This paper summarizes investigations of school connectedness completed by the Social Development Research Group in two longitudinal studies, the Seattle Social Development Project and Raising Healthy ...Children. The theoretical importance of school connectedness, empirical support for the theoretical propositions of the impact of school connectedness on a variety of problem and positive behaviors, and the impact of interventions to improve school connectedness as a "mechanism to improve outcomes" for children and adolescents are described. This paper uses a definition of school connectedness and school bonding, derived from control theory and revised by investigations of the concept. The term used for school connectedness, school bonding, consists of two primary and interdependent components: (1) attachment, characterized by close affective relationships with those at school; and (2) commitment, characterized by an investment in school and doing well in school. Results of these studies provide evidence of the importance of school bonding for promoting academic success, reducing barriers to learning, reducing health and safety problems, and reducing deliquency, violence, gang involvement, drug use, and dropout. (Contains 1 table.)
This study sought to determine the characteristics and outcomes of young adults with heart failure (HF).
Few studies have focused on young and very young adults with HF.
Patients were categorized ...into 5 age groups: 20 to 39, 40 to 49, 50 to 59, 60 to 69, and ≥70 years.
The youngest patients with HF were more likely to be obese (youngest vs. oldest: body mass index ≥35 kg/m(2): 23% vs. 6%), of black ethnicity (18% vs. 2%), and have idiopathic-dilated cardiomyopathy (62% vs. 9%) (all p < 0.0001). They were less likely to adhere to medication (nonadherence in youngest vs. oldest: 24% vs. 7%, p = 0.001), salt intake, and other dietary measures (21% vs. 9%, p = 0.002). The youngest patients were less likely to have clinical and radiological signs of HF during hospitalization. Quality of life was worse, but all-cause mortality was lowest in the youngest age group (3-year mortality rates across the respective age categories: 12%, 13%, 13%, 19%, and 31%, respectively). Compared with the referent age group of 60 to 69 years, both all-cause and cardiovascular mortality were lower in the youngest group even after multivariable adjustment (hazard ratio: 0.60, 95% confidence interval: 0.36 to 1.00; p = 0.049, and hazard ratio: 0.71, 95% confidence interval: 0.42 to 1.18, p = 0.186, respectively). Three-year HF hospitalization rates were 24%, 15%, 15%, 22%, and 28% in ages 20 to 39, 40 to 49, 50 to 59, 60 to 69, and ≥70 years, respectively (p < 0.0001).
Beyond divergent etiology and comorbidities, younger patients exhibited striking differences in presentation and outcomes compared with older counterparts. Clinical and radiological signs of HF were less common, yet quality of life was more significantly impaired. Fatal and nonfatal outcomes were discordant, with better survival despite higher hospitalization rates.
Response to neoadjuvant chemotherapy is a significant prognostic factor for the Ewing sarcoma family of tumors (ESFTs). 18Ffluorodeoxyglucose (FDG) positron emission tomography (PET) is a noninvasive ...imaging modality that accurately predicts histopathologic response in several malignancies. To determine the prognostic value of FDG PET response for progression-free survival (PFS) in ESFTs, we reviewed the University of Washington Medical Center experience.
Thirty-six patients with ESFTs were evaluated by FDG PET. All patients received neoadjuvant and adjuvant chemotherapy. FDG PET standard uptake values before (SUV1) and after (SUV2) chemotherapy were analyzed and correlated with chemotherapy response, as assessed by histopathology in surgically excised tumors. Thirty-four patients had both SUV1 and SUV2.
The mean SUV1, SUV2, and ratio of SUV2 to SUV1 (SUV2:1) were 7.9 (range, 2.3 to 32.8), 2.1 (range, 0 to 4.3), and 0.36 (range, 0.00 to 1.00), respectively. Good FDG PET response was defined as SUV2 less than 2.5 or SUV2:1 < or = 0.5. FDG PET response by SUV2 or SUV2:1 was concordant with histologic response in 68% and 69% of patients, respectively. SUV2 was associated with outcome (4-year PFS 72% for SUV2 < 2.5 v 27% for SUV2 > or = 2.5, P = .01 for all patients; 80% for SUV2 < 2.5 v 33% for SUV2 > or = 2.5, P = .036 for localized at diagnosis patients). SUV2:1 < or = 0.5 was not predictive of PFS.
FDG PET imaging of ESFTs correlates with histologic response to neoadjuvant chemotherapy. SUV2 less than 2.5 is predictive of PFS independent of initial disease stage.
A trend in forestry is to move away from intensive stand establishment practices in favor of prescriptions that are lighter on the land. This study examined the condition and projected yields of nine ...different site preparation treatments on two high-elevation sites in central British Columbia. Treatments included the following: raw planting (i.e., no site preparation); scalping; mounding; chemical site preparation; chemical brushing; and combinations of mounding and chemical treatments. All treatments were manually planted with 2+1 bare-root interior spruce (Picea glauca (Moench) Voss x Picea engelmannii Parry ex Engelm.) seedlings. By age 15, trees growing on prepared sites had significantly greater survival, larger stem diameters, and taller tree heights than did trees that were raw planted as seedlings. Moreover, site preparation generally led to earlier and less costly compliance with mandatory reforestation requirements. Growth and yield simulations predicted raw-planted timber volumes that were just 33%-51% of the volumes in the most productive treatments. Financial returns varied as well. Site preparation typically resulted in larger land expectation values than that resulting from raw planting; however, the results were sensitive to rotation length and discount rate. Collectively, these results suggest that moderate investments in site preparation may lead to a more profitable allocation of regeneration resources and a greater future timber supply.
Celotno besedilo
Dostopno za:
BF, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Objective To examine the ability of the Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to detect cognitive impairment in persons with heart failure (HF). ...Background Although the MMSE and MoCA are commonly used screeners in HF, no research team has validated their performance against neuropsychological testing. Methods Participants were 106 patients with HF (49.1% male, 68.13 ± 9.82 years) who completed the MoCA, MMSE, and a full neuropsychological battery. Sensitivity and specificity were examined. Discriminant function analyses tested whether the screeners correctly detected cognitive impairment. Results A MoCA score <25 and MMSE score of <28 yielded optimal sensitivity/specificity (.64/.66 and .70/.66, respectively). The MoCA correctly classified 65% of patients, Wilk's lambda = .91, χ2 (1) = 9.89, p < .01, and the MMSE correctly classified 68%, Wilk's lambda = .87, χ2 (1) = 14.26, p < .001. Conclusions In HF, both the MoCA and MMSE are useful in identifying the majority of patients with and without cognitive impairment. Both tests misclassified approximately one-third of patients, so continued monitoring and evaluation of patients is needed in conjunction with screening.
Summary
Background
Penile lymphoedema (with and without cellulitis) is a rare, often chronic, clinically heterogeneous entity with an uncertain pathogenesis and an important differential diagnosis. ...It creates significant physical and psychosexual morbidity, and presents considerable therapeutic challenges. The existing literature is limited.
Aim
To describe and share our updated cumulative experience of a cohort of patients with penile lymphoedema.
Methods
This was a retrospective review of the case records of patients with chronic penile lymphoedema seen in two dedicated male genital dermatology clinics between January 2011 and July 2016.
Results
In total, 41 cases were identified. Over a third had Crohn disease (CD) (which was occult in one‐third of these), and over a third had serological evidence of streptococcal infection. All patients responded to systemic antibiotics and specialized urological surgery circumcision and excision).
Conclusions
Penile lymphoedema should be investigated to exclude underlying pathology especially CD and streptococcal infection. Treatment with antibiotics should be considered early and long term to try to preserve the foreskin: most patients are uncircumcised. Some patients may benefit from a course or courses of oral steroids. The development of gross dysfunction of the prepuce usually dictates circumcision and excision of lymphoedematous tissue once the situation is medically stabilized.
Purpose: Mesothelin is a glycoprotein expressed on normal mesothelial cells and is overexpressed in several histologic types of tumors
including pancreatic adenocarcinomas. A soluble form of ...mesothelin has been detected in patients with ovarian cancer and malignant
mesothelioma, and has prognostic value. Mesothelin has also been considered as a target for immune-based therapies. We conducted
a study on the potential clinical utility of mesothelin as a biomarker for pancreatic disease and therapeutic target pancreatic
cancer.
Experimental Design: Tumor cellâbound and soluble mesothelin in patients was evaluated by immunohistochemistry and ELISA, respectively. The in vitro cellular immune response to mesothelin was evaluated by INFγ ELISA and intracellular cytokine staining for IFNγ in CD4 + and CD8 + T cells. The level of circulating antibodies to mesothelin was measured by ELISA.
Results: All tumor tissue from patients with pancreatic adenocarcinoma expressed mesothelin ( n = 10). Circulating mesothelin protein was detected in patients with pancreatic adenocarcinoma (73 of 74 patients) and benign
pancreatic disease (5 of 5) but not in healthy individuals. Mesothelin-specific CD4 + and CD8 + T cells were generated from peripheral blood lymphocytes of patients with pancreatic cancer in 50% of patients compared with
only 20% of healthy individuals. Antibodies reactive to mesothelin were detected in <3% of either patients or healthy individuals.
Conclusions: Circulating mesothelin is a useful biomarker for pancreatic disease. Furthermore, mesothelin-specific T cells can be induced
in patients with pancreatic cancer. This suggests that mesothelin is a potential target for immune-based intervention strategies
in pancreatic cancer. (Clin Cancer Res 2009;15(21):6511â8)
Examination of patients with reduced and preserved ejection fraction in the DIG (Digitalis Investigation Group) trials and the CHARM (Candesartan in Heart Failure: Assessment of Reduction in ...Mortality and Morbidity) trials provides comparisons of outcomes in each of these types of heart failure. Comparison of the patients in these trials, along with the I-PRESERVE (Irbesartan in Heart Failure with Preserved Systolic Function Trial), with patients of similar age, sex distribution, and comorbidity in trials of hypertension, diabetes mellitus, angina pectoris, and atrial fibrillation provides even more interesting insights into the relation between phenotype and rates of death and heart failure hospitalization. The poor clinical outcomes in patients with heart failure and preserved ejection fraction do not seem easily explained on the basis of age, sex, comorbidity, blood pressure, or left ventricular structural remodeling but do seem to be explained by the presence of the syndrome of heart failure.
This is a phase II, single-center, single-arm study of patients with resectable adenocarcinoma of the pancreas who were treated with adjuvant interferon-based chemoradiation followed by gemcitabine. ...The primary end point was 2-year overall survival, with secondary endpoints being 2-year disease-free survival, and the frequency of grade 3 or 4 toxicity.
From April 2002 to September 2005, 53 patients with adenocarcinoma of the pancreas underwent curative resection at a single institution, and subsequently received interferon- and gemcitabine-based adjuvant therapy consisting of external-beam irradiation at a dose of 5040 cGy (25 fractions per 5 weeks) and simultaneous 3-drug chemotherapy consisting of (1) continuous infusion 5-fluorouracil (175 mg/m2); (2) weekly intravenous bolus cisplatin (25 mg/m2); and (3) interferon-alpha (3 million units subcutaneously 3 times per week) during the 6 weeks of radiation. This was followed by two 4-week courses of weekly intravenous infusion of gemcitabine (1000 mg/m2, 3 of 4 weeks).
Median follow-up is 38 months. Seventy-seven percent of patients had node-positive disease. Sixteen patients (30%) failed to complete adjuvant therapy, due to disease progression (7 patients), toxicity (7 patients), and consent withdrawal (2 patients). No patients completed planned therapy without dose modification. Median overall survival was 25 months (confidence interval CI = 21.5-48.5 months). Actuarial overall survival for the 1-, 2- and 3-year periods were 75% (CI = 61-85%), 56% (CI = 41-69%), and 41% (26-55%), respectively.
This phase II trial demonstrated increased patient survival compared with historical controls, and equivalent survival compared with the regimen combining interferon-alpha with 5-fluorouracil-based chemoradiation. Despite these encouraging results, significant concerns regarding dose- and treatment-limiting toxicities remain.
To examine the extent to which the phrases, "COVID-19" and "Chinese virus" were associated with anti-Asian sentiments.
Data were collected from Twitter's Application Programming Interface, which ...included the hashtags "#covid19" or "#chinesevirus." We analyzed tweets from March 9 to 23, 2020, corresponding to the week before and the week after President Donald J. Trump's tweet with the phrase, "Chinese Virus." Our analysis focused on 1 273 141 hashtags.
One fifth (19.7%) of the 495 289 hashtags with #covid19 showed anti-Asian sentiment, compared with half (50.4%) of the 777 852 hashtags with #chinesevirus. When comparing the week before March 16, 2020, to the week after, there was a significantly greater increase in anti-Asian hashtags associated with #chinesevirus compared with #covid19 (
< .001).
Our data provide new empirical evidence supporting recommendations to use the less-stigmatizing term "COVID-19," instead of "Chinese virus."
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