participants presented physical characteristics and behavior problems typical of Prader-Willi syndrome. Case 2 presented high blood pressure, high cholesterol and sleep apnea and had to use continuous positive airway pressure to sleep. Both participants were assessed for 12 weeks (three times a week) using a physical activity program designed to improve strength and muscle hypertrophy. The work load was progressively adjusted as necessary and new exercises were added to the program. Prior to the program, the participants' parents received instructions about managing problem behavior and advice about nutrition. After physical activity program several health markers assessed by biological tests and

  16. Statistical identification of syndromes feature and structure of disease of western medicine based on general latent structure model.

    Science.gov (United States)

    Yang, Wei; Yi, Dan-Hui; Xie, Yan-Ming; Tian, Feng

    2012-11-01

    Syndrome differentiation is the character of Chinese medicine (CM). Disease differentiation is the principle of Western medicine (WM). Identifying basic syndromes feature and structure of disease of WM is an important avenue for prevention and treatment of integrated Chinese and Western medicine. The idea here is first to divide all patients suffering from a disease of WM into several groups in the light of the stage of the disease, and secondly to identify basic syndromes feature in a distinct stage, and finally to achieve the purpose of syndrome differentiation. Syndrome differentiation is simply taken as a classifier that classifies patients into distinct classes primarily based on overall observation of their symptoms. Previous clustering methods are unable to cope with the complexity of CM. We therefore show a new multi-dimensional clustering method in the form of general latent structure (GLS) model, which is a suitable statistical learning technique of latent class analysis. In this paper, we learn an optimal GLS model which reflects much better model quality compared with other latent class models from the osteoporosis patient of community women (OPCW) real data including 40-65 year-old women whose bone mineral density (BMD) is less than mean-2.0 standard deviation (M-2.0SD). Further, we illustrate a case analysis of statistical identification of CM syndromes feature and structure of OPCW from qualitative and quantitative contents through the GLS model. Our analysis has discovered natural clusters and structures that correspond well to CM basic syndrome and factors of osteoporosis patients (OP). The GLS model suggests the possibility of establishing objective and quantitative diagnosis standards for syndrome differentiation on OPCW. Hence, for the future it can provide a reference for the similar study from the perspective of a combination of disease differentiation and syndrome differentiation.

  17. Relationships between irritable bowel syndrome, generalized anxiety disorder, and worry-related constructs

    Directory of Open Access Journals (Sweden)

    Amanda Drews

    2008-01-01

    Full Text Available This ex post facto study aimed to replicate previous research demonstrating an association between generalized anxiety disorder (GAD and irritable bowel syndrome (IBS and to extend this work by examining possible relationships between IBS and psychological constructs associated with the development of GAD. A total of 391 undergraduate psychology students completed self-report diagnostic measures of IBS and GAD as well as questionnaire measures of trait anxiety, worry, experiential avoidance, intolerance of uncertainty, and problem-solving confidence. Consistent with previous research, an association between IBS and GAD was found. Compared to participants without IBS, participants endorsing Rome II diagnostic criteria for IBS reported greater trait anxiety, worry, and experiential avoidance. No group differences on measures of intolerance of uncertainty and problem-solving confidence were found. Etiological factors considered specific to the development of GAD (i.e., increased intolerance of uncertainty and deficits in problem-solving confidence do not account for the observed relationships between IBS and general anxiety variables. However, experiential avoidance, or attempts to avoid unwanted bodily sensations, emotions, or other internal events, does appear elevated among IBS individuals. Implications of these findings are discussed within the context of a biopsychosocial model of IBS.

  18. Block-structured adaptive meshes and reduced grids for atmospheric general circulation models.

    Science.gov (United States)

    Jablonowski, Christiane; Oehmke, Robert C; Stout, Quentin F

    2009-11-28

    Adaptive mesh refinement techniques offer a flexible framework for future variable-resolution climate and weather models since they can focus their computational mesh on certain geographical areas or atmospheric events. Adaptive meshes can also be used to coarsen a latitude-longitude grid in polar regions. This allows for the so-called reduced grid setups. A spherical, block-structured adaptive grid technique is applied to the Lin-Rood finite-volume dynamical core for weather and climate research. This hydrostatic dynamics package is based on a conservative and monotonic finite-volume discretization in flux form with vertically floating Lagrangian layers. The adaptive dynamical core is built upon a flexible latitude-longitude computational grid and tested in two- and three-dimensional model configurations. The discussion is focused on static mesh adaptations and reduced grids. The two-dimensional shallow water setup serves as an ideal testbed and allows the use of shallow water test cases like the advection of a cosine bell, moving vortices, a steady-state flow, the Rossby-Haurwitz wave or cross-polar flows. It is shown that reduced grid configurations are viable candidates for pure advection applications but should be used moderately in nonlinear simulations. In addition, static grid adaptations can be successfully used to resolve three-dimensional baroclinic waves in the storm-track region.

  19. Early Intestinal Rehabilitation Therapy Ameliorates Intestinal Adaptation in Children with Short Bowel Syndrome: The Long-Term Outcome.

    Science.gov (United States)

    Guo, Mingxiao; Lu, Chunlei; Li, Yousheng

    2016-12-01

    In the management of short bowel syndrome (SBS), the benefits of treatment with growth hormone (GH), glutamine, and enteral nutrition (EN) on intestinal adaptation among children patients is still controversial. The aim of present study is to determine whether GH, glutamine, and EN have positive effect on intestinal adaptation in children with SBS. Sixteen children with SBS (small bowel remnant length, 56.75 ± 8.09 cm; mean ± SE) were treated with GH (0.05 mg/kg/d), glutamine (0.45 mg/kg/d), plus EN-enriched fiber diet for four weeks. After four weeks of treatment, patients were discharged home; GH was discontinued, but the EN with glutamine was continued. Repeated treatment was performed if there were lose weight, dysplasia, or severe diarrhea. All patients completed the treatment. Body weight, intestinal absorptive capacity, and plasma levels of proteins were significantly improved after complete treatment, without any major adverse effects. On follow-up, no death was reported. Treatment with GH, glutamine, and EN in early stage significantly improved intestinal adaptation in pediatric patients with SBS. Furthermore, the positive effect of the treatment does not seem to be sustained once GH discontinued until the residual intestinal adaptation reaches its maximum.

  20. Effect of corticosteroid injection for trochanter pain syndrome: Design of a randomised clinical trial in general practice

    NARCIS (Netherlands)

    A. Brinks (Tineke); R.M. van Rijn (Rogier); A.M. Bohnen (Arthur); G.L.J. Slee (Gabriël); J.A.N. Verhaar (Jan); B.W. Koes (Bart); S.M. Bierma-Zeinstra (Sita)

    2007-01-01

    textabstractBackground. Regional pain in the hip in adults is a common cause of a general practitioner visit. A considerable part of patients suffer from (greater) trochanteric pain syndrome or trochanteric bursitis. Local corticosteroid injections is one of the treatment options. Although clear

  1. Epidural Steroids for Lumbosacral Radicular Syndrome Compared to Usual Care : Quality of Life and Cost Utility in General Practice

    NARCIS (Netherlands)

    Spijker-Huiges, Antje; Vermeulen, Karin; Winters, Jan C.; van Wijhe, Marten; van der Meer, Klaas

    Objective: To investigate the effect of adding segmental epidural steroid injections (SESIs) to usual care compared with usual care alone on quality of life and cost utility in lumbosacral radicular syndrome (LRS) in general practice. Design: A pragmatic randomized controlled trial. Results were

  2. Effect of corticosteroid injection for trochanter pain syndrome: Design of a randomised clinical trial in general practice

    NARCIS (Netherlands)

    A. Brinks (Tineke); R.M. van Rijn (Rogier); A.M. Bohnen (Arthur); G.L.J. Slee (Gabriël); J.A.N. Verhaar (Jan); B.W. Koes (Bart); S.M. Bierma-Zeinstra (Sita)

    2007-01-01

    textabstractBackground. Regional pain in the hip in adults is a common cause of a general practitioner visit. A considerable part of patients suffer from (greater) trochanteric pain syndrome or trochanteric bursitis. Local corticosteroid injections is one of the treatment options. Although clear evi

  3. GENETIC ARCHITECTURE AND ADAPTIVE SIGNIFICANCE OF THE SELFING SYNDROME IN CAPSELLA

    Science.gov (United States)

    Slotte, Tanja; Hazzouri, Khaled M.; Stern, David; Andolfatto, Peter; Wright, Stephen I.

    2016-01-01

    The transition from outcrossing to predominant self-fertilization is one of the most common evolutionary transitions in flowering plants. This shift is often accompanied by a suite of changes in floral and reproductive characters termed the selfing syndrome. Here, we characterize the genetic architecture and evolutionary forces underlying evolution of the selfing syndrome in Capsella rubella following its recent divergence from the outcrossing ancestor C. grandiflora. We conduct genotyping by multiplexed shotgun sequencing and map floral and reproductive traits in a large (N = 550) F2 population. Our results suggest that in contrast to previous studies of the selfing syndrome, changes at a few loci, some with major effects, have shaped the evolution of the selfing syndrome in Capsella. The directionality of QTL effects, as well as population genetic patterns of polymorphism and divergence at 318 loci, is consistent with a history of directional selection on the selfing syndrome. Our study is an important step toward characterizing the genetic basis and evolutionary forces underlying the evolution of the selfing syndrome in a genetically accessible model system. PMID:22519777

  4. Semantic Verbal Fluency Pattern, Dementia Rating Scores and Adaptive Behavior Correlate With Plasma Aβ42 Concentrations in Down Syndrome Young Adults

    Science.gov (United States)

    Hoyo, Laura Del; Xicota, Laura; Sánchez-Benavides, Gonzalo; Cuenca-Royo, Aida; de Sola, Susana; Langohr, Klaus; Fagundo, Ana B.; Farré, Magí; Dierssen, Mara; de la Torre, Rafael

    2015-01-01

    Down syndrome (DS) is an intellectual disability (ID) disorder in which language and specifically, verbal fluency are strongly impaired domains; nearly all adults show neuropathology of Alzheimer’s disease (AD), including amyloid deposition by their fifth decade of life. In the general population, verbal fluency deficits are considered a strong AD predictor being the semantic verbal fluency task (SVFT) a useful tool for enhancing early diagnostic. However, there is a lack of information about the association between the semantic verbal fluency pattern (SVFP) and the biological amyloidosis markers in DS. In the current study, we used the SVFT in young adults with DS to characterize their SVFP, assessing total generated words, clustering, and switching. We then explored its association with early indicators of dementia, adaptive behavior and amyloidosis biomarkers, using the Dementia Questionnaire for Persons with Intellectual Disability (DMR), the Adaptive Behavior Assessment System-Second Edition (ABAS-II), and plasma levels of Aβ peptides (Aβ40 and Aβ42), as a potent biomarker of AD. In DS, worse performance in SVFT and poorer communication skills were associated with higher plasma Aβ42 concentrations, a higher DMR score and impaired communication skills (ABAS–II). The total word production and switching ability in SVFT were good indicators of plasma Aβ42 concentration. In conclusion, we propose the SVFT as a good screening test for early detection of dementia and amyloidosis in young adults with DS. PMID:26635555

  5. General adaptive-neighborhood technique for improving synthetic aperture radar interferometric coherence estimation.

    Science.gov (United States)

    Vasile, Gabriel; Trouvé, Emmanuel; Ciuc, Mihai; Buzuloiu, Vasile

    2004-08-01

    A new method for filtering the coherence map issued from synthetic aperture radar (SAR) interferometric data is presented. For each pixel of the interferogram, an adaptive neighborhood is determined by a region-growing technique driven by the information provided by the amplitude images. Then pixels in the derived adaptive neighborhood are complex averaged to yield the filtered value of the coherence, after a phase-compensation step is performed. An extension of the algorithm is proposed for polarimetric interferometric SAR images. The proposed method has been applied to both European Remote Sensing (ERS) satellite SAR images and airborne high-resolution polarimetric interferometric SAR images. Both subjective and objective performance analysis, including coherence edge detection, shows that the proposed method provides better results than the standard phase-compensated fixed multilook filter and the Lee adaptive coherence filter.

  6. Adaptive Finite Element Modeling of Marine Controlled-Source Electromagnetic Fields in Two-Dimensional General Anisotropic Media

    Institute of Scientific and Technical Information of China (English)

    LI Yuguo; LUO Ming; PEI Jianxin

    2013-01-01

    In this paper,we extend the scope of numerical simulations of marine controlled-source electromagnetic (CSEM) fields in a particular case of anisotropy (dipping anisotropy) to the general case of anisotropy by using an adaptive finite element approach.In comparison to a dipping anisotropy case,the first order spatial derivatives of the strike-parallel components arise in the partial differential equations for generally anisotropic media,which cause a non-symmetric linear system of equations for finite element modeling.The adaptive finite element method is employed to obtain numerical solutions on a sequence of refined unstructured triangular meshes,which allows for arbitrary model geometries including bathymetry and dipping layers.Numerical results of a 2D anisotropic model show both anisotropy strike and dipping angles have great influence on the marine CSEM responses.

  7. Robust master-slave synchronization for general uncertain delayed dynamical model based on adaptive control scheme.

    Science.gov (United States)

    Wang, Tianbo; Zhou, Wuneng; Zhao, Shouwei; Yu, Weiqin

    2014-03-01

    In this paper, the robust exponential synchronization problem for a class of uncertain delayed master-slave dynamical system is investigated by using the adaptive control method. Different from some existing master-slave models, the considered master-slave system includes bounded unmodeled dynamics. In order to compensate the effect of unmodeled dynamics and effectively achieve synchronization, a novel adaptive controller with simple updated laws is proposed. Moreover, the results are given in terms of LMIs, which can be easily solved by LMI Toolbox in Matlab. A numerical example is given to illustrate the effectiveness of the method.

  8. Adaptive Generalized Projective Synchronization of Takagi-Sugeno Fuzzy Drive-response Dynamical Networks with Time Delay

    Science.gov (United States)

    Zheng, Yong-Ai

    2012-02-01

    Time-delay Takagi-Sugeno fuzzy drive-response dynamical networks (TD-TSFDRDNs) are defined by extending the drive-response dynamical networks. Based on the LaSalle invariant principle, a simple and systematic adaptive control scheme is proposed to synchronize the TD-TSFDRDNs with a desired scalar factor. A sufficient condition for the generalized projective synchronization in TD-TSFDRDNs is derived. Moreover, numerical simulations are provided to verify the correctness and effectiveness of the scheme.

  9. Frequency-adaptive grid-virtual-flux synchronization by multiple second-order generalized integrators under distorted grid conditions

    OpenAIRE

    2015-01-01

    With some of the intermittent new energy and large nonlinear loads, grid voltage unbalance, harmonics, and frequency deviation are increasing year by year. The voltage source converter (VSC) is seriously affected by the various unexpected factors, and the presence of grid impedance makes the situation worse. In order to make the VSC track the nonideal grid quickly and accurately, this paper proposes a frequency-adaptive grid-virtual-flux synchronization by multiple second-order generalized in...

  10. Associations of Proatrial Natriuretic Peptide with Components of the Metabolic Syndrome in Adolescents and Young Adults from the General Population

    DEFF Research Database (Denmark)

    Goharian, Tina S; Gøtze, Jens P; Faber, Jens

    2017-01-01

    BACKGROUND: In middle-aged and elderly populations, circulating natriuretic peptide concentrations are negatively associated with several components of the metabolic syndrome. Whether these negative associations are also present in healthy adolescents and young adults from the general population...... with triglycerides (β = -0.13, P = 0.01), diastolic BP (β = -0.12, P = 0.01) and systolic BP (β = -0.10, P = 0.10), although the latter association was of borderline significance. CONCLUSIONS: The young adults displayed significant negative associations between MR-proANP and several components of the metabolic...... syndrome, whereas such associations were not found among the adolescents besides triglycerides and diastolic BP....

  11. A fully general and adaptive inverse analysis method for cementitious materials

    DEFF Research Database (Denmark)

    Jepsen, Michael S.; Damkilde, Lars; Lövgren, Ingemar

    2016-01-01

    on least square fitting between test data obtained from various kinds of test setup, three-point bending or wedge splitting test, and simulated data obtained by either FEA or analytical models. In the current paper adaptive inverse analysis is conducted on test data obtained from three-point bending...

  12. Klinefelter syndrome has increased brain responses to auditory stimuli and motor output, but not to visual stimuli or Stroop adaptation.

    Science.gov (United States)

    Wallentin, Mikkel; Skakkebæk, Anne; Bojesen, Anders; Fedder, Jens; Laurberg, Peter; Østergaard, John R; Hertz, Jens Michael; Pedersen, Anders Degn; Gravholt, Claus Højbjerg

    2016-01-01

    Klinefelter syndrome (47, XXY) (KS) is a genetic syndrome characterized by the presence of an extra X chromosome and low level of testosterone, resulting in a number of neurocognitive abnormalities, yet little is known about brain function. This study investigated the fMRI-BOLD response from KS relative to a group of Controls to basic motor, perceptual, executive and adaptation tasks. Participants (N: KS = 49; Controls = 49) responded to whether the words "GREEN" or "RED" were displayed in green or red (incongruent versus congruent colors). One of the colors was presented three times as often as the other, making it possible to study both congruency and adaptation effects independently. Auditory stimuli saying "GREEN" or "RED" had the same distribution, making it possible to study effects of perceptual modality as well as Frequency effects across modalities. We found that KS had an increased response to motor output in primary motor cortex and an increased response to auditory stimuli in auditory cortices, but no difference in primary visual cortices. KS displayed a diminished response to written visual stimuli in secondary visual regions near the Visual Word Form Area, consistent with the widespread dyslexia in the group. No neural differences were found in inhibitory control (Stroop) or in adaptation to differences in stimulus frequencies. Across groups we found a strong positive correlation between age and BOLD response in the brain's motor network with no difference between groups. No effects of testosterone level or brain volume were found. In sum, the present findings suggest that auditory and motor systems in KS are selectively affected, perhaps as a compensatory strategy, and that this is not a systemic effect as it is not seen in the visual system.

  13. Klinefelter syndrome has increased brain responses to auditory stimuli and motor output, but not to visual stimuli or Stroop adaptation

    Directory of Open Access Journals (Sweden)

    Mikkel Wallentin

    2016-01-01

    Full Text Available Klinefelter syndrome (47, XXY (KS is a genetic syndrome characterized by the presence of an extra X chromosome and low level of testosterone, resulting in a number of neurocognitive abnormalities, yet little is known about brain function. This study investigated the fMRI-BOLD response from KS relative to a group of Controls to basic motor, perceptual, executive and adaptation tasks. Participants (N: KS = 49; Controls = 49 responded to whether the words “GREEN” or “RED” were displayed in green or red (incongruent versus congruent colors. One of the colors was presented three times as often as the other, making it possible to study both congruency and adaptation effects independently. Auditory stimuli saying “GREEN” or “RED” had the same distribution, making it possible to study effects of perceptual modality as well as Frequency effects across modalities. We found that KS had an increased response to motor output in primary motor cortex and an increased response to auditory stimuli in auditory cortices, but no difference in primary visual cortices. KS displayed a diminished response to written visual stimuli in secondary visual regions near the Visual Word Form Area, consistent with the widespread dyslexia in the group. No neural differences were found in inhibitory control (Stroop or in adaptation to differences in stimulus frequencies. Across groups we found a strong positive correlation between age and BOLD response in the brain's motor network with no difference between groups. No effects of testosterone level or brain volume were found. In sum, the present findings suggest that auditory and motor systems in KS are selectively affected, perhaps as a compensatory strategy, and that this is not a systemic effect as it is not seen in the visual system.

  14. VNTR-DAT1 and COMTVal158Met Genotypes Modulate Mental Flexibility and Adaptive Behavior Skills in Down Syndrome

    Science.gov (United States)

    del Hoyo, Laura; Xicota, Laura; Langohr, Klaus; Sánchez-Benavides, Gonzalo; de Sola, Susana; Cuenca-Royo, Aida; Rodriguez, Joan; Rodríguez-Morató, Jose; Farré, Magí; Dierssen, Mara; de la Torre, Rafael; Cuenca-Royo, Aida

    2016-01-01

    Down syndrome (DS) is an aneuploidy syndrome that is caused by trisomy for human chromosome 21 resulting in a characteristic cognitive and behavioral phenotype, which includes executive functioning and adaptive behavior difficulties possibly due to prefrontal cortex (PFC) deficits. DS also present a high risk for early onset of Alzheimer Disease-like dementia. The dopamine (DA) system plays a neuromodulatory role in the activity of the PFC. Several studies have implicated trait differences in DA signaling on executive functioning based on genetic polymorphisms in the genes encoding for the catechol-O-methyltransferase (COMTVal158Met) and the dopamine transporter (VNTR-DAT1). Since it is known that the phenotypic consequences of genetic variants are modulated by the genetic background in which they occur, we here explore whether these polymorphisms variants interact with the trisomic genetic background to influence gene expression, and how this in turn mediates DS phenotype variability regarding PFC cognition. We genotyped 69 young adults of both genders with DS, and found that VNTR-DAT1 was in Hardy-Weinberg equilibrium but COMTVal158Met had a reduced frequency of Met allele homozygotes. In our population, genotypes conferring higher DA availability, such as Met allele carriers and VNTR-DAT1 10-repeat allele homozygotes, resulted in improved performance in executive function tasks that require mental flexibility. Met allele carriers showed worse adaptive social skills and self-direction, and increased scores in the social subscale of the Dementia Questionnaire for People with Intellectual Disabilities than Val allele homozygotes. The VNTR-DAT1 was not involved in adaptive behavior or early dementia symptoms. Our results suggest that genetic variants of COMTVal158Met and VNTR-DAT1 may contribute to PFC-dependent cognition, while only COMTVal158Met is involved in behavioral phenotypes of DS, similar to euploid population. PMID:27799900

  15. VNTR-DAT1 and COMTVal158Met genotypes modulate mental flexibility and adaptive behavior skills in Down syndrome

    Directory of Open Access Journals (Sweden)

    Laura Del Hoyo

    2016-10-01

    Full Text Available Down syndrome (DS is an aneuploidy syndrome that is caused by trisomy for human chromosome 21 resulting in a characteristic cognitive and behavioral phenotype, which includes executive functioning and adaptive behavior difficulties possibly due to prefrontal cortex (PFC deficits. DS also present a high risk for early onset of Alzheimer Disease (AD-like dementia. The dopamine (DA system plays a neuromodulatory role in the activity of the PFC. Several studies have implicated trait differences in DA signaling on executive functioning based on genetic polymorphisms in the genes encoding for the catechol-O-methyltransferase (COMTVal158Met and the dopamine transporter (VNTR-DAT1. Since it is known that the phenotypic consequences of genetic variants are modulated by the genetic background in which they occur, we here explore whether these polymorphisms variants interact with the trisomic genetic background to influence gene expression, and how this in turn mediates DS phenotype variability regarding PFC cognition. We genotyped 69 young adults of both genders with DS, and found that VNTR-DAT1 was in Hardy-Weinberg equilibrium but COMTVal158Met had a reduced frequency of Met allele homozygotes. In our population, genotypes conferring higher DA availability, such as Met allele carriers and VNTR-DAT1 10-repeat allele homozygotes, resulted in improved performance in executive function tasks that require mental flexibility. Met allele carriers showed worse adaptive social skills and self-direction, and increased scores in the social subscale of the Dementia Questionnaire for People with Intellectual Disabilities than Val allele homozygotes. The VNTR-DAT1 was not involved in adaptive behavior or early dementia symptoms. Our results suggest that genetic variants of COMTVal158Met and VNTR-DAT1 may contribute to PFC-dependent cognition, while only COMTVal158Met is involved in behavioral phenotypes of DS, similar to euploid population.

  16. Correlations Between General Joint Hypermobility and Joint Hypermobility Syndrome and Injury in Contemporary Dance Students.

    Science.gov (United States)

    Ruemper, Alia; Watkins, Katherine

    2012-12-01

    The first objective of this study was to ascertain the prevalence of general joint hypermobility (GJH) and joint hypermobility syndrome (JHS) in BA Dance Theatre 1st and 3rd year students at a contemporary dance conservatory. The second objective was to determine the statistical correlation between GJH, JHS, and injury in this population. A total of 85 (female, N = 78; male, N = 7) contemporary dance students participated in the study. The Beighton score (with a forward flexion test modification) was used to determine GJH, and the Brighton criteria were used to verify JHS. Participants completed a self-reported injury questionnaire that included type of injury (physical complaint, medical diagnosis, or time-loss) and injury frequency. Statistical analysis (Pearson correlation) was used to correlate GJH, JHS, and frequency-of-injury scores. Overall, 69% of the students were found to have GJH, and 33% had JHS. A statistical correlation of r = + 0.331 (p contemporary dance students and suggests that screening programs should include the Brighton criteria to identify JHS in these dancers. Subsequent injury tracking and injury prevention programs would then provide data for further research in this area.

  17. Relationship between Metabolic Syndrome Components and Periodontal Disease in a Japanese General Population: the Suita Study.

    Science.gov (United States)

    Kikui, Miki; Kokubo, Yoshihiro; Ono, Takahiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Watanabe, Makoto; Maeda, Yoshinobu; Miyamoto, Yoshihiro

    2017-05-01

    A positive association between metabolic syndrome (MetS) and periodontal status has recently been noted. However, no study has evaluated the relationship by sex and in a general urban population using the uniform definition proposed in the 2009 Joint Interim Statement. The aim of this study was to clarify the relationship between MetS and periodontal status using the uniform definition in a general urban Japanese population. A total of 1,856 Japanese men and women (mean age: 66.4 years) were studied using data from the Suita study. Periodontal status was evaluated by the Community Periodontal Index (CPI). MetS was defined using the 2009 Joint Interim Statement. The associations of the MetS and its components with periodontal disease were investigated using multiple logistic regression analysis adjusting for age, drinking, and smoking. Among the components of the MetS, low HDL cholesterol level was significantly associated with periodontal disease in men and women [odds ratios (OR)=2.39 and 1.53; 95% confidence intervals=1.36-4.19 and 1.06-2.19]. Furthermore, the risk of periodontal disease showed 1.43-, 1.42-, and 1.89-fold increases in those with 2, 3, and ≥4 components, respectively, compared with those having no components (Ptrend <0.001). For the analysis by sex, the risk of periodontal disease was increased 2.27- and 1.76-fold in those with ≥4 components in men and women, respectively (both Ptrend=0.001). These findings suggest that MetS and lower HDL cholesterol are associated with periodontal disease. Subjects with two or more MetS components had a significantly higher prevalence of periodontal disease.

  18. Positive association between increased popliteal artery vessel wall thickness and generalized osteoarthritis: is OA also part of the metabolic syndrome?

    Energy Technology Data Exchange (ETDEWEB)

    Kornaat, Peter R.; Sharma, Ruby; Geest, Rob J. van der; Lamb, Hildo J.; Bloem, Johan L.; Watt, Iain [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Kloppenburg, Margreet [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Hellio le Graverand, Marie-Pierre [Pfizer Global Research and Development, New London, CT (United States)

    2009-12-15

    The purpose of the study was to determine if a positive association exists between arterial vessel wall thickness and generalized osteoarthritis (OA). Our hypothesis is that generalized OA is another facet of the metabolic syndrome. The medical ethical review board of our institution approved the study. Written informed consent was obtained from each patient prior to the study. Magnetic resonance (MR) images of the knee were obtained in 42 patients who had been diagnosed with generalized OA at multiple joint sites. Another 27 MR images of the knee were obtained from a matched normal (non-OA) reference population. Vessel wall thickness of the popliteal artery was quantitatively measured by dedicated software. Linear regression models were used to investigate the association between vessel wall thickness and generalized OA. Adjustments were made for age, sex, and body mass index (BMI). Confidence intervals (CI) were computed at the 95% level and a significance level of {alpha} = 0.05 was used. Patients in the generalized OA population had a significant higher average vessel wall thickness than persons from the normal reference population (p {<=} {alpha}), even when correction was made for sex, age, and BMI. The average vessel wall thickness of the popliteal artery was 1.09 mm in patients with generalized OA, and 0.96 mm in the matched normal reference population. The association found between increased popliteal artery vessel wall thickness and generalized osteoarthritis suggests that generalized OA might be another facet of the metabolic syndrome. (orig.)

  19. Adaptive-filtering of trisomy 21: risk of Down syndrome depends on family size and age of previous child

    Science.gov (United States)

    Neuhäuser, Markus; Krackow, Sven

    2007-02-01

    The neonatal incidence rate of Down syndrome (DS) is well-known to accelerate strongly with maternal age. This non-linearity renders mere accumulation of defects at recombination during prolonged first meiotic prophase implausible as an explanation for DS rate increase with maternal age, but might be anticipated from chromosomal drive (CD) for trisomy 21. Alternatively, as there is selection against genetically disadvantaged embryos, the screening system that eliminates embryos with trisomy 21 might decay with maternal age. In this paper, we provide the first evidence for relaxed filtering stringency (RFS) to represent an adaptive maternal response that could explain accelerating DS rates with maternal age. Using historical data, we show that the proportion of aberrant live births decrease with increased family size in older mothers, that inter-birth intervals are longer before affected neonates than before normal ones, and that primiparae exhibit elevated levels of DS incidence at higher age. These findings are predicted by adaptive RFS but cannot be explained by the currently available alternative non-adaptive hypotheses, including CD. The identification of the relaxation control mechanism and therapeutic restoration of a stringent screen may have considerable medical implications.

  20. Unraveling the role of perfectionism in chronic fatigue syndrome: is there a distinction between adaptive and maladaptive perfectionism?

    Science.gov (United States)

    Kempke, Stefan; Van Houdenhove, Boudewijn; Luyten, Patrick; Goossens, Lutgarde; Bekaert, Patrick; Van Wambeke, Peter

    2011-04-30

    In the current study, we investigated whether the distinction between adaptive (i.e. high personal standards) and maladaptive (i.e. concern over mistakes and doubt about actions) perfectionism that has been found in the literature, is also valid in patients with chronic fatigue syndrome (CFS). We hypothesized that maladaptive, but not adaptive, perfectionism would be significantly and positively related to severity of fatigue and depression in CFS. We examined this hypothesis in a sample of 192 CFS patients using structural equation modelling (SEM). Although the two perfectionism dimensions were related to each other, results supported a model in which only maladaptive perfectionism was positively related to severity of fatigue and depression. Further, we found that depression fully mediated the effect of maladaptive perfectionism on fatigue. The results suggest that adaptive and maladaptive perfectionism are two distinct, albeit related, dimensions in CFS. Findings of this study have important implications for theory and treatment of CFS, particularly for cognitive-behavioral treatment. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. The nonthyroidal illness syndrome.

    Science.gov (United States)

    Adler, Suzanne Myers; Wartofsky, Leonard

    2007-09-01

    This article briefly summarizes thyroid function alterations generally seen in the euthyroid sick syndrome, provides an overview of specific thyroidal adaptations during several clinical conditions and secondary to specific pharmacologic agents, and discusses the current controversy in thyroid hormone treatment of nonthyroidal illness.

  2. What General Educators Have To Say about Successfully Including Students with Down Syndrome in Their Classes.

    Science.gov (United States)

    Wolpert, Gloria

    2001-01-01

    Investigated classroom management techniques of K-12 teachers whose classrooms included children with Down Syndrome. Teachers, all selected by parents as successful, reported that praise was the best motivator for the Down Syndrome children, and the most effective learning methods were individual and small-group instruction, hands-on activities,…

  3. Dental Management of a 14-Year-Old with Cockayne Syndrome under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Divya Gaddam

    2014-01-01

    Full Text Available Cockayne’s syndrome is a rare, autosomal recessive disorder characterized clinically by cachectic dwarfism, cutaneous photosensitivity, loss of adipose tissue, mental retardation, skeletal and neurological abnormalities, and pigmentary degeneration of the retina. Dental caries is a common finding. Dental rehabilitation of a 14-year-old male with Cockayne’s syndrome is presented.

  4. Cognitive and Adaptive Advantages of Growth Hormone Treatment in Children with Prader-Willi Syndrome

    Science.gov (United States)

    Dykens, Elisabeth M.; Roof, Elizabeth; Hunt-Hawkins, Hailee

    2017-01-01

    Background: People with Prader-Willi syndrome (PWS) typically have mild to moderate intellectual deficits, compulsivity, hyperphagia, obesity, and growth hormone deficiencies. Growth hormone treatment (GHT) in PWS has well-established salutatory effects on linear growth and body composition, yet cognitive benefits of GHT, seen in other patient…

  5. Adaptive Behaviour in Angelman Syndrome: Its Profile and Relationship to Age

    Science.gov (United States)

    Gasca, C. Brun; Obiols, J. E.; Bonillo, A.; Artigas, J.; Lorente, I.; Gabau, E.; Guitart, M.; Turk, J.

    2010-01-01

    Background: Angelman syndrome (AS) is a neurodevelopmental disorder usually caused by an anomaly in the maternally inherited chromosome 15. The main features are severe intellectual disability, speech impairment, ataxia, epilepsy, sleep disorder and a behavioural phenotype that reportedly includes happy disposition, attraction to/fascination with…

  6. Cognitive and Adaptive Advantages of Growth Hormone Treatment in Children with Prader-Willi Syndrome

    Science.gov (United States)

    Dykens, Elisabeth M.; Roof, Elizabeth; Hunt-Hawkins, Hailee

    2017-01-01

    Background: People with Prader-Willi syndrome (PWS) typically have mild to moderate intellectual deficits, compulsivity, hyperphagia, obesity, and growth hormone deficiencies. Growth hormone treatment (GHT) in PWS has well-established salutatory effects on linear growth and body composition, yet cognitive benefits of GHT, seen in other patient…

  7. Early Learning and Adaptive Behaviour in Toddlers with Down Syndrome: Evidence for an Emerging Behavioural Phenotype?

    Science.gov (United States)

    Fidler, Deborah; Hepburn, Susan; Rogers, Sally

    2006-01-01

    Background: Though the Down syndrome behavioural phenotype has been described as involving relative strengths in visuo-spatial processing and sociability, and relative weaknesses in verbal skills and motor planning, the early emergence of this phenotypic pattern of strengths and weaknesses has not yet been fully explored. Method: In this study, we…

  8. Autistic Features, Personality, and Adaptive Behavior in Males with the Fragile X Syndrome and No Autism.

    Science.gov (United States)

    Kerby, Dave S.; Dawson, Brenda L.

    1994-01-01

    Nine adult males with mental retardation resulting from Fragile X syndrome were compared to males with mental retardation of other etiology. Fragile X males showed a distinct psychological profile with more autistic features, more schizoid features, and more schizotypal features. These males were also more shy, more socially withdrawn, less…

  9. Generating Initial Data in General Relativity using Adaptive Finite Element Methods

    CERN Document Server

    Aksoylu, Burak; Bond, Stephen; Holst, Michael

    2008-01-01

    The conformal formulation of the Einstein constraint equations is first reviewed, and we then consider the design, analysis, and implementation of adaptive multilevel finite element-type numerical methods for the resulting coupled nonlinear elliptic system. We derive weak formulations of the coupled constraints, and review some new developments in the solution theory for the constraints in the cases of constant mean extrinsic curvature (CMC) data, near-CMC data, and arbitrarily prescribed mean extrinsic curvature data. We then outline some recent results on a priori and a posteriori error estimates for a broad class of Galerkin-type approximation methods for this system which includes techniques such as finite element, wavelet, and spectral methods. We then use these estimates to construct an adaptive finite element method (AFEM) for solving this system numerically, and outline some new convergence and optimality results. We then describe in some detail an implementation of the methods using the FETK software...

  10. Adaptive Continuous time Markov Chain Approximation Model to\\ud General Jump-Diffusions

    OpenAIRE

    Cerrato, Mario; Lo, Chia Chun; Skindilias, Konstantinos

    2011-01-01

    We propose a non-equidistant Q rate matrix formula and an adaptive numerical algorithm for a continuous time Markov chain to approximate jump-diffusions with affine or non-affine functional specifications. Our approach also accommodates state-dependent jump intensity and jump distribution, a flexibility that is very hard to achieve with other numerical methods. The Kologorov-Smirnov test shows that the proposed Markov chain transition density converges to the one given by the likelihood expan...

  11. Code Development of Three-Dimensional General Relativistic Hydrodynamics with AMR (Adaptive-Mesh Refinement) and Results from Special and General Relativistic Hydrodynamics

    Science.gov (United States)

    Dönmez, Orhan

    2004-09-01

    In this paper, the general procedure to solve the general relativistic hydrodynamical (GRH) equations with adaptive-mesh refinement (AMR) is presented. In order to achieve, the GRH equations are written in the conservation form to exploit their hyperbolic character. The numerical solutions of GRH equations are obtained by high resolution shock Capturing schemes (HRSC), specifically designed to solve nonlinear hyperbolic systems of conservation laws. These schemes depend on the characteristic information of the system. The Marquina fluxes with MUSCL left and right states are used to solve GRH equations. First, different test problems with uniform and AMR grids on the special relativistic hydrodynamics equations are carried out to verify the second-order convergence of the code in one, two and three dimensions. Results from uniform and AMR grid are compared. It is found that adaptive grid does a better job when the number of resolution is increased. Second, the GRH equations are tested using two different test problems which are Geodesic flow and Circular motion of particle In order to do this, the flux part of GRH equations is coupled with source part using Strang splitting. The coupling of the GRH equations is carried out in a treatment which gives second order accurate solutions in space and time.

  12. Heterogeneity-mediated cellular adaptation and its trade-off: searching for the general principles of diseases.

    Science.gov (United States)

    Heng, Henry H

    2017-02-01

    Big-data-omics have promised the success of precision medicine. However, most common diseases belong to adaptive systems where the precision is all but difficult to achieve. In this commentary, I propose a heterogeneity-mediated cellular adaptive model to search for the general model of diseases, which also illustrates why in most non-infectious non-Mendelian diseases the involvement of cellular evolution is less predictable when gene profiles are used. This synthesis is based on the following new observations/concepts: 1) the gene only codes "parts inheritance" while the genome codes "system inheritance" or the entire blueprint; 2) the nature of somatic genetic coding is fuzzy rather than precise, and genetic alterations are not just the results of genetic error but are in fact generated from internal adaptive mechanisms in response to environmental dynamics; 3) stress-response is less specific within cellular evolutionary context when compared to known biochemical specificities; and 4) most medical interventions have their unavoidable uncertainties and often can function as negative harmful stresses as trade-offs. The acknowledgment of diseases as adaptive systems calls for the action to integrate genome- (not simply individual gene-) mediated cellular evolution into molecular medicine. © 2016 John Wiley & Sons, Ltd.

  13. Analysis of Adaptive Feedback and Echo Cancelation Algorithms in A General Multiple-Microphone and Single-Loudspeaker System

    DEFF Research Database (Denmark)

    Guo, Meng; Elmedyb, Thomas Bo; Jensen, Søren Holdt;

    2011-01-01

    In this paper, we analyze a general multiple-microphone and single-loudspeaker system, where an adaptive algorithm is used to cancel acoustic feedback/echo and a beamformer processes the feedback/echo canceled signals. This system can be viewed as part of a typical hearing aid system and....../or a traditional acoustic echo cancelation system. We introduce and derive an approximation of a useful frequency domain measure - the power transfer function - and show how to predict the system stability bound, convergence rate and the steady-state behavior across time and frequency. Furthermore, we show how...... the derived expressions can be used to determine e.g. the step size parameter in the adaptive algorithms to achieve a desired system property e.g. convergence rate at a specific frequency....

  14. Sedation and general anesthesia for patients with Cornelia De Lange syndrome: A case series.

    Science.gov (United States)

    Moretto, Alessandra; Scaravilli, Vittorio; Ciceri, Valentina; Bosatra, Mariagrazia; Giannatelli, Federica; Ateniese, Bianca; Mariani, Milena; Cereda, Anna; Sosio, Simone; Zanella, Alberto; Pesenti, Antonio; Selicorni, Angelo

    2016-06-01

    Cornelia De Lange syndrome (CdLS) is a rare congenital disease characterized by typical facial dysmorphism, developmental disability, and limb deficiency defects. Various congenital malformations and medical complications have been described with gastroesophageal reflux as the major one. CdLS patients often require multiple high-risk anesthetic procedures. At San Gerardo Hospital (Monza, Italy) the management of CdLS patients is routinely organized through a standard protocol and a dedicated pediatric anesthesia team has been implemented. We report on a retrospective descriptive analysis of the anesthetic records of the CdLS patients admitted to San Gerardo Hospital from January 2010 to December 2015. We retrieved: demographics, genetic profiles, type of procedures, anesthetic approaches, anesthetics usage and complications. Data are reported as median (interquartile range) values. Twenty-seven patients (11 female), with age 12 (7-15) years old, weight 24 (14-35) kg, and severity score of 25 (18-32) were included. NIBPL mutations were the most frequently represented. We analyzed 58 procedures (30 esophagogastroduodenoscopies, 8 evoked auditory potential tests, 5 radiodiagnostics, 5 catheters positioning, 4 bronchoscopies) managed by sedation (36) and general anesthesia (6). Each patient underwent one (1-2) anesthetic procedure. Propofol (59%), sevoflurane (31%), fentanyl (24%), and ketamine (10%) were used. Three out of six endotracheal intubations were difficult. The only documented intraoperative complications were three episodes of desaturation (oxygen saturation <90%) occurring during sedations and were managed without the need for an invasive control of the airways. Implementation of a specific management protocol and a dedicated allowed to provide anesthesia to CdLS patients without the occurrence of major complications. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Generalized likelihood uncertainty estimation (GLUE) using adaptive Markov chain Monte Carlo sampling

    DEFF Research Database (Denmark)

    Blasone, Roberta-Serena; Vrugt, Jasper A.; Madsen, Henrik

    2008-01-01

    estimate of the associated uncertainty. This uncertainty arises from incomplete process representation, uncertainty in initial conditions, input, output and parameter error. The generalized likelihood uncertainty estimation (GLUE) framework was one of the first attempts to represent prediction uncertainty...

  16. Functional adaptation of tendon and skeletal muscle to resistance training in three patients with genetically verified classic Ehlers Danlos Syndrome

    DEFF Research Database (Denmark)

    Møller, Mathias Bech; Kjær, Michael; Svensson, René Brüggebusch;

    2014-01-01

    and after intervention in regards to muscle strength, tendon mechanical properties, and muscle function. RESULTS: three subjects completed the scheduled 48 sessions and had no major adverse events. Mean isometric leg extension force and leg extensor power both increased by 8 and 11% respectively (358 to 397......BACKGROUND: tendon and skeletal muscle function adapts to physical training of resistive nature, but it is unknown to what extent persons with genetically altered connective tissue - who have a higher than normal tendon extensibility - will obtain any effect upon their tendon and muscle when...... undergoing muscle strength training. We investigated patients with classical Ehlers Danlos Syndrome (EDS) (collagen type V defect) who display articular hypermobility, skin extensibility and tissue fragility. METHODS: subjects underwent strength training 3 times a week for 4 months and were tested before...

  17. SafeBox: adaptable spatio-temporal generalization for location privacy protection

    Directory of Open Access Journals (Sweden)

    Sergio Mascetti

    2014-08-01

    Full Text Available Spatial and temporal generalization emerged in the literature as a common approach to preserve location privacy. However, existing solutions have two main shortcomings. First, spatiotemporal generalization can be used with different objectives: for example, to guarantee anonymity or to decrease the sensitivity of the location information. Hence, the strategy used to compute the generalization can follow different semantics often depending on the privacy threat, while most of the existing solutions are specifically designed for a single semantics. Second, existing techniques prevent the so-called inversion attack by adopting a top-down strategy that needs to acquire a large amount of information. This may not be feasible when this information is dynamic (e.g., position or properties of objects and needs to be acquired from external services (e.g., Google Maps. In this contribution we present a formal model of the problem that is compatible with most of the semantics proposed so far in the literature, and that supports new semantics as well. Our BottomUp algorithm for spatio-temporal generalization is compatible with the use of online services, it supports generalizations based on arbitrary semantics, and it is safe with respect to the inversion attack. By considering two datasets and two examples of semantics, we experimentally compare BottomUp with a more classical top-down algorithm, showing that BottomUp is efficient and guarantees better performance in terms of the average size (space and time of the generalized regions.

  18. Psychophysiological adaptation of the patient with the remote effect of the III degree acute radiation syndrome

    Directory of Open Access Journals (Sweden)

    Metlyaeva N.A.

    2013-12-01

    putation of both shins at level in top / 3, late beam buttock, right hip ulcers, a beam cataract of the III degree of both eyes, stabilized. The assessment of the efficiency of psychophysiological adaptation in dynamics with 2009 indicates emergence of prevalence of hypochondriac tendencies over a demonstration with accession of high uneasiness and autistic lines at preservation of the leading role of an hypochondriac somatization of alarm with considerable decrease in an emotionality, an integration, a freedom of behavior. The changes revealed in dynamics correspond to the specific increase weight of violations of mental adaptation, characteristic for the period of adaptation exhaustion. The high intelligence, good figurative and logical thinking, well-mannered forms of behavior, high control over the emotional sphere, restraint of emotions, independence, self-sufficiency, organization, behavior taking into account environment requirements provided the patient M. firmness before a heavy illness, promoted good adaptation to an environment with confidence in myself, high social adaptability, opportunity successfully to carry out duties, hold the work account (worked 39 years after accident. Comparative assessment of operator ability of the patient M. showed good average time of common and difficult sensorimotor reactions with 2 mistakes, high time of reaction for moving object, however decrease in accuracy of reaction from 10-13% to 2% testifies to manifestation in dynamics of insufficiency of real functional reserves of nervous system. Conclusions. Efficiency of psychophysiological adaptation depends not only on a dose of radiation and weight of the transferred disease, but, mostly, on premorbid properties of the identity of the victim and his social and labor installation.

  19. Stress, Locus of Control, and Family Cohesion and Adaptability in Parents of Children with Down, Williams, Fragile X, and Prader-Willi Syndromes

    Science.gov (United States)

    Lanfranchi, Silvia; Vianello, Renzo

    2012-01-01

    The present study analyzes differences in parental stress in families of children with Down, Williams, Fragile X, and Prader-Willi syndromes, exploring factors that influence parental stress, such as child's characteristics, parental locus of control, and family cohesion and adaptability. Differences between mothers and fathers are also…

  20. Synergistic effect of supplemental enteral nutrients and exogenous glucagon-like peptide 2 on intestinal adaptation in a rat model of short bowel syndrome

    DEFF Research Database (Denmark)

    Liu, Xiaowen; Nelson, David W; Holst, Jens Juul

    2006-01-01

    BACKGROUND: Short bowel syndrome (SBS) can lead to intestinal failure and require total or supplemental parenteral nutrition (TPN or PN, respectively). Glucagon-like peptide 2 (GLP-2) is a nutrient-dependent, proglucagon-derived gut hormone that stimulates intestinal adaptation. OBJECTIVE: Our...... of GLP-2 (SEN x GLP-2 interaction, P cellularity and digestive capacity in parenterally fed rats with SBS...

  1. Group Training in Interpersonal Problem-Solving Skills for Workplace Adaptation of Adolescents and Adults with Asperger Syndrome: A Preliminary Study

    Science.gov (United States)

    Bonete, Saray; Calero, María Dolores; Fernández-Parra, Antonio

    2015-01-01

    Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study…

  2. Group Training in Interpersonal Problem-Solving Skills for Workplace Adaptation of Adolescents and Adults with Asperger Syndrome: A Preliminary Study

    Science.gov (United States)

    Bonete, Saray; Calero, María Dolores; Fernández-Parra, Antonio

    2015-01-01

    Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study…

  3. Stress, Locus of Control, and Family Cohesion and Adaptability in Parents of Children with Down, Williams, Fragile X, and Prader-Willi Syndromes

    Science.gov (United States)

    Lanfranchi, Silvia; Vianello, Renzo

    2012-01-01

    The present study analyzes differences in parental stress in families of children with Down, Williams, Fragile X, and Prader-Willi syndromes, exploring factors that influence parental stress, such as child's characteristics, parental locus of control, and family cohesion and adaptability. Differences between mothers and fathers are also…

  4. Accurate and general treatment of electrostatic interaction in Hamiltonian adaptive resolution simulations

    Science.gov (United States)

    Heidari, M.; Cortes-Huerto, R.; Donadio, D.; Potestio, R.

    2016-10-01

    In adaptive resolution simulations the same system is concurrently modeled with different resolution in different subdomains of the simulation box, thereby enabling an accurate description in a small but relevant region, while the rest is treated with a computationally parsimonious model. In this framework, electrostatic interaction, whose accurate treatment is a crucial aspect in the realistic modeling of soft matter and biological systems, represents a particularly acute problem due to the intrinsic long-range nature of Coulomb potential. In the present work we propose and validate the usage of a short-range modification of Coulomb potential, the Damped shifted force (DSF) model, in the context of the Hamiltonian adaptive resolution simulation (H-AdResS) scheme. This approach, which is here validated on bulk water, ensures a reliable reproduction of the structural and dynamical properties of the liquid, and enables a seamless embedding in the H-AdResS framework. The resulting dual-resolution setup is implemented in the LAMMPS simulation package, and its customized version employed in the present work is made publicly available.

  5. [A Brillouin Scattering Spectrum Feature Extraction Based on Flies Optimization Algorithm with Adaptive Mutation and Generalized Regression Neural Network].

    Science.gov (United States)

    Zhang, Yan-jun; Liu, Wen-zhe; Fu, Xing-hu; Bi, Wei-hong

    2015-10-01

    According to the high precision extracting characteristics of scattering spectrum in Brillouin optical time domain reflection optical fiber sensing system, this paper proposes a new algorithm based on flies optimization algorithm with adaptive mutation and generalized regression neural network. The method takes advantages of the generalized regression neural network which has the ability of the approximation ability, learning speed and generalization of the model. Moreover, by using the strong search ability of flies optimization algorithm with adaptive mutation, it can enhance the learning ability of the neural network. Thus the fitting degree of Brillouin scattering spectrum and the extraction accuracy of frequency shift is improved. Model of actual Brillouin spectrum are constructed by Gaussian white noise on theoretical spectrum, whose center frequency is 11.213 GHz and the linewidths are 40-50, 30-60 and 20-70 MHz, respectively. Comparing the algorithm with the Levenberg-Marquardt fitting method based on finite element analysis, hybrid algorithm particle swarm optimization, Levenberg-Marquardt and the least square method, the maximum frequency shift error of the new algorithm is 0.4 MHz, the fitting degree is 0.991 2 and the root mean square error is 0.024 1. The simulation results show that the proposed algorithm has good fitting degree and minimum absolute error. Therefore, the algorithm can be used on distributed optical fiber sensing system based on Brillouin optical time domain reflection, which can improve the fitting of Brillouin scattering spectrum and the precision of frequency shift extraction effectively.

  6. Zymosan-induced generalized inflammation: experimental studies into mechanisms leading to multiple organ dysfunction syndrome.

    NARCIS (Netherlands)

    Volman, T.J.H.; Hendriks, T.; Goris, R.J.A.

    2005-01-01

    Patients suffering from multiple organ dysfunction syndrome (MODS) comprise a heterogeneous population, which complicates research in its pathogenesis. Elucidation of the mechanisms involved in the development of MODS will ultimately necessitate the collection of tissue samples and the performance

  7. Carpal tunnel syndrome in general practice (1987 and 2001): incidence and the role of occupational and non-occupational factors

    Science.gov (United States)

    Bongers, Frans JM; Schellevis, Francois G; van den Bosch, Wil JHM; van der Zee, Jouke

    2007-01-01

    Background Most studies on the incidence of the carpal tunnel syndrome and the relation of this disorder with occupation are population-based. In this study we present data from general practice. Aim To compare incidence rates of carpal tunnel syndrome in 1987 with those in 2001, and to study the relationship between carpal tunnel syndrome and occupation. Design of study Analysis of the data of the first and second Dutch National Survey of General Practice, conducted in 1987 and 2001, respectively. Setting General practices in The Netherlands. Method One hundred and three general practices in 1987 with 355 201 listed patients, and 96 practices with 364 998 listed patients in 2001, registered all patients who presented with a new episode of carpal tunnel syndrome. Patient and GP populations were representative for The Netherlands. Results The crude incidence rate was 1.3 per 1000 (95% confidence interval [CI] = 1.0 to 1.5) in 1987, and 1.8 per 1000 (95% CI = 1.7 to 2.0) in 2001. In males it was 0.6 (95% CI = 0.5 to 0.7) and 0.9 (95% CI = 0.8 to 1.0) respectively; in females 1.9 (95% CI = 1.7 to 2.1) and 2.8 (95% CI = 2.6 to 3.1). At both study periods, peak incidence rate occurred in the 45–64-year age group: in 2001 this peak reached 4.8 per 1000 (95 CI = 4.1 to 5.4) for females and 1.6 (95 CI = 1.2 to 2.0) for males. Women who performed unskilled and semi-skilled work had 1.5 times greater risk of acquiring carpal tunnel syndrome than women with higher-skilled jobs (P<0.001). In men no relationship of this kind was found. Conclusion In 2001 the crude incidence rate of carpal tunnel syndrome was 1.5 times higher than in 1987, but the difference was not statistically significant after subdividing by age and sex. In both years the female:male ratio was 3:1. Incidence rates were related to the job level of women, but not of men. PMID:17244422

  8. Overcoming the "Walmart Syndrome": Adapting Problem-Based Management Education in East Asia

    Science.gov (United States)

    Hallinger, Philip; Lu, Jiafang

    2012-01-01

    This paper explores design issues to be considered in adapting the problem-based learning (PBL) for use in the context of East Asian higher education and tests its instructional effectiveness in a Master of Management degree program at a graduate school of business (GSB) in Thailand. The research analyzes course evaluation data obtained from…

  9. Adapting generalization tools to physiographic diversity for the united states national hydrography dataset

    Science.gov (United States)

    Buttenfield, B.P.; Stanislawski, L.V.; Brewer, C.A.

    2011-01-01

    This paper reports on generalization and data modeling to create reduced scale versions of the National Hydrographic Dataset (NHD) for dissemination through The National Map, the primary data delivery portal for USGS. Our approach distinguishes local differences in physiographic factors, to demonstrate that knowledge about varying terrain (mountainous, hilly or flat) and varying climate (dry or humid) can support decisions about algorithms, parameters, and processing sequences to create generalized, smaller scale data versions which preserve distinct hydrographic patterns in these regions. We work with multiple subbasins of the NHD that provide a range of terrain and climate characteristics. Specifically tailored generalization sequences are used to create simplified versions of the high resolution data, which was compiled for 1:24,000 scale mapping. Results are evaluated cartographically and metrically against a medium resolution benchmark version compiled for 1:100,000, developing coefficients of linear and areal correspondence.

  10. Mitochondrial Respiration in Insulin-Producing β-Cells: General Characteristics and Adaptive Effects of Hypoxia.

    Science.gov (United States)

    Hals, Ingrid K; Bruerberg, Simon Gustafson; Ma, Zuheng; Scholz, Hanne; Björklund, Anneli; Grill, Valdemar

    2015-01-01

    To provide novel insights on mitochondrial respiration in β-cells and the adaptive effects of hypoxia. Insulin-producing INS-1 832/13 cells were exposed to 18 hours of hypoxia followed by 20-22 hours re-oxygenation. Mitochondrial respiration was measured by high-resolution respirometry in both intact and permeabilized cells, in the latter after establishing three functional substrate-uncoupler-inhibitor titration (SUIT) protocols. Concomitant measurements included proteins of mitochondrial complexes (Western blotting), ATP and insulin secretion. Intact cells exhibited a high degree of intrinsic uncoupling, comprising about 50% of oxygen consumption in the basal respiratory state. Hypoxia followed by re-oxygenation increased maximal overall respiration. Exploratory experiments in peremabilized cells could not show induction of respiration by malate or pyruvate as reducing substrates, thus glutamate and succinate were used as mitochondrial substrates in SUIT protocols. Permeabilized cells displayed a high capacity for oxidative phosphorylation for both complex I- and II-linked substrates in relation to maximum capacity of electron transfer. Previous hypoxia decreased phosphorylation control of complex I-linked respiration, but not in complex II-linked respiration. Coupling control ratios showed increased coupling efficiency for both complex I- and II-linked substrates in hypoxia-exposed cells. Respiratory rates overall were increased. Also previous hypoxia increased proteins of mitochondrial complexes I and II (Western blotting) in INS-1 cells as well as in rat and human islets. Mitochondrial effects were accompanied by unchanged levels of ATP, increased basal and preserved glucose-induced insulin secretion. Exposure of INS-1 832/13 cells to hypoxia, followed by a re-oxygenation period increases substrate-stimulated respiratory capacity and coupling efficiency. Such effects are accompanied by up-regulation of mitochondrial complexes also in pancreatic islets

  11. General Acid Catalysis: A Flexible Experiment, Adaptable to Student Ability and Various Teaching Approaches.

    Science.gov (United States)

    Bulmer, R. S.; And Others

    1981-01-01

    The acid-catalyzed hydrolysis of N-vinyl pyrrolidone provides a simple spectrophotometric kinetic experiment to introduce general acid catalysis, solvent isotope effects, and other aspects of ionic reactions in solution in advanced courses. The Bronsted equation and concept of linear free-energy changes is also covered. (SK)

  12. Abundance of general aerobic heterotrophic bacteria in the Bering Sea and Chukchi Sea and their adaptation to temperature

    Institute of Scientific and Technical Information of China (English)

    陈皓文; 高爱国; 孙海青; 矫玉田

    2004-01-01

    The abundance of general aerobic heterotrophic bacteria(GAB) from the water and sediment in the Bering Sea and the Chukchi Sea was determined by using petri dish cultivation and counting method. The abundance of GAB among the different sea areas, sampling sites, layers of sediments surveyed and adaptability to differential temperatures was studied. The result obtained showed that: the occurrence percentage of GAB in the surface water was higher than that in sediment, but the abundance was only 0.17% of sediment. The occurrence percentage of GAB in surficial layer of sediment was higher than that in the other layers. The occurrence percentage of GAB in surficial layer of sediment was higher than that in the other layers. The occurrence percentage, abundance and its variation of GAB in the Bering Sea were higher than that in the Chukchi Sea respectively. The average value of the abundance of GAB in sediment showed a trend: roughly higher in the lower latitudinal area than higher latitude. The results from temperature test mean that: the majority of bacteria tested were cold -adapted ones, minority might be mesophilic bacteria. The results indicated that, Arctic ocean bacteria had a stronger adaptability to environmental temperature.

  13. The effectiveness of interventions focused on functional stability on the level of pain in patients with Joint Hypermobility Syndrome compared to general exercise: a systematic review protocol

    DEFF Research Database (Denmark)

    Holtze, Dorte Buch; Jessen-Winge, Christina; Hansen, Karsten Bruun

    2014-01-01

    The objective of this review is to identify what effect a systematic intervention focused on functional stability has on the level of pain (measured by pain scales) in patients with Joint Hypermobility Syndrome (JHS) compared to general exercise. This review will consider studies that include adu...... syndrome; pain; physical therapy; treatment...

  14. Leisure activities in Prader-Wlli syndrome: Implications for health, cognition and adaptive functioning

    Science.gov (United States)

    Dykens, Elisabeth M

    2012-01-01

    To this day, I can recite the Sara Sparrow definition of adaptive behavior. To this day, I recall Sara sitting on the other side of a one-way mirror observing me, an inexperienced clinical psychology intern, administer the Vineland Adaptive Behavior Scales to the mother of a child with learning disabilities. Talk about nervous-- the world’s expert on adaptive behavior held my very internship and career success in her hands! Even though I stumbled through it, Sara reassured me that I did great…all I needed was more practice. So, thousands of Vineland’s later, I was launched. Both my first and my latest publications in the disability field used assessment tools that I learned from Sara—primarily the Vineland, but also several cognitive tests. Beyond these tools, I cherish key insights from Sara that have stayed with me over the long haul. First and foremost, Sara taught me how to be a real psychologist, how to carefully observe and assess people with standardized tools and with my own eyes and ears. Second, she instilled a practical skill that I still am working on—always be on time even if others are late! Third, Sara imbued a sense of fun and adventure into our training and she continued to be a source of inspiration and fun in the years after I left Yale. For us data-driven types, the process of research and discovery is inherently fun—it is a total blast. Yet Sara modeled that fun and enjoyment need to come in other ways that are more balanced or well-rounded—that are, in a word, adaptive. It seems a fitting tribute to Sara to submit a paper that related her treasured Vineland Scales to how people with developmental disabilities have fun. Thank you, Sara. PMID:22484792

  15. Overcoming the Walmart Syndrome: Adapting Problem-based Management Education in East Asia

    OpenAIRE

    Hallinger, Philip; Lu, Jiafang

    2012-01-01

    This paper explores design issues to be considered in adapting the problem-based learning(PBL) for use in the context of East Asian higher education and tests its instructionaleffectiveness in a Master of Management degree program at a graduate school of business(GSB) in Thailand. The research analyzes course evaluation data obtained from 20,988student reports over a seven-year period to assess the impact of a locally developed PBLcurriculum on student perceptions of course effectiveness and ...

  16. Adaptive Generalized Projective Synchronization of Takagi-Sugeno Fuzzy Drive-response Dynamical Networks with Time Delay

    Institute of Scientific and Technical Information of China (English)

    ZHENG Yong-Ai

    2012-01-01

    Time-delay Takagi-Sugeno fuzzy drive-response dynamical networks (TD-TSFDRDNs) are defined by extending the drive-response dynamical networks. Based on the LaSalle invariant principle, a simple and systematic adaptive control scheme is proposed to synchronize the TD-TSFDRDNs with a desired scalar factor. A sufficient condition for the generalized projective synchronization in TD-TSFDRDNs is derived. Moreover, numerical simulations are provided to verify the correctness and effectiveness of the scheme.%Time-delay Takagi-Sugeno fuzzy drive-response dynamical networks (TD-TSFDRDNs) are defined by extending the drive-response dynamical networks.Based on the LaSalle invariant principle,a simple and systematic adaptive control scheme is proposed to synchronize the TD-TSFDRDNs with a desired scalar factor.A sufficient condition for the generalized projective synchronization in TD-TSFDRDNs is derived.Moreover,numerical simulations are provided to verify the correctness and effectiveness of the scheme.

  17. When is it adaptive to be patient? A general framework for evaluating delayed rewards.

    Science.gov (United States)

    Fawcett, Tim W; McNamara, John M; Houston, Alasdair I

    2012-02-01

    The tendency of animals to seek instant gratification instead of waiting for greater long-term benefits has been described as impatient, impulsive or lacking in self-control. How can we explain the evolution of such seemingly irrational behaviour? Here we analyse optimal behaviour in a variety of simple choice situations involving delayed rewards. We show that preferences for more immediate rewards should depend on a variety of factors, including whether the choice is a one-off or is likely to be repeated, the information the animal has about the continuing availability of the rewards and the opportunity to gain rewards through alternative activities. In contrast to the common assertion that rational animals should devalue delayed rewards exponentially, we find that this pattern of discounting is optimal only under restricted circumstances. We predict preference reversal whenever waiting for delayed rewards entails loss of opportunities elsewhere, but the direction of this reversal depends on whether the animal will face the same choice repeatedly. Finally, we question the ecological relevance of standard laboratory tests for impulsive behaviour, arguing that animals rarely face situations analogous to the self-control paradigm in their natural environment. To understand the evolution of impulsiveness, a more promising strategy would be to identify decision rules that are adaptive in a realistic ecological setting, and examine how these rules determine patterns of behaviour in simultaneous choice tests.

  18. General anaesthesia in an adult patient with Morquio syndrom with emphasis on airway issues.

    Science.gov (United States)

    Kadic, Lajla; Driessen, Jacques J

    2012-05-01

    Patients with Morquio syndrome possess a number of characteristics which may complicate an anaesthetic procedure. The most important is that a deposition of mucopolysaccharides in the soft tissues of the oro-pharynx distorts the airway, making the airway management difficult, while the atlanto-axial instability puts these patients at risk of subluxation and quadriparesis. As the endotracheal intubation in Morquio syndrome patients may be difficult or even impossible, we recommend the technique of awake fiberoptic intubation to be considered. Our approach to awake fiberoptic intubation in an adult patient is described in this case report.

  19. General practitioners believe that hypnotherapy could be a useful treatment for irritable bowel syndrome in primary care

    Directory of Open Access Journals (Sweden)

    de Lusignan Simon

    2004-10-01

    Full Text Available Abstract Background Irritable bowel syndrome is a common condition in general practice. It occurs in 10 to 20% of the population, but less than half seek medical assistance with the complaint. Methods A questionnaire was sent to the 406 GPs listed on the West Sussex Health Authority Medical List to investigate their views of this condition and whether they felt hypnotherapy had a place in its management Results 38% of general practitioners responded. The achieved sample shared the characteristics of target sample. Nearly half thought that irritable bowel syndrome (IBS was a "nervous complaint" and used a combination of "the placebo effect of personal care," therapeutic, and dietary advice. There is considerable divergence in the perceived effectiveness of current approaches. Over 70% thought that hypnotherapy may have a role in the management of patients with IBS; though the majority (68% felt that this should not be offered by general practitioners. 84% felt that this should be offered by qualified hypnotherapist, with 40% feeling that this should be offered outside the health service. Conclusions General practitioners vary in their perceptions of what constitutes effective therapy in IBS. They are willing to consider referral to a qualified hypnotherapist.

  20. Diffractive generalized phase contrast for adaptive phase imaging and optical security

    DEFF Research Database (Denmark)

    Palima, Darwin; Glückstad, Jesper

    2012-01-01

    We analyze the properties of Generalized Phase Contrast (GPC) when the input phase modulation is implemented using diffractive gratings. In GPC applications for patterned illumination, the use of a dynamic diffractive optical element for encoding the GPC input phase allows for onthe- fly...... optimization of the input aperture parameters according to desired output characteristics. For wavefront sensing, the achieved aperture control opens a new degree of freedom for improving the accuracy of quantitative phase imaging. Diffractive GPC input modulation also fits well with grating-based optical...

  1. [Burnout Syndrome, Family and Work Related Variables on General Practitioners in Bogota. A Strategy of Work Quality].

    Science.gov (United States)

    Aguirre Roldán, Adriana María; Quijano Barriga, Ana María

    2015-01-01

    The burnout syndrome is a set of work-related symptoms related to weariness and exhaustion, in response to the emotional stress at work and its consequences. The aim of the study was to measure the frequency of burnout in General Practitioners (GPs) from 3 private institutions in Bogotá, Colombia and to determine the associated factors according to the variables taken into account. It is a descriptive cross-sectional study which was used to analyse the Questionnaire for Burnout Syndrome (CESQT). The population was 106 GPs. The level of burnout was at a critical level in 6.6% of the GP population. The variables showed that having a stable partner and children are a protective factor. By contrast, work in emergency rooms is a risk factor. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. Drug reaction with eosinophilia and systemic symptoms syndrome is not uncommon and shows better clinical outcome than generally recognised.

    Science.gov (United States)

    Nam, Y H; Park, M R; Nam, H J; Lee, S K; Kim, K H; Roh, M S; Um, S-J; Son, C-H

    2015-01-01

    Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare disease which can cause severe morbidity and mortality. The aim of this study is to evaluate the clinical manifestation and course of DRESS syndrome. We conducted a retrospective analysis of prospectively collected data in 45 patients with DRESS syndrome diagnosed between September 2009 and August 2011. The most common causative drug group was antibiotics (n=13, 28.9%), followed by anticonvulsants (n=12, 26.7%), antituberculosis drugs (n=6, 13.3%), non-steroidal anti-inflammatory drugs (n=4, 8.9%), undetermined agents (n=4, 8.9%), allopurinol (n=3, 6.7%), and others (n=3, 6.7%). The latency period ranged from 2 to 120 days, with a mean of 20.2 ± 24.3 days. The longest latency period was noted for the antituberculosis drug group, at 46.5 ± 29.9 days. Eosinophilia in peripheral blood examination was noted in 35 subjects (77.8%). Atypical lymphocytosis was noted in 16 patients (35.6%), and thrombocytopenia in seven patients (15.6%). Hepatic involvement was noted in 39 (86.7%) study patients, kidney in eight (17.8%), lung in four (8.9%), and central nervous system in one (2.3%). Systemic corticosteroids were administered to 10 patients (22.2%). Forty-three patients (95.6%) showed complete recovery, while two patients had poor outcomes. DRESS syndrome was not more uncommon than generally recognised. Antibiotics were the most frequently implicated drug group, followed by anticonvulsants. Most patients with this disease showed a better clinical outcome than that which had been generally expected. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.

  3. General anaesthesia in an adult patient with Morquio syndrom with emphasis on airway issues.

    NARCIS (Netherlands)

    Kadic, L.; Driessen, J.J.

    2012-01-01

    Patients with Morquio syndrome possess a number of characteristics which may complicate an anaesthetic procedure. The most important is that a deposition of mucopolysaccharides in the soft tissues of the oro-pharynx distorts the airway, making the airway management difficult, while the atlanto-axial

  4. General and Special Education Teachers' Attitudes toward Inclusion of Down Syndrome Students

    Science.gov (United States)

    Mastin, Debra

    2010-01-01

    Educational, social, and learning development theories for inclusion, grounded in Bandura's social cognitive theory, do not explicitly take into account individuals with Down syndrome, one of the most common birth defects. The problem addressed in this study was the lack of data regarding teacher attitudes toward inclusion of students with Down…

  5. Cytogenetic Profile of Down Syndrome Cases Seen by a General Genetics Outpatient Service in Brazil

    Science.gov (United States)

    Biselli, Joice; Goloni-Bertollo, Eny; Ruiz, Mariangela; Pavarino-Bertelli, Erika

    2009-01-01

    Down syndrome or trisomy 21 can be caused by three types of chromosomal abnormalities: free trisomy 21, translocation or mosaicism. The cytogenetic diagnosis, made through karyotypic examination, is important mainly to determine recurrence risks to assist genetic counselling. The object of this work was to carry out a cytogenetic profile of…

  6. Twiddler's syndrome in a patient with a deep brain stimulation device for generalized dystonia

    DEFF Research Database (Denmark)

    Astradsson, Arnar; Schweder, Patrick M; Joint, Carole

    2011-01-01

    Deep brain stimulation (DBS) is the technique of neurostimulation of deep brain structures for the treatment of conditions such as essential tremor, dystonia, Parkinson's disease and chronic pain syndromes. The procedure uses implanted deep brain stimulation electrodes connected to extension leads...

  7. Effect of alpha-naphthylisothiocyanate-induced liver injury on intestinal adaptation in a rat model of short bowel syndrome.

    Science.gov (United States)

    Sukhotnik, Igor; Razon, Hila; Pollak, Yulia; Hayari, Lili; Bejar, Jacob; Mogilner, Jorge G; Sylvester, Karl G

    2012-02-01

    Progressive hyperbilirubinemia and end-stage liver failure are among the most serious complications of short bowel syndrome (SBS), representing the principle cause of death in a majority of fatal cases. In the current study, we examined the effects of alpha-naphthylisothiocyanate (ANIT)-induced liver injury on intestinal adaptation in a rat model of SBS. Male rats were divided into four groups: Sham rats underwent bowel transection (n = 8), Sham liver-injury rats underwent bowel transection and IP injection of ANIT (100 mg/kg, n = 8), SBS rats underwent a 75% bowel resection, and SBS-ANIT rats underwent bowel resection and liver injury similar to group sham-ANIT (n = 8). Fourteen days after intervention, liver biopsies and intestinal samples were obtained and evaluated for liver damage and measures of intestinal adaptation. Real time PCR and Western blotting were used to determine the level of bax and bcl-2 mRNA and protein, and p-ERK protein levels. Statistical analysis was performed using the one-way ANOVA test, with p < 0.05 considered statistically significant. All ANIT-treated animals exhibited histological evidence of liver damage that was associated with the expansion of atypical ductal proliferation near the periportal areas, intense neutrophil infiltration in the liver, increased mitotic activity, Kupfer cells hyperplasia and fatty liver degeneration. ANIT-induced liver damage in bowel resected animals was associated with a significant decrease in all parameters of intestinal adaptation including bowel and mucosal weight in jejunum (twofold decrease) and ileum (twofold decrease), mucosal DNA in jejunum (fourfold decrease), mucosal protein in jejunum (threefold decrease) and ileum (threefold decrease), villus height in jejunum (38%) and ileum (34%), and crypt depth in jejunum (24%) and ileum (30%) compared to SBS animals. Both Sham-ANIT and SBS-ANIT rats demonstrated decreased enterocyte proliferation rates that were accompanied by decreased p-ERK protein

  8. Fast adaptive principal component extraction based on a generalized energy function

    Institute of Scientific and Technical Information of China (English)

    欧阳缮; 保铮; 廖桂生

    2003-01-01

    By introducing an arbitrary diagonal matrix, a generalized energy function (GEF) is proposed for searching for the optimum weights of a two layer linear neural network. From the GEF, we derive a recur- sive least squares (RLS) algorithm to extract in parallel multiple principal components of the input covari-ance matrix without designing an asymmetrical circuit. The local stability of the GEF algorithm at the equilibrium is analytically verified. Simulation resultsshow that the GEF algorithm for parallel multiple principal components extraction exhibits the fast convergence and has the improved robustness resis- tance tothe eigenvalue spread of the input covariance matrix as compared to the well-known lateral inhi- bition model (APEX) and least mean square error reconstruction(LMSER) algorithms.

  9. Reproductive adaptations to a large-brained fetus open a vulnerability to anovulation similar to polycystic ovary syndrome.

    Science.gov (United States)

    Barnett, Deborah K; Abbott, David H

    2003-01-01

    During the ovarian or menstrual cycle, prior to ovulation, many female primates exhibit a relatively prolonged follicular phase and terminate the postovulatory luteal phase with menstrual bleeding. The prolonged follicular phase is a trait that distinguishes primate from nonprimate species. It enables extended estrogen-induced proliferation and growth of the uterine endometrium prior to progesterone-induced maturation during the luteal phase to accommodate a potential pregnancy with a rapidly invading placenta. Progressive development of both an extended duration of estrogen-induced, preimplantation endometrial proliferation and a rapidly invading placenta across the Primate order may well have been necessary to accommodate differentiation and growth of an increasingly large fetal brain. Prolongation of the follicular phase in primates has also led to the isolation of the final stages of follicle selection (growth deviation of the dominant follicle from its contemporaries) solely within the follicular phase and thus outside the protection of luteal phase progesterone inhibition of pituitary luteinizing hormone (LH) secretion. Such primate reproductive characteristics put the latter stages of ovarian follicle selection at risk of exposure to excessive pituitary secretion of LH. Excessive secretion of LH during follicle selection could result not only in impaired follicle development, excessive ovarian androgen secretion, and ovulation failure, but also in excessive estrogenic stimulation of the uterine endometrium without intervening menstrual periods. Such reproductive abnormalities are all found in a single, prevalent infertility syndrome afflicting women in their reproductive years: polycystic ovary syndrome (PCOS). We propose that successful female reproductive adaptations to accommodate the growth demands of large-brained primate fetuses have facilitated a particular vulnerability of higher primates to hypergonadotropic disruption of ovulatory function, as

  10. 女大学生经前期综合征与学校适应性相关性分析%Correlation between premenstrual syndrome and adaptability for female college students

    Institute of Scientific and Technical Information of China (English)

    宋培歌; 王代娣; 吴恺君; 刘兆; 谢红

    2013-01-01

    目的 了解女大学生经前期综合征与学校适应性及两者的相关性,为采取有针对性的入学教育提供建议.方法 便利整群抽取北京大学医学部2011年新入学女大学生445名,采用一般资料调查表、经前期综合征调查表、经前期综合征症状打分表、学校适应水平量表进行调查.结果 新入学女大学生中46.3%有不同程度的经前期综合征,突出表现的症状为易激动、注意力不集中、嗜睡及焦虑;新人学女大学生总体适应性水平得分为(244.97 ±30.89)分,城镇生源在角色适应性和环境的总体认同上优于农村生源(P值均<0.01);除职业选择适应性维度之外,新人学女大学生经前期综合征严重程度与总体学校适应性及其余各维度均呈负相关(P值均<0.01).结论 经前期综合征与学校适应性之间呈负相关,应引起学校的高度重视,通过各种途径改善女大学生的生理心理卫生状况.%Objective To study the prevalence and the relationship of premenstrual syndrome ( PMS) and adaptability in female college students. Methods For convenience, a cluster sampling of the 445 newly enrolled female students from the Health Science Centre of Peking University in 2011 was surveyed for data collection by using of series of questionnaires; The general information questionnaire, the questionnaire of premenstrual syndrome, the level of premenstrual syndrome, and the school adaption questionnaire. Results It was found that 46. 3% of female college students suffered from premenstrual syndrome and the major symptoms were irritability, impaired concentration, drowsiness and anxiety. Further study revealed that the average score of the o-verall adaptability of the newly enrolled female students was (244. 97 ± 30. 89) , and score in self-adaptability and environmental general evaluation for urban students were significantly better than that for rural students ( P <0. 01). Finally, in addition to

  11. Cultural adaptation of the Michigan Hand Outcomes Questionnaire in patients with Carpal Tunnel Syndrome:A Turkish version study

    Institute of Scientific and Technical Information of China (English)

    Ilkerilhanli; Dilek Durmus; Gulhan Orekici

    2015-01-01

    Objective: Cultural adaptations of the questionnaires are important for easy use. We aimed to assess the reliability and validity of the Turkish Version of the Michigan Hand Outcomes Questionnaire in patients with Carpal Tunnel Syndrome. Methods: To assess test-retest reliability, the Turkish “Michigan Hand Outcomes Questionnaire” and “Disabilities of Arm, Shoulder and Hand”questionnaires were answered by patients and controls and were repeated a week later. For testing internal consistency, the Cronbach's alpha test was used. For testing validity, correlations between the subscales of the“Michigan Hand Outcomes Questionnaire” and “Disabilities of Arm, Shoulder and Hand” questionnaire were measured in patient groups. One hundred patients with idiopathic Carpal Tunnel Syndrome and 50 healthy participants were included in the study. Results: In test-retest reliability, intraclass correlations of the subscales of the“Michigan Hand Outcomes Questionnaire”were high. Cronbach's alphas were found to be high in all subscales. There was no significant correlation between asthetics and pain scales. We found significant differences between patients and controls regarding all subscales of the“Michigan Hand Outcomes Questionnaire”. Correlations between subscales of the “Michigan Hand Outcomes Questionnaire” and “Disabilities of Arm, Shoulder and Hand”questionnaire were significant. We found no difference between one-hand effected and two-hand effected patients, in terms of the “Michigan Hand Outcomes Questionnaire”, “Disabilities of Arm, Shoulder and Hand” questionnaire Function/Symptom and Work average scores. Conclusion: This study showed that the Turkish version of the“Michigan Hand Outcomes Questionnaire”is reliable and valid and can be used in Turkish patients with Carpal Tunnel Syndrome because it is comprehensible and practicable. Copyright © 2015, Chinese Medical Association Production. Production and hosting by Elsevier B

  12. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7 scale as a screening tool

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    Pérez-Páramo María

    2010-01-01

    Full Text Available Abstract Background Generalized anxiety disorder (GAD is a prevalent mental health condition which is underestimated worldwide. This study carried out the cultural adaptation into Spanish of the 7-item self-administered GAD-7 scale, which is used to identify probable patients with GAD. Methods The adaptation was performed by an expert panel using a conceptual equivalence process, including forward and backward translations in duplicate. Content validity was assessed by interrater agreement. Criteria validity was explored using ROC curve analysis, and sensitivity, specificity, predictive positive value and negative value for different cut-off values were determined. Concurrent validity was also explored using the HAM-A, HADS, and WHO-DAS-II scales. Results The study sample consisted of 212 subjects (106 patients with GAD with a mean age of 50.38 years (SD = 16.76. Average completion time was 2'30''. No items of the scale were left blank. Floor and ceiling effects were negligible. No patients with GAD had to be assisted to fill in the questionnaire. The scale was shown to be one-dimensional through factor analysis (explained variance = 72%. A cut-off point of 10 showed adequate values of sensitivity (86.8% and specificity (93.4%, with AUC being statistically significant [AUC = 0.957-0.985; p 0.001. Limitations Elderly people, particularly those very old, may need some help to complete the scale. Conclusion After the cultural adaptation process, a Spanish version of the GAD-7 scale was obtained. The validity of its content and the relevance and adequacy of items in the Spanish cultural context were confirmed.

  13. Time Frame and Justice Motive: Future Perspective Moderates the Adaptive Function of General Belief in a Just World

    Science.gov (United States)

    Wu, Michael Shengtao; Sutton, Robbie M.; Yan, Xiaodan; Zhou, Chan; Chen, Yiwen; Zhu, Zhuohong; Han, Buxin

    2013-01-01

    Background The human ability to envision the future, that is, to take a future perspective (FP), plays a key role in the justice motive and its function in transcending disadvantages and misfortunes. The present research investigated whether individual (Study 1) and situational (Study 2) differences in FP moderated the association of general belief in a just world (GBJW) with psychological resilience. Methodology/Principal Findings We investigated FP, GBJW, and resilience in sample of adolescents (n = 223) and disaster survivors (n = 218) in China. In Study 1, adolescents revealed stronger GBJW than PBJW, and GBJW uniquely predicted resilience in the daily lives of those with high FP (but not those with low FP). In Study 2, natural priming of FP (vs. no FP) facilitated the association of GBJW with resilience after disaster. Conclusions/Significance Supporting predictions, participants endorsed GBJW more strongly than PBJW. Further, GBJW interacted with FP in both studies, such that there was an association between GBJW and resilience at high but not low levels of FP. The results corroborate recent findings suggesting that GBJW may be more psychologically adaptive than PBJW among some populations. They also confirm that focusing on the future is an important aspect of the adaptive function of just-world beliefs. PMID:24312235

  14. Generalized tetanus could be complicated with Guillain–Barré syndrome

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    Jae Hoon Lee

    2016-07-01

    Full Text Available A retrospective analysis of patients diagnosed with tetanus was conducted to evaluate the occurrence of Guillain–Barré syndrome (GBS. Two of 13 tetanus cases were complicated with GBS. Their symptoms and signs related to GBS improved markedly after a 5-day infusion of intravenous immunoglobulin. Physicians should keep in mind that GBS can be an important cause of muscle weakness in patients with tetanus.

  15. A dynamically bi-orthogonal method for time-dependent stochastic partial differential equations II: Adaptivity and generalizations

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    Cheng, Mulin, E-mail: mulinch@caltech.edu [Computing and Mathematical Sciences, California Institute of Technology, Pasadena, CA 91125 (United States); Hou, Thomas Y., E-mail: hou@cms.caltech.edu [Computing and Mathematical Sciences, California Institute of Technology, Pasadena, CA 91125 (United States); Zhang, Zhiwen, E-mail: zhangzw@caltech.edu [Computing and Mathematical Sciences, California Institute of Technology, Pasadena, CA 91125 (United States)

    2013-06-01

    This is part II of our paper in which we propose and develop a dynamically bi-orthogonal method (DyBO) to study a class of time-dependent stochastic partial differential equations (SPDEs) whose solutions enjoy a low-dimensional structure. In part I of our paper [9], we derived the DyBO formulation and proposed numerical algorithms based on this formulation. Some important theoretical results regarding consistency and bi-orthogonality preservation were also established in the first part along with a range of numerical examples to illustrate the effectiveness of the DyBO method. In this paper, we focus on the computational complexity analysis and develop an effective adaptivity strategy to add or remove modes dynamically. Our complexity analysis shows that the ratio of computational complexities between the DyBO method and a generalized polynomial chaos method (gPC) is roughly of order O((m/N{sub p}){sup 3}) for a quadratic nonlinear SPDE, where m is the number of mode pairs used in the DyBO method and N{sub p} is the number of elements in the polynomial basis in gPC. The effective dimensions of the stochastic solutions have been found to be small in many applications, so we can expect m is much smaller than N{sub p} and computational savings of our DyBO method against gPC are dramatic. The adaptive strategy plays an essential role for the DyBO method to be effective in solving some challenging problems. Another important contribution of this paper is the generalization of the DyBO formulation for a system of time-dependent SPDEs. Several numerical examples are provided to demonstrate the effectiveness of our method, including the Navier–Stokes equations and the Boussinesq approximation with Brownian forcing.

  16. Dose reduction in spiral CT angiography of thoracic outlet syndrome by anatomically adapted tube current modulation

    Energy Technology Data Exchange (ETDEWEB)

    Mastora, I.; Remy-Jardin, M.; Remy, J. [Dept. of Radiology, University Center Hospital Calmette, Lille (France); Medical Research Group, Lille (France); Suess, C.; Scherf, C. [Siemens Medical Systems, Forcheim (Germany); Guillot, J.P. [Dept. of Radiology, University Center Hospital Calmette, Lille (France)

    2001-04-01

    The aim of this study was to evaluate dose reduction in spiral CT angiography of the thoracic outlet by on-line tube-current control. Prospectively, 114 patients undergoing spiral CT angiography of the subclavian artery for thoracic outlet arterial syndromes were evaluated with and without tube-current modulation at the same session (scanning parameters for the two successive angiograms, one in the neutral position and one after the postural maneuver): 140 kV; 206 mA; scan time 0.75 s; collimation 3 mm; pitch = (1). The dose reduction system was applied in the neutral position in the first 92 consecutive patients and after postural maneuver in the remaining 22 consecutive patients. Dose reduction and image quality were analyzed in the overall study group (group 1; n = 114). The influence of the arm position was assessed in 44 of the 114 patients (group 2), matched by the transverse diameter of the upper thorax. The mean dose reduction was 33 % in group 1 (range 22-40 %) and 34 % in group 2 (range 26-40 %). In group 2 the only difference in image quality was a significantly higher frequency of graininess on low-dose scans compared with reference scans whatever the patient's arm position, graded as minimal in 38 of the 44 patients (86 %). When the low-dose technique was applied after postural maneuver in group 2: (a) the mean dose reduction was significantly higher (35 vs 32 % in the neutral position; p = 0.006); (b) graininess was less frequent (82 vs 91 % in the neutral position); and (c) the percentage of graininess graded as minimal was significantly higher (83 vs 70 % in the neutral position; p = 0.2027). On-line tube-current modulation enables dose reduction on high-quality, diagnostic spiral CT angiograms of the thoracic outlet and should be applied during data acquisition in the neutral position and after postural maneuver for optimal use. (orig.)

  17. Blood Pressure and Hemodynamic Adaptations after a Training Program in Young Individuals with Down Syndrome

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    Bruna Barboza Seron

    2015-06-01

    Full Text Available Background: Cardiovascular diseases affect people worldwide. Individuals with Down Syndrome (DS have an up to sixteen-time greater risk of mortality from cardiovascular diseases. Objective: To evaluate the effects of aerobic and resistance exercises on blood pressure and hemodynamic variables of young individuals with DS. Methods: A total of 29 young individuals with DS participated in the study. They were divided into two groups: aerobic training (AT (n = 14, and resistance training (TR (n = 15. Their mean age was 15.7 ± 2.82 years. The training program lasted 12 weeks, and had a frequency of three times a week for AT and twice a week for RT. AT was performed in treadmill/ bicycle ergometer, at an intensity between 50%-70% of the HR reserve. RT comprised nine exercises with three sets of 12 repetition-maximum. Systolic blood pressure (SBP, diastolic blood pressure (DBP, mean blood pressure (MBP and hemodynamic variables were assessed beat-to-beat using the Finometer device before/after the training program. Descriptive analysis, the Shapiro-Wilk test to check the normality of data, and the two-way ANOVA for repeated measures were used to compare pre- and post-training variables. The Pearson’s correlation coefficient was calculated to correlate hemodynamic variables. The SPSS version 18.0 was used with the significance level set at p < 0.05. Results: After twelve weeks of aerobic and/or resistance training, significant reductions in variables SBP, DBP and MBP were observed. Conclusion: This study suggests a chronic hypotensive effect of moderate aerobic and resistance exercises on young individuals with DS.

  18. Characterization of homologous and heterologous adaptive immune responses in porcine reproductive and respiratory syndrome virus infection

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    Díaz Ivan

    2012-04-01

    Full Text Available Abstract The present study characterized the homologous and heterologous immune response in type-I porcine reproductive and respiratory syndrome virus (PRRSV infection. Two experiments were conducted: in experiment 1, eight pigs were inoculated with PRRSV strain 3262 and 84 days post-inoculation (dpi they were challenged with either strain 3262 or strain 3267 and followed for the next 14 days (98 dpi. In experiment 2, eight pigs were inoculated with strain 3267 and challenged at 84 dpi as above. Clinical course, viremia, humoral response (neutralizing and non-neutralizing antibodies, NA and virus-specific IFN-γ responses (ELISPOT were evaluated all throughout the study. Serum levels of IL-1, IL-6, IL-8, TNF-α and TGF-β were determined (ELISA after the second challenge. In experiment 1 primo-inoculation with strain 3262 induced viremia of ≤ 28 days, low titres of homologous NA but strong IFN-γ responses. In contrast, strain 3267 induced longer viremias (up to 56 days, higher NA titres (≤ 6 log2 and lower IFN-γ responses. Inoculation with 3267 produced higher serum IL-8 levels. After the re-challenge at 84 dpi, pigs in experiment 1 developed mostly a one week viremia regardless of the strain used. In experiment 2, neither the homologous nor the heterologous challenge resulted in detectable viremia although PRRSV was present in tonsils of some animals. Homologous re-inoculation with 3267 produced elevated TGF-β levels in serum for 7–14 days but this did not occur with the heterologous re-inoculation. In conclusion, inoculation with different PRRSV strains result in different virological and immunological outcomes and in different degrees of homologous and heterologous protection.

  19. Adaptation and failure of pancreatic beta cells in murine models with different degrees of metabolic syndrome.

    Science.gov (United States)

    Medina-Gomez, Gema; Yetukuri, Laxman; Velagapudi, Vidya; Campbell, Mark; Blount, Margaret; Jimenez-Linan, Mercedes; Ros, Manuel; Oresic, Matej; Vidal-Puig, Antonio

    2009-01-01

    The events that contribute to the expansion of beta-cell mass and enhanced beta-cell function in insulin-resistant states have not been elucidated fully. Recently, we showed that beta-cell adaptation failed dramatically in adult, insulin-resistant POKO mice, which contrasts with the appropriate expansion of beta cells in their ob/ob littermates. Thus, we hypothesised that characterisation of the islets in these mouse models at an early age should provide a unique opportunity to: (1) identify mechanisms involved in sensing insulin resistance at the level of the beta cells, (2) identify molecular effectors that contribute to increasing beta-cell mass and function, and (3) distinguish primary events from secondary events that are more likely to be present at more advanced stages of diabetes. Our results define the POKO mouse as a model of early lipotoxicity. At 4 weeks of age, it manifests with inappropriate beta-cell function and defects in proliferation markers. Other well-recognised pathogenic effectors that were observed previously in 16-week-old mice, such as increased reactive oxygen species (ROS), macrophage infiltration and endoplasmic reticulum (ER) stress, are also present in both young POKO and young ob/ob mice, indicating the lack of predictive power with regards to the severity of beta-cell failure. Of interest, the relatively preserved lipidomic profile in islets from young POKO mice contrasted with the large changes in lipid composition and the differences in the chain length of triacylglycerols in the serum, liver, muscle and adipose tissue in adult POKO mice. Later lipotoxic insults in adult beta cells contribute to the failure of the POKO beta cell. Our results indicate that the rapid development of insulin resistance and beta-cell failure in POKO mice makes this model a useful tool to study early molecular events leading to insulin resistance and beta-cell failure. Furthermore, comparisons with ob/ob mice might reveal important adaptive mechanisms

  20. Adaptation of the jejunal mucosa in the experimental blind loop syndrome: changes in paracellular conductance and tight junction structure.

    Science.gov (United States)

    Schulzke, J D; Fromm, M; Bentzel, C J; Menge, H; Riecken, E O

    1987-01-01

    Self-filling blind loops of rat jejunum exhibit hyperregenerative transformation of the mucosa. We used this experimental model to characterise mechanisms, which may occur under similar conditions in man (stagnant loop syndrome). Epithelial and subepithelial resistance were measured in the Ussing-chamber by voltage divider ratio measurements after positioning a microelectrode between epithelium and subepithelial tissue layers. In the blind loop, epithelial resistance increased from 8 +/- 1 to 23 +/- 1 omega cm2 and subepithelial resistance from 39 +/- 4 to 86 +/- 8 omega cm2 as compared with control jejunum. The increase in the subepithelial resistance was paralleled anatomically by an increase in the thickness of the subepithelial tissue layers from 63 +/- 4 microns to 177 +/- 19 microns. Ultrastructural analysis of the tight junction area by freeze fracture electron microscopy revealed an increase in the total junctional 'depth' in the crypts from 243 +/- 9 nm in control jejunum to 396 +/- 17 nm in the blind loop, while the number of horizontally oriented 'strands' remained unchanged. Villus tight junctions did not differ between blind loop and control. We interpret the alterations in the self-filling blind loop as an adaptive response of the epithelium which reduces backleakage of already absorbed electrolytes across the tight junction into the intestinal lumen. This mechanism is suitable to support the intestine in maintaining body electrolyte and water contents during cellular electrolyte malabsorption.

  1. Cultural adaptation: translatability assessment and linguistic validation of the patient-reported outcome instrument for irritable bowel syndrome with diarrhea

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    Delgado-Herrera L

    2016-06-01

    Full Text Available Leticia Delgado-Herrera,1 Kathryn Lasch,2 Ana Popielnicki,3 Akito Nishida,4 Rob Arbuckle,5 Benjamin Banderas,6 Susan Zentner,1 Ingrid Gagainis,1 Bernhardt Zeiher1 1Astellas Pharma Global Development, Northbrook, IL, 2Pharmerit International, Newton, MA, USA; 3TransPerfect, Linguistic Validation Group, Boston, MA, USA; 4Development Project Management, Astellas Pharma Inc, Tokyo, Japan; 5Patient-Centered Outcomes Adelphi Values, Bollington, UK; 6Patient-Centered Outcomes Adelphi Values, Boston, MA, USA Background and objective: Following a 2009 US Food and Drug Administration guidance, a new patient-reported outcome (PRO instrument was developed to support end points in multinational clinical trials assessing irritable bowel syndrome with diarrhea (IBS-D symptom severity. Our objective was to assess the translatability of the IBS-D PRO instrument into ten languages, and subsequently perform a cultural adaptation/linguistic validation of the questionnaire into Japanese and US Spanish. Materials and methods: Translatability assessments of the US English version of the IBS-D PRO were performed by experienced PRO translators who were native speakers of each target language and currently residing in target-language countries. Languages were Chinese (People’s Republic of China, Dutch (the Netherlands, French (Belgium, German (Germany, Japanese (Japan, Polish (Poland, Portuguese (Brazil, Russian (Russia, Spanish (Mexico, and Spanish (US. The project team assessed the instrument to identify potential linguistic and/or cultural adaptation issues. After the issues identified were resolved, the instrument was translated into Spanish (US and Japanese through a process of two forward translations, one reconciled translation, and one backward translation. The project team reviewed the translated versions before the instruments were evaluated by cognitive debriefing interviews with samples of five Spanish (US and five Japanese IBS-D patients. Results

  2. Cultural adaptation: translatability assessment and linguistic validation of the patient-reported outcome instrument for irritable bowel syndrome with diarrhea

    Science.gov (United States)

    Delgado-Herrera, Leticia; Lasch, Kathryn; Popielnicki, Ana; Nishida, Akito; Arbuckle, Rob; Banderas, Benjamin; Zentner, Susan; Gagainis, Ingrid; Zeiher, Bernhardt

    2016-01-01

    Background and objective Following a 2009 US Food and Drug Administration guidance, a new patient-reported outcome (PRO) instrument was developed to support end points in multinational clinical trials assessing irritable bowel syndrome with diarrhea (IBS-D) symptom severity. Our objective was to assess the translatability of the IBS-D PRO instrument into ten languages, and subsequently perform a cultural adaptation/linguistic validation of the questionnaire into Japanese and US Spanish. Materials and methods Translatability assessments of the US English version of the IBS-D PRO were performed by experienced PRO translators who were native speakers of each target language and currently residing in target-language countries. Languages were Chinese (People’s Republic of China), Dutch (the Netherlands), French (Belgium), German (Germany), Japanese (Japan), Polish (Poland), Portuguese (Brazil), Russian (Russia), Spanish (Mexico), and Spanish (US). The project team assessed the instrument to identify potential linguistic and/or cultural adaptation issues. After the issues identified were resolved, the instrument was translated into Spanish (US) and Japanese through a process of two forward translations, one reconciled translation, and one backward translation. The project team reviewed the translated versions before the instruments were evaluated by cognitive debriefing interviews with samples of five Spanish (US) and five Japanese IBS-D patients. Results Linguistic and cultural adaptation concerns identified during the translatability assessment required minor revisions, mainly the presentation of dates/times and word structure. During the cognitive debriefing interviews, two of five Spanish respondents misunderstood the term “bowel movement” to mean only diarrhea in the Spanish version. Consequently, the term was changed from “movimiento intestinal” to “evacuaciones”. None of the Japanese respondents identified issues with the Japanese version. Conclusion

  3. Intestinal adaptation in patients with short bowel syndrome. Measurement by calcium absorption

    Energy Technology Data Exchange (ETDEWEB)

    Gouttebel, M.C.; Saint Aubert, B.; Colette, C.; Astre, C.; Monnier, L.H.; Joyeux, H. (Cancer Institute, Montpellier (France))

    1989-05-01

    Functional adaptation of remaining intestine was evaluated in 30 patients with extensive small bowel resection. Calcium and xylose absorption tests were compared. Calcium absorption was measured by a double-radiotracer technique. Serum xylosemia was measured 2 hr after D-xylose ingestion. Patients were divided into two groups according to the time interval between surgery and evaluation: less (group I) or more (group II) than two years. A statistically significant correlation was found between xylosemia and remaining small bowel length (r = 0.71; P less than 0.001) and between calcium absorption and remaining small bowel length (r = 0.75; P less than 0.001) in group I. A significant correlation was also observed between calcium absorption and time after surgery (r = 0.65; P = 0.001) but not for xylose absorption. Calcium absorption value was significantly increased in group II patients compared with group I patients matched for remaining small bowel length (36.2 +/- 12.5% vs 14.5 +/- 9.1%; P less than 0.001) while no difference was observed between the two groups concerning xylose absorption. These data indicate that intestinal calcium absorption continues to increase for more than two years after a major bowel resection in man. The intestine does not seem to recover all its functions at the same time.

  4. A study on phenomenology of Dhat syndrome in men in a general medical setting

    OpenAIRE

    Prakash, Sathya; Sharan, Pratap; Sood, Mamta

    2016-01-01

    Background: “Dhat syndrome” is believed to be a culture-bound syndrome of the Indian subcontinent. Although many studies have been performed, many have methodological limitations and there is a lack of agreement in many areas. Aims: The aim is to study the phenomenology of “Dhat syndrome” in men and to explore the possibility of subtypes within this entity. Settings and Design: It is a cross-sectional descriptive study conducted at a sex and marriage counseling clinic of a tertiary care teach...

  5. [General cognitive functioning and psycholinguistic abilities in children with Smith-Magenis Syndrome].

    Science.gov (United States)

    Garayzábal Heinze, Elena; Lens Villaverde, María; Moruno López, Esther; Conde Magro, Tatiana; Moura, Luis Felipe; Fernández, Montserrat; Sampaio, Adriana

    2011-11-01

    This study is a neuropsycholinguistic research of a rare genetic syndrome with microdeletion that co-occurs with intellectual disabilities and relatively good language abilities, the Smith-Magenis Syndrome (SMS). Nevertheless, there are no cognitive and psycholinguistic profile analyses performed with Spanish population. In this sense, we characterized the cognitive and psycholinguistic profile of a sample with 9 participants with SMS (7 to 11 years of age). The cognitive and psychological profile was assessed with diverse standardized tests: Wechsler Intelligence Scale for Children - IV version, Illinois Test of Psycholinguistic Abilities and Peabody Picture Vocabulary Test. Results suggest a specific cognitive and psychological profile characterized by a low IQ and relative good abilities in integrating information, whereas attention problems and hyperactive behaviors were displayed when interacting with the child during the assessment. This work is the first evidence of the cognitive and psycholinguistic profile characterization in patients with SMS in Spain, and will help to guide a more accurate diagnosis and differential intervention in rare genetic diseases with similar cognitive and psycholinguistic profiles.

  6. [Simple febrile seizure, complex seizure, generalized epilepsy with febrile seizure plus, FIRES and new syndromes].

    Science.gov (United States)

    Moreno de Flagge, Noris

    2013-01-01

    Febrile seizures are the most common seizures in childhood. They have been observed in 2-5% of children before the age of 5, but in some populations this figure may increase to 15%. It is a common cause of pediatric hospital admissions and cause of anxiety for parents. Febrile seizures could be the first manifestation of epilepsy. About 13% of epileptic patients have a history of febrile seizure, and 30% have had recurrent febrile seizures. Their phenotypic characteristics allow, in the majority of cases, a classification of the seizure, an elaboration of a prognosis and to assume a specific therapeutic attitude. It is possible to describe a spectrum according to their severity, from the benign simple seizure to the more complex, febrile seizure plus, Dravet'syndrome, and FIRES. During the past decade, molecular genetic studies have contributed to the identification of genetic factors involved in febrile seizure and related disorders, making the necessity of a careful follow up of these patients in order to detect risk factors earlier. We have reviewed the medical literature to update current knowledge of febrile seizures, their prognosis and their relation to new epileptic syndromes.

  7. Quality of life, general health status and related factors in women of polycystic ovary syndrome in Yazd (IRAN 2014

    Directory of Open Access Journals (Sweden)

    Farzaneh Ebrahimi

    2016-07-01

    Full Text Available polycystic ovary syndrome leads to augmentation of behavioral disorders among women and the affects their quality of life. The present study is being carried out in order to assess the quality of life and the level of general health in women suffering polycystic ovary syndrome in Baghayipour Treatment Center customers in the city of Yazd in IRAN 2013-14 and its relevant factors. This descriptive-analytical study has been done in a cross-sectional method during nine months on seventy three women who were suffering polycystic ovary syndrome through convenience sampling technique. For data collection PCOSQ and GHQ-28 surveys are used. Factors to enter the study involve the age range of 15-49, affliction with PCO, satisfaction of taking part in a study and the factors for leaving it including being affected with galactorrhoea (i.e. automatic lactation from breasts, thyroid problems, Cushing syndrome or the consumers of corticosteroid drugs. The data were analyzed by means of SPSS software and the descriptive statistics tests and regression. The results of descriptive statistics tests indicated that the average age of 26.28± 5.59 years, body mass index (BMI of 28.09 ± 5.06, %5.5 of the participants are illiterate, %17.8 of them are people with less than high school diploma, %24.7 have high school diploma degree, and %52.1 of them have university degrees. The average score for the quality of life among women was 111.36 ± 21.39 as well. The greatest factor influencing the quality of life according to the achieved score in these patients were menstruation problems, hirsutism, emotional problems, weight, and finally infertility respectively. By means of regression test there was a meaningful statistical correlation with significance level value of (p<0.05 between the quality of life with BMI, number of pregnancy, intervals between menstruation cycles, and the extent of satisfaction with body image. Polycystic ovary syndrome has a negative impact on

  8. Adaptive and Maladaptive Correlates of Repetitive Behavior and Restricted Interests in Persons with Down Syndrome and Developmentally-Matched Typical Children: A Two-Year Longitudinal Sequential Design

    Science.gov (United States)

    Evans, David W.; Kleinpeter, F. Lee; Slane, Mylissa M.; Boomer, K. B.

    2014-01-01

    We examined the course of repetitive behavior and restricted interests (RBRI) in children with and without Down syndrome (DS) over a two-year time period. Forty-two typically-developing children and 43 persons with DS represented two mental age (MA) levels: “younger” 2–4 years; “older” 5–11 years. For typically developing younger children some aspects of RBRI increased from Time 1 to Time 2. In older children, these aspects remained stable or decreased over the two-year period. For participants with DS, RBRI remained stable or increased over time. Time 1 RBRI predicted Time 2 adaptive behavior (measured by the Vineland Scales) in typically developing children, whereas for participants with DS, Time 1 RBRI predicted poor adaptive outcome (Child Behavior Checklist) at Time 2. The results add to the body of literature examining the adaptive and maladaptive nature of repetitive behavior. PMID:24710387

  9. Adaptive and maladaptive correlates of repetitive behavior and restricted interests in persons with down syndrome and developmentally-matched typical children: a two-year longitudinal sequential design.

    Directory of Open Access Journals (Sweden)

    David W Evans

    Full Text Available We examined the course of repetitive behavior and restricted interests (RBRI in children with and without Down syndrome (DS over a two-year time period. Forty-two typically-developing children and 43 persons with DS represented two mental age (MA levels: "younger" 2-4 years; "older" 5-11 years. For typically developing younger children some aspects of RBRI increased from Time 1 to Time 2. In older children, these aspects remained stable or decreased over the two-year period. For participants with DS, RBRI remained stable or increased over time. Time 1 RBRI predicted Time 2 adaptive behavior (measured by the Vineland Scales in typically developing children, whereas for participants with DS, Time 1 RBRI predicted poor adaptive outcome (Child Behavior Checklist at Time 2. The results add to the body of literature examining the adaptive and maladaptive nature of repetitive behavior.

  10. SUDDEN CARDIAC ARREST DURING GENERAL ANAESTHESIA IN AN UNDIAGNOSED BRUGADA SYNDROME

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    Jyothsna

    2015-05-01

    Full Text Available The clinical presentation of BS varies from patients being asymptomatic, to having a history of syncope, seizures, palpitations, nocturnal agonal respiration, and aborted sudden death and the majority of patients have a family history of sudden death or ma lignant arrhythmias. It is important for the anesthesiologist to be familiar with Brugada syndrome since known and unknown BS patients may present for surgery. Investigations revealed an haemoglobin of 9.3gm/dl, serum creat - 0.73, normal electrocardiogram ( ECG and serum electrolytes and blood sugar level were within normal range. ECG showed ventricular fibrillation followed by asystole. Immediate Cardiopulmonary resuscitation (CPR was initiated and inj adrenaline 1 in 10000 1mg iv given. Rest of the period of ICU stay was uneventful while adequate analgesia/and sedation along with close monitoring was done

  11. Necesidades de aprendizaje del especialista en Medicina General Integral sobre síndrome demencial Needs of learning of specialist of Integral General Medicine on dementia syndrome

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    Víctor T. Pérez Martínez

    2010-03-01

    Full Text Available Introducción: las necesidades de aprendizaje o capacitación son la resultante de un proceso de comparación entre un patrón de conocimientos o habilidades y la realidad. Siempre resulta de contrastar un desempeño ideal o propuesto con el real, bien sea para un individuo o un grupo determinado. Objetivos: identificar las necesidades de aprendizaje que, sobre el síndrome demencial, tienen los médicos que laboran en los equipos de atención primaria de salud del municipio Playa. Métodos: se realizó la identificación de necesidades de aprendizaje mediante un cuestionario escrito, que se aplicó de forma colectiva y anónima a 20 especialistas de Medicina General Integral seleccionados al azar y que laboran en tres policlínicos del extremo este del municipio Playa. Resultados: se puntualizaron las deficiencias e insuficiencias de los conocimientos y habilidades profesionales sobre el síndrome demencial, fundamentalmente en lo referente al diagnóstico, y su terapéutica desactualizada. Conclusiones: a pesar de que la demencia senil constituye una entidad mayor en el orden geriátrico, psiquiátrico, epidemiológico y socioeconómico, la gran mayoría de los especialistas no la identifican debidamente, por lo que persiste como una entidad infradiagnosticada e infravalorada.Introduction: needs of learning or training are the result of a comparison process between the knowledges or abilities and the reality. Always it comes of to verify an ideal performance or the proposed compared to the real one, for a subject or a determined group. Objectives: to identify the needs of learning that on the dementia syndrome, have the physicians working in health primary care teams from Playa municipality. Methods: authors identified the needs of learning by a written questionnaire, applied in a collective or anonymous way in 20 specialists of Integral General Medicine working in three polyclinics from eastern extreme of Playa municipality. It was a random

  12. Effects of carpal tunnel syndrome on adaptation of multi-digit forces to object weight for whole-hand manipulation.

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    Full Text Available The delicate tuning of digit forces to object properties can be disrupted by a number of neurological and musculoskeletal diseases. One such condition is Carpal Tunnel Syndrome (CTS, a compression neuropathy of the median nerve that causes sensory and motor deficits in a subset of digits in the hand. Whereas the effects of CTS on median nerve physiology are well understood, the extent to which it affects whole-hand manipulation remains to be addressed. CTS affects only the lateral three and a half digits, which raises the question of how the central nervous system integrates sensory feedback from affected and unaffected digits to plan and execute whole-hand object manipulation. We addressed this question by asking CTS patients and healthy controls to grasp, lift, and hold a grip device (445, 545, or 745 g for several consecutive trials. We found that CTS patients were able to successfully adapt grip force to object weight. However, multi-digit force coordination in patients was characterized by lower discrimination of force modulation to lighter object weights, higher across-trial digit force variability, the consistent use of excessively large digit forces across consecutive trials, and a lower ability to minimize net moments on the object. Importantly, the mechanical requirement of attaining equilibrium of forces and torques caused CTS patients to exert excessive forces at both CTS-affected digits and digits with intact sensorimotor capabilities. These findings suggest that CTS-induced deficits in tactile sensitivity interfere with the formation of accurate sensorimotor memories of previous manipulations. Consequently, CTS patients use compensatory strategies to maximize grasp stability at the expense of exerting consistently larger multi-digit forces than controls. These behavioral deficits might be particularly detrimental for tasks that require fine regulation of fingertip forces for manipulating light or fragile objects.

  13. Effects of carpal tunnel syndrome on adaptation of multi-digit forces to object weight for whole-hand manipulation.

    Science.gov (United States)

    Zhang, Wei; Johnston, Jamie A; Ross, Mark A; Smith, Anthony A; Coakley, Brandon J; Gleason, Elizabeth A; Dueck, Amylou C; Santello, Marco

    2011-01-01

    The delicate tuning of digit forces to object properties can be disrupted by a number of neurological and musculoskeletal diseases. One such condition is Carpal Tunnel Syndrome (CTS), a compression neuropathy of the median nerve that causes sensory and motor deficits in a subset of digits in the hand. Whereas the effects of CTS on median nerve physiology are well understood, the extent to which it affects whole-hand manipulation remains to be addressed. CTS affects only the lateral three and a half digits, which raises the question of how the central nervous system integrates sensory feedback from affected and unaffected digits to plan and execute whole-hand object manipulation. We addressed this question by asking CTS patients and healthy controls to grasp, lift, and hold a grip device (445, 545, or 745 g) for several consecutive trials. We found that CTS patients were able to successfully adapt grip force to object weight. However, multi-digit force coordination in patients was characterized by lower discrimination of force modulation to lighter object weights, higher across-trial digit force variability, the consistent use of excessively large digit forces across consecutive trials, and a lower ability to minimize net moments on the object. Importantly, the mechanical requirement of attaining equilibrium of forces and torques caused CTS patients to exert excessive forces at both CTS-affected digits and digits with intact sensorimotor capabilities. These findings suggest that CTS-induced deficits in tactile sensitivity interfere with the formation of accurate sensorimotor memories of previous manipulations. Consequently, CTS patients use compensatory strategies to maximize grasp stability at the expense of exerting consistently larger multi-digit forces than controls. These behavioral deficits might be particularly detrimental for tasks that require fine regulation of fingertip forces for manipulating light or fragile objects.

  14. Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice

    Directory of Open Access Journals (Sweden)

    Verhaar Jan AN

    2007-09-01

    Full Text Available Abstract Background Regional pain in the hip in adults is a common cause of a general practitioner visit. A considerable part of patients suffer from (greater trochanteric pain syndrome or trochanteric bursitis. Local corticosteroid injections is one of the treatment options. Although clear evidence is lacking, small observational studies suggest that this treatment is effective in the short-term follow-up. So far, there are no randomised controlled trials available evaluating the efficacy of injection therapy. This study will investigate the efficacy of local corticosteroid injections in the trochanter syndrome in the general practice, using a randomised controlled trial design. The cost effectiveness of the corticosteroid injection therapy will also be assessed. Secondly, the role of co-morbidity in relation to the efficacy of local corticosteroid injections will be investigated. Methods/Design This study is a pragmatic, open label randomised trial. A total of 150 patients (age 18–80 years visiting the general practitioner with complaints suggestive of trochanteric pain syndrome will be allocated to receive local corticosteroid injections or to receive usual care. Usual care consists of analgesics as needed. The randomisation is stratified for yes or no co-morbidity of low back pain, osteoarthritis of the hip, or both. The treatment will be evaluated by means of questionnaires at several time points within one year, with the 3 month and 1 year evaluation of pain and recovery as primary outcome. Analyses of primary and secondary outcomes will be made according to the intention-to-treat principle. Direct and indirect costs will be assessed by questionnaires. The cost effectiveness will be estimated using the following ratio: CE ratio = (cost of injection therapy minus cost of usual care/(effect of injection therapy minus effect of usual care. Discussion This study design is appropriate to estimate effectiveness and cost-effectiveness of the

  15. Data-driven robust approximate optimal tracking control for unknown general nonlinear systems using adaptive dynamic programming method.

    Science.gov (United States)

    Zhang, Huaguang; Cui, Lili; Zhang, Xin; Luo, Yanhong

    2011-12-01

    In this paper, a novel data-driven robust approximate optimal tracking control scheme is proposed for unknown general nonlinear systems by using the adaptive dynamic programming (ADP) method. In the design of the controller, only available input-output data is required instead of known system dynamics. A data-driven model is established by a recurrent neural network (NN) to reconstruct the unknown system dynamics using available input-output data. By adding a novel adjustable term related to the modeling error, the resultant modeling error is first guaranteed to converge to zero. Then, based on the obtained data-driven model, the ADP method is utilized to design the approximate optimal tracking controller, which consists of the steady-state controller and the optimal feedback controller. Further, a robustifying term is developed to compensate for the NN approximation errors introduced by implementing the ADP method. Based on Lyapunov approach, stability analysis of the closed-loop system is performed to show that the proposed controller guarantees the system state asymptotically tracking the desired trajectory. Additionally, the obtained control input is proven to be close to the optimal control input within a small bound. Finally, two numerical examples are used to demonstrate the effectiveness of the proposed control scheme.

  16. Weak-lensing shear estimates with general adaptive moments, and studies of bias by pixellation, PSF distortions, and noise

    CERN Document Server

    Simon, Patrick

    2016-01-01

    In weak gravitational lensing, weighted quadrupole moments of the brightness profile in galaxy images are a common way to estimate gravitational shear. We employ general adaptive moments (GLAM) to study causes of shear bias on a fundamental level and for a practical definition of an image ellipticity. For GLAM, the ellipticity is identical to that of isophotes of elliptical images, and this ellipticity is always an unbiased estimator of reduced shear. Our theoretical framework reiterates that moment-based techniques are similar to a model-based approach in the sense that they fit an elliptical profile to the image to obtain weighted moments. As a result, moment-based estimates of ellipticities are prone to underfitting bias. The estimation is fundamentally limited mainly by pixellation which destroys information on the original, pre-seeing image. We give an optimized estimator for the pre-seeing GLAM ellipticity and its bias for noise-free images. To deal with images where pixel noise is prominent, we conside...

  17. The Coexistence of Generalized and Lateralized Periodic Discharges: Report of Two Adult Cases with SSPE and MELAS Syndrome

    Directory of Open Access Journals (Sweden)

    Aslıhan Taşkıran

    2011-09-01

    Full Text Available Generalized and lateralized periodic discharges have not been reported previously in the same EEG simultaneously. Here, we report two adult patients who suffered from rare clinical conditions [subacute sclerosing panencephalitis (SSPE and nitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS syndrome]. Their EEGs showed the same pattern consisting of generalized periodic discharges and lateralized periodic discharges in the same EEG simultaneously. Although the appearances of the EEG were very similar, discharges became more prominent after intravenous diazepam injection in the case with SSPE but were suppressed in the case with MELAS. Lesions in the magnetic resonance imaging (MRI were located posteriorly in both patients, involving mainly subcortical white matter in the case with SSPE, but mainly the cortical area in the case with MELAS. Generalized periodic discharges are also reported in MELAS for the first time. The underlying mechanisms of the genesis of periodic discharges are still not known, and these two patients may help us to learn more about these rare patterns.

  18. Is there evidence that we should screen the general population for Lynch syndrome with genetic testing? A systematic review

    Science.gov (United States)

    Prince, Anya E R; Cadigan, R Jean; Henderson, Gail E; Evans, James P; Adams, Michael; Coker-Schwimmer, Emmanuel; Penn, Dolly C; Van Riper, Marcia; Corbie-Smith, Giselle; Jonas, Daniel E

    2017-01-01

    Background The emerging dual imperatives of personalized medicine and technologic advances make population screening for preventable conditions resulting from genetic alterations a realistic possibility. Lynch syndrome is a potential screening target due to its prevalence, penetrance, and the availability of well-established, preventive interventions. However, while population screening may lower incidence of preventable conditions, implementation without evidence may lead to unintentional harms. We examined the literature to determine whether evidence exists that screening for Lynch-associated mismatch repair (MMR) gene mutations leads to improved overall survival, cancer-specific survival, or quality of life. Documenting evidence and gaps is critical to implementing genomic approaches in public health and guiding future research. Materials and methods Our 2014–2015 systematic review identified studies comparing screening with no screening in the general population, and controlled studies assessing analytic validity of targeted next-generation sequencing, and benefits or harms of interventions or screening. We conducted meta-analyses for the association between early or more frequent colonoscopies and health outcomes. Results Twelve studies met our eligibility criteria. No adequate evidence directly addressed the main question or the harms of screening in the general population. Meta-analyses found relative reductions of 68% for colorectal cancer incidence (relative risk: 0.32, 95% confidence interval: 0.23–0.43, three cohort studies, 590 participants) and 78% for all-cause mortality (relative risk: 0.22, 95% confidence interval: 0.09–0.56, three cohort studies, 590 participants) for early or more frequent colonoscopies among family members of people with cancer who also had an associated MMR gene mutation. Conclusion Inadequate evidence exists examining harms and benefits of population-based screening for Lynch syndrome. Lack of evidence highlights the need

  19. Cardiac Autonomic Alteration and Metabolic Syndrome: An Ambulatory ECG-based Study in A General Population

    Science.gov (United States)

    Ma, Yan; Tseng, Ping-Huei; Ahn, Andrew; Wu, Ming-Shiang; Ho, Yi-Lwun; Chen, Ming-Fong; Peng, Chung-Kang

    2017-01-01

    Metabolic syndrome (MetS) has been associated with chronic damage to the cardiovascular system. This study aimed to evaluate early stage cardiac autonomic dysfunction with electrocardiography (ECG)-based measures in MetS subjects. During 2012–2013, 175 subjects with MetS and 226 healthy controls underwent ECG recordings of at least 4 hours starting in the morning with ambulatory one-lead ECG monitors. MetS was diagnosed using the criteria defined in the Adult Treatment Panel III, with a modification of waist circumference for Asians. Conventional heart rate variability (HRV) analysis, and complexity index (CI1–20) calculated from 20 scales of entropy (multiscale entropy, MSE), were compared between subjects with MetS and controls. Compared with the healthy controls, subjects with MetS had significantly reduced HRV, including SDNN and pNN20 in time domain, VLF, LF and HF in frequency domain, as well as SD2 in Poincaré analysis. MetS subjects have significantly lower complexity index (CI1–20) than healthy subjects (1.69 ± 0.18 vs. 1.77 ± 0.12, p < 0.001). MetS severity was inversely associated with the CI1–20 (r = −0.27, p < 0.001). MetS is associated with significant alterations in heart rate dynamics, including HRV and complexity. PMID:28290487

  20. Incorporating AAC and General Instructional Strategies in Requesting Interventions: A Case Study in Down Syndrome

    Science.gov (United States)

    Lanter, Elizabeth; Russell, Sharon D.; Kuriakose, Annu; Blevins, Kasey E.

    2016-01-01

    This article provides clinicians and educators a useful conceptualization of general instructional strategies often used to promote the performance of requests in children with developmental disabilities, and which can be applied in interventions that utilize augmentative and alternative communication. A case study illustrates the specialized…

  1. Chronically administered retinoic acid has trophic effects in the rat small intestine and promotes adaptation in a resection model of short bowel syndrome.

    Science.gov (United States)

    Wang, Lihua; Tang, Yuzhu; Rubin, Deborah C; Levin, Marc S

    2007-06-01

    Following the loss of functional small bowel surface area, the intestine undergoes a compensatory adaptive response. The observation that adaptation is inhibited in vitamin A-deficient rats following submassive intestinal resection suggested that vitamin A is required for this response and raised the possibility that exogenous vitamin A could augment adaptation. Therefore, to directly assess whether chronically administered retinoic acid could stimulate gut adaptation in a model of short bowel syndrome and to address the mechanisms of any such effects, Sprague-Dawley rats were implanted with controlled release retinoic acid or control pellets and then subjected to mid-small bowel or sham resections. At 2 wk postoperation, changes in gut morphology, crypt cell proliferation and apoptosis, enterocyte migration, the extracellular matrix, and gene expression were assessed. Retinoic acid had significant trophic effects in resected and sham-resected rats. Retinoic acid markedly inhibited apoptosis and stimulated crypt cell proliferation and enterocyte migration postresection. Data presented indicate that these proadaptive effects of retinoic acid may be mediated via changes in the extracellular matrix (e.g., by increasing collagen IV synthesis, decreasing E-cadherin expression, and reducing integrin beta(3) levels), via affects on Hedgehog signaling (e.g., by reducing expression of the Hedgehog receptors Ptch and Ptch2 and the Gli1 transcription factor), by increasing expression of Reg1 and Pap1, and by modulation of retinoid and peroxisome proliferator-activated receptor signaling pathways. These studies are the first to demonstrate that retinoic acid can significantly enhance intestinal adaptation and suggest it may be beneficial in patients with short bowel syndrome.

  2. Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study.

    Science.gov (United States)

    Bonete, Saray; Calero, María Dolores; Fernández-Parra, Antonio

    2015-05-01

    Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study describes preliminary data from a group format manual-based intervention, the Interpersonal Problem-Solving for Workplace Adaptation Programme, aimed at improving the cognitive and metacognitive process of social problem-solving skills focusing on typical social situations in the workplace based on mediation as the main strategy. A total of 50 adults with Asperger syndrome received the programme and were compared with a control group of typical development. The feasibility and effectiveness of the treatment were explored. Participants were assessed at pre-treatment and post-treatment on a task of social problem-solving skills and two secondary measures of socialisation and work profile using self- and caregiver-report. Using a variety of methods, the results showed that scores were significantly higher at post-treatment in the social problem-solving task and socialisation skills based on reports by parents. Differences in comparison to the control group had decreased after treatment. The treatment was acceptable to families and subject adherence was high. The Interpersonal Problem-Solving for Workplace Adaptation Programme appears to be a feasible training programme.

  3. Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part IV--Sport Groups

    Science.gov (United States)

    Lieberman, Lauren; Lucas, Mark; Jones, Jeffery; Humphreys, Dan; Cody, Ann; Vaughn, Bev; Storms, Tommie

    2013-01-01

    "Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part IV--Sport Groups" provides the the following articles: (1) "Sport Programming Offered by Camp Abilities and the United States Association for Blind Athletes" (Lauren Lieberman and Mark…

  4. Development of Object Control in the First Year: Emerging Category Discrimination and Generalization in Infants' Adaptive Selection of Action

    Science.gov (United States)

    Mash, Clay; Bornstein, Marc H.; Banerjee, Abhilasha

    2014-01-01

    This research examined the development of adaptive generalization in infants' object-directed actions. Infants ages 9 and 12 months participated in an object manipulation task with stimulus objects from 2 categories that differed in shape and weight and that bore a consistent shape or weight correspondence. Weight differences between…

  5. Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part IV--Sport Groups

    Science.gov (United States)

    Lieberman, Lauren; Lucas, Mark; Jones, Jeffery; Humphreys, Dan; Cody, Ann; Vaughn, Bev; Storms, Tommie

    2013-01-01

    "Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part IV--Sport Groups" provides the the following articles: (1) "Sport Programming Offered by Camp Abilities and the United States Association for Blind Athletes" (Lauren Lieberman and Mark…

  6. Diet in subjects with irritable bowel syndrome: A cross-sectional study in the general population

    Directory of Open Access Journals (Sweden)

    Ligaarden Solveig C

    2012-06-01

    Full Text Available Abstract Background Patients with irritable bowel syndrome (IBS often relate symptoms to the intake of certain foods. This study assesses differences in diet in subjects with and without IBS. Methods The cross-sectional, population-based study was conducted in Norway in 2001. Out of 11078 invited subjects, 4621 completed a survey about abdominal complaints and intake of common food items. IBS and IBS subgroups were classified according to Rome II criteria. Results IBS was diagnosed in 388 subjects (8.4% and, of these, 26.5% had constipation-predominant IBS (C-IBS, 44.8% alternating IBS (A-IBS, and 28.6% diarrhoea-predominant IBS (D-IBS. Low intake of dairy products (portions/day (Odds Ratio 0.85 [CI 0.78 to 0.93], p = 0.001 and high intake of water (100 ml/day (1.08 [1.02 to 1.15], p = 0.002, tea (1.05 [1.01 to 1.10], p = 0.019 and carbonated beverages (1.07 [1.01 to 1.14], p = 0.023 were associated with IBS. A lower intake of dairy products and a higher intake of alcohol and carbonated beverages were associated with D-IBS and a higher intake of water and tea was associated with A-IBS. In subjects with IBS the severity of symptoms was associated with a higher intake of vegetables and potatoes in subjects with C-IBS, with a higher intake of vegetables in subjects with A-IBS, and with a higher intake of fruits and berries, carbonated beverages and alcohol in subjects with D-IBS. Conclusions In this study, the diet differed in subjects with and without IBS and between IBS subgroups and was associated with the severity of symptoms.

  7. Acute effects of the glucagon-like peptide 2 analogue, teduglutide, on intestinal adaptation in short bowel syndrome

    Science.gov (United States)

    Neonatal short bowel syndrome following massive gut resection is associated with malabsorption of nutrients. The intestinotrophic factor glucagon-like peptide 2 (GLP-2) improves gut function in adult patients with short bowel syndrome, but its effect in pediatric patients remains unknown. Our object...

  8. Overlap of symptoms of gastroesophageal reflux disease, dyspepsia and irritable bowel syndrome in the general population

    DEFF Research Database (Denmark)

    Rasmussen, Sanne; Jensen, Trine Holm; Henriksen, Susanne Lund

    2014-01-01

    of the three conditions in a Western general population. Material and methods. A nationwide study of 100,000 individuals 20 years and above, randomly selected in the general population. A web-based questionnaire survey formed the basis of this study. Questions regarding FD and IBS were extracted from the ROME...... III adult questionnaire. Questions regarding GERD were developed based on the Montreal definition. Prevalence estimates for GERD, FD IBS were calculated in total and for each sex separately and for four age groups. A Venn diagram was constructed, illustrating the overlap between the three conditions....... Results. The overall response rate was 52.2%. The prevalence of GERD, FD and IBS was 11.2%, 7.7% and 10.5%, respectively, and overlap between two or three of these conditions was seen among 6.5% of the respondents. Among individuals meeting the criteria of one or more of the conditions GERD, FD and IBS...

  9. Association of brain-derived neurotrophic factor (BDNF) haploinsufficiency with lower adaptive behaviour and reduced cognitive functioning in WAGR/11p13 deletion syndrome.

    Science.gov (United States)

    Han, Joan C; Thurm, Audrey; Golden Williams, Christine; Joseph, Lisa A; Zein, Wadih M; Brooks, Brian P; Butman, John A; Brady, Sheila M; Fuhr, Shannon R; Hicks, Melanie D; Huey, Amanda E; Hanish, Alyson E; Danley, Kristen M; Raygada, Margarita J; Rennert, Owen M; Martinowich, Keri; Sharp, Stephen J; Tsao, Jack W; Swedo, Susan E

    2013-01-01

    In animal studies, brain-derived neurotrophic factor (BDNF) is an important regulator of central nervous system development and synaptic plasticity. WAGR (Wilms tumour, Aniridia, Genitourinary anomalies, and mental Retardation) syndrome is caused by 11p13 deletions of variable size near the BDNF locus and can serve as a model for studying human BDNF haploinsufficiency (+/-). We hypothesized that BDNF+/- would be associated with more severe cognitive impairment in subjects with WAGR syndrome. Twenty-eight subjects with WAGR syndrome (6-28 years), 12 subjects with isolated aniridia due to PAX6 mutations/microdeletions (7-54 years), and 20 healthy controls (4-32 years) received neurocognitive assessments. Deletion boundaries for the subjects in the WAGR group were determined by high-resolution oligonucleotide array comparative genomic hybridization. Within the WAGR group, BDNF+/- subjects (n = 15), compared with BDNF intact (+/+) subjects (n = 13), had lower adaptive behaviour (p = .02), reduced cognitive functioning (p = .04), higher levels of reported historical (p = .02) and current (p = .02) social impairment, and higher percentage meeting cut-off score for autism (p = .047) on Autism Diagnostic Interview-Revised. These differences remained nominally significant after adjusting for visual acuity. Using diagnostic measures and clinical judgement, 3 subjects (2 BDNF+/- and 1 BDNF+/+) in the WAGR group (10.7%) were classified with autism spectrum disorder. A comparison group of visually impaired subjects with isolated aniridia had cognitive functioning comparable to that of healthy controls. In summary, among subjects with WAGR syndrome, BDNF+/- subjects had a mean Vineland Adaptive Behaviour Compose score that was 14-points lower and a mean intelligence quotient (IQ) that was 20-points lower than BDNF+/+ subjects. Our findings support the hypothesis that BDNF plays an important role in human neurocognitive development.

  10. Porcine models for the metabolic syndrome, digestive and bone disorders: a general overview.

    Science.gov (United States)

    Litten-Brown, J C; Corson, A M; Clarke, L

    2010-06-01

    The aim of this review article is to provide an overview of the role of pigs as a biomedical model for humans. The usefulness and limitations of porcine models have been discussed in terms of metabolic, cardiovascular, digestive and bone diseases in humans. Domestic pigs and minipigs are the main categories of pigs used as biomedical models. One drawback of minipigs is that they are in short supply and expensive compared with domestic pigs, which in contrast cost more to house, feed and medicate. Different porcine breeds show different responses to the induction of specific diseases. For example, ossabaw minipigs provide a better model than Yucatan for the metabolic syndrome as they exhibit obesity, insulin resistance and hypertension, all of which are absent in the Yucatan. Similar metabolic/physiological differences exist between domestic breeds (e.g. Meishan v. Pietrain). The modern commercial (e.g. Large White) domestic pig has been the preferred model for developmental programming due to the 2- to 3-fold variation in body weight among littermates providing a natural form of foetal growth retardation not observed in ancient (e.g. Meishan) domestic breeds. Pigs have been increasingly used to study chronic ischaemia, therapeutic angiogenesis, hypertrophic cardiomyopathy and abdominal aortic aneurysm as their coronary anatomy and physiology are similar to humans. Type 1 and II diabetes can be induced in swine using dietary regimes and/or administration of streptozotocin. Pigs are a good and extensively used model for specific nutritional studies as their protein and lipid metabolism is comparable with humans, although pigs are not as sensitive to protein restriction as rodents. Neonatal and weanling pigs have been used to examine the pathophysiology and prevention/treatment of microbial-associated diseases and immune system disorders. A porcine model mimicking various degrees of prematurity in infants receiving total parenteral nutrition has been established to

  11. [Correction by natural adaptogens of hormonal-metabolic status disorders in rats during the development of adaptation syndrome using functional tests with dexamethasone and ACTH].

    Science.gov (United States)

    Udintsev, S N; Krylova, S G; Konovalova, O N

    1991-12-01

    Rats exposed to stress by fixation develop a complex of hormonal metabolic homeostasis disturbances (as evidenced by changed levels of ACTH, insulin, 11-HOCS, urea, glucose). One of the major mechanisms of these disorders in reduced hypothalamus sensitivity to regulatory signals and exhausted adrenocortical functional activity, developing at the stages of anxiety and exhaustion of the adaptation syndrome, respectively, and detectable by functional tests with dexamethasone and ACTH. Administration of natural adaptogens (Scutellaria baicalensis extract and its active principle, baikalin flavonoid) was conducive to normalization of the majority of the examined parameters whatever the direction of changes.

  12. Cognitive control adjustments in healthy older and younger adults: Conflict adaptation, the error-related negativity (ERN), and evidence of generalized decline with age.

    Science.gov (United States)

    Larson, Michael J; Clayson, Peter E; Keith, Cierra M; Hunt, Isaac J; Hedges, Dawson W; Nielsen, Brent L; Call, Vaughn R A

    2016-03-01

    Older adults display alterations in neural reflections of conflict-related processing. We examined response times (RTs), error rates, and event-related potential (ERP; N2 and P3 components) indices of conflict adaptation (i.e., congruency sequence effects) a cognitive control process wherein previous-trial congruency influences current-trial performance, along with post-error slowing, correct-related negativity (CRN), error-related negativity (ERN) and error positivity (Pe) amplitudes in 65 healthy older adults and 94 healthy younger adults. Older adults showed generalized slowing, had decreased post-error slowing, and committed more errors than younger adults. Both older and younger adults showed conflict adaptation effects; magnitude of conflict adaptation did not differ by age. N2 amplitudes were similar between groups; younger, but not older, adults showed conflict adaptation effects for P3 component amplitudes. CRN and Pe, but not ERN, amplitudes differed between groups. Data support generalized declines in cognitive control processes in older adults without specific deficits in conflict adaptation.

  13. Colonic GLP-2 is not sufficient to promote jejunal adaptation in a PN-dependent rat model of human short bowel syndrome

    DEFF Research Database (Denmark)

    Koopmann, Matthew C; Liu, Xiaowen; Boehler, Christopher J

    2009-01-01

    BACKGROUND: Bowel resection may lead to short bowel syndrome (SBS), which often requires parenteral nutrition (PN) due to inadequate intestinal adaptation. The objective of this study was to determine the time course of adaptation and proglucagon system responses after bowel resection in a PN......-dependent rat model of SBS. METHODS: Rats underwent jugular catheter placement and a 60% jejunoileal resection + cecectomy with jejunoileal anastomosis or transection control surgery. Rats were maintained exclusively with PN and killed at 4 hours to 12 days. A nonsurgical group served as baseline. Bowel growth...... peaked from days 4-7 after resection and then approached baseline. Plasma IGF-I increased with resection through day 12. Jejunum and colon GLP-2 receptor RNAs peaked by day 1 and then declined below baseline. CONCLUSIONS: After bowel resection resulting in SBS in the rat, peak proglucagon, plasma GLP-2...

  14. 短肠综合征肠适应机制研究进展%Intestinal adaptation in short bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    郭明晓

    2013-01-01

    The process of intestinal adaptation is complex and multifaceted. Although a number of trophic nutrients and non-nutritive factors have been identified in animal studies, successful, reproducible clinical trials in humans are awaited. Understanding mechanisms underlying this adaptive process may direct research toward strategies that maximize intestinal function and impart a true clinical benefit to patients with short bowel syndrome.%短肠综合征残余肠道代偿是一个复杂的过程.许多因素对肠道代偿作用虽然在动物实验中已得到证实,但在临床应用中仍存有争议.阐明肠代偿机制对促进短肠病人残余肠道代偿功能具有重要的指导意义.

  15. An examination of the relationship of anxiety and intelligence to adaptive functioning in children with chromosome 22q11.2 deletion syndrome.

    Science.gov (United States)

    Angkustsiri, Kathleen; Leckliter, Ingrid; Tartaglia, Nicole; Beaton, Elliott A; Enriquez, Janice; Simon, Tony J

    2012-01-01

    This study investigates the relationship between anxiety symptoms and adaptive function in children with chromosome 22q11.2 deletion syndrome (22q11.2DS). Seventy-eight children between 7 and 14 years of age with 22q11.2DS and 36 typically developing (TD) children without known genetic syndromes participated in a larger study of neurocognition. Parents completed questionnaires about their child's anxiety symptoms (Behavior Assessment System for Children, 2nd edition [BASC-2] and Spence Children's Anxiety Scale [SCAS]) and adaptive functioning (BASC-2 and Adaptive Behavior Assessment System, 2nd edition). Within the 22q11.2DS group, different DSM-IV anxiety domains were also analyzed using SCAS subscales. Based on parent report, 19% of children with 22q11.2DS had a prior diagnosis of an anxiety disorder versus 58% with at least 1 elevated anxiety score (BASC-2 or SCAS). Mean BASC-2 anxiety scores were significantly higher in 22q11.2DS (55.6 ± 12.5) than in TD children (48.3 ± 10; p = .003), and a greater percentage of children with 22q11.2DS (37%) had an elevated BASC-2 anxiety scores compared with TD children (14%; p = .01). Higher anxiety scores were related to lower adaptive function (r = -.27; p = .015), but there was no relationship between Wechsler Intelligence Scale for Children, 4th edition Full Scale Intelligence Quotient and BASC-2 adaptive skills (r = -.06; p = .6) in the 22q11.2DS group. For the individual SCAS anxiety subscales, panic-agoraphobia (r = -.38; p = .03), physical injury (r = -.34; p = .05), and obsessive-compulsive disorder (r = -.47; p = .005) were significantly negatively related to adaptive function in 22q11.2DS. Despite the known risk, anxiety is underidentified in children with 22q11.2DS. The presence of anxiety symptoms, but not intelligence levels, in children with 22q11.2DS negatively correlated with adaptive function and impacts everyday living skills.

  16. Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome.

    Science.gov (United States)

    Xará, Daniela; Mendonça, Júlia; Pereira, Helder; Santos, Alice; Abelha, Fernando José

    2015-01-01

    Patients with STOP-BANG score >3 have a high risk of Obstructive sleep apnea. The aim of this study was to evaluate early postoperative respiratory complications in adults with STOP-BANG score >3 after general anesthesia. This is a prospective double cohort study matching 59 pairs of adult patients with STOP-BANG score >3 (high risk of obstructive sleep apnea) and patients with STOP-BANG score <3 (low risk of obstructive sleep apnea), similar with respect to gender, age and type of surgery, admitted after elective surgery in the Post-Anaesthesia Care Unit in May 2011. Primary outcome was the development of adverse respiratory events. Demographics data, perioperative variables, and postoperative length of stay in the Post-Anesthesia Care Unit and in hospital were recorded. The Mann-Whitney test, the chi-square test and the Fisher exact test were used for comparisons. Subjects in both pairs of study subjects had a median age of 56 years, including 25% males, and 59% were submitted to intra-abdominal surgery. High risk of obstructive sleep apnea patients had a higher median body mass index (31 versus 24kg/m(2), p<0.001) and had more frequently co-morbidities, including hypertension (58% versus 24%, p<0.001), dyslipidemia (46% versus 17%, p<0.001) and insulin-treated diabetes mellitus (17% versus 2%, p=0.004). These patients were submitted more frequently to bariatric surgery (20% versus 2%, p=0.002). Patients with high risk of obstructive sleep apnea had more frequently adverse respiratory events (39% versus 10%, p<0.001), mild to moderate desaturation (15% versus 0%, p=0.001) and inability to breathe deeply (34% versus 9%, p=0.001). After general anesthesia high risk of obstructive sleep apnea patients had an increased incidence of postoperative respiratory complications. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  17. [Adverse respiratory events after general anesthesia in patients at high risk of obstructive sleep apnea syndrome].

    Science.gov (United States)

    Xará, Daniela; Mendonça, Júlia; Pereira, Helder; Santos, Alice; Abelha, Fernando José

    2015-01-01

    Patients with STOP-BANG score >3 have a high risk of Obstructive sleep apnea. The aim of this study was to evaluate early postoperative respiratory complications in adults with STOP-BANG score >3 after general anesthesia. This is a prospective double cohort study matching 59 pairs of adult patients with STOP-BANG score >3 (high risk of obstructive sleep apnea) and patients with STOP-BANG score <3 (low risk of obstructive sleep apnea), similar with respect to gender, age and type of surgery, admitted after elective surgery in the Post-Anaesthesia Care Unit in May 2011. Primary outcome was the development of adverse respiratory events. Demographics data, perioperative variables, and postoperative length of stay in the Post-Anesthesia Care Unit and in hospital were recorded. The Mann-Whitney test, the chi-square test and the Fisher exact test were used for comparisons. Subjects in both pairs of study subjects had a median age of 56 years, including 25% males, and 59% were submitted to intra-abdominal surgery. High risk of obstructive sleep apnea patients had a higher median body mass index (31 versus 24kg/m(2), p<0.001) and had more frequently co-morbidities, including hypertension (58% versus 24%, p<0.001), dyslipidemia (46% versus 17%, p<0.001) and insulin-treated diabetes mellitus (17% versus 2%, p=0.004). These patients were submitted more frequently to bariatric surgery (20% versus 2%, p=0.002). Patients with high risk of obstructive sleep apnea had more frequently adverse respiratory events (39% versus 10%, p<0.001), mild to moderate desaturation (15% versus 0%, p=0.001) and inability to breathe deeply (34% versus 9%, p=0.001). After general anesthesia high risk of obstructive sleep apnea patients had an increased incidence of postoperative respiratory complications. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status

    Directory of Open Access Journals (Sweden)

    Melani Carla

    2008-10-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Methods Seven regions were considered (overall population, 14.9 million over 3–6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare. Incidence rates of in-hospital cases of CTS were estimated based on 1 codified demographic, diagnostic and intervention data in obligatory discharge records from all Italian public/private hospitals, archived (according to residence on regional databases; 2 demographic general population data for each region. We compared (using the χscore test age-sex-specific rates between married, unmarried, divorced and widowed subsets of the general population. We calculated standardized incidence ratios (SIRs for married/unmarried men and women. Results Age-standardized incidence rates (per 100,000 person-years of in-hospital cases of CTS were 166 in women and 44 in men (106 overall. Married subjects of both sexes showed higher age-specific rates with respect to unmarried men/women. SIRs were calculated comparing married vs unmarried rates of both sexes: 1.59 (95% confidence interval [95% CI], 1.57–1.60 in women, and 1.42 (95% CI, 1.40–1.45 in men. As compared with married women/men, widows/widowers both showed 2–3-fold higher incidence peaks during the fourth decade of life (beyond 50 years of age, widowed subjects showed similar trends to unmarried counterparts. Conclusion This large population-based study illustrates distinct age-related trends in men and women, and also raises the question whether marital status could be associated with CTS in the general population.

  19. Impact of Dry Eye Syndrome on Vision-Related Quality of Life in a Non-Clinic-Based General Population

    Directory of Open Access Journals (Sweden)

    Le Qihua

    2012-07-01

    Full Text Available Abstract Background Dry eye syndrome (DES is a common ocular disorder occurring in general population. The purpose of this study is to evaluate the impact of DES on vision-related quality of life (QoL in a non-clinic-based general population. Methods This population-based cross-sectional study enrolled subjects older than 40 years, who took part in an epidemiological study on dry eye in Sanle Community, Shanghai. Apart from the collection of sociodemographics, dry eye symptoms, and other clinical data, a Chinese version of the 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25 was administered to all subjects. Comparisons of the NEI VFQ-25 subscale item scores and composite score were made among subgroups divided according to the presence of dry eye symptoms or signs. Multivariate regression analysis was performed to investigate the relationship between the clinical variables and the VFQ-25 composite score. Results A total of 229 participants were enrolled in the study, with an average age of (60.7 ±10.1 years old. Majority of these participants were female (59.8 %, 137/229. The total DES symptom scores (TDSS in subjects either with definite DES or only with dry eye symptoms were significantly higher (F = 60.331, P  Conclusions The symptoms of dry eye are associated with an adverse impact on vision-related QoL in non-clinic-based general population, which is mainly represented as more ocular pain and discomfort, and impaired mental health as well. Apart from clinical examination, it is also important to refer to subjective symptoms and QoL scores when assessing the severity of DES.

  20. Colonic spirochetosis is associated with colonic eosinophilia and irritable bowel syndrome in a general population in Sweden.

    Science.gov (United States)

    Walker, Marjorie M; Talley, Nicholas J; Inganäs, Linn; Engstrand, Lars; Jones, Michael P; Nyhlin, Henry; Agréus, Lars; Kjellstrom, Lars; Öst, Åke; Andreasson, Anna

    2015-02-01

    Irritable bowel syndrome (IBS) is a functional disorder defined by symptoms in the absence of overt pathology. Colonic spirochetosis (CS), defined by histologic observation of spirochetal strains of Brachyspira in colonic biopsies, is uncommon and considered of doubtful significance. We aimed to determine the prevalence of CS in the general population, identify subtle colon pathologies, and evaluate a link with symptoms of IBS. Colonoscopy was performed in 745 subjects (aged 19-70 years, mean age 51 years, 43% male) with biopsies (ileum and 4 colonic sites) from a random population sample, Stockholm, Sweden, who completed a validated questionnaire of gastrointestinal symptoms; IBS was identified by Rome III criteria. CS was identified by histology and immunohistochemistry. In a general population, 17 individuals (2.28%; 95% confidence interval, 1.2%-3.5%) were diagnosed as having CS by histology; 6 (35%) had IBS. CS was always present in the sigmoid colon, but only 14 rectal biopsies. Eosinophils were increased in colon biopsies in CS cases versus controls, in the transverse (P = .02), sigmoid colon (P = .001), and rectum (P = .0005) with subepithelial eosinophil clusters (P = .053). Lymphoid follicles (at any site) were present in 13 CS (P = .0003). There was a 3-fold increased risk of IBS in CS (odds ratio, 3.59; 95% confidence interval, 1.27-10.11; P = .015). Polyps and diverticular disease were similar in CS cases and controls. The prevalence of CS in a general population is 2% and associated with nonconstipating IBS. Colonic eosinophilia with lymphoid follicles may signify the presence of CS.

  1. Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.

    LENUS (Irish Health Repository)

    Sugrue, Michael

    2012-01-31

    BACKGROUND: Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death. PATIENTS AND METHODS: Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation. CONCLUSIONS: All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.

  2. General practice out-of-hours service in Ireland provides a new source of syndromic surveillance data on influenza.

    LENUS (Irish Health Repository)

    Brabazon, E D

    2010-01-01

    The use of routinely available electronic sources of healthcare data on the spread of influenza has the potential to enhance current surveillance activities. This study aimed to develop a method for identifying influenza-related records from general practitioner(GP) out-of-hours (OOH) services in Ireland. Data from one such service were interrogated for keywords relating to influenza-like illness (ILI) and a proxy measure of influenza activity in the community setting was developed. Comparison of this syndromic surveillance measure with national data on ILI consultation rates demonstrated a statistically significant temporal correlation.In five out of six influenza seasons investigated,peaks in the GP OOH influenza-related calls appeared at least one week ahead of peaks in the national ILI consultation rates. The method described in this paper has been extended to nine OOH services in Ireland (covering 70% of the Irish population) to provide weekly figures on self-reported illness for influenza in the community and its data have been incorporated into the national weekly influenza reports produced by the Health Protection Surveillance Centre. These data should provide early warnings of both seasonal and pandemic influenza in Ireland.

  3. The General Weakness Syndrome Therapy (GymNAST) study: protocol for a cohort study on recovery on walking function.

    Science.gov (United States)

    Mehrholz, Jan; Mückel, Simone; Oehmichen, Frank; Pohl, Marcus

    2014-10-24

    Critical illness myopathy (CIM) and polyneuropathy (CIP) are common complications of critical illness that frequently occur together. Both cause so called intensive care unit (ICU)-acquired muscle weakness. This weakness of limb muscles increases morbidity and delay rehabilitation and recovery of walking ability. Although full recovery has been reported people with severe weakness may take months to improve walking. Focused physical rehabilitation of people with ICU-acquired muscle weakness is therefore of great importance. However, although physical rehabilitation is common, detailed knowledge about the pattern and the time course of recovery of walking function are not well understood. Therefore, the aim of the General Weakness Syndrome Therapy (GymNAST) study is to describe the time course of recovery of walking function and other activities of daily living in these patients. We conduct a prospective cohort study of people with ICU-acquired muscle weakness with defined diagnosis of CIM or CIP. Based on our sample size calculation, approximately 150 patients will be recruited from the ICU of our hospital in Germany. Amount and content of physical rehabilitation, clinical tests for example, muscle strength and motor function and neuropsychological assessments will be used as independent variables. The primary outcomes will include recovery of walking function and mobility. Secondary outcomes will include global motor function, activities in daily life and participation. The study is being carried out in agreement with the Declaration of Helsinki and conducted with the approval of the local medical Ethics Committee (Landesärztekammer Sachsen, Germany, reference number EK-BR-32/13-1) and with the understanding and written consent of each patient's guardian. The results of this study will be published in peer-reviewed journals and disseminated to the medical society and general public. Published by the BMJ Publishing Group Limited. For permission to use (where not

  4. General solution to diagonal model matching control of multiple-output-delay systems and its applications in adaptive scheme

    Institute of Scientific and Technical Information of China (English)

    Yingmin Jia

    2009-01-01

    This paper mainly studies the model matching problem of multiple-output-delay systems in which the reference model is assigned to a diagonal transfer function matrix.A new model matching controller structure is first developed,and then,it is shown that the controller is feasible if and only if the sets of Diophantine equations have common solutions.The obtained controller allows a parametric representation,which shows that an adaptive scheme can be used to tolerate parameter variations in the plants.The resulting adaptive law can guarantee the global stability of the closed-loop systems and the convergence of the output error.

  5. Gut hormones, and short bowel syndrome: The enigmatic role of glucagon-like peptide-2 in the regulation of intestinal adaptation

    Institute of Scientific and Technical Information of China (English)

    GR Martin; PL Beck; DL Sigalet

    2006-01-01

    Short bowel syndrome (SBS) refers to the malabsorption of nutrients, water, and essential vitamins as a result of disease or surgical removal of parts of the small intestine. The most common reasons for removing part of the small intestine are due to surgical intervention for the treatment of either Crohn's disease or necrotizing enterocolitis. Intestinal adaptation following resection may take weeks to months to be achieved, thus nutritional support requires a variety of therapeutic measures, which include parenteral nutrition. Improper nutrition management can leave the SBS patient malnourished and/or dehydrated, which can be life threatening. The development of therapeutic strategies that reduce both the complications and medical costs associated with SBS/long-term parenteral nutrition while enhancing the intestinal adaptive response would be valuable.Currently, therapeutic options available for the treatment of SBS are limited. There are many potential stimulators of intestinal adaptation including peptide hormones, growth factors, and neuronally-derived components. Glucagon-like peptide-2 (GLP-2) is one potential treatment for gastrointestinal disorders associated with insufficient mucosal function. A significant body of evidence demonstrates that GLP-2is atrophic hormone that plays an important role in controlling intestinal adaptation. Recent data from clinical trials demonstrate that GLP-2 is safe, well-tolerated, and promotes intestinal growth in SBS patients. However,the mechanism of action and the localization of the glucagon-like peptide-2 receptor (GLP-2R) remains an enigma. This review summarizes the role of a number of mucosal-derived factors that might be involved with intestinal adaptation processes; however, this discussion primarily examines the physiology, mechanism of action,and utility of GLP-2 in the regulation of intestinal mucosal growth.

  6. Model-free adaptive sliding mode controller design for generalized projective synchronization of the fractional-order chaotic system via radial basis function neural networks

    Indian Academy of Sciences (India)

    L M WANG

    2017-09-01

    A novel model-free adaptive sliding mode strategy is proposed for a generalized projective synchronization (GPS) between two entirely unknown fractional-order chaotic systems subject to the external disturbances. To solve the difficulties from the little knowledge about the master–slave system and to overcome the bad effects of the external disturbances on the generalized projective synchronization, the radial basis function neural networks are used to approach the packaged unknown master system and the packaged unknown slave system (including the external disturbances). Consequently, based on the slide mode technology and the neural network theory, a model-free adaptive sliding mode controller is designed to guarantee asymptotic stability of the generalized projective synchronization error. The main contribution of this paper is that a control strategy is provided for the generalized projective synchronization between two entirely unknown fractional-order chaotic systems subject to the unknown external disturbances, and the proposed control strategy only requires that the master system has the same fractional orders as the slave system. Moreover, the proposed method allows us to achieve all kinds of generalized projective chaos synchronizations by turning the user-defined parameters onto the desired values. Simulation results show the effectiveness of the proposed method and the robustness of the controlled system.

  7. Model-free adaptive sliding mode controller design for generalized projective synchronization of the fractional-order chaotic system via radial basis function neural networks

    Science.gov (United States)

    Wang, L. M.

    2017-09-01

    A novel model-free adaptive sliding mode strategy is proposed for a generalized projective synchronization (GPS) between two entirely unknown fractional-order chaotic systems subject to the external disturbances. To solve the difficulties from the little knowledge about the master-slave system and to overcome the bad effects of the external disturbances on the generalized projective synchronization, the radial basis function neural networks are used to approach the packaged unknown master system and the packaged unknown slave system (including the external disturbances). Consequently, based on the slide mode technology and the neural network theory, a model-free adaptive sliding mode controller is designed to guarantee asymptotic stability of the generalized projective synchronization error. The main contribution of this paper is that a control strategy is provided for the generalized projective synchronization between two entirely unknown fractional-order chaotic systems subject to the unknown external disturbances, and the proposed control strategy only requires that the master system has the same fractional orders as the slave system. Moreover, the proposed method allows us to achieve all kinds of generalized projective chaos synchronizations by turning the user-defined parameters onto the desired values. Simulation results show the effectiveness of the proposed method and the robustness of the controlled system.

  8. [Prevalence and Comorbidity of Self-Reported Diagnosis of Burnout Syndrome in the General Population - Results of the German Health Interview and Examination Survey for Adults (DEGS1)].

    Science.gov (United States)

    Maske, Ulrike E; Riedel-Heller, Steffi G; Seiffert, Ingeburg; Jacobi, Frank; Hapke, Ulfert

    2016-01-01

    Objective: To determine the prevalence and comorbid mental disorders of self-reported diagnosis of burnout syndrome in the general population of Germany. Methods: In the German Health Interview and Examination Survey (DEGS1) self-reported diagnosis of a burnout syndrome made by a physician or psychotherapist was assessed in a standardized interview (N = 7987). For N = 4483 mental disorders were determined with the Composite International Diagnostic Interview (CIDI). Weighted lifetime and 12-month prevalences were calculated. Results: Lifetime prevalence of diagnosed burnout syndrome was 4.2 % (women 5.2 %, men 3.3 %), 12-month prevalence was 1.5 % (women 1.9 %, men 1.1 %). Highest prevalences were found in 40 - 59 year olds, in people with middle and high socio-economic status and in women with low and men with high social support. Among the 12-month cases, 70.9 % had at least one DSM-IV disorder. Associations were found for the diagnosis of burnout syndrome with somatoform, affective and anxiety disorders. Conclusion: The diagnosis of burnout syndrome is less frequently given and reported than expected. People with a burnout diagnosis often have a manifest mental disorder. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Comparison of the metabolic syndrome risk in valproate-treated patients with epilepsy and the general population in Estonia.

    Directory of Open Access Journals (Sweden)

    Aleksei Rakitin

    Full Text Available No study has explored the risk of metabolic syndrome (MS in patients with epilepsy treated with valproate (VPA at the population level. The aim of this study was to compare the risk of MS in VPA-treated patients in Estonia to the risk in the general population.This study involved 118 patients with epilepsy (63 men, 55 women who received VPA monotherapy. MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Data were compared with the results of a population-based study of the prevalence of MS in the same geographic region (N = 493; 213 men, 280 women.In the multiple logistic regression analysis, after adjustment for age and sex, the risk of MS in VPA-treated patients was not increased compared to the control subjects (odds ratio [OR] = 1.00; 95% confidence interval [CI], 0.59-1.68. VPA-treated patients had higher serum insulin concentrations than control subjects, independent of body mass index (BMI. A positive association was found between MS development and BMI (OR = 1.47; 95% CI, 1.25-1.73 in VPA-treated patients, but there were no associations with the VPA dosage or the homeostasis model assessment-estimated insulin resistance (HOMA-IR index. In control subjects, BMI and HOMA-IR had similar predictive abilities for MS occurrence. In VPA-treated patients, the predictive ability of the HOMA-IR index was significantly lower than that of BMI, with areas under the receiver operating characteristic curves of 0.808 and 0.897 (P = 0.05, respectively.The risk of MS is not increased among VPA-treated patients with epilepsy in Estonia compared to the general population. The HOMA-IR index likely has a lower predictive ability for MS in VPA-treated patients compared to its predictive ability in the general population.

  10. Increased pathogenicity of European porcine reproductive and respiratory syndrome virus is associated with enhanced adaptive responses and viral clearance

    NARCIS (Netherlands)

    Morgan, S.B.; Graham, S.P.; Salguero, F.J.; Sánchez Cordón, P.J.; Mokhtar, H.; Rebel, J.M.J.; Weesendorp, E.; Bodman-Smith, K.B.; Steinbach, F.; Frossard, J.P.

    2013-01-01

    Porcine reproductive and respiratory syndrome (PRRS) is one of the most economically important diseases of swine worldwide. Since its first emergence in 1987 the PRRS virus (PRRSV) has become particularly divergent with highly pathogenic strains appearing in both Europe and Asia. However, the

  11. Klinefelter syndrome has increased brain responses to auditory stimuli and motor output, but not to visual stimuli or Stroop adaptation

    DEFF Research Database (Denmark)

    Wallentin, Mikkel; Skakkebæk, Anne; Bojesen, Anders

    2016-01-01

    Klinefelter syndrome (47, XXY) (KS) is a genetic syndrome characterized by the presence of an extra X chromosome and low level of testosterone, resulting in a number of neurocognitive abnormalities, yet little is known about brain function. This study investigated the fMRI-BOLD response from KS r....... No effects of testosterone level or brain volume were found. In sum, the present findings suggest that auditory and motor systems in KS are selectively affected, perhaps as a compensatory strategy, and that this is not a systemic effect as it is not seen in the visual system.......Klinefelter syndrome (47, XXY) (KS) is a genetic syndrome characterized by the presence of an extra X chromosome and low level of testosterone, resulting in a number of neurocognitive abnormalities, yet little is known about brain function. This study investigated the fMRI-BOLD response from KS...... response to motor output in primary motor cortex and an increased response to auditory stimuli in auditory cortices, but no difference in primary visual cortices. KS displayed a diminished response to written visual stimuli in secondary visual regions near the Visual Word Form Area, consistent...

  12. The nevoid basal-cell carcinoma syndrome. Simultaneous extirpation of numerous basal-cell carcinomas on the face by curettage and electrodesiccation under general anesthesia.

    Science.gov (United States)

    Camisa, C

    1981-11-01

    The case of a young, mentally retarded woman with the nevoid basal-cell carcinoma syndrome is presented in whom about 150 basal-cell carcinomas on the face were treated simultaneously be curettage and electrodesiccation with the patient under general anesthesia. Such a method is excellent for eradicating numerous carcinomas rapidly, effectively, and at once, especially when cooperation of the patient is not optimal.

  13. Sleep apnea syndrome: central sleep apnea and pulmonary hypertension worsened during treatment with auto-CPAP, but improved by adaptive servo-ventilation.

    Science.gov (United States)

    Ono, Hiroshi; Fujimoto, Hiroyuki; Kobayashi, Yoshinori; Kudoh, Shoji; Gemma, Akihiko

    2010-01-01

    In this 71-year-old man diagnosed as obstructive sleep apnea syndrome initially, the apnea-hypopnea index in polysomnography was 31.3/hour. He started auto-adjusted continuous positive airway pressure (auto-CPAP) treatment in July 2005 but developed congestive heart failure in December 2007. Pulmonary arterial pressure (PAP), estimated by echocardiography, was 71 mmHg. In January 2008, during simplified sleep examination with a breath-movement sensor under auto-CPAP, many central-type apneas were recognized. After replacing auto-CPAP with adaptive servo-ventilation (ASV), the apnea-hypopnea index was 5.3/hour and PAP became 36 mmHg after 3 months. It was thought that the increase of PAP was due to long-term inadequate use of auto-CPAP.

  14. A double-loop structure in the adaptive generalized predictive control algorithm for control of robot end-point contact force.

    Science.gov (United States)

    Wen, Shuhuan; Zhu, Jinghai; Li, Xiaoli; Chen, Shengyong

    2014-09-01

    Robot force control is an essential issue in robotic intelligence. There is much high uncertainty when robot end-effector contacts with the environment. Because of the environment stiffness effects on the system of the robot end-effector contact with environment, the adaptive generalized predictive control algorithm based on quantitative feedback theory is designed for robot end-point contact force system. The controller of the internal loop is designed on the foundation of QFT to control the uncertainty of the system. An adaptive GPC algorithm is used to design external loop controller to improve the performance and the robustness of the system. Two closed loops used in the design approach realize the system׳s performance and improve the robustness. The simulation results show that the algorithm of the robot end-effector contacting force control system is effective.

  15. Acute effects of the glucagon-like peptide 2 analogue, teduglutide, on intestinal adaptation in short bowel syndrome.

    Science.gov (United States)

    Thymann, Thomas; Stoll, Barbara; Mecklenburg, Lars; Burrin, Douglas G; Vegge, Andreas; Qvist, Niels; Eriksen, Thomas; Jeppesen, Palle B; Sangild, Per T

    2014-06-01

    Neonatal short bowel syndrome following massive gut resection is associated with malabsorption of nutrients. The intestinotrophic factor glucagon-like peptide 2 (GLP-2) improves gut function in adult patients with short bowel syndrome, but its effect in pediatric patients remains unknown. Our objective was to test the efficacy of the long-acting synthetic human GLP-2 analogue, teduglutide (ALX-0600), in a neonatal piglet jejunostomy model. Two-day-old pigs were subjected to resection of 50% of the small intestine (distal part), and the remnant intestine was exteriorized on the abdominal wall as a jejunostomy. All pigs were given total parenteral nutrition for 7 days and a single daily injection of the following doses of teduglutide: 0.01 (n = 6), 0.02 (n = 6), 0.1 (n = 5), or 0.2 mg · kg · day (n = 6), and compared with placebo (n = 9). Body weight increment was similar for all 4 teduglutide groups but higher than placebo (P short bowel syndrome.

  16. Klinefelter syndrome has increased brain responses to auditory stimuli and motor output, but not to visual stimuli or Stroop adaptation

    DEFF Research Database (Denmark)

    Wallentin, Mikkel; Skakkebæk, Anne; Bojesen, Anders

    2016-01-01

    with the widespread dyslexia in the group. No neural differences were found in inhibitory control (Stroop) or in adaptation to differences in stimulus frequencies. Across groups we found a strong positive correlation between age and BOLD response in the brain’s motor network with no difference between groups...

  17. Klinefelter syndrome has increased brain responses to auditory stimuli and motor output, but not to visual stimuli or Stroop adaptation

    DEFF Research Database (Denmark)

    Wallentin, Mikkel; Skakkebæk, Anne; Bojesen, Anders

    2016-01-01

    with the widespread dyslexia in the group. No neural differences were found in inhibitory control (Stroop) or in adaptation to differences in stimulus frequencies. Across groups we found a strong positive correlation between age and BOLD response in the brain's motor network with no difference between groups...

  18. Functional adaptation of tendon and skeletal muscle to resistance training in three patients with genetically verified classic Ehlers Danlos Syndrome

    DEFF Research Database (Denmark)

    Møller, Mathias Bech; Kjær, Michael; Svensson, René Brüggebusch

    2014-01-01

    undergoing muscle strength training. We investigated patients with classical Ehlers Danlos Syndrome (EDS) (collagen type V defect) who display articular hypermobility, skin extensibility and tissue fragility. METHODS: subjects underwent strength training 3 times a week for 4 months and were tested before...... sway-area of the participants decreased by 26% (0.144 to 0.108 m(2)). On the subscale of CIS20 the participants lowered their average subjective fatigue score from 33 to 25. CONCLUSION: in this small pilot study, heavy resistance training was both feasible and effective in classic Ehlers Danlos...

  19. Cross-cultural adaptation and reliability testing of the Tilburg Frailty Indicator for optimizing care of Polish patients with frailty syndrome

    Directory of Open Access Journals (Sweden)

    Uchmanowicz I

    2014-06-01

    Full Text Available Izabella Uchmanowicz,1 Beata Jankowska-Polańska,1 Maria Łoboz-Rudnicka,2 Stanislaw Manulik,3 Krystyna Łoboz-Grudzień,1,2 Robbert JJ Gobbens4 1Department of Clinical Nursing, Wroclaw Medical University, 2Department of Cardiology, T Marciniak Memorial Hospital, 3Primary Care Practice, Wroclaw, Poland; 4Research and Development Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands Background: Frail older people are at high risk of developing adverse outcomes, such as disability, mortality, hospitalization, and institutionalization. Previous research suggests that the Tilburg Frailty Indicator (TFI is a valid and reliable instrument for measuring frailty. The aim of this study was to adapt and to test the reliability of the Polish version of the TFI. Method: A standard guideline was used for translation and cultural adaptation of the English version of the TFI into Polish. The study included 100 Polish patients (mean age 68.2±6.5 years, among them 42 men and 58 women. Cronbach’s alpha was used for analysis of the internal consistency of the TFI. Results: The mean total TFI score was 6.7±3.1. Forty patients scored ≥5, which corresponded to being frail. Cronbach’s alpha reliability coefficients of the instrument ranged from 0.68 to 0.72 and item-total correlation ranged from 0.12 to 0.52. Conclusion: The TFI is valid and reproducible for assessment of frailty syndrome among a Polish population. The Polish adaptation of the TFI proved a useful and fast tool for assessing frailty. Keywords: internal consistency, validity, older individuals, aging

  20. The presence of alpha interferon at the time of infection alters the innate and adaptive immune responses to porcine reproductive and respiratory syndrome virus.

    Science.gov (United States)

    Brockmeier, Susan L; Loving, Crystal L; Nelson, Eric A; Miller, Laura C; Nicholson, Tracy L; Register, Karen B; Grubman, Marvin J; Brough, Douglas E; Kehrli, Marcus E

    2012-04-01

    Porcine reproductive and respiratory syndrome (PRRS) is one of the most devastating and costly diseases to the swine industry worldwide. Overall, the adaptive immune response to PRRS virus (PRRSV) is weak, which results in delayed elimination of virus from the host and inferior vaccine protection. PRRSV has been shown to induce a meager alpha interferon (IFN-α) response, and we hypothesized that elevated IFN-α levels early in infection would shorten the induction time and increase elements of the adaptive immune response. To test this, we measured both antibody and cell-mediated immunity in pigs after the administration of a nonreplicating human adenovirus type 5 vector expressing porcine IFN-α (Ad5-pIFN-α) at the time of PRRSV infection and compared the results to those for pigs infected with PRRSV alone. Viremia was delayed, and there was a decrease in viral load in the sera of pigs administered the Ad5-pIFN-α. Although seroconversion was slightly delayed in pigs receiving Ad5-pIFN-α, probably due to the early reduction in viral replication, little difference in the overall or neutralizing antibody response was seen. However, there was an increase in the number of virus-specific IFN-γ-secreting cells detected in the pigs receiving Ad5-pIFN-α, as well as an altered cytokine profile in the lung at 14 days postinfection, indicating that the presence of IFN-α at the time of infection can alter innate and adaptive immune responses to PRRSV.

  1. The Extend of Adaptation Bloom's Taxonomy of Cognitive Domain In English Questions Included in General Secondary Exams

    Directory of Open Access Journals (Sweden)

    Mohammad Akram Alzu'bi

    2014-04-01

    Full Text Available The study aimed at analyzing English questions of the Jordanian Secondary Certificate Examinations via Blooms' cognitive levels. An analysis sheet was prepared by the researcher for the purpose of the study, which was ensured to be valid and reliable. The whole questions of the general secondary examinations for English course in both levels (level three and level four during 2010-2013 composed the sample of the study. Frequencies and percentages were tabulated to facilitate the analysis of the results. The result of the study revealed that the total percentage of the first three levels (comprehension, knowledge, and analysis is (69.6 but the total percentage of the last three levels (application, synthesis, and evaluation is (30.4 so it indicated that the English questions included in general secondary examinations emphasize low order thinking levels. The researcher recommended that the questions designers should improve their questioning techniques in writing questions of exams.

  2. An Analysis of the Romanian General Accounting Plan. Opportunities for Adaptation to the Activity-Based Costing (ABC Method

    Directory of Open Access Journals (Sweden)

    Irina-Alina Preda

    2008-11-01

    Full Text Available In this article, we analyze the causes that have led to the improvement of the Romanian general accounting plan according to the Activity- Based Costing (ABC method. We explain the advantages presented by the dissociated organization of management accounting, in contrast with the tabular- statistical form. The article also describes the methodological steps to be taken in the process of recording book entries, according to the Activity-Based Costing (ABC method in Romania.

  3. Impact of the metabolic syndrome on the predictive values of new risk markers in the general population

    DEFF Research Database (Denmark)

    Olsen, MH; Hansen, Tine Willum; Christensen, M K;

    2008-01-01

    Although the metabolic syndrome (MetS) is positively associated with high-sensitivity C-reactive protein (hsCRP), negatively associated with N-terminal pro-brain natriuretic peptide (Nt-proBNP) and inconsequently related to urine albumin/creatinine ratio (UACR) they are all associated with cardio...

  4. Functional adaptation of tendon and skeletal muscle to resistance training in three patients with genetically verified classic Ehlers Danlos Syndrome

    DEFF Research Database (Denmark)

    Møller, Mathias Bech; Kjær, Michael; Svensson, René Brüggebusch

    2014-01-01

    undergoing muscle strength training. We investigated patients with classical Ehlers Danlos Syndrome (EDS) (collagen type V defect) who display articular hypermobility, skin extensibility and tissue fragility. METHODS: subjects underwent strength training 3 times a week for 4 months and were tested before...... and after intervention in regards to muscle strength, tendon mechanical properties, and muscle function. RESULTS: three subjects completed the scheduled 48 sessions and had no major adverse events. Mean isometric leg extension force and leg extensor power both increased by 8 and 11% respectively (358 to 397...... sway-area of the participants decreased by 26% (0.144 to 0.108 m(2)). On the subscale of CIS20 the participants lowered their average subjective fatigue score from 33 to 25. CONCLUSION: in this small pilot study, heavy resistance training was both feasible and effective in classic Ehlers Danlos...

  5. Adaptive hierarchic transformations for dynamically $p$-enriched slope-limiting over discontinuous Galerkin systems of generalized equations

    CERN Document Server

    Michoski, C; Dawson, C; Kubatko, E J; Wirasaet, D; Westerink, J J

    2010-01-01

    We study a family of generalized slope limiters in two dimensions for Runge-Kutta discontinuous Galerkin (RKDG) solutions of advection--diffusion systems. We analyze the numerical behavior of these limiters applied to a pair of model problems, comparing the error of the approximate solutions, and discuss each limiter's advantages and disadvantages. We then introduce a series of coupled $p$-enrichment schemes that may be used as standalone dynamic $p$-enrichment strategies, or may be augmented via any in the family of variable-in-$p$ slope limiters presented.

  6. Individuality and adaptation across levels of selection: How shall we name and generalize the unit of Darwinism?

    Science.gov (United States)

    Gould, Stephen Jay; Lloyd, Elisabeth A.

    1999-01-01

    Two major clarifications have greatly abetted the understanding and fruitful expansion of the theory of natural selection in recent years: the acknowledgment that interactors, not replicators, constitute the causal unit of selection; and the recognition that interactors are Darwinian individuals, and that such individuals exist with potency at several levels of organization (genes, organisms, demes, and species in particular), thus engendering a rich hierarchical theory of selection in contrast with Darwin’s own emphasis on the organismic level. But a piece of the argument has been missing, and individuals at levels distinct from organisms have been denied potency (although granted existence within the undeniable logic of the theory), because they do not achieve individuality with the same devices used by organisms and therefore seem weak by comparison. We show here that different features define Darwinian individuality across scales of size and time. In particular, species-individuals may develop few emergent features as direct adaptations. The interactor approach works with emergent fitnesses, not with emergent features; and species, as a consequence of their different mechanism for achieving individuality (reproductive exclusivity among subparts, that is, among organisms), express many effects from other levels. Organisms, by contrast, suppress upwardly cascading effects, because the organismic style of individuality (by functional integration of subparts) does not permit much competition or differential reproduction of parts from within. Species do not suppress the operation of lower levels; such effects therefore become available as exaptations conferring emergent fitness—a primary source of the different strength that species achieve as effective Darwinian individuals in evolution. PMID:10518549

  7. Piriformis Syndrome

    Science.gov (United States)

    ... of sitting for a long period of time, climbing stairs, walking, or running. × Definition Piriformis syndrome is a ... of sitting for a long period of time, climbing stairs, walking, or running. View Full Definition Treatment Generally, ...

  8. Adaptive evolution of interleukin-3 (IL3), a gene associated with brain volume variation in general human populations.

    Science.gov (United States)

    Li, Ming; Huang, Liang; Li, Kaiqin; Huo, Yongxia; Chen, Chunhui; Wang, Jinkai; Liu, Jiewei; Luo, Zhenwu; Chen, Chuansheng; Dong, Qi; Yao, Yong-gang; Su, Bing; Luo, Xiong-jian

    2016-04-01

    Greatly expanded brain volume is one of the most characteristic traits that distinguish humans from other primates. Recent studies have revealed genes responsible for the dramatically enlarged human brain size (i.e., the microcephaly genes), and it has been well documented that many microcephaly genes have undergone accelerated evolution along the human lineage. In addition to being far larger than other primates, human brain volume is also highly variable in general populations. However, the genetic basis underlying human brain volume variation remains elusive and it is not known whether genes regulating human brain volume variation also have experienced positive selection. We have previously shown that genetic variants (near the IL3 gene) on 5q33 were significantly associated with brain volume in Chinese population. Here, we provide further evidence that support the significant association of genetic variants on 5q33 with brain volume. Bioinformatic analyses suggested that rs31480 is likely to be the causal variant among the studied SNPs. Molecular evolutionary analyses suggested that IL3 might have undergone positive selection in primates and humans. Neutrality tests further revealed signatures of positive selection of IL3 in Han Chinese and Europeans. Finally, extended haplotype homozygosity (EHH) and relative EHH analyses showed that the C allele of SNP rs31480 might have experienced recent positive selection in Han Chinese. Our results suggest that IL3 is an important genetic regulator for human brain volume variation and implied that IL3 might have experienced weak or modest positive selection in the evolutionary history of humans, which may be due to its contribution to human brain volume.

  9. CHARGE syndrome

    Directory of Open Access Journals (Sweden)

    Prasad Chitra

    2006-09-01

    Full Text Available Abstract CHARGE syndrome was initially defined as a non-random association of anomalies (Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness. In 1998, an expert group defined the major (the classical 4C's: Choanal atresia, Coloboma, Characteristic ears and Cranial nerve anomalies and minor criteria of CHARGE syndrome. Individuals with all four major characteristics or three major and three minor characteristics are highly likely to have CHARGE syndrome. However, there have been individuals genetically identified with CHARGE syndrome without the classical choanal atresia and coloboma. The reported incidence of CHARGE syndrome ranges from 0.1–1.2/10,000 and depends on professional recognition. Coloboma mainly affects the retina. Major and minor congenital heart defects (the commonest cyanotic heart defect is tetralogy of Fallot occur in 75–80% of patients. Choanal atresia may be membranous or bony; bilateral or unilateral. Mental retardation is variable with intelligence quotients (IQ ranging from normal to profound retardation. Under-development of the external genitalia is a common finding in males but it is less apparent in females. Ear abnormalities include a classical finding of unusually shaped ears and hearing loss (conductive and/or nerve deafness that ranges from mild to severe deafness. Multiple cranial nerve dysfunctions are common. A behavioral phenotype for CHARGE syndrome is emerging. Mutations in the CHD7 gene (member of the chromodomain helicase DNA protein family are detected in over 75% of patients with CHARGE syndrome. Children with CHARGE syndrome require intensive medical management as well as numerous surgical interventions. They also need multidisciplinary follow up. Some of the hidden issues of CHARGE syndrome are often forgotten, one being the feeding adaptation of these children, which needs an early aggressive approach from a feeding team. As the child

  10. Asperger syndrome and "non-verbal learning problems" in a longitudinal perspective: neuropsychological and social adaptive outcome in early adult life.

    Science.gov (United States)

    Hagberg, Bibbi S; Nydén, Agneta; Cederlund, Mats; Gillberg, Christopher

    2013-12-15

    Co-existence of Asperger syndrome (AS) and non-verbal learning disability (NLD) has been proposed based on the observation that people with AS tend to have significantly higher verbal than performance IQ (VIQ > PIQ by ≥ 15 points), one of the core features of NLD. In the present study we examined neuropsychological and social adaptive profiles with "non-verbal learning problems" associated with NLD in a group of individuals with AS followed from childhood into early adult life. The group was divided into three subgroups: (i) persistent NLD (P-NLD), i.e. NLD (VIQ > PIQ) both in childhood and early adulthood occasions, (ii) childhood NLD (CO-NLD), i.e. NLD (VIQ > PIQ) only at original diagnosis, or (iii) No NLD (VIQ > PIQ) ever (NO-NLD). All three subgroups were followed prospectively from childhood into adolescence and young adult life. One in four to one in five of the whole group of males with AS had P-NLD. The P-NLD subgroup had poorer neuropsychological outcome in early adult life than did those with CO-NLD and those with NO-NLD. There were no unequivocal markers in early childhood that predicted subgroup status in early adult life, but early motor delay and a history of early speech-language problems tended to be associated with P-NLD. © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. [Intravenous Sedation and Repeated "the Same Day General Anesthesia" for a School-age Boy with Dandy-Walker Syndrome and Dentinogenesis].

    Science.gov (United States)

    Hitosugi, Takashi; Tsukamoto, Masanori; Fujiwara, Shigeki; Yokoyama, Takeshi

    2016-03-01

    Dandy-Walker syndrome (DWS) is characterized by perfect or partial defect of the cerebellum vermis and cystic dilatation of the posterior fossa communicating with the fourth ventricle. Common clinical signs are mental retardation, cerebellar ataxia, and those of increased intracranial pressure (ICP). Associated congenital anomalies are craniofacial, cardiac, renal, and skeletal abnormalities. We experienced a case of intravenous sedation and six times of "the same day" general anesthesia for a school-aged boy (10-13 years old) with DWS and hypodentinogenesis. The patient underwent an examination and dental treatments. We had to pay attention to airway management tracheal tube selection and control of ICP. In addition, we should prevent tooth injuries through mishaps during tracheal intubations, since all-tooth-hypoplasia with fragile dental crowns was strongly suggested in this case. Detailed postoperative care is also required for general anesthesia afflicted with DWS.

  12. MMPI-2 profiles and illness perception in fibromyalgia syndrome: The role of therapeutic exercise as adapted physical activity.

    Science.gov (United States)

    Paolucci, Teresa; Vetrano, Mario; Zangrando, Federico; Vulpiani, Maria Chiara; Grasso, Maria Rosaria; Trifoglio, Domenica; Di Franco, Manuela; Iannuccelli, Cristina; Sorgi, Maria Laura; Reis, Victor; Saraceni, Vincenzo Maria; Guidetti, Laura

    2015-01-01

    Control of pain management is an important up-stream process in fibromyalgia (FM) mechanisms. To investigate whether adapted physical activity (APA) could change the illness perception in relation to the FM personality profile. Thirty-seven women with FM allocated randomly: 19 treatment group (TG) and 18 control group (CG). Interventions: exercises program included ten sessions, two times for week for one hour each and observation for CG. Scales: Illness Perception Questionnaire-revisited (IPQ-r) for the mental representation of the disease, Minnesota Multiphasic Personality Inventory profiles (MMPI-2) for personality tool and Fibromyalgia Impact Questionnaire (FIQ) for function, impact and symptoms. Outcome assessments were performed before rehabilitation treatment (T0) than at the end (T1), and a follow-up 12 weeks after treatment (T2). APA was efficacy to improve FIQ values in TG at T1 and T2 test days (P = 0.014). Changes in IPQ-R values in T2 were not significant. All patients presented a baseline T-score≥65 in at least one of the basic and content MMPI-2 scales (Hy, D, Hs and Hea and Anx). APA was efficacy in FM, but further research to differentiate between illness experience rather than focus ona strict personality profile are necessary.

  13. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial.

    Science.gov (United States)

    White, P D; Goldsmith, K A; Johnson, A L; Potts, L; Walwyn, R; DeCesare, J C; Baber, H L; Burgess, M; Clark, L V; Cox, D L; Bavinton, J; Angus, B J; Murphy, G; Murphy, M; O'Dowd, H; Wilks, D; McCrone, P; Chalder, T; Sharpe, M

    2011-03-05

    Trial findings show cognitive behaviour therapy (CBT) and graded exercise therapy (GET) can be effective treatments for chronic fatigue syndrome, but patients' organisations have reported that these treatments can be harmful and favour pacing and specialist health care. We aimed to assess effectiveness and safety of all four treatments. In our parallel-group randomised trial, patients meeting Oxford criteria for chronic fatigue syndrome were recruited from six secondary-care clinics in the UK and randomly allocated by computer-generated sequence to receive specialist medical care (SMC) alone or with adaptive pacing therapy (APT), CBT, or GET. Primary outcomes were fatigue (measured by Chalder fatigue questionnaire score) and physical function (measured by short form-36 subscale score) up to 52 weeks after randomisation, and safety was assessed primarily by recording all serious adverse events, including serious adverse reactions to trial treatments. Primary outcomes were rated by participants, who were necessarily unmasked to treatment assignment; the statistician was masked to treatment assignment for the analysis of primary outcomes. We used longitudinal regression models to compare SMC alone with other treatments, APT with CBT, and APT with GET. The final analysis included all participants for whom we had data for primary outcomes. This trial is registered at http://isrctn.org, number ISRCTN54285094. We recruited 641 eligible patients, of whom 160 were assigned to the APT group, 161 to the CBT group, 160 to the GET group, and 160 to the SMC-alone group. Compared with SMC alone, mean fatigue scores at 52 weeks were 3·4 (95% CI 1·8 to 5·0) points lower for CBT (p = 0·0001) and 3·2 (1·7 to 4·8) points lower for GET (p = 0·0003), but did not differ for APT (0·7 [-0·9 to 2·3] points lower; p = 0·38). Compared with SMC alone, mean physical function scores were 7·1 (2·0 to 12·1) points higher for CBT (p = 0·0068) and 9·4 (4·4 to 14·4) points higher

  14. 短肠综合征时结肠的代偿研究%Colonic adaption in short bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    许剑民; 靳大勇; 吴肇汉

    2001-01-01

    than those of the control group (P<0.05). After 3 h of recirculation, the level of water, xylose and 15 N-glycine absorption(P<0.05) was elevated of the enteral nutrition group. Conclusion Colonic morphologic and functional adaption occurred in short bowel rats. Early and proper enteral nutrition can not only give enough nutrition but also enhance colonic adaption to the short bowel rats.

  15. Burnout syndrome among dental students: a short version of the "Burnout Clinical Subtype Questionnaire" adapted for students (BCSQ-12-SS).

    Science.gov (United States)

    Montero-Marin, Jesus; Monticelli, Francesca; Casas, Marina; Roman, Amparo; Tomas, Inmaculada; Gili, Margarita; Garcia-Campayo, Javier

    2011-12-12

    Burnout has been traditionally defined in relation to the dimensions of "exhaustion", "cynicism", and "inefficiency". More recently, the Burnout Clinical Subtype Questionnaire (BCSQ-12) further established three different subtypes of burnout: the "frenetic" subtype (related to "overload"), the "under-challenged" subtype (related to "lack of development"), and the "worn-out" subtype (related to "neglect"). However, to date, these definitions have not been applied to students. The aims of this research were (1) to adapt a Spanish version of the BCSQ-12 for use with students, (2) to test its factorial validity, internal consistency, convergent and discriminant validity, and (3) to assess potential socio-demographic and occupational risk factors associated with the development of the subtypes. We used a cross-sectional design on a sample of dental students (n = 314) from Santiago and Huesca universities (Spain). Participants completed the Burnout Clinical Subtype Questionnaire Student Survey (BCSQ-12-SS), the Maslach Burnout Inventory Student Survey (MBI-SS), and a series of socio-demographic and occupational questions formulated for the specific purpose of this study. Data were subjected to exploratory factor analysis (EFA) using the principal component method with varimax orthogonal rotation. To assess the relations with the criterion, we calculated the Pearson correlation coefficient (r), multiple correlation coefficient (R(y.123)), and the coefficient of determination (R(2)(y.123)). To assess the association between the subtypes and the socio-demographic variables, we examined the adjusted odds ratio (OR) obtained from multivariate logistic regression models. Factorial analyses supported the theoretical proposition of the BCSQ-12-SS, with α-values exceeding 0.80 for all dimensions. The "overload-exhaustion" relation was r = 0.59 (p burnout as established by the BCSQ-12-SS. As such, the BCSQ-12-SS can be used for the recognition of clinical profiles and for the

  16. Low glycemic index treatment for seizure control in Angelman syndrome: A case series from the Center for Dietary Therapy of Epilepsy at the Massachusetts General Hospital.

    Science.gov (United States)

    Grocott, Olivia R; Herrington, Katherine S; Pfeifer, Heidi H; Thiele, Elizabeth A; Thibert, Ronald L

    2017-03-01

    The low glycemic index treatment, a dietary therapy that focuses on glycemic index and reduced carbohydrate intake, has been successful in reducing seizure frequency in the general epilepsy population. Epilepsy is a common feature of Angelman syndrome and seizures are often refractory to multiple medications, especially in those with maternal deletions. Dietary therapy has become a more frequently used option for treating epilepsy, often in combination with other antiepileptic drugs, due to its efficacy and favorable side effect profile. This study aimed to assess the effectiveness of the low glycemic index treatment for seizure control in Angelman syndrome. Through a retrospective medical record review of 23 subjects who utilized the low glycemic index treatment at the Clinic and Center for Dietary Therapy of Epilepsy at the Massachusetts General Hospital, we found that the high level of seizure control and favorable side effect profile make the low glycemic index treatment a viable treatment for seizures in Angelman syndrome. The majority of subjects in our cohort experienced some level of seizure reduction after initiating the diet, 5 (22%) maintained complete seizure freedom, 10 (43%) maintained seizure freedom except in the setting of illness or non-convulsive status epilepticus, 7 (30%) had a decrease in seizure frequency, and only 1 (4%) did not have enough information to determine seizure control post-initiation. The low glycemic index treatment monotherapy was successful for some subjects in our cohort but most subjects used an antiepileptic drug concurrently. Some subjects were able to maintain the same level of seizure control on a liberalized version of the low glycemic index treatment which included a larger amount of low glycemic carbohydrates. No correlation between the level of carbohydrate restriction and level of seizure control was found. Few subjects experienced side effects and those that did found them to be mild and easily treated. The

  17. Social communication competence and functional adaptation in a general population of children: preliminary evidence for sex-by-verbal IQ differential risk.

    Science.gov (United States)

    Skuse, David H; Mandy, William; Steer, Colin; Miller, Laura L; Goodman, Robert; Lawrence, Kate; Emond, Alan; Golding, Jean

    2009-02-01

    The proportion of schoolchildren with mild social communicative deficits far exceeds the number diagnosed with an autistic spectrum disorder (ASD). We aimed to ascertain both the population distribution of such deficits and their association with functional adaptation and cognitive ability in middle childhood. The parent-report Social and Communication Disorders Checklist was administered to participants (n = 8,094) in the Avon Longitudinal Study of Parents and Children. We correlated impairment severity with independent clinical diagnoses of ASD, cognitive abilities, and teacher-rated maladaptive behavior. Social and Communication Disorders Checklist scores were continuously distributed in the general population; boys had mean scores 30% higher than girls. Social communicative deficits were associated with functional impairment at school, especially in domains of hyperactivity and conduct disorders. A sex-by-verbal IQ interaction effect occurred: verbal IQ was protective against social communication impairments across the range of abilities in female subjects only. In male subjects, this protective effect did not exist for those with above-average verbal IQ. Social communicative deficits are of prognostic significance, in terms of behavioral adjustment at school, for boys and girls. Their high general population prevalence emphasizes the importance of measuring such traits among clinically referred children who do not meet diagnostic ASD criteria. Above-average verbal IQ seems to confer protection against social communication impairments in female subjects but not in male subjects.

  18. Autoinflammatory syndromes.

    Science.gov (United States)

    Galeazzi, M; Gasbarrini, G; Ghirardello, A; Grandemange, S; Hoffman, H M; Manna, R; Podswiadek, M; Punzi, L; Sebastiani, G D; Touitou, I; Doria, A

    2006-01-01

    The autoinflammatory disorders are a new and expanding classification of inflammatory diseases characterized by recurrent episodes of systemic inflammation in the absence of pathogens, autoantibodies or antigen specific T cells. These disorders are caused by primary dysfunction of the innate immune system, without evidence of adaptive immune dysregulation. Innate immune abnormalities include aberrant responses to pathogen associated molecular patterns (PAMPs) like lipopolysaccharide and peptidoglycan, prominent neutrophilia in blood and tissues, and dysregulation of inflammatory cytokines (IL-1beta, TNF-alpha) or their receptors. The autoinflammatory diseases comprise both hereditary (Familial Mediterranean Fever, FMF; Mevalonate Kinase Deficiency, MKD; TNF Receptor Associated Periodic Syndrome, TRAPS; Cryopyrin Associated Periodic Syndrome, CAPS; Blau syndrome; Pyogenic sterile Arthritis, Pyoderma gangrenosum and Acne syndrome, PAPA; Chronic Recurrent Multifocal Osteomyelitis, CRMO) and multifactorial (Crohn's and Behçet's diseases) disorders. Mutations responsible for FMF, TRAPS, CAPS, PAPA are in proteins involved in modulation of inflammation and apoptosis.

  19. The PEX study – Exercise therapy for patellofemoral pain syndrome: design of a randomized clinical trial in general practice and sports medicine [ISRCTN83938749

    Directory of Open Access Journals (Sweden)

    Verhaar Jan AN

    2006-03-01

    Full Text Available Abstract Background Patellofemoral complaints are frequently seen in younger and active patients. Clinical strategy is usually based on decreasing provoking activities as sports and demanding knee activities during work and leisure and reassuring the patient on the presumed good outcome. Exercise therapy is also often prescribed although evidence on effectiveness is lacking. The objective of this article is to present the design of a randomized clinical trial that examines the outcome of exercise therapy supervised by a physical therapist versus a clinically accepted "wait and see" approach (information and advice about the complaints only. The research will address to both effectiveness and cost effectiveness of supervised exercise therapy in patients with patellofemoral pain syndrome (PFPS. Methods/design 136 patients (adolescents and young adults with patellofemoral pain syndrome are recruited in general practices and sport medicine centers. They will be randomly allocated receiving either 3 months of exercise therapy (or usual care. The primary outcome measures are pain, knee function and perception of recovery after 3 months and 12 months of follow up and will be measured by self reporting. Measurements will take place at baseline, 6 weeks, and 3 monthly until 1 year after inclusion in the study. Secondary outcome measurements include an economic evaluation. A cost-utility analysis will be performed that expresses health improvements in Quality Adjusted Life Years (QALYs and incorporates direct medical costs and productivity costs Discussion This study has been designed after reviewing the literature on exercise therapy for patellofemoral pain syndrome. It was concluded that to merit the effect of exercise therapy a trial based on correct methodological concept needed to be executed. The PEX study is a randomized clinical trial where exercise therapy is compared to usual care. This trial started in April 2005 and will finish in June 2007

  20. Helping General Physical Educators and Adapted Physical Educators Address the Office of Civil Rights Dear Colleague Guidance Letter: Part III--Practitioners and Programs

    Science.gov (United States)

    Poulin, David; Martinez, David; Aenchbacher, Amy; Aiello, Rocco; Doyle, Mike; Hilgenbrinck, Linda; Busse, Sean; Cappuccio, Jim

    2013-01-01

    In Part III of the feature, physical educators and adapted physical educators offer current best practices as models of implementation for readers. Contributions included are: (1) Answer to the Dear Colleague Letter from the Anchorage School District's Adapted Sport Program (David Poulin); (2) Georgia's Adapted Physical Educators Response to the…

  1. Mycobiome of the bat white nose syndrome affected caves and mines reveals diversity of fungi and local adaptation by the fungal pathogen Pseudogymnoascus (Geomyces destructans.

    Directory of Open Access Journals (Sweden)

    Tao Zhang

    Full Text Available Current investigations of bat White Nose Syndrome (WNS and the causative fungus Pseudogymnoascus (Geomyces destructans (Pd are intensely focused on the reasons for the appearance of the disease in the Northeast and its rapid spread in the US and Canada. Urgent steps are still needed for the mitigation or control of Pd to save bats. We hypothesized that a focus on fungal community would advance the understanding of ecology and ecosystem processes that are crucial in the disease transmission cycle. This study was conducted in 2010-2011 in New York and Vermont using 90 samples from four mines and two caves situated within the epicenter of WNS. We used culture-dependent (CD and culture-independent (CI methods to catalogue all fungi ('mycobiome'. CD methods included fungal isolations followed by phenotypic and molecular identifications. CI methods included amplification of DNA extracted from environmental samples with universal fungal primers followed by cloning and sequencing. CD methods yielded 675 fungal isolates and CI method yielded 594 fungal environmental nucleic acid sequences (FENAS. The core mycobiome of WNS comprised of 136 operational taxonomic units (OTUs recovered in culture and 248 OTUs recovered in clone libraries. The fungal community was diverse across the sites, although a subgroup of dominant cosmopolitan fungi was present. The frequent recovery of Pd (18% of samples positive by culture even in the presence of dominant, cosmopolitan fungal genera suggests some level of local adaptation in WNS-afflicted habitats, while the extensive distribution of Pd (48% of samples positive by real-time PCR suggests an active reservoir of the pathogen at these sites. These findings underscore the need for integrated disease control measures that target both bats and Pd in the hibernacula for the control of WNS.

  2. Causes of metabolic syndrome and obesity-related co-morbidities Part 1: A composite unifying theory review of human-specific co-adaptations to brain energy consumption.

    Science.gov (United States)

    McGill, Anne-Thea

    2014-01-01

    The medical, research and general community is unable to effect significantly decreased rates of central obesity and related type II diabetes mellitus (TIIDM), cardiovascular disease (CVD) and cancer. All conditions seem to be linked by the concept of the metabolic syndrome (MetS), but the underlying causes are not known. MetS markers may have been mistaken for causes, thus many treatments are destined to be suboptimal. The current paper aims to critique current paradigms, give explanations for their persistence, and to return to first principles in an attempt to determine and clarify likely causes of MetS and obesity related comorbidities. A wide literature has been mined, study concepts analysed and the basics of human evolution and new biochemistry reviewed. A plausible, multifaceted composite unifying theory is formulated. The basis of the theory is that the proportionately large, energy-demanding human brain may have driven co-adaptive mechanisms to provide, or conserve, energy for the brain. A 'dual system' is proposed. 1) The enlarged, complex cortico-limbic-striatal system increases dietary energy by developing strong neural self-reward/motivation pathways for the acquisition of energy dense food, and (2) the nuclear factor-erythroid 2-related factor 2 (NRF2) cellular protection system amplifies antioxidant, antitoxicant and repair activity by employing plant chemicals, becoming highly energy efficient in humans. The still-evolving, complex human cortico-limbic-striatal system generates strong behavioural drives for energy dense food procurement, including motivating agricultural technologies and social system development. Addiction to such foods, leading to neglect of nutritious but less appetizing 'common or garden' food, appears to have occurred. Insufficient consumption of food micronutrients prevents optimal human NRF2 function. Inefficient oxidation of excess energy forces central and non-adipose cells to store excess toxic lipid. Oxidative stress and

  3. Generalized odontodysplasia in a 5-year-old patient with Hallermann-Streiff syndrome: clinical aspects, cone beam computed tomography findings, and conservative clinical approach.

    Science.gov (United States)

    Damasceno, Juliana Ximenes; Couto, José Luciano Pimenta; Alves, Karla Shangela da Silva; Chaves, Cauby Maia; Costa, Fábio Wildson Gurgel; Pimenta, Alynne de Menezes Vieira; Fonteles, Cristiane Sá Roriz

    2014-08-01

    This article aims to report the main clinical aspects, cone beam computed tomography (CBCT) findings, and conservative oral rehabilitation in a child born from a consanguineous marriage who presented with Hallermann-Streiff syndrome (HSS) and generalized odontodysplasia. A 5-year-old girl presented with a diagnosis of HSS for oral evaluation. Radiographically, all teeth showed wide pulp chambers and roots with thin dentinal walls and open apices, resembling ghost teeth and indicating a diagnosis of odontodysplasia. Oral rehabilitation consisted of partial dentures that were regularly adjusted to conform the device with the pattern of growth and development of the child. CBCT scan provided great insight into HSS, allowing a detailed view of the morphologic aspects and associated trabecular bone pattern. Treatment of these 2 rare conditions in young children must consider the stage of growth and development. Although extremely rare in HSS, odontodysplasia should be investigated and conservatively managed in young children.

  4. Correlation between chronic obstructive pulmonary disease and obstructive sleep apnea syndrome in a general population in Iran

    Directory of Open Access Journals (Sweden)

    Babak Amra

    2011-01-01

    Full Text Available Background: The aim of this study was to evaluate epidemiological relationship between chronic obstructive pulmonary disease and sleep apnea syndrome in a sample of Persian population. Methods: As a part of a population-based cross-sectional study, 3900 randomly selected individuals aged 15 years or older were invited to take part in the survey; 3770 individuals (96.6% agreed to fill out the respiratory and sleep questionnaire. Those subjects suspected to have either chronic obstructive pulmonary disease and/or obstructive sleep apnea underwent spirometry and polysomnography test if indicated. Spirometric measurements were performed on 420 invited responders. Polysomnography measurements were performed on 25 of the responders. Results: Prevalence rates for sleep apnea, chronic obstructive pulmonary disease and current asthma were 4.98%, 5.7% and 3.1%, respectively. Logistic regression showed independent associations between sleep apnea and chronic obstructive pulmonary disease. There was no significant independent association between sleep apnea symptoms and current asthma and wheeze ever. Conclusions: These observations indicated relationship between chronic obstructive pulmonary disease and obstructive sleep apnea. These observations indicated the necessity of further studies to explain the possible common pathogenic mechanisms involved in two disease entities.

  5. Generalized Anxiety and Major Depressive syndrome measured by the SCL-90-R in Two Manganese (Mn) Exposed Ohio Towns

    Science.gov (United States)

    Objective: Environmental exposure to manganese (Mn) may cause generalized anxiety (GA) and major depression (MD) in residents living in Mn-exposed areas. Marietta and East Liverpool are two Ohio towns identified as having elevated levels of Mn. The objective was to determine if l...

  6. Generalized Anxiety and Major Depressive syndrome measured by the SCL-90-R in Two Manganese (Mn) Exposed Ohio Towns

    Science.gov (United States)

    Objective: Environmental exposure to manganese (Mn) may cause generalized anxiety (GA) and major depression (MD) in residents living in Mn-exposed areas. Marietta and East Liverpool are two Ohio towns identified as having elevated levels of Mn. The objective was to determine if l...

  7. Enhancing Classification Performance of Functional Near-Infrared Spectroscopy- Brain–Computer Interface Using Adaptive Estimation of General Linear Model Coefficients

    Directory of Open Access Journals (Sweden)

    Nauman Khalid Qureshi

    2017-07-01

    Full Text Available In this paper, a novel methodology for enhanced classification of functional near-infrared spectroscopy (fNIRS signals utilizable in a two-class [motor imagery (MI and rest; mental rotation (MR and rest] brain–computer interface (BCI is presented. First, fNIRS signals corresponding to MI and MR are acquired from the motor and prefrontal cortex, respectively, afterward, filtered to remove physiological noises. Then, the signals are modeled using the general linear model, the coefficients of which are adaptively estimated using the least squares technique. Subsequently, multiple feature combinations of estimated coefficients were used for classification. The best classification accuracies achieved for five subjects, for MI versus rest are 79.5, 83.7, 82.6, 81.4, and 84.1% whereas those for MR versus rest are 85.5, 85.2, 87.8, 83.7, and 84.8%, respectively, using support vector machine. These results are compared with the best classification accuracies obtained using the conventional hemodynamic response. By means of the proposed methodology, the average classification accuracy obtained was significantly higher (p < 0.05. These results serve to demonstrate the feasibility of developing a high-classification-performance fNIRS-BCI.

  8. Adaptive smoothing of high angular resolution diffusion-weighted imaging data by generalized cross-validation improves Q-ball orientation distribution function reconstruction.

    Science.gov (United States)

    Metwalli, Nader S; Hu, Xiaoping P; Carew, John D

    2010-09-01

    Q-ball imaging (QBI) is a high angular resolution diffusion-weighted imaging (HARDI) technique for reconstructing the orientation distribution function (ODF). Some form of smoothing or regularization is typically required in the ODF reconstruction from low signal-to-noise ratio HARDI data. The amount of smoothing or regularization is usually set a priori at the discretion of the investigator. In this article, we apply an adaptive and objective means of smoothing the raw HARDI data using the smoothing splines on the sphere method with generalized cross-validation (GCV) to estimate the diffusivity profile in each voxel. Subsequently, we reconstruct the ODF, from the smoothed data, based on the Funk-Radon transform (FRT) used in QBI. The spline method was applied to both simulated data and in vivo human brain data. Simulated data show that the smoothing splines on the sphere method with GCV smoothing reduces the mean squared error in estimates of the ODF as compared with the standard analytical QBI approach. The human data demonstrate the utility of the method for estimating smooth ODFs.

  9. Scheie syndrome

    Science.gov (United States)

    ... Hurler syndrome) MPS II (Hunter syndrome) MPS IV (Morquio syndrome) MPS III (Sanfilippo syndrome) Causes Scheie syndrome ... Autosomal recessive Cloudy cornea Hearing loss Hurler syndrome Morquio syndrome Review Date 4/20/2015 Updated by: ...

  10. Prevalence of the metabolic syndrome in patients with hypertension treated in general practice in Spain: an assessment of blood pressure and low-density lipoprotein cholesterol control and accuracy of diagnosis.

    Science.gov (United States)

    Barrios, Vivencio; Escobar, Carlos; Calderón, Alberto; Llisterri, José L; Alegría, Eduardo; Muñiz, Javier; Matalí, Arantxa

    2007-01-01

    This study was designed to evaluate whether primary care physicians in Spain accurately diagnose the metabolic syndrome in hypertensive patients, to define the profile and management of these patients in clinical practice, and to ascertain the level of blood pressure and low-density lipoprotein cholesterol control. Data were analyzed from a cross-sectional survey involving 12,954 patients with hypertension (Prevención Cardiovascular en España en Atención Primaria: Intervención Sobre el Colesterol en Hipertensión [PRESCOT] study), wherein 52% of the cohort fulfilled the National Cholesterol Education Program-Adult Treatment Panel criteria for the metabolic syndrome. The majority of patients (54.6%) had 3 risk factors, 32.4% had 4, and 13% had 5 risk factors. Physician diagnosis of the metabolic syndrome was poor, with 43.7% of physicians missing the diagnosis and 12.9% wrongly diagnosing the metabolic syndrome. Blood pressure and low-density lipoprotein cholesterol control rates were very low, with only 4.7% of metabolic syndrome patients achieving control for both blood pressure and low-density lipoprotein cholesterol vs 13.5% for non-metabolic syndrome patients (P<.0001). These findings demonstrate that the metabolic syndrome is common in patients with hypertension and that it is generally poorly diagnosed and treated by primary care physicians.

  11. Is adaptation. Truly an adaptation? Is adaptation. Truly an adaptation?

    Directory of Open Access Journals (Sweden)

    Thais Flores Nogueira Diniz

    2008-04-01

    Full Text Available The article begins by historicizing film adaptation from the arrival of cinema, pointing out the many theoretical approaches under which the process has been seen: from the concept of “the same story told in a different medium” to a comprehensible definition such as “the process through which works can be transformed, forming an intersection of textual surfaces, quotations, conflations and inversions of other texts”. To illustrate this new concept, the article discusses Spike Jonze’s film Adaptation. according to James Naremore’s proposal which considers the study of adaptation as part of a general theory of repetition, joined with the study of recycling, remaking, and every form of retelling. The film deals with the attempt by the scriptwriter Charles Kaufman, cast by Nicholas Cage, to adapt/translate a non-fictional book to the cinema, but ends up with a kind of film which is by no means what it intended to be: a film of action in the model of Hollywood productions. During the process of creation, Charles and his twin brother, Donald, undergo a series of adventures involving some real persons from the world of film, the author and the protagonist of the book, all of them turning into fictional characters in the film. In the film, adaptation then signifies something different from itstraditional meaning. The article begins by historicizing film adaptation from the arrival of cinema, pointing out the many theoretical approaches under which the process has been seen: from the concept of “the same story told in a different medium” to a comprehensible definition such as “the process through which works can be transformed, forming an intersection of textual surfaces, quotations, conflations and inversions of other texts”. To illustrate this new concept, the article discusses Spike Jonze’s film Adaptation. according to James Naremore’s proposal which considers the study of adaptation as part of a general theory of repetition

  12. Prevalence of the metabolic syndrome, insulin resistance index, leptin and thyroid hormone levels in the general population of Merida (Venezuela).

    Science.gov (United States)

    Uzcátegui, Euderruh; Valery, Lenin; Uzcátegui, Lilia; Gómez Pérez, Roald; Marquina, David; Baptista, Trino

    2015-06-01

    The metabolic syndrome (MetSyn) is a significant risk factor for cardiovascular events, but scarce information exists about its frequency in Venezuela. In this cross-sectional study, we quantified the prevalence of the MetSyn in a probabilistic, stratified sample of 274 subjects aged > or =18 years from the Libertador district in Merida, Venezuela. Secondary outcomes were the measurement of thyroid hormones (free T4 and TSH), leptin levels, and insulin resistance index (HOMA2-IR). The frequency of MetSyn (percentage +/- 95% confidence interval) according to several diagnostic criteria was as follows: National Cholesterol Education Panel (NCEP, original): 27.4% (22.1-32.7); modified NCEP: 31.8% (26.3-37.3); International Diabetes Federation: 40.9% (35.1-46.7); Latin American Diabetes Association: 27% (21.7-32.3), and Venezuelan criteria: 31.8% (26.3-37.3). The MetSyn was more frequent in males than in females with most diagnostic criteria. The estimated prevalence of type 2 diabetes mellitus was 2.9% either according to the patients' self reports or to fasting glucose level found to be above 126 mg/dL. Abnormal HOMA2-IR index, free T4 and TSH (above the 95th percentile) were detected in 4.5%, 4.4% and 5.1% of the sample, respectively. Free T4 and TSH levels below the 5th percentile were detected in 4.4% and 4.7% of subjects respectively. These values are presented for comparisons with forthcoming studies in specific clinical populations. While studies are being conducted about the different definitions of the MetSyn in Venezuela, we recommend analyzing and publishing local research data with all the available criteria so as to allow comparisons with the results already reported in the literature.

  13. Key clinical features a general internist needs to know about Brugada syndrome: a case-based discussion

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    WuQiang Fan

    2015-06-01

    Full Text Available Introduction: Brugada syndrome (BrS is an autosomal dominant genetic disorder involving the abnormal function of cardiac voltage-gated sodium ion channels. Sodium channel loss of function can lead to early repolarization and loss of the Phase 2 action potential dome in cardiomyocytes. In BrS, this sodium channelopathy occurs in some, but not all, epicardial cells thus creating 1 juxtaposition of depolarized and repolarized cells in the epicardium and 2 a transmural voltage gradient. Together, these conditions can set up a Phase 2 reentry and resultant malignant cardiac arrhythmia. Of the three types of electrocardiogram (EKG changes seen in BrS, only the Type 1 EKG is considered diagnostic. In a controlled setting, sodium channel blockers and Brugada EKG leads may be used to unmask this diagnostic EKG finding. Fever and certain medications that interfere with the sodium channel can also trigger these changes, which can be catastrophic. Case report: A 26-year-old white male presented with febrile upper respiratory infection symptoms and had an EKG change, which was initially misinterpreted as an ST elevated myocardial infarction due to ST-T segment elevation in leads V1 and V2. The patient reported past recurrent syncopal episodes leading to a recent suspected diagnosis of BrS. A later episode of febrile illness, triggering a Type 1 EKG pattern, led to a subsequent hospital admission for continuous cardiac monitoring. On that occasion, he was placed on a wearable external defibrillator pending placement of implantable cardioverter defibrillator (ICD device. Conclusion: Due to the gravity of symptoms that can manifest in the BrS patient, it is important to recognize and treat this condition promptly and effectively. BrS patients require admission for continuous cardiac monitoring when febrile and certain medications interfering with the sodium channel should be avoided in this population. Although medications may be used as one treatment modality

  14. Key clinical features a general internist needs to know about Brugada syndrome: a case-based discussion.

    Science.gov (United States)

    Fan, WuQiang; Chachula, Laura; Wu, Yin; Khalighi, Koroush

    2015-01-01

    Brugada syndrome (BrS) is an autosomal dominant genetic disorder involving the abnormal function of cardiac voltage-gated sodium ion channels. Sodium channel loss of function can lead to early repolarization and loss of the Phase 2 action potential dome in cardiomyocytes. In BrS, this sodium channelopathy occurs in some, but not all, epicardial cells thus creating 1) juxtaposition of depolarized and repolarized cells in the epicardium and 2) a transmural voltage gradient. Together, these conditions can set up a Phase 2 reentry and resultant malignant cardiac arrhythmia. Of the three types of electrocardiogram (EKG) changes seen in BrS, only the Type 1 EKG is considered diagnostic. In a controlled setting, sodium channel blockers and Brugada EKG leads may be used to unmask this diagnostic EKG finding. Fever and certain medications that interfere with the sodium channel can also trigger these changes, which can be catastrophic. A 26-year-old white male presented with febrile upper respiratory infection symptoms and had an EKG change, which was initially misinterpreted as an ST elevated myocardial infarction due to ST-T segment elevation in leads V1 and V2. The patient reported past recurrent syncopal episodes leading to a recent suspected diagnosis of BrS. A later episode of febrile illness, triggering a Type 1 EKG pattern, led to a subsequent hospital admission for continuous cardiac monitoring. On that occasion, he was placed on a wearable external defibrillator pending placement of implantable cardioverter defibrillator (ICD) device. Due to the gravity of symptoms that can manifest in the BrS patient, it is important to recognize and treat this condition promptly and effectively. BrS patients require admission for continuous cardiac monitoring when febrile and certain medications interfering with the sodium channel should be avoided in this population. Although medications may be used as one treatment modality, definitive therapy is placement of an ICD device.

  15. Functional Constipation and Constipation-Predominant Irritable Bowel Syndrome in the General Population: Data from the GECCO Study

    Directory of Open Access Journals (Sweden)

    Paul Enck

    2016-01-01

    Full Text Available Background. The prevalence of constipation in the (German population has been shown to be 14.9% in a telephone survey, but more detailed data are required to characterize the sociographics and clinical characteristics of persons with different types of functional constipation, either constipation-predominant irritable bowel syndrome (IBS-C or functional constipation with or without meeting Rome criteria. Methods. Of 2239 constipated individuals identified during the telephone interview, 1037 (46.3% were willing to provide a postal address for a questionnaire, of which 589 (56.8% returned the questionnaire, inquiring about sociographic data, clinical symptoms, and health care behavior related to constipation, as well as health-related quality-of-life (SF12. Subgroups of functionally constipated individuals were compared. Results. More than 50% of the respondents reported a somatic comorbid condition and/or regular medication intake that may contribute to constipation. We split the remaining individuals (N=214 into three groups, matching Rome-criteria for IBS (IBS-C, n=64 and for functional constipation (FC-R, n=36 and FC not matching Rome criteria (n=114. Nearly all sociographic and clinical characteristics were equal among them, and all individuals with constipation had similar and lowered QOL on the SF-12 physical health domain, but in IBS-C the scores were also significantly lower in comparison to FC-R and FC, in both the physical health and the mental health domain. Conclusion. Only a fraction of individuals with chronic constipation match Rome criteria for IBS-C or FC, but subgroups do not differ with respect to most other measures except quality-of-life profiles.

  16. The prevalence of the metabolic syndrome in a danish population of women with previous gestational diabetes mellitus is three-fold higher than in the general population

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Mathiesen, Elisabeth; Hansen, Torben

    2005-01-01

    Diabetes and obesity, components of the metabolic syndrome, are common characteristics of women with prior gestational diabetes mellitus (GDM). Due to increasing incidence of diabetes and obesity, the metabolic syndrome might comprise a major health problem among these women....

  17. Effects of Carpal Tunnel Syndrome on adaptation of multi-digit forces to object mass distribution for whole-hand manipulation

    Directory of Open Access Journals (Sweden)

    Zhang Wei

    2012-11-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a compression neuropathy of the median nerve that results in sensorimotor deficits in the hand. Until recently, the effects of CTS on hand function have been studied using mostly two-digit grip tasks. The purpose of this study was to investigate the coordination of multi-digit forces as a function of object center of mass (CM during whole-hand grasping. Methods Fourteen CTS patients and age- and gender-matched controls were instructed to grasp, lift, hold, and release a grip device with five digits for seven consecutive lifts while maintaining its vertical orientation. The object CM was changed by adding a mass at different locations at the base of the object. We measured forces and torques exerted by each digit and object kinematics and analyzed modulation of these variables to object CM at object lift onset and during object hold. Our task requires a modulation of digit forces at and after object lift onset to generate a compensatory moment to counteract the external moment caused by the added mass and to minimize object tilt. Results We found that CTS patients learned to generate a compensatory moment and minimized object roll to the same extent as controls. However, controls fully exploited the available degrees of freedom (DoF in coordinating their multi-digit forces to generate a compensatory moment, i.e., digit normal forces, tangential forces, and the net center of pressure on the finger side of the device at object lift onset and during object hold. In contrast, patients modulated only one of these DoFs (the net center of pressure to object CM by modulating individual normal forces at object lift onset. During object hold, however, CTS patients were able to modulate digit tangential force distribution to object CM. Conclusions Our findings suggest that, although CTS did not affect patients’ ability to perform our manipulation task, it interfered with the modulation of specific grasp

  18. Development of computerised adaptive testing (CAT) for the EORTC QLQ-C30 dimensions: general approach and initial results for physical functioning

    NARCIS (Netherlands)

    Petersen, M.A.; Groenvold, M.; Aaronson, N.K.; Chie, W.C.; Conroy, T.; Costantini, A.; Fayers, P.; Helbostad, J.; Holzner, B.; Kaasa, S.; Singer, S.; Velikova, G.; Young, T.

    2010-01-01

    Background Health-related quality of life (HRQOL) questionnaires should ideally be adapted to the individual patient and at the same time scores should be directly comparable across patients. This is achievable using a computerised adaptive test (CAT). Basing the CAT on an existing instrument

  19. Excited states of large open-shell molecules: an efficient, general, and spin-adapted approach based on a restricted open-shell ground state wave function.

    Science.gov (United States)

    Roemelt, Michael; Neese, Frank

    2013-04-11

    A spin-adapted configuration interaction with singles method that is based on a restricted open-shell reference function (ROCIS) with general total spin S is presented. All excited configuration state functions (CSFs) are generated with the aid of a spin-free second quantization formalism that only leads to CSFs within the first order interacting space. By virtue of the CSF construction, the formalism involves higher than singly excited determinants but not higher than singly excited configurations. Matrix elements between CSFs are evaluated on the basis of commutator relationships using a symbolic algebra program. The final equations were, however, hand-coded in order to maximize performance. The method can be applied to fairly large systems with more than 100 atoms in reasonable wall-clock times and also parallelizes well. Test calculations demonstrate that the approach is far superior to UHF-based configuration interaction with single excitations but necessarily falls somewhat short of quantitative accuracy due to the lack of dynamic correlation contributions. In order to implicitly account for dynamic correlation in a crude way, the program optionally allows for the use of Kohn-Sham orbitals in combination with a modest downscaling of two-electron integrals (DFT/ROCIS). All two-electron integrals of Kohn-Sham orbitals that appear in the Hamiltonian matrix are reduced by a total of three scaling parameters that are suitable for a wide range of molecules. Test calculations on open-shell organic radicals as well as transition metal complexes demonstrate the wide applicability of the method and its ability to calculate the electronic spectra of large molecular systems.

  20. [Is the observation of patients with sleep-apnea-syndrome after surgery of the upper airway in an intensive care unit generally necessary?].

    Science.gov (United States)

    Kehrl, W; Schottke-Hennings, H; Offergeld, Ch; Grundmann, T

    2005-04-01

    Although it is known that after surgery of the nose and/or the paranasal sinuses serious complications can arise for patients suffering from Sleep-Apnea-Syndrome (SAS), there exists no general recommendation for postoperative care of these patients. This retrospective analysis is dealing with the question whether it is generally necessary to observe SAS-patients after nasal surgery including intubation in an Intensive Care Unit (ICU). 24 Patients of the ORL-Dept., Marienkrankenhaus Hamburg, suffering from SAS underwent surgery of the nose, the paranasal sinuses and/or the pharynx including total intravenous anesthesia (TIVA) during the period of 1. 10. 2000 until 1. 5. 2004. SAS was diagnosed in 6 cases due to defined clinical criteria and in 18 cases due to the polysomnographic findings in the sleeping laboratory's examination. All patients were observed postoperatively for one night in an ICU. The anesthesia protocol and the intensive care curve of each patient were systematically evaluated with special regard of the following parameters: Risk factors (Body Mass Index; other diseases, ASA-classification), premedication drugs, duration of the surgery, drugs for pain relief, lowest O2-saturation of blood, lowest heartrate, highest systolic blood pressure, adverse effects, intensive care interventions. Intensive care interventions were never needed. 2 patients received a low dosage of oxygeninsufflation via a face mask, in 5 cases calcium-antagonist drugs were administered due to high blood pressure and in 1 case Metamizole administration was necessary due to high temperatures. An accompanying bradycardia of the same patient was treated by administration of Atropine. The lower average O2-saturation was 93.6 +/- 1.7 % (Minimum value: 89 %). The maximum systolic blood pressure was 165.8 +/- 21.2 mm Hg and the lowest average heart rate was 65.4 +/- 13.2 bpm. Patients suffering from a mild to moderate SAS do not need a general postoperative surveillance in an ICU if the

  1. An Adaptive Importance Sampling Theory Based on The Generalized Genetic Algorithm%基于广义遗传算法的自适应重要抽样理论

    Institute of Scientific and Technical Information of China (English)

    董聪; 郭晓华

    2000-01-01

    In the present paper,using the generalized genetic algorithm,the problem of finding out all design points in the case of generalized multiple design point is solved,establishing recursion-type bound-and-classification algorithm,the problem of reducing and synthesizing generaliged multiple design points is also solved.The present paper shows that the adaptive importance sampling theory based on the generalized genetic algorithm is an more efficient tool for the reliability simulation of nonlinear sys-tems.

  2. Behavior and neuropsychiatric manifestations in Angelman syndrome.

    Science.gov (United States)

    Pelc, Karine; Cheron, Guy; Dan, Bernard

    2008-06-01

    Angelman syndrome has been suggested as a disease model of neurogenetic developmental condition with a specific behavioral phenotype. It is due to lack of expression of the UBE3A gene, an imprinted gene located on chromosome 15q. Here we review the main features of this phenotype, characterized by happy demeanor with prominent smiling, poorly specific laughing and general exuberance, associated with hypermotor behavior, stereotypies, and reduced behavioral adaptive skills despite proactive social contact. All these phenotypic characteristics are currently difficult to quantify and have been subject to some differences in interpretation. For example, prevalence of autistic disorder is still debated. Many of these features may occur in other syndromic or nonsyndromic forms of severe intellectual disability, but their combination, with particularly prominent laughter and smiling may be specific of Angelman syndrome. Management of problematic behaviors is primarily based on behavioral approaches, though psychoactive medication (eg, neuroleptics or antidepressants) may be required.

  3. Competencias del especialista en medicina general integral para la atención exitosa del síndrome demencial Competences of integral general medicine specialists for a successful care of dementia syndrome

    Directory of Open Access Journals (Sweden)

    Víctor T. Pérez Martínez

    2010-12-01

    Full Text Available INTRODUCCIÓN: la competencia es la posibilidad de integrar un conjunto de funciones y estructuras de diferentes niveles de terminación y de momentos de culminación, que al orientarse hacia una profesión o actividad, se perfecciona, se integra y coordina funcionalmente. OBJETIVO: determinar las competencias específicas para brindar atención integral al anciano que sufre de síndrome demencial, según las exigencias del actual modelo de atención comunitaria. MÉTODOS: se realizó un estudio de carácter exploratorio, descriptivo y de corte transversal, durante el año 2008. Se desarrolló un trabajo de grupo con informantes claves que ofrecen atención especializada al anciano desde los diferentes gabinetes de salud que funcionan en las 3 policlínicas del extremo este del municipio Playa, aplicándose diferentes técnicas grupales, entre las que se destacaron: la tormenta y la escritura de ideas, las que, unidas a la experiencia y el conocimiento de cada participante, propiciaron el logro del objetivo propuesto. RESULTADOS: como principal aporte teórico se determinó un conjunto de competencias que permiten al especialista en medicina general integral atender, de forma adecuada, al paciente que sufre demencia, orientadas esencialmente al diagnóstico temprano y correcto de esta frecuente problemática de salud en el anciano. CONCLUSIONES: se definió un sistema de competencias, en términos de conocimientos, habilidades y actitudes, que permiten al especialista en medicina general integral la atención exitosa del paciente que sufre de síndrome demencial.INTRODUCTION: competence is the possibility to integrate a set of functions and structures of different levels of completion and of culmination moments that if are directed to a profession or activity may be improved, integrated and coordinated in a functional way. OBJECTIVE: to determine the specific competences to offer a integral care to elderly suffering of dementia syndrome

  4. Genetics Home Reference: Rabson-Mendenhall syndrome

    Science.gov (United States)

    ... Management Genetic Testing (1 link) Genetic Testing Registry: Pineal hyperplasia AND diabetes mellitus syndrome General Information from ... area? Other Names for This Condition Mendenhall syndrome pineal hyperplasia and diabetes mellitus syndrome pineal hyperplasia, insulin- ...

  5. A tumor profile in Patau syndrome (trisomy 13).

    Science.gov (United States)

    Satgé, Daniel; Nishi, Motoi; Sirvent, Nicolas; Vekemans, Michel; Chenard, Marie-Pierre; Barnes, Ann

    2017-08-01

    Individuals with trisomic conditions like Down syndrome and Edwards syndrome are prone to certain types of malignancy. However, for Patau syndrome (constitutional trisomy 13), which occurs in 1/10,000-1/20,000 live births, the tumor profile has not been well characterized. An awareness of susceptibility to malignancies can improve care of affected individuals, as well as further our understanding of the contribution of trisomy to carcinogenesis. Therefore, we conducted an extensive review of the literature; we found 17 malignancies reported in individuals with Patau syndrome. These comprised eight embryonic tumors, three leukemias, two malignant germ cell tumors, two carcinomas, a malignant brain tumor, and a sarcoma. Benign tumors were mainly extragonadal teratomas. The small number of reported malignant tumors suggests that there is not an increased risk of cancer in the context of trisomy 13. The tumor profile in Patau syndrome differs from that observed in Edwards syndrome (trisomy 18) and Down syndrome (trisomy 21), suggesting that the supernumerary chromosome 13 could promote particular tumor formations as it does particular malformations. No general and direct relationships of tumor occurrence with organ weight, congenital malformations, histological changes, or presence of tumor suppressor genes on chromosome 13 were observed. However, some tumors were found in tissues whose growth and development are controlled by genes mapping to chromosome 13. Recent reports of successful outcomes following surgical treatment and adapted chemotherapy indicate that treatment of cancer is possible in Patau syndrome. © 2017 Wiley Periodicals, Inc.

  6. A general risk-based adaptive management scheme incorporating the Bayesian Network Relative Risk Model with the South River, Virginia, as case study.

    Science.gov (United States)

    Landis, Wayne G; Markiewicz, April J; Ayre, Kim K; Johns, Annie F; Harris, Meagan J; Stinson, Jonah M; Summers, Heather M

    2017-01-01

    Adaptive management has been presented as a method for the remediation, restoration, and protection of ecological systems. Recent reviews have found that the implementation of adaptive management has been unsuccessful in many instances. We present a modification of the model first formulated by Wyant and colleagues that puts ecological risk assessment into a central role in the adaptive management process. This construction has 3 overarching segments. Public engagement and governance determine the goals of society by identifying endpoints and specifying constraints such as costs. The research, engineering, risk assessment, and management section contains the decision loop estimating risk, evaluating options, specifying the monitoring program, and incorporating the data to re-evaluate risk. The 3rd component is the recognition that risk and public engagement can be altered by various externalities such as climate change, economics, technological developments, and population growth. We use the South River, Virginia, USA, study area and our previous research to illustrate each of these components. In our example, we use the Bayesian Network Relative Risk Model to estimate risks, evaluate remediation options, and provide lists of monitoring priorities. The research, engineering, risk assessment, and management loop also provides a structure in which data and the records of what worked and what did not, the learning process, can be stored. The learning process is a central part of adaptive management. We conclude that risk assessment can and should become an integral part of the adaptive management process. Integr Environ Assess Manag 2017;13:115-126. © 2016 SETAC.

  7. Functional limitations in functional somatic syndromes and well-defined medical diseases : Results from the general population cohort LifeLines

    NARCIS (Netherlands)

    Joustra, Monica L.; Janssens, Karin A.M.; Bültmann, Ute; Rosmalen, Judith G.M.

    Objective: Functional somatic syndromes (FSS), defined as physical syndromes without known underlying organic pathology, are sometimes regarded as less serious conditions than well-defined medical diseases (MD). The aims of this study were to evaluate functional limitations in FSS, and to compare

  8. Habitual coffee but not green tea consumption is inversely associated with metabolic syndrome: an epidemiological study in a general Japanese population.

    Science.gov (United States)

    Hino, Asuka; Adachi, Hisashi; Enomoto, Mika; Furuki, Kumiko; Shigetoh, Yoshiyuki; Ohtsuka, Maki; Kumagae, Shun-Ichi; Hirai, Yuji; Jalaldin, Ali; Satoh, Akira; Imaizumi, Tsutomu

    2007-06-01

    In Japan, metabolic syndrome used to be rare, and the level of coffee consumption was low. However, the Japanese life style has been changing rapidly, and these changes have been associated with a steady increase in the frequency of metabolic syndrome and with greater consumption of coffee. We examined the relationship between metabolic syndrome and the consumption of coffee or green tea. A total of 1902 Japanese aged over 40 years (785 men and 1117 women) received population-based health check-up in 1999. We measured components of metabolic syndrome (blood pressure, waist circumference, fasting plasma glucose, and lipid profiles). Eating and drinking patterns were evaluated by a food frequency questionnaire. Multivariate analyses were performed to clarify the association between coffee or green tea consumption and the components of metabolic syndrome. All components of metabolic syndrome except for HDL-cholesterol were significantly (pcoffee but not green tea consumption by multivariate analysis after adjusting for confounding factors. The larger was the number of components of metabolic syndrome, the lower was the level of coffee consumption (pcoffee drinkers. Thus, coffee but not green tea consumption was inversely associated with metabolic syndrome.

  9. Development of computerised adaptive testing (CAT) for the EORTC QLQ-C30 dimensions - general approach and initial results for physical functioning

    DEFF Research Database (Denmark)

    Petersen, Morten Aa; Groenvold, Mogens; Aaronson, Neil K;

    2010-01-01

    Health-related quality of life (HRQOL) questionnaires should ideally be adapted to the individual patient and at the same time scores should be directly comparable across patients. This is achievable using a computerised adaptive test (CAT). Basing the CAT on an existing instrument enables measur...... measurement within an established HRQOL framework and allows backward-compatibility with studies using the original instrument. Because of these advantages the EORTC Quality of Life Group (QLG) has initiated a project to develop a CAT version of the widely used EORTC QLQ-C30....

  10. Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Ramachandran Sudarshan

    2012-08-01

    Full Text Available Turner syndrome is a genetic disorder that affects mostly females. Affected females have characteristic features such as short stature, premature ovarian failure, and several other features. Oral manifestations of this condition are not much discussed in the literature. But reported literature includes teeth, palate, periodontal and salivary changes. So the aim of this review is to illustrate the general manifestations, and especially the oral manifestations of Turner syndrome and evaluate their possible management. [Archives Medical Review Journal 2012; 21(4.000: 246-252

  11. General Information about Myelodysplastic Syndromes

    Science.gov (United States)

    ... and given back to the patient through an infusion . These reinfused stem cells grow into (and restore) ... of the following: Transfusion therapy . Erythropoiesis-stimulating agents . Antibiotic therapy. Treatments to slow progression to acute myeloid ...

  12. Dravet syndrome

    Directory of Open Access Journals (Sweden)

    Incorpora Gemma

    2009-09-01

    Full Text Available Abstract "Dravet syndrome" (DS previously named severe myoclonic epilepsy of infancy (SMEI, or epilepsy with polymorphic seizures, is a rare disorder characterized by an early, severe, generalized, epileptic encephalopathy. DS is characterized by febrile and afebrile seizures beginning in the 1st year of life followed by different types of seizures (either focal or generalized, which are typically resistant to antiepileptic drugs. A developmental delay from the 2nd to 3rd year of life becomes evident, together with motor disturbances and personality disorders. Beside the classic syndrome, there are milder cases which have been called severe myoclonic epilepsy borderline (SMEB. DS is caused by a mutation in the neuronal sodium channel gene, SCN1A , that is also mutated in generalized epilepsy with FS+ (GEFS+.

  13. C-reactive protein, high-molecular-weight adiponectin and development of metabolic syndrome in the Japanese general population: a longitudinal cohort study.

    Directory of Open Access Journals (Sweden)

    Yoshifumi Saisho

    Full Text Available AIMS: To clarify predictive values of C-reactive protein (CRP and high-molecular-weight (HMW adiponectin for development of metabolic syndrome. RESEARCH DESIGN AND METHODS: We conducted a prospective cohort study of Japanese workers who had participated in an annual health checkup in 2007 and 2011. A total of 750 subjects (558 men and 192 women, age 46±8 years who had not met the criteria of metabolic syndrome and whose CRP and HMW-adiponectin levels had been measured in 2007 were enrolled in this study. Associations between CRP, HMW-adiponectin and development of metabolic syndrome after 4 years were assessed by logistic regression analysis and their predictive values were compared by receiver operating characteristic analysis. RESULTS: Among 750 subjects, 61 (8.1% developed metabolic syndrome defined by modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III criteria and 53 (7.1% developed metabolic syndrome defined by Japan Society for the Study of Obesity (JASSO in 2011. Although CRP and HMW-adiponectin were both significantly correlated with development of metabolic syndrome, multivariate logistic regression analysis revealed that HMW-adiponectin but not CRP was associated with metabolic syndrome independently of BMI or waist circumference. Adding these biomarkers to BMI or waist circumference did not improve the predictive value for metabolic syndrome. CONCLUSION: Our findings indicate that the traditional markers of adiposity such as BMI or waist circumference remain superior markers for predicting metabolic syndrome compared to CRP, HMW-adiponectin, or the combination of both among the Japanese population.

  14. [The inhibitor of free radical processes decrease of protein biosynthesis in gun short wound tissues and weaken development of the general adaptation syndrome].

    Science.gov (United States)

    Todorov, I N; Bogdanov, G N; Mitrokhin, Iu I; Varfolomeev, V N; Sidorenko, L I; Mishchenko, D V

    2006-01-01

    The dynamics of total protein biosynthesis and procollagen biosynthesis in skeletal muscle of injury tissues with the antioxidant BHT (dibunol) treatment and with common healing were studied. The obtained date indicate that the AO treatment reduce the rate of biosynthesis both the total proteins and procollagen at the 3th day of healing. Dibunol also considerably reduce the protein biosynthesis in adrenals and brake of corticosteroids biogenesis as measured by ESR-signals intensity of reduced adrenodoxine. AO treatment also reduce the protein biosynthesis in thymus, spleen and bone marrow. The lowering of functional activity of endocrine and immune systems indicate that the AO significantly inhibit the systemic reactions of organism induced by acute wound affect. It was suggested that as "primary mediator" of stress-reaction may be considered lipoperoxide radicals and decay products of lipohydroperoide.

  15. Eagle syndrome. A narrative review

    OpenAIRE

    Heber Arbildo; Luis Gamarra; Sandra Rojas; Edward Infantes; Hernán Vásquez

    2016-01-01

    Painful disorders in the maxillofacial region are common in dental practice. Most of these conditions are not properly diagnosed because of inadequate knowledge of craniofacial and cervico-pharyngeal syndromes such as Eagle Syndrome. The aim of this review is to describe the general aspects, diagnosis and treatment of Eagle syndrome. Eagle syndrome or stylohyoid syndrome was first described by Watt W. Eagle in 1937. It was defined as orofacial pain related to the elongation of the styloid pro...

  16. Fatal cardiac arrhythmia and long-QT syndrome in a new form of congenital generalized lipodystrophy with muscle rippling (CGL4 due to PTRF-CAVIN mutations.

    Directory of Open Access Journals (Sweden)

    Anna Rajab

    2010-03-01

    Full Text Available We investigated eight families with a novel subtype of congenital generalized lipodystrophy (CGL4 of whom five members had died from sudden cardiac death during their teenage years. ECG studies revealed features of long-QT syndrome, bradycardia, as well as supraventricular and ventricular tachycardias. Further symptoms comprised myopathy with muscle rippling, skeletal as well as smooth-muscle hypertrophy, leading to impaired gastrointestinal motility and hypertrophic pyloric stenosis in some children. Additionally, we found impaired bone formation with osteopenia, osteoporosis, and atlanto-axial instability. Homozygosity mapping located the gene within 2 Mbp on chromosome 17. Prioritization of 74 candidate genes with GeneDistiller for high expression in muscle and adipocytes suggested PTRF-CAVIN (Polymerase I and transcript release factor/Cavin as the most probable candidate leading to the detection of homozygous mutations (c.160delG, c.362dupT. PTRF-CAVIN is essential for caveolae biogenesis. These cholesterol-rich plasmalemmal vesicles are involved in signal-transduction and vesicular trafficking and reside primarily on adipocytes, myocytes, and osteoblasts. Absence of PTRF-CAVIN did not influence abundance of its binding partner caveolin-1 and caveolin-3. In patient fibroblasts, however, caveolin-1 failed to localize toward the cell surface and electron microscopy revealed reduction of caveolae to less than 3%. Transfection of full-length PTRF-CAVIN reestablished the presence of caveolae. The loss of caveolae was confirmed by Atomic Force Microscopy (AFM in combination with fluorescent imaging. PTRF-CAVIN deficiency thus presents the phenotypic spectrum caused by a quintessential lack of functional caveolae.

  17. Offering fragile X syndrome carrier screening: a prospective mixed-methods observational study comparing carrier screening of pregnant and non-pregnant women in the general population

    Science.gov (United States)

    Martyn, M; Anderson, V; Archibald, A; Carter, R; Cohen, J; Delatycki, M; Donath, S; Emery, J; Halliday, J; Hill, M; Sheffield, L; Slater, H; Tassone, F; Younie, S; Metcalfe, S

    2013-01-01

    Introduction Fragile X syndrome (FXS) is the leading cause of inherited intellectual and developmental disability. Policy development relating to carrier screening programmes for FXS requires input from large studies examining not only test uptake but also psychosocial aspects. This study will compare carrier screening in pregnant and non-pregnant populations, examining informed decision-making, psychosocial issues and health economics. Methods and Analysis Pregnant and non-pregnant women are being recruited from general practices and obstetric services. Women receive study information either in person or through clinic mail outs. Women are provided pretest counselling by a genetic counsellor and make a decision about testing in their own time. Data are being collected from two questionnaires: one completed at the time of making the decision about testing and the second 1 month later. Additional data are gathered through qualitative interviews conducted at several time points with a subset of participating women, including all women with a positive test result, and with staff from recruiting clinics. A minimum sample size of 500 women/group has been calculated to give us 88% power to detect a 10% difference in test uptake and 87% power to detect a 10% difference in informed choice between the pregnant and non-pregnant groups. Questionnaire data will be analysed using descriptive statistics and multivariate logistic regression models. Interview data will be thematically analysed. Willingness-to-pay and cost effectiveness analyses will also be performed. Recruitment started in July 2009 and data collection will be completed by December 2013. Ethics and Dissemination Ethics approval has been granted by the Universities of Melbourne and Western Australia and by recruiting clinics, where required. Results will be reported in peer-reviewed publications, conference presentations and through a website http://www.fragilexscreening.net.au. The results of this study will

  18. Hutchinson-Gilford Progeria Syndrome

    National Research Council Canada - National Science Library

    Gopal G; Belavadi GB

    2014-01-01

    Hutchinson-Gilford Progeria syndrome (HGPS) is a rare pediatric genetic syndrome associated with a characteristic aged appearance very early in life, generally leading to death in the second decade of life...

  19. Dumping Syndrome

    Science.gov (United States)

    ... System & How it Works Digestive Diseases A-Z Dumping Syndrome What is dumping syndrome? Dumping syndrome occurs when food, especially sugar, ... the colon and rectum—and anus. What causes dumping syndrome? Dumping syndrome is caused by problems with ...

  20. Prevalence and determinants of metabolic syndrome: a cross-sectional survey of general medical outpatient clinics using National Cholesterol Education Program-Adult Treatment Panel III criteria in Botswana

    Directory of Open Access Journals (Sweden)

    Omech B

    2016-08-01

    Full Text Available Bernard Omech,1 Jose-Gaby Tshikuka,2 Julius C Mwita,1 Billy Tsima,2 Oathokwa Nkomazana,3 Kennedy Amone-P’Olak4 1Department of Internal Medicine, 2Department of Family Medicine and Public Health, 3Department of Surgery, 4Department of Psychology, University of Botswana, Gaborone, Botswana Background: Low- and middle-income countries, including Botswana, are facing rising prevalence of obesity and obesity-related cardiometabolic complications. Very little information is known about clustering of cardiovascular risk factors in the outpatient setting during routine visits. We aimed to assess the prevalence and identify the determinants of metabolic syndrome among the general outpatients’ attendances in Botswana. Methods: A cross-sectional study was conducted from August to October 2014 involving outpatients aged ≥20 years without diagnosis of diabetes mellitus. A precoded questionnaire was used to collect data on participants’ sociodemographics, risk factors, and anthropometric indices. Fasting blood samples were drawn and analyzed for glucose and lipid profile. Metabolic syndrome was assessed using National Cholesterol Education Program-Adult Treatment Panel III criteria. Results: In total, 291 participants were analyzed, of whom 216 (74.2% were females. The mean age of the total population was 50.1 (±11 years. The overall prevalence of metabolic syndrome was 27.1% (n=79, with no significant difference between the sexes (female =29.6%, males =20%, P=0.11. A triad of central obesity, low high-density lipoprotein-cholesterol, and elevated blood pressure constituted the largest proportion (38 [13.1%] of cases of metabolic syndrome, followed by a combination of low high-density lipoprotein, elevated triglycerides, central obesity, and elevated blood pressure, with 17 (5.8% cases. Independent determinants of metabolic syndrome were antihypertensive use and increased waist circumference. Conclusion: Metabolic syndrome is highly prevalent in

  1. [Autoinflammatory syndromes].

    Science.gov (United States)

    Gomes, José Melo; Gomes, Sónia Melo; Conde, Marta

    2010-01-01

    Autoinflammatory syndromes (AIS) are a heterogeneous group of congenital diseases characterized by the presence of recurrent episodes of fever and local or generalized inflammation, in the absence of infectious agents, detectable auto-antibodies or antigen-specific autoreactive T-cells. These diseases have been much better understood during the past 15 years, mainly due to the marked advances of the Human Genoma Project and its implications in the identification and characterization of genetic mutations. In this paper we make a revision of the classification of AIS and focus our attention specially on the cryopyrin-associated periodic syndromes (CAPS), in particular the CINCA syndrome that shares many clinical characteristics with juvenile idiopathic arthritis.

  2. Eagle's Syndrome

    Directory of Open Access Journals (Sweden)

    Pinheiro, Thaís Gonçalves

    2014-01-01

    Full Text Available Introduction: Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is difficult, and it is generally confounded by other manifestations of cervicopharyngeal pain. Objective: To describe a case of Eagle's syndrome. Case Report: A 53-year-old man reported lateral pain in his neck that had been present for 30 years. Computed tomography (CT of the neck showed elongation and ossification of the styloid processes of the temporal bone, which was compatible with Eagle's syndrome. Surgery was performed for bilateral resection of the stylohyoid ligament by using a transoral and endoscopic access route. The patient continued to present pain laterally in the neck, predominantly on his left side. CT was performed again, which showed elongation of the styloid processes. The patient then underwent lateral cervicotomy with resection of the stylohyoid process, which partially resolved his painful condition. Final Comments: Patients with Eagle's syndrome generally have a history of chronic pain. Appropriate knowledge of this disease is necessary for adequate treatment to be provided. The importance of diagnosing this uncommon and often unsuspected disease should be emphasized, given that correct clinical-surgical treatment is frequently delayed. The diagnosis of Eagle's syndrome is clinical and radiographic, and the definitive treatment in cases of difficult-to-control pain is surgical.

  3. [Congenital cataract: general review].

    Science.gov (United States)

    Roche, O; Beby, F; Orssaud, C; Dupont Monod, S; Dufier, J L

    2006-04-01

    Cataract is a loss of lens transparency because of a protein alteration. Etiopathogenesis is poorly understood but new mutations of different developmental genes involved are found in 25% of cases. Frequency of onset, particularly when different ocular development anomalies occur, is related to the lens induction phenomena on the eye's anterior segment structure during embryologic development. Genetic transmission is often found on the dominant autosomal mode. Diagnosis is based on a complete and detailed examination of the eye, often with general anaesthesia. This condition predisposes children to later, sometimes serious amblyopia. Different clinical aspects can be observed: from cataract with ocular and/or systemic anomalies to polymalformative syndrome, skeletal, dermatological, neurological, metabolic, and genetic or chromosomal diseases. A general systematic pediatric examination is necessary. Congenital cataract requires first and foremost early diagnosis and a search for all etiologies. Surgical treatment is adapted case by case but it has progressed with the quality of today's intraocular lenses even if systematic implantation continues to be debated. Life-long monitoring is absolutely necessary.

  4. A quantitative review of pollination syndromes: do floral traits predict effective pollinators?

    Science.gov (United States)

    Rosas-Guerrero, Víctor; Aguilar, Ramiro; Martén-Rodríguez, Silvana; Ashworth, Lorena; Lopezaraiza-Mikel, Martha; Bastida, Jesús M; Quesada, Mauricio

    2014-03-01

    The idea of pollination syndromes has been largely discussed but no formal quantitative evaluation has yet been conducted across angiosperms. We present the first systematic review of pollination syndromes that quantitatively tests whether the most effective pollinators for a species can be inferred from suites of floral traits for 417 plant species. Our results support the syndrome concept, indicating that convergent floral evolution is driven by adaptation to the most effective pollinator group. The predictability of pollination syndromes is greater in pollinator-dependent species and in plants from tropical regions. Many plant species also have secondary pollinators that generally correspond to the ancestral pollinators documented in evolutionary studies. We discuss the utility and limitations of pollination syndromes and the role of secondary pollinators to understand floral ecology and evolution.

  5. Pfeiffer syndrome

    Directory of Open Access Journals (Sweden)

    Fryns Jean-Pierre

    2006-06-01

    Full Text Available Abstract Pfeiffer syndrome is a rare autosomal dominantly inherited disorder that associates craniosynostosis, broad and deviated thumbs and big toes, and partial syndactyly on hands and feet. Hydrocephaly may be found occasionally, along with severe ocular proptosis, ankylosed elbows, abnormal viscera, and slow development. Based on the severity of the phenotype, Pfeiffer syndrome is divided into three clinical subtypes. Type 1 "classic" Pfeiffer syndrome involves individuals with mild manifestations including brachycephaly, midface hypoplasia and finger and toe abnormalities; it is associated with normal intelligence and generally good outcome. Type 2 consists of cloverleaf skull, extreme proptosis, finger and toe abnormalities, elbow ankylosis or synostosis, developmental delay and neurological complications. Type 3 is similar to type 2 but without a cloverleaf skull. Clinical overlap between the three types may occur. Pfeiffer syndrome affects about 1 in 100,000 individuals. The disorder can be caused by mutations in the fibroblast growth factor receptor genes FGFR-1 or FGFR-2. Pfeiffer syndrome can be diagnosed prenatally by sonography showing craniosynostosis, hypertelorism with proptosis, and broad thumb, or molecularly if it concerns a recurrence and the causative mutation was found. Molecular genetic testing is important to confirm the diagnosis. Management includes multiple-staged surgery of craniosynostosis. Midfacial surgery is performed to reduce the exophthalmos and the midfacial hypoplasia.

  6. [Course of development in the second and third decades of life in patients with Kanner's syndrome. Results with special consideration of socially adaptive behavior].

    Science.gov (United States)

    Klosinski, G; Troje, A E

    2004-07-01

    The course of development of 18 patients with Kanner autism (mean age 28 years) in their second and third decades was explored and recorded with respect to factors affecting social competence in adulthood. To validate the diagnosis, we used the Childhood Autism Rating Scale. A version of the Vineland Adaptive Behavior Scales was employed to assess social adaptation. On average, the individuals showed socially adaptive skills that are typical for healthy children at the age of 4 years and 3 months. Of the autistic persons, 72% showed a characteristic pattern: scoring highest in daily living skills and lowest in social skills, especially in interpersonal relationships, where they performed at an average age equivalent of only 2 years and 7 months.

  7. The neuropsychological profile of patients with 3-methylglutaconic aciduria type III, Costeff syndrome.

    Science.gov (United States)

    Sofer, S; Schweiger, A; Blumkin, L; Yahalom, G; Anikster, Y; Lev, D; Ben-Zeev, B; Lerman-Sagie, T; Hassin-Baer, S

    2015-04-01

    Costeff syndrome is a rare genetic neuro-ophthalmological syndrome consisting of early-onset bilateral optic atrophy along with a progressive complex motor disorder with elevated levels of urinary 3-methylglutaconic acid and 3-methylglutaric acid. While borderline to mild cognitive deficits have been considered to be common in patients with this syndrome, a comprehensive cognitive assessment has never been performed. The aim of the current study was to explore the cognitive profile associated with Costeff syndrome. Sixteen adult patients diagnosed with Costeff syndrome were administered a neuropsychological test battery that was composed of standardized verbal tests adapted for the blind. General intelligence ranged from average to borderline, with a group mean consistent with intact general cognitive functioning (VIQmean  = 85, z = -1) in the low-average range of the general population. The auditory immediate and delayed memory indexes were in the average range and were significantly higher than the general cognitive functioning, whereas the working memory index was significantly lower than the general cognitive functioning. Adult patients with Costeff syndrome have intact global cognition and learning abilities and strong auditory memory performance. © 2015 Wiley Periodicals, Inc.

  8. Effect of Increased Immunosuppression on Developmental Outcome of Opsoclonus Myoclonus Syndrome (OMS).

    Science.gov (United States)

    Mitchell, Wendy G; Wooten, Amelia A; O'Neil, Sharon H; Rodriguez, Jenny G; Cruz, Rosa E; Wittern, Rachael

    2015-07-01

    Opsoclonus myoclonus syndrome (OMS) produces long-term cognitive, behavioral, and motor deficits. Objective was to see if more aggressive treatment improved outcome. Assessment included opsoclonus myoclonus syndrome rating, developmental/cognitive and motor assessment, and adaptive behavior. Fourteen subjects completed testing. Nine had neuroblastoma. Onset was at 10 to 35 months; onset to diagnosis: 2 days to 14 months, and onset to first treatment: 5 days to 15 months. Initial treatment was corticotropin (12), oral steroids (3), plus intravenous immunoglobulin in all. Ten received rituximab, 5 cyclophosphamide. Age at testing ranged from 2.5 to 10.3 years. Adaptive Behavior Score (11 subjects), mean 93.5; estimated Intelligence Quotient/Developmental Quotient mean 93.5; Motor: mean 92.8. Residual opsoclonus myoclonus syndrome symptoms at the time of the evaluation were generally minor; opsoclonus myoclonus syndrome scores ranged from 0 to 6. Comparison to previously reported opsoclonus myoclonus syndrome subjects showed improved outcomes: Adaptive behavior, cognitive and motor scores were significantly higher (P < .001) in new subjects. Outcomes have improved with more aggressive immunosuppression, with most opsoclonus myoclonus syndrome survivors now functioning at or near normal.

  9. Intestinal mucosal adaptation

    Institute of Scientific and Technical Information of China (English)

    Laurie Drozdowski; Alan BR Thomson

    2006-01-01

    Intestinal failure is a condition characterized by malnutrition and/or dehydration as a result of the inadequate digestion and absorption of nutrients. The most common cause of intestinal failure is short bowel syndrome, which occurs when the functional gut mass is reduced below the level necessary for adequate nutrient and water absorption. This condition may be congenital, or may be acquired as a result of a massive resection of the small bowel. Following resection, the intestine is capable of adaptation in response to enteral nutrients as well as other trophic stimuli. Identifying factors that may enhance the process of intestinal adaptation is an exciting area of research with important potential clinical applications.

  10. Cushing syndrome

    Science.gov (United States)

    Hypercortisolism; Cortisol excess; Glucocorticoid excess - Cushing syndrome ... The most common cause of Cushing syndrome is taking too much ... exogenous Cushing syndrome . Prednisone, dexamethasone, and ...

  11. Serotonin syndrome

    Science.gov (United States)

    Hyperserotonemia; Serotonergic syndrome; Serotonin toxicity; SSRI - serotonin syndrome; MAO - serotonin syndrome ... two medicines that affect the body's level of serotonin are taken together at the same time. The ...

  12. Mutation in LEMD3 (Man1 Associated with Osteopoikilosis and Late-Onset Generalized Morphea: A New Buschke-Ollendorf Syndrome Variant

    Directory of Open Access Journals (Sweden)

    Benjamin Korman

    2016-01-01

    Full Text Available Introduction. Buschke-Ollendorf syndrome (BOS is an uncommon syndrome characterized by osteopoikilosis and other bone abnormalities, accompanied by skin lesions, most frequently connective tissue nevi. BOS is caused by mutations in the LEMD3 gene, which encodes the inner nuclear membrane protein Man1. We describe a unique case of osteopoikilosis associated with late-onset localized scleroderma and familial LEMD3 mutations. Case Report. A 72-year-old woman presented with adult-onset diffuse morphea and bullous skin lesions. Evaluation revealed multiple hyperostotic lesions (osteopoikilosis suggestive of BOS. DNA sequencing identified a previously undescribed nonsense mutation (Trp621X in the LEMD3 gene encoding Man1. Two additional family members were found to have osteopoikilosis and carry the same LEMD3 mutation. Conclusions and Relevance. We report a unique familial LEMD3 mutation in an individual with osteopoikilosis and late-onset morphea. We propose that this constellation represents a novel syndromic variant of BOS.

  13. Past and future corollaries of theories on causes of metabolic syndrome and obesity related co-morbidities part 2: a composite unifying theory review of human-specific co-adaptations to brain energy consumption.

    Science.gov (United States)

    McGill, Anne-Thea

    2014-01-01

    Metabolic syndrome (MetS) predicts type II diabetes mellitus (TIIDM), cardiovascular disease (CVD) and cancer, and their rates have escalated over the last few decades. Obesity related co-morbidities also overlap the concept of the metabolic syndrome (MetS). However, understanding of the syndrome's underlying causes may have been misapprehended. The current paper follows on from a theory review by McGill, A-T in Archives of Public Health, 72: 30. This accompanying paper utilises research on human evolution and new biochemistry to theorise on why MetS and obesity arise and how they affect the population. The basis of this composite unifying theory is that the proportionately large, energy-demanding human brain may have driven co-adaptive mechanisms to provide, or conserve, energy for the brain. A 'dual system' is proposed. 1) The enlarged, complex cortico-limbic-striatal system increases dietary energy by developing strong neural self-reward/motivation pathways for the acquisition of energy dense food, and (2) the nuclear factor-erythroid 2-related factor 2 (NRF2) cellular protection system amplifies antioxidant, antitoxicant and repair activity by employing plant chemicals. In humans who consume a nutritious diet, the NRF2 system has become highly energy efficient. Other relevant human-specific co-adaptations are explored. In order to 'test' this composite unifying theory it is important to show that the hypothesis and sub-theories pertain throughout the whole of human evolution and history up till the current era. Corollaries of the composite unifying theory of MetS are examined with respect to past under-nutrition and malnutrition since agriculture began 10,000 years ago. The effects of man-made pollutants on degenerative change are examined. Projections are then made from current to future patterns on the state of 'insufficient micronutrient and/or unbalanced high energy malnutrition with central obesity and metabolic dysregulation' or 'malnubesity'. Forecasts

  14. General Lack of Correlations between Age and Signs of the Metabolic Syndrome in Subjects with Non-diabetic Fasting Glucose Values.

    Science.gov (United States)

    Preuss, Harry G; Mrvichin, Nate; Clouatre, Dallas; Bagchi, Debasis; Preuss, Jeffrey M; Perricone, Nicholas V; Swaroop, Anand; Kaats, Gilbert R

    2017-01-01

    Insulin resistance and advancing age are well-recognized risk factors for metabolic syndrome. Recent reports indicate that fasting glucose levels in non-diabetic patients correlate appropriately with the development of certain elements in metabolic syndrome, which suggest a cause-effect relationship with insulin resistance. The present investigation assessed whether a significant association exists between chronological age and various elements of metabolic syndrome in this same group of subjects possessing non-diabetic fasting glucose levels. Baseline data were taken from 288 subjects (age 17-87 years) with fasting glucose levels ≤ 125 mg/dl. Correlations between chronological age and different metabolic parameters were assessed to determine any statistically significant relationships and compare these with previously demonstrated metabolic parameters. With the exception of systolic blood pressure, the following correlations between age and components of metabolic syndrome were not significant or even significant in the opposite direction compared to those found in the same population using fasting glucose as the independent variable: body weight, body fat, diastolic blood pressure, white blood cell count (WBC)/neutrophil count, and circulating levels of insulin, high-density lipoprotein (HDL) cholesterol, triglycerides, high-sensitivity C-reactive protein (hs-CRP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). Although systolic blood pressure still increased, it was to a lesser extent than might be expected. In the present investigation, a cross-sectional analysis was carried out over a wide age range of subjects. It is noteworthy that fasting glucose levels and the other major elements of metabolic syndrome did not change significantly with advancing age. These results demonstrate that decreasing insulin resistance and fasting glucose levels may be an important way to overcome the adverse effects and perturbations of advancing age

  15. [Manual therapy in general practice].

    Science.gov (United States)

    Березуцкий, Владимир И

    2016-01-01

    The article is devoted to manual therapy practice for diagnostics and treatment of vertebrogenic pain syndrome in general practice. Analytical roundup of sources proves medical advantage of implementation of manual therapy basic methods by general practice specialists.

  16. The effectiveness of interventions focused on functional stability on the level of pain in patients with Joint Hypermobility Syndrome compared to general exercise

    DEFF Research Database (Denmark)

    Holtze, Dorte Buch; Jessen-Winge, Christina; Hansen, Karsten Bruun

    2014-01-01

    or historically) and arthralgia in ≥4 joints for more than 3 months while the 8 minor criteria are; considering a lower Beighton- and arthralgia score, dislocation/subluxation in one or more joints, soft tissue rheumatism, Marfanoid habitus, abnormal skin, eye signs and varicose veins, hernia or uterine...... syndrome; pain; physical therapy; treatment...

  17. Social Communication Competence and Functional Adaptation in a General Population of Children: Preliminary Evidence for Sex-by-Verbal IQ Differential Risk

    Science.gov (United States)

    Skuse, David H.; Mandy, William D.; Steer, Colin; Miller, Laura L.; Lawrence, Kate; Amond, Alan; Golding, Jean

    2009-01-01

    Results from a Social and Communication Disorders Checklist finds that the scores were continuously distributed in the general population and that boys had mean scores 30 percent higher than girls. Above-average verbal IQ appears to protect female subjects from social communication impairments but not in male subjects. Participants to the study…

  18. Post-Polio Syndrome

    Science.gov (United States)

    ... or fatigue, this may overwork already stressed-out motor neurons and increase your risk of post-polio syndrome. Generally, post-polio syndrome is rarely life-threatening, but severe muscle weakness can lead to complications: Falls. Weakness in your leg muscles makes it ...

  19. Gardner Syndrome

    Science.gov (United States)

    ... Home > Types of Cancer > Gardner Syndrome Request Permissions Gardner Syndrome Approved by the Cancer.Net Editorial Board , 06/2014 What is Gardner syndrome? Gardner syndrome is a subtype of familial ...

  20. Klinefelter Syndrome

    Directory of Open Access Journals (Sweden)

    Hande Peynirci

    2013-09-01

    Full Text Available Klinefelter syndrome is the most common sex chromosome disorder in males. Variation in clinical presentation and insufficient awareness of this syndrome among clinicians lead to fifty percent of patients remain undetected. Typical clinical features of Klinefelter syndrome are various degrees of hypogonadal symptoms, atrophic testes and gynaecomastia. However, these typical clinical symptoms may not be present in all patients. Even if serum testosterone levels are not markedly low, elevated serum follicle-stimulating hormone is a considerable laboratory finding. Definitive diagnosis is made by karyotype analysis of peripheral blood lymphocytes. It must be kept in mind that this analysis may be normal in rare conditions. Early recognition of patients during puberty and handling them as soon as possible is important. Testosterone replacement therapy results in increased muscle mass, bone mineral density and libido. The patient’s mood and self-esteem improve significantly. In general, patients with Klinefelter syndrome are accepted as infertile, however, assisted reproductive techniques may provide fertilization. Turk Jem 2013; 17: 63-7

  1. 广泛性焦虑症中医症状及证候要素的临床调研%Clinical investigation on TCM symptoms and syndrome factors of generalized anxiety disorder

    Institute of Scientific and Technical Information of China (English)

    耿东; 郭蓉娟

    2013-01-01

    Objective To explore the distribution characteristics of TCM symptoms and syndrome factors of generalized anxiety disorder.Methods The patients with diagnosed generalized anxiety disorder (n =200) were asked to fill in the questionnaire for collecting four examination information.The distribution characteristics of TCM symptoms and syndrome factors were analyzed by applying Hamilton Anxiety Scale (HAMA) 、Hamilton Depression Scale (HAMD),dexcriptive analysis and cluster analysis.The syndrome factors and HAMA scores were given Spearman correlation analysis.Results The first ten symptoms were impatient,irritability,depressed mood,oppression in the chest,sighing,fatigue,palpitation,dreaminess,short breath,heaviness of head and body,lassitude of spirit,laziness to speak,dry mouth and throat and bitter taste in mouth.The syndrome factors included qi stagnation,qi deficiency,fireheat,blood deficiency,yin deficiency,phlegm syndrome and blood stasis.According to the clustering results,blood deficiency,fire-heat,phlegm syndrome,qi deficiency,qi stagnation and yin deficiency were clustered into one class,and blood stasis was clustered into another class.Qi deficiency and qi stagnation were positively correlated to HAMA scores (P < 0.05).Conclusion TCM syndrome factors are mainly qi deficiency and qi stagnation in the patients with generalized anxiety disorder,and the more serious the anxiety is,the higher the scores of these syndrome factors are.%目的 探讨广泛性焦虑症中医症状及证候要素分布特征.方法 由确诊的200例广泛性焦虑症患者填写四诊信息采集表,应用汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)评分,采用描述性分析和聚类分析对症状、证候要素等的分布特点进行分析,并对证候要素与HAMA分值进行Spearman相关分析.结果 前十位症状依次为急躁易怒、心情郁闷、胸闷喜太息、乏力疲倦、心慌多梦、短气、头身困重、神疲懒言、口干咽燥、口苦,证

  2. 简单分段线性混沌系统与SETMOS混沌系统的自适应广义同步%Adaptive generalized synchronization of simple piecewise linear chaotic system and SETMOS chaotic system

    Institute of Scientific and Technical Information of China (English)

    刘保军; 蔡理; 冯朝文

    2012-01-01

    研究了基于SETMOS构成的、参数未知的类双涡卷混沌系统与结构不同的简单分段线性混沌系统的广义自适应同步方法.通过分析混沌系统的特点和广义同步的定义,基于李雅普诺夫稳定性理论,提出了一种新颖的、结构简单的自适应控制器和参数更新律,来实现不同结构、驱动系统参数未知的混沌系统的广义同步.这种方法还可以应用于不同结构或相同结构的其他同步问题,如自适应广义反同步等,应用范围较广.仿真结果进一步证实了该方法的有效性和可行性.%The generalized synchronization of different structure chaotic systems based on SETMOS with unknown parameters,double-scroll-like chaotic system and simple piecewise linear chaotic system is investigated with respect to an assumed function. By analyzing characteristics of the chaotic systems and definition of the generalized synchronization,based on Lyapnuov stability theorem,novel and simple adaptive controllers and corresponding parameter update law are proposed for generalized synchronization of different chaotic systems with unknown parameters.Further,if the function is changed,the theory can also be applied for other synchronization for different structure chaotic systems,such as adaptive generalized anti-synchronization.Numerical simulation results are provided to show the effectiveness and feasibility of the proposed theory.

  3. Nível de adaptação baseado no modelo de Roy em mães de crianças portadores de Síndrome de Down Mothers with Down syndrome children and their psychosocial level of adaptation according to Roy model

    Directory of Open Access Journals (Sweden)

    Allyne Nóbrega Fortes

    2006-09-01

    ção. Resultados e discussões: No modo do Autoconceito, houve 12 casos de nível de adaptação compensatório, um de nível integrado e nenhum comprometido. No modo de Desempenho de papéis houve 3 casos com nível comprometido, 10 casos de nível integrado e nenhum de nível compensatório. No modo de Interdependência houve 10 casos com nível integrado, 3 casos com nível compensatório, e nenhum caso de nível de adaptação comprometido. Conclusões:Verificou-se que todas as participantes estavam vivenciando um nível de adaptação compensatório geral, considerando-se que não foi observado qualquer caso de nível totalmente integrado ou comprometido.Objective: We aimed to analyze the psychosocial adaptation level of mothers with Down’s syndrome children. Methodology: The sampling was composed by all mothers of children carriers of Down’s syndrome, assisted in a treatment and precocious stimulation’s nucleus that accepted. The data were organized following thematic analysis technique. The adaptation level was classified: integrated (only positive adaptation indicators, compensatory (positive adaptation indicators and adaptation common problems and compromised (only adaptation common problems. Results and discussion: In the Self-concept mode, there were 12 cases of compensatory adaptation level, one of integrated level and none committed level. In the Role function mode 3 interviewees reached commited level, in 10 cases integrated level and none of compensatory level. In the Interdependence mode 10 participants existed attained integrated level, 3 participants showed compensatory level, and any case of commited level of adaptation was registered. Conclusions: We verify that all the participants were living a general compensatory adaptation level, whereas any case of completely integrated or commited level was observed.

  4. Myh11(R247C/R247C) mutations increase thoracic aorta vulnerability to intramural damage despite a general biomechanical adaptivity.

    Science.gov (United States)

    Bellini, Chiara; Wang, Shanzhi; Milewicz, Dianna M; Humphrey, Jay D

    2015-01-02

    Genetic studies in patients reveal that mutations to genes that encode contractile proteins in medial smooth muscle cells can cause thoracic aortic aneurysms and dissections. Mouse models of such mutations, including Acta2(-/-) and Myh11(R247C/R247C), surprisingly do not present with any severe vascular phenotype under normal conditions. This observation raises the question whether these mutations nevertheless render the thoracic aorta increasingly vulnerable to aneurysms or dissections in the presence of additional, epigenetic, factors such as hypertension, a known risk factor for thoracic aortic disease. Accordingly, we compared the structure and biaxial mechanical properties of the ascending and descending thoracic aorta from male wild-type and Myh11(R247C/R247C) mice under normotension and induced hypertension. On average, the mutant aortas exhibited near normal biomechanics under normotensive hemodynamics and near normal adaptations to hypertensive hemodynamics, yet the latter led to intramural delaminations or premature deaths in over 20% of these mice. Moreover, the delaminated vessels exhibited localized pools of mucoid material, similar to the common histopathologic characteristic observed in aortas from humans affected by thoracic aortic aneurysms and dissections. The present findings suggest, therefore, that mutations to smooth muscle cell contractile proteins may place the thoracic aorta at increased risk to epigenetic factors and that there is a need to focus on focal, not global, changes in aortic structure and properties, including the pooling of glycosaminoglycans/proteoglycans that may lead to thoracic aortic dissection.

  5. Myh11R247C/R247C Mutations Increase Thoracic Aorta Vulnerability to Intramural Damage Despite a General Biomechanical Adaptivity

    Science.gov (United States)

    Bellini, Chiara; Wang, Shanzhi; Milewicz, Dianna M.; Humphrey, Jay D.

    2014-01-01

    Genetic studies in patients reveal that mutations to genes that encode contractile proteins in medial smooth muscle cells can cause thoracic aortic aneurysms and dissections. Mouse models of such mutations, including Acta2−/− and Myh11 R247C/R247C, surprisingly do not present with any severe vascular phenotype under normal conditions. This observation raises the question whether these mutations nevertheless render the thoracic aorta increasingly vulnerable to aneurysms or dissections in the presence of additional, epigenetic, factors such as hypertension, a known risk factor for thoracic aortic disease. Accordingly, we compared the structure and biaxial mechanical properties of the ascending and descending thoracic aorta from male wild-type and Myh11 R247C/R247C mice under normotension and induced hypertension. On average, the mutant aortas exhibited near normal biomechanics under normotensive hemodynamics and near normal adaptations to hypertensive hemodynamics, yet the latter led to intramural delaminations or premature deaths in over 20 percent of these mice. Moreover, the delaminated vessels exhibited localized pools of mucoid material, similar to the common histopathologic characteristic observed in aortas from humans affected by thoracic aortic aneurysms and dissections. The present findings suggest, therefore, that mutations to smooth muscle cell contractile proteins may place the thoracic aorta at increased risk to epigenetic factors and that there is a need to focus on focal, not global, changes in aortic structure and properties, including the pooling of glycosaminoglycans / proteoglycans that may lead to thoracic aortic dissection. PMID:25433566

  6. A Finger-Stick Whole-Blood HIV Self-Test as an HIV Screening Tool Adapted to the General Public.

    Science.gov (United States)

    Prazuck, Thierry; Karon, Stephen; Gubavu, Camelia; Andre, Jerome; Legall, Jean Marie; Bouvet, Elisabeth; Kreplak, Georges; Teglas, Jean Paul; Pialoux, Gilles

    2016-01-01

    In 2013, the French Health Authority approved the use of HIV self-tests in pharmacies for the general public. This screening tool will allow an increase in the number of screenings and a reduction in the delay between infection and diagnosis, thus reducing the risk of further infections. We previously compared 5 HIV-self test candidates (4 oral fluid and one whole blood) and demonstrated that the whole blood HIV test exhibited the optimal level of performance (sensitivity/specificity). We studied the practicability of an easy-to-use finger-stick whole blood HIV self-test "autotest VIH®", when used in the general public. This multicenter cross-sectional study involved 411 participants from the Parisian region (AIDES and HF association) between April and July 2014 and was divided into 2 separate studies: one evaluating the capability of participants to obtain an interpretable result using only the information notice, and a second evaluating the interpretation of test results, using a provided chart. A total of 411 consenting participants, 264 in the first study and 147 in the second, were included. All participants were over 18 years of age. In the first study, 99.2% of the 264 participants correctly administered the auto-test, and 21.2% needed, upon their request, telephone assistance. Ninety-two percent of participants responded that the test was easy/very easy to perform, and 93.5% did not find any difficulty obtaining a sufficient good quantity of blood. In the second study, 98.1% of the 147 participants correctly interpreted the results. The reading/interpretation errors concerned the negative (2.1%) or the indeterminate (3.3%) auto-tests. The success rate of handling and interpretation of this self-test is very satisfactory, demonstrating its potential for use by the general public and its utility to increase the number of opportunities to detect HIV patients.

  7. A Finger-Stick Whole-Blood HIV Self-Test as an HIV Screening Tool Adapted to the General Public.

    Directory of Open Access Journals (Sweden)

    Thierry Prazuck

    Full Text Available In 2013, the French Health Authority approved the use of HIV self-tests in pharmacies for the general public. This screening tool will allow an increase in the number of screenings and a reduction in the delay between infection and diagnosis, thus reducing the risk of further infections. We previously compared 5 HIV-self test candidates (4 oral fluid and one whole blood and demonstrated that the whole blood HIV test exhibited the optimal level of performance (sensitivity/specificity. We studied the practicability of an easy-to-use finger-stick whole blood HIV self-test "autotest VIH®", when used in the general public.This multicenter cross-sectional study involved 411 participants from the Parisian region (AIDES and HF association between April and July 2014 and was divided into 2 separate studies: one evaluating the capability of participants to obtain an interpretable result using only the information notice, and a second evaluating the interpretation of test results, using a provided chart.A total of 411 consenting participants, 264 in the first study and 147 in the second, were included. All participants were over 18 years of age. In the first study, 99.2% of the 264 participants correctly administered the auto-test, and 21.2% needed, upon their request, telephone assistance. Ninety-two percent of participants responded that the test was easy/very easy to perform, and 93.5% did not find any difficulty obtaining a sufficient good quantity of blood. In the second study, 98.1% of the 147 participants correctly interpreted the results. The reading/interpretation errors concerned the negative (2.1% or the indeterminate (3.3% auto-tests.The success rate of handling and interpretation of this self-test is very satisfactory, demonstrating its potential for use by the general public and its utility to increase the number of opportunities to detect HIV patients.

  8. Intestinal mucosal atrophy and adaptation

    Institute of Scientific and Technical Information of China (English)

    Darcy Shaw; Kartik Gohil; Marc D Basson

    2012-01-01

    Mucosal adaptation is an essential process in gut homeostasis.The intestinal mucosa adapts to a range of pathological conditions including starvation,short-gut syndrome,obesity,and bariatric surgery.Broadly,these adaptive functions can be grouped into proliferation and differentiation.These are influenced by diverse interactions with hormonal,immune,dietary,nervous,and mechanical stimuli.It seems likely that clinical outcomes can be improved by manipulating the physiology of adaptation.This review will summarize current understanding of the basic science surrounding adaptation,delineate the wide range of potential targets for therapeutic intervention,and discuss how these might be incorporated into an overall treatment plan.Deeper insight into the physiologic basis of adaptation will identify further targets for intervention to improve clinical outcomes.

  9. Compartment syndromes

    Institute of Scientific and Technical Information of China (English)

    Aly Saber

    2014-01-01

    Body compartments bound by fascia and limited by bony backgrounds are found in the extremities, buttocks, abdomen and thoracic cavity; conditions that cause intracompartmental swelling and hypertension can lead to ischemia and limb loss.Although compartment syndromes are described in all body regions from head to toe, the etiology, diagnosis, treatment, and prevention are best characterized for three key body regions: the first is extremity, the second is abdominal, and the third is thoracic compartment syndromes.Thoracic compartment syndrome usually occurs as a result of pathological accumulation of air, fluid or blood in the mediastinum and has traditionally been described in trauma.As the intracranial contents are confined within a rigid bony cage, any increase in volume within thiscompartment as a result of brain oedema or an expanding traumatic intracranial haematoma, leads to a reciprocal decrease in the volume of cerebrospinal fluid and intracranial venous blood volume.Limb compartment syndromes may present either in acute or chronic clinical forms.Intra-abdominal pressure can be measured by direct or indirect methods.While the direct methods are quite accurate, theyare impractical and not feasible for routine practice.Indirect measurement is done through inferior vena cava, gastric, rectal and urinary bladder.Indirect measurement through urinary bladder is the simplest and is considered the method of choice for intra-abdominal pressure measurement.The management of patients with intra-abdominal hypertension is based on four important principles: the first is related to the specific procedures aiming at lowering intra-abdominal pressure and the consequences of intra-abdominal hypertension and abdominal compartment syndrome; the second is for general support and medical management of the critically ill patient; while the third is surgical decompression and the fourth is optimization after surgical decompression.

  10. Behavior and neuropsychiatric manifestations in Angelman syndrome

    Directory of Open Access Journals (Sweden)

    Karine Pelc

    2008-06-01

    Full Text Available Karine Pelc1, Guy Cheron2, Bernard Dan1,21Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB, Brussels, Belgium; 2Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles (ULB, Brussels, BelgiumAbstract: Angelman syndrome has been suggested as a disease model of neurogenetic developmental condition with a specific behavioral phenotype. It is due to lack of expression of the UBE3A gene, an imprinted gene located on chromosome 15q. Here we review the main features of this phenotype, characterized by happy demeanor with prominent smiling, poorly specific laughing and general exuberance, associated with hypermotor behavior, stereotypies, and reduced behavioral adaptive skills despite proactive social contact. All these phenotypic characteristics are currently difficult to quantify and have been subject to some differences in interpretation. For example, prevalence of autistic disorder is still debated. Many of these features may occur in other syndromic or nonsyndromic forms of severe intellectual disability, but their combination, with particularly prominent laughter and smiling may be specific of Angelman syndrome. Management of problematic behaviors is primarily based on behavioral approaches, though psychoactive medication (eg, neuroleptics or antidepressants may be required.Keywords: Angelman syndrome, UBE3A, chromosome 15, behavioral phenotypes, autism, neurogenetics

  11. A Finger-Stick Whole-Blood HIV Self-Test as an HIV Screening Tool Adapted to the General Public

    Science.gov (United States)

    Prazuck, Thierry; Karon, Stephen; Gubavu, Camelia; Andre, Jerome; Legall, Jean Marie; Bouvet, Elisabeth; Kreplak, Georges; Teglas, Jean Paul; Pialoux, Gilles

    2016-01-01

    Background In 2013, the French Health Authority approved the use of HIV self-tests in pharmacies for the general public. This screening tool will allow an increase in the number of screenings and a reduction in the delay between infection and diagnosis, thus reducing the risk of further infections. We previously compared 5 HIV-self test candidates (4 oral fluid and one whole blood) and demonstrated that the whole blood HIV test exhibited the optimal level of performance (sensitivity/specificity). We studied the practicability of an easy-to-use finger-stick whole blood HIV self-test “autotest VIH®”, when used in the general public. Methods and Materials This multicenter cross-sectional study involved 411 participants from the Parisian region (AIDES and HF association) between April and July 2014 and was divided into 2 separate studies: one evaluating the capability of participants to obtain an interpretable result using only the information notice, and a second evaluating the interpretation of test results, using a provided chart. Results A total of 411 consenting participants, 264 in the first study and 147 in the second, were included. All participants were over 18 years of age. In the first study, 99.2% of the 264 participants correctly administered the auto-test, and 21.2% needed, upon their request, telephone assistance. Ninety-two percent of participants responded that the test was easy/very easy to perform, and 93.5% did not find any difficulty obtaining a sufficient good quantity of blood. In the second study, 98.1% of the 147 participants correctly interpreted the results. The reading/interpretation errors concerned the negative (2.1%) or the indeterminate (3.3%) auto-tests. Conclusions The success rate of handling and interpretation of this self-test is very satisfactory, demonstrating its potential for use by the general public and its utility to increase the number of opportunities to detect HIV patients. PMID:26882229

  12. Progress Toward a New/Modern Nonhydrostatic Mars General Circulation Model: Adapting MPAS-A to Study the Atmosphere of Mars

    Science.gov (United States)

    Tyler, Daniel; Barnes, Jeffrey R.

    2016-10-01

    As the database of observations of the Martian atmosphere grows to considerable size and depth, atmospheric modeling becomes more constrained. Improved models and modeling techniques are needed to maintain the scientifically productive interaction between the two specialities. We have begun a process of adapting the nonhydrostatic state-of-the-art atmospheric model for prediction across scales (MPAS-A) to study the atmosphere of Mars. Useful descriptions and references can be found at ( https://mpas-dev.github.io/ ). The key features of this model are: 1) it is global and nonhydrostatic, 2) in its basic configuration it has isotropic spatial resolution that is not hindered by a 'pole problem' as are many GCMs, 3) it is designed to be and is typically run with regions of refined resolution (allowing for true mesoscale simulations, without nest boundary issues, while being forced globally in a fully consistent fashion). Initial testing of the model under Mars conditions has been performed: with Mars topography and surface pressure, at a spatial resolution of ~60 km, and with air temperatures relaxed to a 3-D temperature field for a moderately high dust loading at winter solstice in either hemisphere. Results are fascinatingly complex, and depict a good overall agreement with the expected zonal-mean circulation under these conditions. The model is being run on Pleiades at the NAS supercomputing facility at NASA/Ames, where tests using various numbers of processor cores reveal a near-linear scalability (the decrease in elapsed wall-clock time to the number of cores). Having completed this initial testing phase, we expect to present results where the model is being run: 1) with a simple atmospheric radiation scheme, 2) with realistic surface properties and a soil model, and 3) with a capable PBL scheme. Upon reaching that point in development, we will be able to compare and contrast results from our mission-support modeling efforts for both the Mars 2020 and Insight

  13. The neurodevelopmental frontostriatal disorders: evolutionary adaptiveness and anomalous lateralization.

    Science.gov (United States)

    Bradshaw, J L; Sheppard, D M

    2000-06-15

    The frontostriatal system (dorsolateral prefrontal cortex, lateral orbitofrontal cortex, anterior cingulate, supplementary motor area, and associated basal-ganglia structures) is subject to a range of neurodevelopmental disorders: Tourette's syndrome (TS), obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), schizophrenia (SCZ), autism, and probably depression. The system is responsible for our adaptive responses (initiation, execution, or withholding) to environmental situations, and the above disorders, involving effectively excessive release or withholding of various types of response, are all a consequence of changes in specific frontostriatal regions. The disorders all have a genetic component, and their persistence in the genome indicates that their clinical manifestations may also be associated, perhaps in low levels in close relatives, with certain adaptive advantages in given situations. Thus autism is associated with computational careers, depression with literary creativity, SCZ with lateral thinking and the Odyssean personality, ADHD with an Ice-Age readiness to respond, OCD with a focused range of interests, and TS with competitive sports and jazz improvisation. The disorders are all highly comorbid, and which one predominantly manifests may depend on how the frontostriatal system happens to be compromised as a result of inherited genetic predispositions and environmental contingency. We review the adaptive nature of the various subclinical manifestations and the evidence for concomitant phenomena (possibly epiphenomena): alterations in structural, functional, and behavioral lateralization in each syndrome. Indeed it is not clear that altered lateralization in frontostriatal disorders of a neurodevelopmental origin generally has any adaptive significance; it may often simply serve as a marker for altered regulatory function of the frontostriatal system, alterations which in low genetic dosage or penetrance continue to

  14. Adapting machine learning techniques to censored time-to-event health record data: A general-purpose approach using inverse probability of censoring weighting.

    Science.gov (United States)

    Vock, David M; Wolfson, Julian; Bandyopadhyay, Sunayan; Adomavicius, Gediminas; Johnson, Paul E; Vazquez-Benitez, Gabriela; O'Connor, Patrick J

    2016-06-01

    Models for predicting the probability of experiencing various health outcomes or adverse events over a certain time frame (e.g., having a heart attack in the next 5years) based on individual patient characteristics are important tools for managing patient care. Electronic health data (EHD) are appealing sources of training data because they provide access to large amounts of rich individual-level data from present-day patient populations. However, because EHD are derived by extracting information from administrative and clinical databases, some fraction of subjects will not be under observation for the entire time frame over which one wants to make predictions; this loss to follow-up is often due to disenrollment from the health system. For subjects without complete follow-up, whether or not they experienced the adverse event is unknown, and in statistical terms the event time is said to be right-censored. Most machine learning approaches to the problem have been relatively ad hoc; for example, common approaches for handling observations in which the event status is unknown include (1) discarding those observations, (2) treating them as non-events, (3) splitting those observations into two observations: one where the event occurs and one where the event does not. In this paper, we present a general-purpose approach to account for right-censored outcomes using inverse probability of censoring weighting (IPCW). We illustrate how IPCW can easily be incorporated into a number of existing machine learning algorithms used to mine big health care data including Bayesian networks, k-nearest neighbors, decision trees, and generalized additive models. We then show that our approach leads to better calibrated predictions than the three ad hoc approaches when applied to predicting the 5-year risk of experiencing a cardiovascular adverse event, using EHD from a large U.S. Midwestern healthcare system.

  15. A randomised trial of adaptive pacing therapy, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome (PACE): statistical analysis plan

    Science.gov (United States)

    2013-01-01

    Background The publication of protocols by medical journals is increasingly becoming an accepted means for promoting good quality research and maximising transparency. Recently, Finfer and Bellomo have suggested the publication of statistical analysis plans (SAPs).The aim of this paper is to make public and to report in detail the planned analyses that were approved by the Trial Steering Committee in May 2010 for the principal papers of the PACE (Pacing, graded Activity, and Cognitive behaviour therapy: a randomised Evaluation) trial, a treatment trial for chronic fatigue syndrome. It illustrates planned analyses of a complex intervention trial that allows for the impact of clustering by care providers, where multiple care-providers are present for each patient in some but not all arms of the trial. Results The trial design, objectives and data collection are reported. Considerations relating to blinding, samples, adherence to the protocol, stratification, centre and other clustering effects, missing data, multiplicity and compliance are described. Descriptive, interim and final analyses of the primary and secondary outcomes are then outlined. Conclusions This SAP maximises transparency, providing a record of all planned analyses, and it may be a resource for those who are developing SAPs, acting as an illustrative example for teaching and methodological research. It is not the sum of the statistical analysis sections of the principal papers, being completed well before individual papers were drafted. Trial registration ISRCTN54285094 assigned 22 May 2003; First participant was randomised on 18 March 2005. PMID:24225069

  16. A randomised trial of adaptive pacing therapy, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome (PACE): statistical analysis plan.

    Science.gov (United States)

    Walwyn, Rebecca; Potts, Laura; McCrone, Paul; Johnson, Anthony L; DeCesare, Julia C; Baber, Hannah; Goldsmith, Kimberley; Sharpe, Michael; Chalder, Trudie; White, Peter D

    2013-11-13

    The publication of protocols by medical journals is increasingly becoming an accepted means for promoting good quality research and maximising transparency. Recently, Finfer and Bellomo have suggested the publication of statistical analysis plans (SAPs).The aim of this paper is to make public and to report in detail the planned analyses that were approved by the Trial Steering Committee in May 2010 for the principal papers of the PACE (Pacing, graded Activity, and Cognitive behaviour therapy: a randomised Evaluation) trial, a treatment trial for chronic fatigue syndrome. It illustrates planned analyses of a complex intervention trial that allows for the impact of clustering by care providers, where multiple care-providers are present for each patient in some but not all arms of the trial. The trial design, objectives and data collection are reported. Considerations relating to blinding, samples, adherence to the protocol, stratification, centre and other clustering effects, missing data, multiplicity and compliance are described. Descriptive, interim and final analyses of the primary and secondary outcomes are then outlined. This SAP maximises transparency, providing a record of all planned analyses, and it may be a resource for those who are developing SAPs, acting as an illustrative example for teaching and methodological research. It is not the sum of the statistical analysis sections of the principal papers, being completed well before individual papers were drafted. ISRCTN54285094 assigned 22 May 2003; First participant was randomised on 18 March 2005.

  17. Adaptation, validation and reliability of the Massachusetts General Hospital-Sexual Functioning Questionnaire in a Colombian sample and factorial equivalence with the Spanish version

    Directory of Open Access Journals (Sweden)

    Laurent Marchal-Bertrand

    2016-01-01

    Full Text Available Las disfunciones sexuales son un problema muy frecuente. Es necesario contar con instrumentos adaptados a la población colombiana con el fin de evaluar su funcionamiento sexual porque hasta la fecha ninguno de ellos se ha validado. El objetivo de este estudio fue adaptar y validar el Cuestionario de funcionamiento sexual del Hospital General de Massachusetts en la población colombiana y compararla con una muestra similar de Espa˜na. Se utilizaron dos muestras diferentes en este estudio. Por una parte, una muestra de jueces expertos que realizaron la adaptación cultural y la evaluación de la escala, y por la otra, una segunda muestra final de 1.117 participantes - hombres y mujeres de ambas nacionalidades - que respondieron el cuestionario, junto con otros, a través de una plataforma virtual. Algunos de los elementos se ajustaron según los resultados iniciales de la evaluación realizada por jueces expertos. Se obtuvieron coeficientes alfa de Cronbach entre 0.81 y 0.92 después de la aplicación de la prueba. Las propiedades psicométricas de la escala son adecuadas y este instrumento se correlaciona debidamente con otras variables para el criterio. La validez del constructo se evaluó mediante invariancia factorial. El modelo configural unidimensional para los hombres (RMSEA = 0.000; CFI = 1 y para las mujeres (RMSEA = 0.048; CFI = 0.997 tenía un ajuste adecuado, y también se alcanzó un nivel de estricta invariancia. Puede realizarse un cribado con esta primera escala validada para evaluar las dificultades sexuales de la población colombiana y compararlas con las de la población española.

  18. Methods of Developing Adaptive Treatment Strategies for Traditional Chinese Medicine Syndrome Differentiation and Treatment%适合中医辨证论治的适应性治疗策略评价方法思考

    Institute of Scientific and Technical Information of China (English)

    鲍爱霞; 天才; 高莉敏

    2015-01-01

    中医学强调的辨证论治是建立在整体观理念上的体现个体化诊疗和动态治疗的技术,然而目前中医药临床试验经常采用的RCT设计,并不能体现辨证论治的个体化诊疗和动态治疗观。适应性治疗策略是根据个体患者不断变化的状态调整治疗措施的一组决策规则,整个决策过程体现了个体化治疗和动态治疗。从这个角度来看,中医辨证论治的过程就是一个适应性治疗决策的过程。因此,在开展中医临床疗效评价时,引入开发最优适应性治疗策略方法,可以真实客观地反应不同治疗策略的疗效。在已发表的国外文献中可以看到,已经有一些探索开发适应性治疗策略的临床研究,而国内真正使用适应性治疗策略的临床研究还鲜有报道。本文简单介绍了适应性治疗策略的概念,并重点探讨3种能够考虑远期疗效,并能比较不同适应性治疗策略整体疗效的方法,并详细介绍了SMART设计,以期为未来在中医科研工作中实施SMART设计奠定基础及提供新的科研思路和方法。%Traditional Chinese medicine (TCM) emphasizes treatment based on syndrome differentiation, which em-bodies the concept of individualized diagnosis and dynamic treatment on a holistic view. RCT was frequently used in TCM clinical study. However, it cannot reflect the concept of treatment based on syndrome differentiation. The use of adaptive treatment strategies (ATS) in clinical research can adjust therapy in patients according to the change of disease, so it can reflect personalized medicine and dynamic treatment. From this perspective, the process of treat-ment based on syndrome differentiation was a process of adaptive treatment decision. So the method for developing ATS can effectively evaluate the efficacy of different treatment strategies in TCM clinical study. ATS had been used in some clinical studies from published literatures abroad

  19. 自适应控制参数的通用差异演化算法研究%Research on generalized differential evolution algorithm based on adaptive controlling parameter

    Institute of Scientific and Technical Information of China (English)

    简平; 邹鹏; 熊伟; 陈治科

    2012-01-01

    为提高求解多目标优化问题效率,对通用差异演化(GDE)算法及其自适应参数控制问题进行了研究.首先,分析了GDE3算法的编码、交叉、变异、选择等原理和算法流程;然后,利用个体的适应度作为参数调整的依据,并结合一定的调整概率提出一种新的对缩放因子和交叉概率参数自适应控制策略,提高算法的搜索能力;最后,通过典型的多目标函数对自适应控制参数的通用演化算法( selfGDE3)、GDE3和非劣分层遗传算法2(NSGA-Ⅱ)的性能进行比较分析,结果表明,selfGDE3算法具有良好的搜索性能.%In order to solve the multi-objective optimization problem efficiently, this paer researched on generalized differential evolution algorithm and the method of adaptive controlling parameter. Firstly, it analyzed the principle and process of generalized differential evolution algorithm 3,including coding,crossover,mutation. Secondly, the algorithm put forward adaptive controlling strategy to crossover and mutation parameter based on the fitness of individual and the adjusting probability, which improved the performance of algorithm. Finally, it compared the performance of selfGDE3 , GDE3 and NSGA- II through testing some benchmark functions. The results show the feasibility of selfGDE3.

  20. Adaptive Lighting

    DEFF Research Database (Denmark)

    Petersen, Kjell Yngve; Søndergaard, Karin; Kongshaug, Jesper

    2015-01-01

    Adaptive Lighting Adaptive lighting is based on a partial automation of the possibilities to adjust the colour tone and brightness levels of light in order to adapt to people’s needs and desires. IT support is key to the technical developments that afford adaptive control systems. The possibilities...... offered by adaptive lighting control are created by the ways that the system components, the network and data flow can be coordinated through software so that the dynamic variations are controlled in ways that meaningfully adapt according to people’s situations and design intentions. This book discusses...... differently into an architectural body. We also examine what might occur when light is dynamic and able to change colour, intensity and direction, and when it is adaptive and can be brought into interaction with its surroundings. In short, what happens to an architectural space when artificial lighting ceases...

  1. 针灸治疗腰痛的辨证取穴概况%The General Situation of Acupoint Selection Based on Syndrome Differentiation in Acupuncture Therapy for Low Back Pain

    Institute of Scientific and Technical Information of China (English)

    曾源; 郭伟

    2016-01-01

    Objective:To investigate the methods of syndrome differentiation and general situation of acupoint selection in acupuncture therapy for low back pain, in order to provide some ideas and methods for clinical treatment of low back pain. Methods:Related literatures at home and abroad in recent years were consulted, generalized, analyzed and summed up. Results:The diverse methods of syndrome differentiation in acupuncture thera-py for low back pain have achieved satisfactory curative effects in clinical treatment, which highlighted the superiority of TCM syndrome differentia-tion and treatment. Acupoint selection for low back pain showed a certain degree of regularity in ancient and modern literatures, but they had both similarities and differences. Conclusions: Specific methods of acupuncture therapy for low back pain should be determined according to patients' conditions and nature of low back pain to give full play to the advantages of syndrome differentiation and treatment of acupuncture therapy for low back pain. Acupoint selection can be studied by referring to ancient and modern literatures and summarized and developed in accordance with Chi-nese medicine theories and the development trend of modern researches.%目的:探讨针灸治疗腰痛的辨证方法及取穴概况,为临床治疗腰痛提供思路和方法.方法:查阅近年国内外相关文献,进行归纳、分析和总结.结果:针灸治疗腰痛的辨证方法多样,临床治疗中均取得了较满意疗效,突出了中医辨证论治的优势;腰痛取穴在古代及现代文献中均有一定规律,但两者既有相似性又有差异性.结论:针灸治疗腰痛应根据患者情况和腰痛性质选择具体方法,充分发挥针灸治疗腰痛的辨证论治优势;取穴可以参考古代及现代的文献研究,结合中医理论及现代研究的发展方向,不断总结和发展.

  2. Knowledge and Attitudes of General Practitionerstowards Sleep Apnea-hypopnea syndrome%全科医师对睡眠呼吸暂停低通气综合征的认知和态度

    Institute of Scientific and Technical Information of China (English)

    李惠; 何玉霞; 黄亚梅; 赵静

    2015-01-01

    目的:通过对全科医师进行知识培训以及问卷调查,了解全科医师对于睡眠呼吸暂停低通气综合征的认知和态度。方法:针对2012至2014年来我院进行培训的60名全科医师,进行睡眠呼吸暂停低通气综合征的知识讲座,并在听取知识讲座的前后,分别填写知识问卷及态度问卷。结果:聆听讲座后医师们的知识得分(32.82±21.96)高于听讲座前(87.88±6.93),并具有统计学差异(P0.05),听讲座后更认为睡眠呼吸暂停低通气综合征需要积极治疗(2.75±1.22,4.73±0.58),并具有统计学差异(P 0.05)before and after thelecture. They agreed aggressive treatment more after listening to lectures(2.75±1.22,4.73±0.58), and there has significant difference(P<0.05). Physicians are more likely to choose a way to get online teaching sleep apnea hypopnea syndrome-related knowledge.ConclusionsGeneral practitioners knew little about sleep apnea syndrome.Knowledge of sleep apnea syndrome can be improved with a short training course. General practitioners were willing to get knowledge about sleep apnea syndrome, and network teaching is the most popular way to get the knowledge.

  3. Identification of major quantitative trait loci underlying floral pollination syndrome divergence in Penstemon.

    Science.gov (United States)

    Wessinger, Carolyn A; Hileman, Lena C; Rausher, Mark D

    2014-08-05

    Distinct floral pollination syndromes have emerged multiple times during the diversification of flowering plants. For example, in western North America, a hummingbird pollination syndrome has evolved more than 100 times, generally from within insect-pollinated lineages. The hummingbird syndrome is characterized by a suite of floral traits that attracts and facilitates pollen movement by hummingbirds, while at the same time discourages bee visitation. These floral traits generally include large nectar volume, red flower colour, elongated and narrow corolla tubes and reproductive organs that are exerted from the corolla. A handful of studies have examined the genetic architecture of hummingbird pollination syndrome evolution. These studies find that mutations of relatively large effect often explain increased nectar volume and transition to red flower colour. In addition, they suggest that adaptive suites of floral traits may often exhibit a high degree of genetic linkage, which could facilitate their fixation during pollination syndrome evolution. Here, we explore these emerging generalities by investigating the genetic basis of floral pollination syndrome divergence between two related Penstemon species with different pollination syndromes--bee-pollinated P. neomexicanus and closely related hummingbird-pollinated P. barbatus. In an F2 mapping population derived from a cross between these two species, we characterized the effect size of genetic loci underlying floral trait divergence associated with the transition to bird pollination, as well as correlation structure of floral trait variation. We find the effect sizes of quantitative trait loci for adaptive floral traits are in line with patterns observed in previous studies, and find strong evidence that suites of floral traits are genetically linked. This linkage may be due to genetic proximity or pleiotropic effects of single causative loci. Interestingly, our data suggest that the evolution of floral traits

  4. Metabolic Syndrome

    Science.gov (United States)

    ... hypertension, hypertriglyceridemia, insulin resistance syndrome, low HDL cholesterol, Metabolic Syndrome, overweight, syndrome x, type 2 diabetes Family Health, Kids and Teens, Men, Women January 2005 Copyright © American Academy of Family PhysiciansThis ...

  5. Marfan Syndrome

    Science.gov (United States)

    Marfan syndrome is a disorder that affects connective tissue. Connective tissues are proteins that support skin, bones, ... fibrillin. A problem with the fibrillin gene causes Marfan syndrome. Marfan syndrome can be mild to severe, ...

  6. Williams syndrome

    Science.gov (United States)

    Williams-Beuren syndrome ... Williams syndrome is caused by not having a copy of several genes. Parents may not have any family history of the condition. However, people with Williams syndrome have a 50% chance of passing the ...

  7. Fahr's Syndrome

    Science.gov (United States)

    ... Page You are here Home » Disorders » All Disorders Fahr's Syndrome Information Page Fahr's Syndrome Information Page What research is being done? ... and conducts research on neurogenetic disorders such as Fahr's Syndrome. The goals of this research are to ...

  8. Developing More Adaptable Individuals and Institutions

    Science.gov (United States)

    2010-02-01

    interact with each other. And leaders must prepare to respond adaptively, with “new attitudes, mindsets, and 2 Mink Spaans, Maartje Spoelstra, Erik... innovative and adaptive leaders down to the lowest levels… [and] Improv[ing] Service and institutional adaptability to deal with rapid change. 11...Generally recognized adaptability skills such as critical thinking, self- awareness, and various social skills have universal applicability

  9. 抽动秽语综合征患儿与正常儿童适应行为比较%Comparison of adaptive behaviors between normal children and children with Tourette syndrome

    Institute of Scientific and Technical Information of China (English)

    梁月竹; 王楠; 郑毅

    2005-01-01

    背景:抽动秽语综合征( tourette syndrome,TS)患儿的学习和社会适应能力有一定障碍,对 TS患者适应行为能力的评估,有助于弥补 TS所致的功能缺损. 目的:比较 TS患儿与正常儿童的适应行为能力,寻找进行干预的可能性. 设计:以患者和正常学生为研究对象,横断面的病例-对照,观察对比研究. 单位:一所大学医院儿科. 对象: 1999- 10/2001- 10就诊于首都医科大学附属北京安定医院儿科门诊以及住院患儿 33例(患儿组),纳入标准为符合 ICD 10 TS诊断标准的知情同意的患者.男 17例 ,女 16例.对照组为同期随机抽自北京市一普通小学 2~ 5年级学生,共 33名,男 16名 ,女 17名,无 TS、注意缺陷多动障碍、品行问题和情绪问题,经老师和家长同意后加入研究. 方法:采用儿童适应行为量表对 33例 TS患儿和 33名正常儿童进行了评定. 主要观察指标:儿童适应行为评定量表评分. 结果: TS患儿除感觉运动 (23.7± 0.6)和时空定向项目 (11.7± 3.0)与正常儿童 (23.6± 0.7,12.8± 3.2)接近外,其他分量表、因子和适应能力商数均低于正常儿童,差异有统计学显著意义( t=3.21~ 11.91,P< 0.05 ~ P< 0.01) ,且与该病的严重程度呈负相关 (r=- 0.377~ 0.661,P < 0.05~ 0.01). 结论: TS患儿的适应能力评估对 TS的严重程度的判断有重要作用 ,对治疗措施的拟订有指导意义.%BACKGROUND:Children with Tourette syndrome(TS) have certain handicaps in learning and social adaptation.An appropriate assessment of the ability of adaptive behaviors of TS children will be helpful to repair the functional impairment caused by TS. OBJECTIVE:To compare the adaptive behaviors between TS children and normal children. DESIGN:A cross sectional case controlled observational comparative study,taking TS children and normal students as the subjects. SETTING:A pediatric department of a university hospital. PARTICIPANTS:The TS group enrolled 33

  10. Síndrome de dolor urogenito-perineal: un reto para el médico general integral Syndrome of urogenital and perineal pain: a challenge for the comprehensive general doctor

    Directory of Open Access Journals (Sweden)

    Yanet Cabrera Cao

    2005-08-01

    Full Text Available La prostatitis crónica no bacteriana sintomática o síndrome de dolor urogenito-perineal constituye un importante problema de salud en la población masculina, que le afecta su calidad de vida y sexualidad. Con el objetivo de brindar un material ameno y actualizado, se realizó una revisión bibliográfica que profundiza en la etiología, patogenia y recomendaciones actuales del tratamiento de esta enfermedad a nivel primario de atención. Se concluyó que los cambios positivos en el estilo de vida y el apoyo psicoemocional constituyen elementos de gran importancia a tener en cuenta en su seguimiento, siendo el profesional de la atención primaria de salud un pilar indispensable en el tratamiento adecuado a este tipo de paciente.The non bacterial symptomatic chronic prostatitis or syndrome of urogenital and perineal pain is an important health problem in the male population that affects its quality of life and sexuality. In order to provide an updated material, it was made a bibliographic review that goes deep into the ethiology, pathogeny and currrent recommendations of the treatment of this disease. It was concluded that the positive changes in the lifestyle and the psychoemotional support are very important elements to be taken into account in its follow-up. The primary health care professional is an indispensable milestone in the adequate treatment of this type of patient.

  11. ADAPT Dataset

    Data.gov (United States)

    National Aeronautics and Space Administration — Advanced Diagnostics and Prognostics Testbed (ADAPT) Project Lead: Scott Poll Subject Fault diagnosis in electrical power systems Description The Advanced...

  12. Toilet training in individuals with Angelman syndrome: a case series.

    Science.gov (United States)

    Radstaake, Maartje; Didden, Robert; Peters-Scheffers, Nienke; Moore, Dennis W; Anderson, Angelika; Curfs, Leopold M G

    2014-08-01

    To assess if adapted versions of the response restriction toilet training protocol, based on the behavioral phenotype of Angelman syndrome (AS), were successful in fostering urinary continence in seven individuals with AS. Data were collected in AB-designs during baseline, training, generalization and follow-up. The response restriction protocol was adapted: individuals were trained in their natural environment, were prompted to void and along with improving continence, the interval between voids was prolonged and time-on-toilet decreased. During generalization five individuals had less than two accidents and one to six correct voids per day; during baseline more accidents and/or less correct voids occurred. In two participants correct voids increased, but several accidents still occurred. Three participants maintained positive results after 3-18 months. Despite their intellectual and behavioral challenges, urinary continence can be acquired in AS. Several indications of voiding dysfunctions were found; further research is indicated.

  13. Adaptation through proportion

    Science.gov (United States)

    Xiong, Liyang; Shi, Wenjia; Tang, Chao

    2016-08-01

    Adaptation is a ubiquitous feature in biological sensory and signaling networks. It has been suggested that adaptive systems may follow certain simple design principles across diverse organisms, cells and pathways. One class of networks that can achieve adaptation utilizes an incoherent feedforward control, in which two parallel signaling branches exert opposite but proportional effects on the output at steady state. In this paper, we generalize this adaptation mechanism by establishing a steady-state proportionality relationship among a subset of nodes in a network. Adaptation can be achieved by using any two nodes in the sub-network to respectively regulate the output node positively and negatively. We focus on enzyme networks and first identify basic regulation motifs consisting of two and three nodes that can be used to build small networks with proportional relationships. Larger proportional networks can then be constructed modularly similar to LEGOs. Our method provides a general framework to construct and analyze a class of proportional and/or adaptation networks with arbitrary size, flexibility and versatile functional features.

  14. DOWN SYNDROME WITH MOYAMOYA SYNDROME

    National Research Council Canada - National Science Library

    Mohan Makwana; R. K. Vishnoi; Jai Prakash Soni; Kapil Jetha; Suresh Kumar Verma; Pradeep Singh Rathore; Monika Choudhary

    2017-01-01

    ...,” in which the arterial changes are seen among patients with various syndromes or other disease processes- Down syndrome, sickle cell anaemia, neurofibromatosis type-1, congenital heart disease...

  15. [Mucous diaphragm of the cervical esophagus. Apropos of 38 cases discovered during upper endoscopy at the General Hospital of Dakar. Relationship with the Kelly-Paterson or the Plummer-Vinson syndrome].

    Science.gov (United States)

    Peghini, M; Barabe, P G; Jean, P; Griffet, P; Eynard, J P; Mbaye, P S; Wade, B; Houenassi, M

    1989-01-01

    At the occasion of 15,000 high endoscopies performed during the past 5 years at the general Hospital of Dakar (Senegal) 38 mucous diaphragms of cervical esophagus were discovered. 36 patients are Black Senegalese; 29 females and 9 males with a mean age of 37. Dysphagia was present 29 times and anemia 22 times. Endoscopies diagnosis is easy, putting into light a mucous diaphragm at the level or immediately below Killian mouth. 18 of these cases have been classified as Kelly-Paterson syndrome. Performed in 30 patients, the treatment consists in breaking down the mucous diaphragm with an endoscope. It is difficult to keep on endoscopic monitoring, although it is essential because the risk of cancerisation.

  16. Mirizzi’s Syndrome

    Directory of Open Access Journals (Sweden)

    Fachrull

    2015-12-01

    Full Text Available Mirizzi’s syndrome was an obstruction caused by gallstone located in gallbladder neck (or cystic duct or outside gallbladder that caused a dilatation of gallbladder and narrowing of adjacent duct, sometimes with the presence of cholecystocholedochal fistula. Mirizzi’s syndrome was a rare complication of gallbladder stone. We reported a 42 years old woman complained progressive icteric sclera. Patients also complained dark urine and light stool. During physical examination, we found an icteric sclera, pain in right upper quadrant (visual analogue scale/VAS 3, and generalized icterus (greenish yellow. Complete examination revealed a Mirizzi’s syndrome.

  17. Gardner′s Syndrome

    Directory of Open Access Journals (Sweden)

    Sapna Panjwani

    2011-01-01

    Full Text Available Gardner′s syndrome is an autosomal dominant disease and is a subtype of familial adenomatous polyposis. It is characterized by adenomatous intestinal polyps, multiple osteomas in the skull, maxillae, mandible, and multiple cutaneous and subcutaneous masses (epidermoids and desmoid. Intestinal polyps, if not treated, have 100% chance of becoming malignant. We report a case of a 25-year-old female patient with Gardner′s syndrome, with clinical manifestations including impacted supernumerary teeth, odontomes, sebaceous cyst on the scalp, and osteomas. It is important for the general dental practitioners to be aware of the clinical and radiological characteristics of Gardner′s syndrome.

  18. [Asperger's syndrome in females].

    Science.gov (United States)

    Waris, Petra; Kulomäki, Tuula; Tani, Pekka

    2011-01-01

    Literature on Asperger's syndrome (AS) has mainly described symptoms that are manifested in boys. Only recently, attention has been paid on the features in AS girls that differ from the typical clinical picture and may complicate the detection of the syndrome. Because AS girls may react passively in general or compensate or hide their difficulties by other abilities, the need for support is not necessarily brought up. In that case this developmental disorder easily remains unrecognized. Recognition of the syndrome at an early stage makes early supportive actions possible.

  19. [Asperger syndrome in contemporary fictions].

    Science.gov (United States)

    Pourre, F; Aubert, E; Andanson, J; Raynaud, J-P

    2012-12-01

    During recent years, fictions featuring a character with Asperger syndrome have been increasingly produced in literature, cinema and TV. Thus, the public has gradually discovered the existence of this specific category of autism spectrum, which is far removed from old popular representations of autistic disorders, often associated with mental retardation. To describe the reactions generated by these characters in order to identify their major functions and also to try to explain their recent increase in fictions. First, we explored international publications concerning this topic. A group of experienced clinicians systematically examined works of fiction produced between 2000 and 2010 that included a character with Asperger syndrome. More than 30 productions have been identified and analyzed using a method adapted from focus group. Over 30 productions have been recorded and analyzed. The reactions generated by these characters are described. They range from fascination to empathy; if these heroes sometimes induce laughter (because of comedy situations), they also lead us to question our vision of the world and ask ourselves about notions such as difference, normality and tolerance. We illustrate this phenomenon with examples from literature, cinema or television. Four hypotheses are proposed trying to explain the recent multiplication of these fictional characters with Asperger syndrome. The first puts forward authors' informative and educational motivations, these authors being aware of this issue. The second is supported by the "hero" concept, which has evolved gradually into the figures of the scientific world and the so-called "Geek" community. The third hypothesis, a metaphorical one, considers these heroes as symbols of a future society: a hyper systematized society, devoid of empathy, as if to warn of a risk of evolution of humanity toward a generalized mental blindness. The fourth and last hypothesis explores the personal resonance, supported by

  20. Adapt or Die

    DEFF Research Database (Denmark)

    Brody, Joshua Eric; Larsen, Kasper Green

    2015-01-01

    In this paper, we study the role non-adaptivity plays in maintaining dynamic data structures. Roughly speaking, a data structure is non-adaptive if the memory locations it reads and/or writes when processing a query or update depend only on the query or update and not on the contents of previously...... read cells. We study such non-adaptive data structures in the cell probe model. This model is one of the least restrictive lower bound models and in particular, cell probe lower bounds apply to data structures developed in the popular word-RAM model. Unfortunately, this generality comes at a high cost......: the highest lower bound proved for any data structure problem is only polylogarithmic. Our main result is to demonstrate that one can in fact obtain polynomial cell probe lower bounds for non-adaptive data structures. To shed more light on the seemingly inherent polylogarithmic lower bound barrier, we study...

  1. Adaptive Architectural Envelope

    DEFF Research Database (Denmark)

    Foged, Isak Worre; Kirkegaard, Poul Henning

    2010-01-01

    different shape alternatives. The adaptive structure is a proposal for a responsive building envelope which is an idea of a first level operational framework for present and future investigations towards performance based responsive architectures through a set of responsive typologies. A mock- up concept......Recent years have seen an increasing variety of applications of adaptive architectural structures for improvement of structural performance by recognizing changes in their environments and loads, adapting to meet goals, and using past events to improve future performance or maintain serviceability....... The general scopes of this paper are to develop a new adaptive kinetic architectural structure, particularly a reconfigurable architectural structure which can transform body shape from planar geometries to hyper-surfaces using different control strategies, i.e. a transformation into more than one or two...

  2. Adaptive Alternating Minimization Algorithms

    CERN Document Server

    Niesen, Urs; Wornell, Gregory

    2007-01-01

    The classical alternating minimization (or projection) algorithm has been successful in the context of solving optimization problems over two variables or equivalently of finding a point in the intersection of two sets. The iterative nature and simplicity of the algorithm has led to its application to many areas such as signal processing, information theory, control, and finance. A general set of sufficient conditions for the convergence and correctness of the algorithm is quite well-known when the underlying problem parameters are fixed. In many practical situations, however, the underlying problem parameters are changing over time, and the use of an adaptive algorithm is more appropriate. In this paper, we study such an adaptive version of the alternating minimization algorithm. As a main result of this paper, we provide a general set of sufficient conditions for the convergence and correctness of the adaptive algorithm. Perhaps surprisingly, these conditions seem to be the minimal ones one would expect in ...

  3. A holistic strategy for adaptive land management

    Science.gov (United States)

    Adaptive management is widely applied to natural resources management. Adaptive management can be generally defined as an iterative decision-making process that incorporates formulation of management objectives, actions designed to address these objectives, monitoring of results, and repeated adapta...

  4. Climate adaptation

    Science.gov (United States)

    Kinzig, Ann P.

    2015-03-01

    This paper is intended as a brief introduction to climate adaptation in a conference devoted otherwise to the physics of sustainable energy. Whereas mitigation involves measures to reduce the probability of a potential event, such as climate change, adaptation refers to actions that lessen the impact of climate change. Mitigation and adaptation differ in other ways as well. Adaptation does not necessarily have to be implemented immediately to be effective; it only needs to be in place before the threat arrives. Also, adaptation does not necessarily require global, coordinated action; many effective adaptation actions can be local. Some urban communities, because of land-use change and the urban heat-island effect, currently face changes similar to some expected under climate change, such as changes in water availability, heat-related morbidity, or changes in disease patterns. Concern over those impacts might motivate the implementation of measures that would also help in climate adaptation, despite skepticism among some policy makers about anthropogenic global warming. Studies of ancient civilizations in the southwestern US lends some insight into factors that may or may not be important to successful adaptation.

  5. Síndrome de intestino corto: definición, causas, adaptación intestinal y sobrecrecimiento bacteriano Short bowel syndrome: definition, causes, intestinal adaptation and bacterial overgrowth

    Directory of Open Access Journals (Sweden)

    M. D. Ballesteros Pomar

    2007-05-01

    ón parenteral.The short bowel syndrome (SBS is a complex entity due to anatomical or functional loss of part of the small bowel originating a clinical picture with severe metabolic and nutritional impairments due to reduction of the effective absorptive surface area of the gut. SBS is one of the causes of a larger entity known as "intestinal failure". Currently, mesenteric vascular accidents are the main cause in adults, followed by inflammatory bowel disease, and radiation enteritis, whereas in children, the main causes are congenital and perinatal diseases. The clinical picture associated with SBS varies according to the length and location of affected small bowel, the presence of underlying disease, the presence or absence of the large bowel and ileocecal valve, and the nature of the underlying disease. Intestinal adaptation is the process by which, throughout 1-2 years, intestinal absorption is reestablished to the situation prior to intestinal resection, and is a key factor determining whether a patient with SBS will progress to intestinal failure and depend on DPN. Intestinal adaptation may take place if the patient does oral intake higher than the usual one (hyperphagia; besides, the bowel may also adapt to secure a more effective absorption per surface area unit, either by increasing the absorptive surface area (structural adaptation and/or slowing intestinal transit (functional adaptation. These changes are not still clearly established in humans, but there are so in animal models. The presence of nutrients within the intestinal lumen and certain gastrointestinal hormones, particularly GLP-2, have an influence on a successful adaptation process. Patients with SBS are prone to the occurrence of bacterial overgrowth that makes adaptation difficult and worsens the symptoms, besides being a factor for dependence on parenteral nutrition.

  6. Kindler syndrome

    Directory of Open Access Journals (Sweden)

    Kaviarasan P

    2005-01-01

    Full Text Available Kindler syndrome is a rare autosomal recessive disorder associated with skin fragility. It is characterized by blistering in infancy, photosensitivity and progressive poikiloderma. The syndrome involves the skin and mucous membrane with radiological changes. The genetic defect has been identified on the short arm of chromosome 20. This report describes an 18-year-old patient with classical features like blistering and photosensitivity in childhood and the subsequent development of poikiloderma. The differential diagnosis of Kindler syndrome includes diseases like Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. Our patient had classical cutaneous features of Kindler syndrome with phimosis as a complication.

  7. Vineland Adaptive Behavior Scales.

    Science.gov (United States)

    Icabone, Dona G.

    1999-01-01

    This article describes the Vineland Adaptive Behavior Scales, a general assessment of personal and social sufficiency of individuals from birth through adulthood to determine areas of strength and weakness. The instrument assesses communication, daily living skills, socialization, and motor skills. Its administration, standardization, reliability,…

  8. Adaptive designs for sequential experiments

    Institute of Scientific and Technical Information of China (English)

    林正炎; 张立新

    2003-01-01

    Various adaptive designs have been proposed and applied to clinical trials, bioassay, psychophysics, etc.Adaptive designs are also useful in high cost engineering trials.More and more people have been paying attention to these design methods. This paper introduces several broad families of designs, such as the play-the-winner rule, randomized play-the-winner rule and its generalization to the multi-arm case, doubly biased coin adaptive design, Markov chain model.

  9. Protein Adaptations in Archaeal Extremophiles

    OpenAIRE

    Reed, Christopher J; Hunter Lewis; Eric Trejo; Vern Winston; Caryn Evilia

    2013-01-01

    Extremophiles, especially those in Archaea, have a myriad of adaptations that keep their cellular proteins stable and active under the extreme conditions in which they live. Rather than having one basic set of adaptations that works for all environments, Archaea have evolved separate protein features that are customized for each environment. We categorized the Archaea into three general groups to describe what is known about their protein adaptations: thermophilic, psychrophilic, and halophil...

  10. Lowe syndrome

    Directory of Open Access Journals (Sweden)

    Loi Mario

    2006-05-01

    Full Text Available Abstract Lowe syndrome (the oculocerebrorenal syndrome of Lowe, OCRL is a multisystem disorder characterised by anomalies affecting the eye, the nervous system and the kidney. It is a uncommon, panethnic, X-linked disease, with estimated prevalence in the general population of approximately 1 in 500,000. Bilateral cataract and severe hypotonia are present at birth. In the subsequent weeks or months, a proximal renal tubulopathy (Fanconi-type becomes evident and the ocular picture may be complicated by glaucoma and cheloids. Psychomotor retardation is evident in childhood, while behavioural problems prevail and renal complications arise in adolescence. The mutation of the gene OCRL1 localized at Xq26.1, coding for the enzyme phosphatidylinositol (4,5 bisphosphate 5 phosphatase, PtdIns (4,5P2, in the trans-Golgi network is responsible for the disease. Both enzymatic and molecular testing are available for confirmation of the diagnosis and for prenatal detection of the disease. The treatment includes: cataract extraction, glaucoma control, physical and speech therapy, use of drugs to address behavioural problems, and correction of the tubular acidosis and the bone disease with the use of bicarbonate, phosphate, potassium and water. Life span rarely exceeds 40 years.

  11. KBG syndrome

    Directory of Open Access Journals (Sweden)

    Brancati Francesco

    2006-12-01

    Full Text Available Abstract KBG syndrome is a rare condition characterised by a typical facial dysmorphism, macrodontia of the upper central incisors, skeletal (mainly costovertebral anomalies and developmental delay. To date, KBG syndrome has been reported in 45 patients. Clinical features observed in more than half of patients that may support the diagnosis are short stature, electroencephalogram (EEG anomalies (with or without seizures and abnormal hair implantation. Cutaneous syndactyly, webbed short neck, cryptorchidism, hearing loss, palatal defects, strabismus and congenital heart defects are less common findings. Autosomal dominant transmission has been observed in some families, and it is predominantly the mother, often showing a milder clinical picture, that transmits the disease. The diagnosis is currently based solely on clinical findings as the aetiology is unknown. The final diagnosis is generally achieved after the eruption of upper permanent central incisors at 7–8 years of age when the management of possible congenital anomalies should have been already planned. A full developmental assessment should be done at diagnosis and, if delays are noted, an infant stimulation program should be initiated. Subsequent management and follow-up should include an EEG, complete orthodontic evaluation, skeletal investigation with particular regard to spine curvatures and limb asymmetry, hearing testing and ophthalmologic assessment.

  12. Ambiguous Adaptation

    DEFF Research Database (Denmark)

    Møller Larsen, Marcus; Lyngsie, Jacob

    We investigate why some exchange relationships terminate prematurely. We argue that investments in informal governance structures induce premature termination in relationships already governed by formal contracts. The formalized adaptive behavior of formal governance structures and the flexible a...

  13. Toothbrush Adaptations.

    Science.gov (United States)

    Exceptional Parent, 1987

    1987-01-01

    Suggestions are presented for helping disabled individuals learn to use or adapt toothbrushes for proper dental care. A directory lists dental health instructional materials available from various organizations. (CB)

  14. Jacobsen syndrome.

    Science.gov (United States)

    Mattina, Teresa; Perrotta, Concetta Simona; Grossfeld, Paul

    2009-03-07

    Jacobsen syndrome is a MCA/MR contiguous gene syndrome caused by partial deletion of the long arm of chromosome 11. To date, over 200 cases have been reported. The prevalence has been estimated at 1/100,000 births, with a female/male ratio 2:1. The most common clinical features include pre- and postnatal physical growth retardation, psychomotor retardation, and characteristic facial dysmorphism (skull deformities, hypertelorism, ptosis, coloboma, downslanting palpebral fissures, epicanthal folds, broad nasal bridge, short nose, v-shaped mouth, small ears, low set posteriorly rotated ears). Abnormal platelet function, thrombocytopenia or pancytopenia are usually present at birth. Patients commonly have malformations of the heart, kidney, gastrointestinal tract, genitalia, central nervous system and skeleton. Ocular, hearing, immunological and hormonal problems may be also present. The deletion size ranges from approximately 7 to 20 Mb, with the proximal breakpoint within or telomeric to subband 11q23.3 and the deletion extending usually to the telomere. The deletion is de novo in 85% of reported cases, and in 15% of cases it results from an unbalanced segregation of a familial balanced translocation or from other chromosome rearrangements. In a minority of cases the breakpoint is at the FRA11B fragile site. Diagnosis is based on clinical findings (intellectual deficit, facial dysmorphic features and thrombocytopenia) and confirmed by cytogenetics analysis. Differential diagnoses include Turner and Noonan syndromes, and acquired thrombocytopenia due to sepsis. Prenatal diagnosis of 11q deletion is possible by amniocentesis or chorionic villus sampling and cytogenetic analysis. Management is multi-disciplinary and requires evaluation by general pediatrician, pediatric cardiologist, neurologist, ophthalmologist. Auditory tests, blood tests, endocrine and immunological assessment and follow-up should be offered to all patients. Cardiac malformations can be very severe

  15. Jacobsen syndrome

    Directory of Open Access Journals (Sweden)

    Grossfeld Paul

    2009-03-01

    Full Text Available Abstract Jacobsen syndrome is a MCA/MR contiguous gene syndrome caused by partial deletion of the long arm of chromosome 11. To date, over 200 cases have been reported. The prevalence has been estimated at 1/100,000 births, with a female/male ratio 2:1. The most common clinical features include pre- and postnatal physical growth retardation, psychomotor retardation, and characteristic facial dysmorphism (skull deformities, hypertelorism, ptosis, coloboma, downslanting palpebral fissures, epicanthal folds, broad nasal bridge, short nose, v-shaped mouth, small ears, low set posteriorly rotated ears. Abnormal platelet function, thrombocytopenia or pancytopenia are usually present at birth. Patients commonly have malformations of the heart, kidney, gastrointestinal tract, genitalia, central nervous system and skeleton. Ocular, hearing, immunological and hormonal problems may be also present. The deletion size ranges from ~7 to 20 Mb, with the proximal breakpoint within or telomeric to subband 11q23.3 and the deletion extending usually to the telomere. The deletion is de novo in 85% of reported cases, and in 15% of cases it results from an unbalanced segregation of a familial balanced translocation or from other chromosome rearrangements. In a minority of cases the breakpoint is at the FRA11B fragile site. Diagnosis is based on clinical findings (intellectual deficit, facial dysmorphic features and thrombocytopenia and confirmed by cytogenetics analysis. Differential diagnoses include Turner and Noonan syndromes, and acquired thrombocytopenia due to sepsis. Prenatal diagnosis of 11q deletion is possible by amniocentesis or chorionic villus sampling and cytogenetic analysis. Management is multi-disciplinary and requires evaluation by general pediatrician, pediatric cardiologist, neurologist, ophthalmologist. Auditory tests, blood tests, endocrine and immunological assessment and follow-up should be offered to all patients. Cardiac malformations can be

  16. Reliability study of the Behavioral Assessment of the Dysexecutive Syndrome adapted for a Brazilian sample of older-adult controls and probable early Alzheimer's disease patients Um estudo de confiabilidade da Bateria de Avaliação da Síndrome Disexecutiva adaptada para uma amostra brasileira de idosos controles e pacientes com doença de Alzheimer provável em fase inicial

    Directory of Open Access Journals (Sweden)

    Fabíola Canali

    2011-12-01

    Full Text Available OBJECTIVE: Ecological tests are useful in assessing executive function deficits and may be of value in appraising response to treatment in Alzheimer's disease patients. Our aims were to examine executive function using the Behavioral Assessment of the Dysexecutive Syndrome for a Brazilian sample of older-adult controls and probable early Alzheimer's disease patients, and verify the applicability of this test battery. METHOD: Forty-one older-adult controls were matched with mild Alzheimer's disease patients by age, education, and gender. RESULTS: There significant inter-group differences in overall profile and almost all subtests except temporal judgment, time spent on planning the first and second Zoo Map visit, number of errors when copying drawings, naming pictures and Six Modified Elements arithmetic, and dysexecutive questionnaire self-rating. The Behavioral Assessment of the Dysexecutive Syndrome item that best discriminated controls from patients was the Modified Six Elements - adapted (general index, with a sensitivity of 80% and specificity of 90%, (AUC = 0.91, p OBJETIVO: Testes ecológicos são os mais indicados para a avaliação dos déficits nas funções executivas, sendo importante também na avaliação da resposta ao tratamento de pacientes com doença de Alzheimer. O objetivo deste estudo é verificar o desempenho nas funções executivas usando a Behavioural Assessment of the Dysexecutive Syndrome em uma amostra brasileira de idosos controles e pacientes com doença de Alzheimer provável em fase inicial e a aplicabilidade desta bateria ecológica em nosso meio. MÉTODO: Avaliamos com a Behavioural Assessment of the Dysexecutive Syndrome 41 idosos controles e 41 pacientes com doença de Alzheimer provável em fase inicial, sem diferença estatisticamente significativa em relação à idade, escolaridade e sexo. RESULTADOS: Houve diferença estatisticamente significativa entre os grupos no escore total e em quase todos os

  17. Adaptive context exploitation

    Science.gov (United States)

    Steinberg, Alan N.; Bowman, Christopher L.

    2013-05-01

    This paper presents concepts and an implementation scheme to improve information exploitation processes and products by adaptive discovery and processing of contextual information. Context is used in data fusion - and in inferencing in general - to provide expectations and to constrain processing. It also is used to infer or refine desired information ("problem variables") on the basis of other available information ("context variables"). Contextual exploitation becomes critical in several classes of inferencing problems in which traditional information sources do not provide sufficient resolution between entity states or when such states are poorly or incompletely modeled. An adaptive evidence-accrual inference method - adapted from developments in target recognition and scene understanding - is presented; whereby context variables are selected on the basis of (a) their utility in refining explicit problem variables, (b) the probability of evaluating these variables to within a given accuracy, given candidate system actions (data collection, mining or processing), and (c) the cost of such actions. The Joint Directors of Laboratories (JDL) Data Fusion Model, with its extension to dual Resource Management functions, has been adapted to accommodate adaptive information exploitation, to include adaptive context exploitation. The interplay of Data Fusion and Resource Management (DF&RM) functionality in exploiting contextual information is illustrated in terms of the dual-node DF&RM architecture. An important advance is in the integration of data mining methods for data search/discovery and for abductive model refinement.

  18. Hedonic "adaptation"

    OpenAIRE

    2008-01-01

    People live in a world in which they are surrounded by potential disgust elicitors such as ``used'' chairs, air, silverware, and money as well as excretory activities. People function in this world by ignoring most of these, by active avoidance, reframing, or adaptation. The issue is particularly striking for professions, such as morticians, surgeons, or sanitation workers, in which there is frequent contact with major disgust elicitors. In this study, we study the ``adaptation'' process to d...

  19. Strategic Adaptation

    DEFF Research Database (Denmark)

    Andersen, Torben Juul

    2015-01-01

    This article provides an overview of theoretical contributions that have influenced the discourse around strategic adaptation including contingency perspectives, strategic fit reasoning, decision structure, information processing, corporate entrepreneurship, and strategy process. The related...... concepts of strategic renewal, dynamic managerial capabilities, dynamic capabilities, and strategic response capabilities are discussed and contextualized against strategic responsiveness. The insights derived from this article are used to outline the contours of a dynamic process of strategic adaptation...

  20. Vascular compression syndromes.

    Science.gov (United States)

    Czihal, Michael; Banafsche, Ramin; Hoffmann, Ulrich; Koeppel, Thomas

    2015-11-01

    Dealing with vascular compression syndromes is one of the most challenging tasks in Vascular Medicine practice. This heterogeneous group of disorders is characterised by external compression of primarily healthy arteries and/or veins as well as accompanying nerval structures, carrying the risk of subsequent structural vessel wall and nerve damage. Vascular compression syndromes may severely impair health-related quality of life in affected individuals who are typically young and otherwise healthy. The diagnostic approach has not been standardised for any of the vascular compression syndromes. Moreover, some degree of positional external compression of blood vessels such as the subclavian and popliteal vessels or the celiac trunk can be found in a significant proportion of healthy individuals. This implies important difficulties in differentiating physiological from pathological findings of clinical examination and diagnostic imaging with provocative manoeuvres. The level of evidence on which treatment decisions regarding surgical decompression with or without revascularisation can be relied on is generally poor, mostly coming from retrospective single centre studies. Proper patient selection is critical in order to avoid overtreatment in patients without a clear association between vascular compression and clinical symptoms. With a focus on the thoracic outlet-syndrome, the median arcuate ligament syndrome and the popliteal entrapment syndrome, the present article gives a selective literature review on compression syndromes from an interdisciplinary vascular point of view.

  1. Adaptation in Collaborative Governance Regimes

    Science.gov (United States)

    Emerson, Kirk; Gerlak, Andrea K.

    2014-10-01

    Adaptation and the adaptive capacity of human and environmental systems have been of central concern to natural and social science scholars, many of whom characterize and promote the need for collaborative cross-boundary systems that are seen as flexible and adaptive by definition. Researchers who study collaborative governance systems in the public administration, planning and policy literature have paid less attention to adaptive capacity specifically and institutional adaptation in general. This paper bridges the two literatures and finds four common dimensions of capacity, including structural arrangements, leadership, knowledge and learning, and resources. In this paper, we focus on institutional adaptation in the context of collaborative governance regimes and try to clarify and distinguish collaborative capacity from adaptive capacity and their contributions to adaptive action. We posit further that collaborative capacities generate associated adaptive capacities thereby enabling institutional adaptation within collaborative governance regimes. We develop these distinctions and linkages between collaborative and adaptive capacities with the help of an illustrative case study in watershed management within the National Estuary Program.

  2. Alternative adaptive immunity in invertebrates

    DEFF Research Database (Denmark)

    Kurtz, Joachim; Armitage, Sophie Alice Octavia

    2006-01-01

    Vertebrate adaptive immunity is characterized by challenge-specific long-term protection. This specific memory is achieved through the vast diversity of somatically rearranged immunological receptors such as antibodies. Whether or not invertebrates are capable of a comparable phenotypic plasticity...... and memory has long been a matter of debate. A recent study on Anopheles gambiae mosquitoes now establishes Down syndrome cell adhesion molecule (Dscam) as a key immune surveillance factor with characteristics analogous to antibodies....

  3. Distal arthrogryposis syndrome

    Directory of Open Access Journals (Sweden)

    Kulkarni K

    2008-01-01

    Full Text Available A 5-month-old male infant presented with weak cry, decreased body movements, tightness of whole body since birth, and one episode of generalized seizure on day 4 of life. He was born at term by elective caesarian section performed for breech presentation. The child had failure to thrive, contractures at elbow and knee joints, hypertonia, microcephaly, small mouth, retrognathia, and camptodactyly. There was global developmental delay. Abdominal examination revealed umbilical and bilateral inguinal hernia. Visual evoked response and brainstem evoked response audiometry were abnormal. Nerve conduction velocity was normal. Magnetic resonance imaging of brain revealed paucity of white matter in bilateral cerebral hemispheres with cerebellar and brain stem atrophy. The differential diagnoses considered in the index patient were distal arthrogryposis (DA syndrome, cerebroculofacioskeletal syndrome, and Pena Shokier syndrome. The index patient most likely represents a variant of DA: Sheldon Hall syndrome.

  4. Ehlers-Danlos syndrome

    Directory of Open Access Journals (Sweden)

    Wakhloo Tulika

    2015-01-01

    Full Text Available Ehlers-Danlos syndrome is a group of clinically and genetically heterogeneous inherited connective tissue disorders with widespread manifestations. The prevalence of this syndrome is 1:5000 worldwide without gender, racial or ethnic associations. This syndrome is characterized by joint hypermobility, dermal hyperelasticity and tissue fragility caused by mutations in genes encoding collagen type I, III, V and enzymes involved in the posttranslational modifications of collagen. The oral manifestations include increased mucosal fragility, delayed wound healing, early onset generalized periodontitis and temporomandibular joint hypermobility. Children presenting with this syndrome are often misdiagnosed for hematological problem as they present with bruising, malignancy and/or child abuse. A thorough assessment of the patient is, therefore, essential for early diagnosis and patient referral. This paper reviews current literature, oral manifestations, diagnostic investigations and effective dental management.

  5. Targeted therapy for genetic cancer syndromes: Von Hippel-Lindau disease, Cowden syndrome, and Proteus syndrome.

    Science.gov (United States)

    Agarwal, Rishi; Liebe, Sarah; Turski, Michelle L; Vidwans, Smruti J; Janku, Filip; Garrido-Laguna, Ignacio; Munoz, Javier; Schwab, Richard; Rodon, Jordi; Kurzrock, Razelle; Subbiah, Vivek

    2015-02-01

    Von Hippel-Lindau disease, Cowden syndrome, and Proteus syndrome are cancer syndromes which affect multiple organs and lead to significant decline in quality of life in affected patients. These syndromes are rare and typically affect the adolescent and young adult population, resulting in greater cumulative years of life lost. Improved understanding of the underpinnings of the genetic pathways underlying these syndromes and the rapid evolution of targeted therapies in general have made it possible to develop therapeutic options for these patients and other genetic cancer syndromes. Targeted therapies especially antiangiogenics and inhibitors of the PIK3CA/AKT/mTOR signaling pathway have shown activity in selected group of patients affected by these syndromes or in patients harboring specific sporadic mutations which are otherwise characteristic of these syndromes. Unfortunately due to the rare nature, patients with these syndromes are not the focus of clinical trials and unique results seen in these patients can easily go unnoticed. Most of the data suggesting benefits of targeted therapies are either case reports or small case series. Thus, a literature review was indicated. In this review we explore the use of molecularly targeted therapy options in Von Hippel-Lindau disease, Cowden syndrome, and Proteus syndrome.

  6. Unilateral straight hair and congenital horner syndrome.

    Science.gov (United States)

    Wang, Frederick M; Wertenbaker, Christian; Cho, Hyung; Marmor, Maury A; Ahn-Lee, Sandra S; Bernard, Bruno A

    2012-06-01

    Congenital Horner syndrome is a rare disorder that accounts for less than 5% of all cases of Horner syndrome. Like Horner syndrome in general, it consists primarily of ptosis, miosis, and anhidrosis. Congenital Horner syndrome may manifest some special features such as iris heterochromia since the sympathetic nervous system is an essential component for the development and maintenance of eye color. We present 3 cases of unilateral straight hair in association with congenital Horner syndrome in which the patients had straight hair ipsilateral to the Horner syndrome, whereas on the contralateral side, it was curly, and we discuss possible mechanisms for this phenomenon.

  7. Gitelman syndrome

    Directory of Open Access Journals (Sweden)

    Levtchenko Elena N

    2008-07-01

    Full Text Available Abstract Gitelman syndrome (GS, also referred to as familial hypokalemia-hypomagnesemia, is characterized by hypokalemic metabolic alkalosis in combination with significant hypomagnesemia and low urinary calcium excretion. The prevalence is estimated at approximately 1:40,000 and accordingly, the prevalence of heterozygotes is approximately 1% in Caucasian populations, making it one of the most frequent inherited renal tubular disorders. In the majority of cases, symptoms do not appear before the age of six years and the disease is usually diagnosed during adolescence or adulthood. Transient periods of muscle weakness and tetany, sometimes accompanied by abdominal pain, vomiting and fever are often seen in GS patients. Paresthesias, especially in the face, frequently occur. Remarkably, some patients are completely asymptomatic except for the appearance at adult age of chondrocalcinosis that causes swelling, local heat, and tenderness over the affected joints. Blood pressure is lower than that in the general population. Sudden cardiac arrest has been reported occasionally. In general, growth is normal but can be delayed in those GS patients with severe hypokalemia and hypomagnesemia. GS is transmitted as an autosomal recessive trait. Mutations in the solute carrier family12, member 3 gene, SLC12A3, which encodes the thiazide-sensitive NaCl cotransporter (NCC, are found in the majority of GS patients. At present, more than 140 different NCC mutations throughout the whole protein have been identified. In a small minority of GS patients, mutations in the CLCNKB gene, encoding the chloride channel ClC-Kb have been identified. Diagnosis is based on the clinical symptoms and biochemical abnormalities (hypokalemia, metabolic alkalosis, hypomagnesemia and hypocalciuria. Bartter syndrome (especially type III is the most important genetic disorder to consider in the differential diagnosis of GS. Genetic counseling is important. Antenatal diagnosis for GS

  8. Syndromic autism: II. Genetic syndromes associated with autism

    National Research Council Canada - National Science Library

    Artigas-Pallarés, J; Gabau-Vila, E; Guitart-Feliubadaló, M

    2005-01-01

    ..., tuberous sclerosis, Duchenne's disease, Timothy syndrome, 10p terminal deletion, Cowden syndrome, 45,X/46,XY mosaicism, Myhre syndrome, Sotos syndrome, Cohen syndrome, Goldenhar syndrome, Joubert...

  9. Edwards' syndrome.

    Science.gov (United States)

    Crawford, Doreen; Dearmun, Annette

    2016-12-08

    Edwards' syndrome is a serious genetic condition that affects fetal cellular functions, tissue development and organogenesis. Most infants with the syndrome are female, but there is no race predominance.

  10. Dravet Syndrome

    Science.gov (United States)

    ... Craniosynostosis Information Page Creutzfeldt-Jakob Disease Information Page Cushing's Syndrome Information Page Dandy-Walker Syndrome Information Page Deep Brain Stimulation for Parkinson's Disease Information Page Dementia Information ...

  11. Paraneoplastic Syndromes

    Science.gov (United States)

    ... dementia, seizures, sensory loss in the limbs, and vertigo or dizziness. Paraneoplastic syndromes include Lambert-Eaton myasthenic ... dementia, seizures, sensory loss in the limbs, and vertigo or dizziness. Paraneoplastic syndromes include Lambert-Eaton myasthenic ...

  12. Turner Syndrome

    Science.gov (United States)

    Turner syndrome is a genetic disorder that affects a girl's development. The cause is a missing or incomplete ... t work properly. Other physical features typical of Turner syndrome are Short, "webbed" neck with folds of skin ...

  13. Cushing's Syndrome

    Science.gov (United States)

    Cushing's syndrome is a hormonal disorder. The cause is long-term exposure to too much cortisol, a hormone ... cause your body to make too much cortisol. Cushing's syndrome is rare. Some symptoms are Upper body obesity ...

  14. Lynch Syndrome

    Science.gov (United States)

    ... colon cancer may include surgery, chemotherapy and radiation therapy. Cancer screening for people with Lynch syndrome If you ... et al. Milestones of Lynch syndrome: 1895-2015. Nature Reviews Cancer. http://www.nature.com/nrc/journal/vaop/ncurrent/ ...

  15. Metabolic Syndrome

    Science.gov (United States)

    Metabolic syndrome is a group of conditions that put you at risk for heart disease and diabetes. These ... doctors agree on the definition or cause of metabolic syndrome. The cause might be insulin resistance. Insulin is ...

  16. Meckel syndrome

    National Research Council Canada - National Science Library

    Salonen, R; Paavola, P

    1998-01-01

    Meckel syndrome (MKS) is a lethal syndrome with a central nervous system malformation, usually occipital meningoencephalocele, bilaterally large multicystic kidneys with fibrotic changes of the liver, and polydactyly in most cases...

  17. Angelman Syndrome

    Science.gov (United States)

    ... this syndrome often display hyperactivity, small head size, sleep disorders, and movement and balance disorders that can cause ... this syndrome often display hyperactivity, small head size, sleep disorders, and movement and balance disorders that can cause ...

  18. Apert Syndrome.

    Science.gov (United States)

    Datta, Saikat; Saha, Sandip; Kar, Arnab; Mondal, Souvonik; Basu, Syamantak

    2014-09-01

    Apert syndrome is one of the craniosynostosis syndromes which, due to its association with other skeletal anomalies, is also known as acrocephalosyndactyly. It is a rare congenital anomaly which stands out from other craniosynostosis due to its characteristic skeletal presentations.

  19. Genetics Home Reference: Gitelman syndrome

    Science.gov (United States)

    ... Genetic Testing (1 link) Genetic Testing Registry: Familial hypokalemia-hypomagnesemia General Information from MedlinePlus (5 links) Diagnostic ... my area? Other Names for This Condition familial hypokalemia-hypomagnesemia Gitelman's syndrome GS hypokalemia-hypomagnesemia, primary renotubular, ...

  20. Learning about Down Syndrome

    Science.gov (United States)

    ... genetic terms used on this page Learning About Down Syndrome What is Down syndrome? What are the symptoms ... syndrome Additional Resources for Down Syndrome What is Down syndrome? Down syndrome is a chromosomal condition related to ...