Objectives
To assess test–retest reliability of musculoskeletal ultrasound (US) measures of inflammation in patients with knee osteoarthritis (OA) and to assess the sensitivity to change of US ...measures of inflammation in patients with knee OA.
Methods
To mimic a common clinical scenario, 36 patients (n = 70 knees) with symptomatic knee OA who were in stable condition underwent 2 assessments within 14 days by different operators and different US machines, graded by a single rater. Test–retest reliability was measured using Cohen's kappa coefficient, intraclass correlation coefficient (ICC), and absolute agreement parameters. A total of 51 patients (n = 72 knees) were tested immediately before and 21–28 days after intraarticular glucocorticoid injection to investigate sensitivity to change and longitudinal construct validity. Paired t‐tests and standardized response mean (SRM) were used to assess sensitivity to change. Multivariate linear regression was used to investigate longitudinal construct validity of US with Knee Injury and Osteoarthritis Outcome Score (KOOS) pain scores, while adjusting for covariates.
Results
US measures of inflammation demonstrated moderate (κ = 0.41, 0.60) to substantial (κ = 0.61, 0.80) agreement. Quantitative measures of synovitis and effusion demonstrated good test–retest reliability (ICC2,1 0.71, 0.92). US measures of synovitis and effusion demonstrated low‐to‐moderate sensitivity to change (SRM –0.29, –0.50). The associations between changes in US measures and KOOS pain scores over time were low, and 95% confidence intervals included zero.
Conclusion
In a clinical setting, US measures of inflammatory features of knee OA have substantial reliability and low‐to‐moderate sensitivity to change, whereas measures of structural OA features are less reliable. Longitudinal construct validity of US measures of synovitis and effusion to KOOS pain scores is not strongly supported.
The MinION sequencing platform offers near real-time analysis of DNA sequence; this makes the tool attractive for deployment in fieldwork or clinical settings. We used the MinION platform coupled to ...the NanoOK RT software package to perform shotgun metagenomic sequencing and profile mock communities and faecal samples from healthy and ill preterm infants. Using Nanopore data, we reliably classified a 20-species mock community and captured the diversity of the immature gut microbiota over time and in response to interventions such as probiotic supplementation, antibiotic treatment or episodes of suspected sepsis. We also performed rapid real-time runs to assess gut-associated microbial communities in critically ill and healthy infants, facilitated by NanoOK RT software package, which analysed sequences as they were generated. Our pipeline reliably identified pathogenic bacteria (that is, Klebsiella pneumoniae and Enterobacter cloacae) and their corresponding antimicrobial resistance gene profiles within as little as 1 h of sequencing. Results were confirmed using pathogen isolation, whole-genome sequencing and antibiotic susceptibility testing, as well as mock communities and clinical samples with known antimicrobial resistance genes. Our results demonstrate that MinION (including cost-effective Flongle flow cells) with NanoOK RT can process metagenomic samples to a rich dataset in < 5 h, which creates a platform for future studies aimed at developing these tools and approaches in clinical settings with a focus on providing tailored patient antimicrobial treatment options.
The subclass Enoplia (Phylum Nematoda) is purported to be the earliest branching clade amongst all nematode taxa, yet the deep phylogeny of this important lineage remains elusive. Free-living marine ...species within the order Enoplida play prominent roles in marine ecosystems, but previous molecular phylogenies have provided only the briefest evolutionary insights; this study aimed to firmly resolve internal relationships within the hyper-diverse but poorly understood Enoplida. In addition, we revisited the molecular framework of the Nematoda using a rigorous phylogenetic approach in order to investigate patterns of early splits amongst the oldest lineages (Dorylaimia and Enoplia).
Morphological identifications, nuclear gene sequences (18S and 28S rRNA), and mitochondrial gene sequences (cox1) were obtained from marine Enoplid specimens representing 37 genera. The 18S gene was used to resolve deep splits within the Enoplia and evaluate the branching order of major clades in the nematode tree; multiple phylogenetic methods and rigorous empirical tests were carried out to assess tree topologies under different parameters and combinations of taxa. Significantly increased taxon sampling within the Enoplida resulted in a well-supported, robust phylogenetic topology of this group, although the placement of certain clades was not fully resolved. Our analysis could not unequivocally confirm the earliest splits in the nematode tree, and outgroup choice significantly affected the observed branching order of the Dorylaimia and Enoplia. Both 28S and cox1 were too variable to infer deep phylogeny, but provided additional insight at lower taxonomic levels.
Analysis of internal relationships reveals that the Enoplia is split into two main clades, with groups consisting of terrestrial (Triplonchida) and primarily marine fauna (Enoplida). Five independent lineages were recovered within the Enoplida, containing a mixture of marine and terrestrial species; clade structure suggests that habitat transitions have occurred at least four times within this group. Unfortunately, we were unable to obtain a consistent or well-supported topology amongst early-branching nematode lineages. It appears unlikely that single-gene phylogenies using the conserved 18S gene will be useful for confirming the branching order at the base of the nematode tree-future efforts will require multi-gene analyses or phylogenomic methods.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objective The objective of the study was to correlate the presence of major levator ani muscle (LAM) injuries on magnetic resonance imaging (MRI) with fecal incontinence (FI), pelvic organ prolapse ...(POP), and urinary incontinence (UI) in primiparous women 6-12 months postpartum. Study Design A published scoring system was used to characterize LAM injuries on MRI dichotomously (MRI negative, no/mild vs MRI positive, major). Results Major LAM injuries were observed in 17 of 89 (19.1%) women who delivered vaginally with external anal sphincter (EAS) injuries, 3 of 88 (3.5%) who delivered vaginally without EAS injury, and 0 of 29 (0%) who delivered by cesarean section before labor ( P = .0005). Among women with EAS injuries, those with major LAM injuries trended toward more FI, 35.3% vs 16.7% ( P = .10) and POP, 35.3% vs 15.5% ( P = .09), but not UI ( P = 1.0). Conclusion These data support the growing body of literature suggesting that both EAS and LAM are important for fecal continence and that multiple injuries contribute to pelvic floor dysfunction.
The Returns to Criminal Capital Loughran, Thomas A.; Nguyen, Holly; Piquero, Alex R. ...
American sociological review,
12/2013, Letnik:
78, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Human capital theory posits that individuals increase their labor market returns through investments in education and training. This concept has been studied extensively across several disciplines. ...An analog concept of criminal capital, the focus of some speculation and limited empirical study, remains considerably less developed theoretically and methodologically. This article offers a formal theoretical model of criminal capital indicators and tests for greater illegal wage returns using a sample of serious adolescent offenders, many of whom participate in illegal income-generating activities. Our results reveal that, consistent with human capital theory, important illegal wage premiums are associated with investments in criminal capital, notably an increasing but declining marginal return to experience and a premium for specialization. Furthermore, as in studies of legal labor markets, we find strong evidence that, if left unaccounted for, nonrandom sample selection causes severe bias in models of illegal wages. We discuss theoretical and practical implications of these results, along with directions for future research.
Neuronal excitotoxicity induced by aberrant excitation of glutamatergic receptors contributes to brain damage in stroke. Here we show that tau-deficient (tau
) mice are profoundly protected from ...excitotoxic brain damage and neurological deficits following experimental stroke, using a middle cerebral artery occlusion with reperfusion model. Mechanistically, we show that this protection is due to site-specific inhibition of glutamate-induced and Ras/ERK-mediated toxicity by accumulation of Ras-inhibiting SynGAP1, which resides in a post-synaptic complex with tau. Accordingly, reducing SynGAP1 levels in tau
mice abolished the protection from pharmacologically induced excitotoxicity and middle cerebral artery occlusion-induced brain damage. Conversely, over-expression of SynGAP1 prevented excitotoxic ERK activation in wild-type neurons. Our findings suggest that tau mediates excitotoxic Ras/ERK signaling by controlling post-synaptic compartmentalization of SynGAP1.Excitotoxicity contributes to neuronal injury following stroke. Here the authors show that tau promotes excitotoxicity by a post-synaptic mechanism, involving site-specific control of ERK activation, in a mouse model of stroke.
High-latitude (i.e., "polar") Mesozoic fauna endured months of twilight and relatively low mean annual temperatures. Yet non-avian dinosaurs flourished in this taxing environment. Fossils of basal ...ornithopod dinosaurs ("hypsilophodontids") are common in the Early Cretaceous high-latitude sediments of Victoria, Australia, and four taxa have been described; although their ontogenetic histories are largely unexplored. In the present study, eighteen tibiae and femora were utilized in the first multi-specimen ontogenetic histological analysis of Australian polar hypsilophodontids. The sample consists of eleven individuals from the Flat Rocks locality (Late Valanginian or Barremian), and five from the Dinosaur Cove locality (Albian). In both groups, growth was most rapid during the first three years, and skeletal maturity occurred between five and seven years. There is a weak asymptotic trend in a plot of growth mark count versus femur length, with considerable individual variation. Histology suggests two genera are present within the Dinosaur Cove sample, but bone microstructure alone could not distinguish genera within the Flat Rocks sample, or across the two geologically separate (~ 26 Ma) localities. Additional histologic sampling, combined with morphological analyses, may facilitate further differentiation between ontogenetic, individual, and species variation.
Black men are more likely to die of prostate cancer than white men. In men with similar stages of disease, the contribution of biological vs nonbiological differences to this observed disparity is ...unclear.
To quantify the association of black race with long-term survival outcomes after controlling for known prognostic variables and access to care among men with prostate cancer.
This multiple-cohort study included updated individual patient-level data of men with clinical T1-4N0-1M0 prostate cancer from the following 3 cohorts: Surveillance, Epidemiology, and End Results (SEER n = 296 273); 5 equal-access regional medical centers within the Veterans Affairs health system (VA n = 3972); and 4 pooled National Cancer Institute-sponsored Radiation Therapy Oncology Group phase 3 randomized clinical trials (RCTs n = 5854). Data were collected in the 3 cohorts from January 1, 1992, through December 31, 2013, and analyzed from April 27, 2017, through April 13, 2019.
In the VA and RCT cohorts, all patients received surgery and radiotherapy, respectively, with curative intent. In SEER, radical treatment, hormone therapy, or conservative management were received.
Prostate cancer-specific mortality (PCSM). Secondary measures included other-cause mortality (OCM). To adjust for demographic-, cancer-, and treatment-related baseline differences, inverse probability weighting (IPW) was performed.
Among the 306 100 participants included in the analysis (mean SD age, 64.9 8.9 years), black men constituted 52 840 patients (17.8%) in the SEER cohort, 1513 (38.1%) in the VA cohort, and 1129 (19.3%) in the RCT cohort. Black race was associated with an increased age-adjusted PCSM hazard (subdistribution hazard ratio sHR, 1.30; 95% CI, 1.23-1.37; P < .001) within the SEER cohort. After IPW adjustment, black race was associated with a 0.5% (95% CI, 0.2%-0.9%) increase in PCSM at 10 years after diagnosis (sHR, 1.09; 95% CI, 1.04-1.15; P < .001), with no significant difference for high-risk men (sHR, 1.04; 95% CI, 0.97-1.12; P = .29). No significant differences in PCSM were found in the VA IPW cohort (sHR, 0.85; 95% CI, 0.56-1.30; P = .46), and black men had a significantly lower hazard in the RCT IPW cohort (sHR, 0.81; 95% CI, 0.66-0.99; P = .04). Black men had a significantly increased hazard of OCM in the SEER (sHR, 1.30; 95% CI, 1.27-1.34; P < .001) and RCT (sHR, 1.17; 95% CI, 1.06-1.29; P = .002) IPW cohorts.
In this study, after adjustment for nonbiological differences, notably access to care and standardized treatment, black race did not appear to be associated with inferior stage-for-stage PCSM. A large disparity remained in OCM for black men with nonmetastatic prostate cancer.
ABSTRACT
Interventions targeting parents’ mental health in the perinatal period are critical due to potential consequences of perinatal mental illness for the parent, the infant, and their family. To ...date, most programs have targeted mothers. This systematic review explores the current status and evidence for intervention programs aiming to prevent or treat paternal mental illness in the perinatal period. Electronic databases were systematically searched to identify peer‐reviewed studies that described an intervention targeting fathers’ mental health in the perinatal period. Mental health outcomes included depression, anxiety, and stress as well as more general measures of psychological functioning. Eleven studies were identified. Three of five psychosocial interventions and three massage‐technique interventions reported significant effects. None of the couple‐based interventions reported significant effects. A number of methodological limitations were identified, including inadequate reporting of study designs, and issues with the timing of interventions. The variability in outcomes measures across the studies made it difficult to evaluate the overall effectiveness of the interventions. Father‐focused interventions aimed at preventing perinatal mood problems will be improved if future studies utilize more rigorous research strategies.
RESUMEN
Las intervenciones que se enfocan en la salud mental de los padres en el período perinatal son críticas debido a las consecuencias potenciales de la enfermedad mental perinatal para el progenitor, el infante y su familia. Hasta ahora, la mayoría de los programas se han enfocado en las madres. Esta revisión sistemática explora la actual condición y evidencia para programas de intervención con miras a prevenir o tratar la enfermedad mental paterna en el período perinatal. Se investigaron los bancos de información electrónica sistemáticamente para identificar estudios avalados por colegas que describen una intervención enfocada en la salud mental de los papás en el período perinatal. Entre los resultados de salud mental se incluyeron la depresión, la ansiedad, el estrés así como también medidas más generales del funcionamiento sicológico. Se identificaron once estudios. Tres de cinco intervenciones sicosociales y tres intervenciones de técnica de masaje reportaron efectos significativos. Ninguna de las intervenciones con base en la pareja reportó efectos significativos. Se identificó un número de limitaciones metodológicas, incluyendo el reporte inadecuado de diseños de estudio y asuntos relacionados con el momento de las intervenciones. La variabilidad en medidas de resultados a través de los estudios dificultó la evaluación de la efectividad general de las intervenciones. Las intervenciones enfocadas en el papá con miras a prevenir problemas perinatales de estado de ánimo mejorarán si los estudios futuros utilizan estrategias de investigación más rigurosas.
RÉSUMÉ
Les interventions ciblant la santé mentale des parents dans la période périnatale sont extrêmement importantes du fait des conséquences potentielles de la maladie mentale périnatale pour le parent, le bébé et leur famille. Jusqu’à présent la plupart des programmes ont ciblé les mères. Cette revue systématique explore le statut et l’évidence actuels des programmes d'intervention ayant pour but de prévenir ou de traiter la maladie mentale paternelle durant la période périnatale. Les bases de données électroniques ont fait l'objet d'une recherche systématique afin d'identifier des études (à processus d’évaluation par les pairs) décrivant une intervention ciblant la santé mentale des pères durant la période périnatale. Les résultats de santé mentale ont inclu la dépression, l'anxiété, le stress ainsi que des mesures plus générales de fonctionnement psychologique. Onze études ont été identifiées. Trois sur cinq interventions psychosociales et trois interventions de technique de massage ont fait d’état d'effet importants. Aucune des interventions basées sur le couple n'a fait état d'effets importants. Un nombre de limites méthodologiques ont été identifiées, y compris l'inadéquation des concepts des études, et des problèmes sur le moment choisi des interventions. La variabilité des mesures de résultat au travers des études a rendu l’évaluation de l'efficacité générale des interventions difficile. Les interventions ciblant le père ayant pour but de prévenir les problèmes d'humeur périnatale verront des améliorations si les études à venir utilisent des stratégies de recherche plus rigoureuses.
ZUSAMMENFASSUNG
Interventionen, die auf die psychische Gesundheit der Eltern in der Perinatalperiode abzielen, sind entscheidend wegen der möglichen Folgen der perinatalen psychischen Erkrankungen auf die Eltern, das Kind und ihre Familie. Bis heute zielen die meisten Programme auf Mütter ab. Dieses systematische Review untersucht den aktuellen Stand und Belege für Interventionsprogramme zur Prävention oder Behandlung väterlicher psychischer Erkrankungen in der Perinatalperiode. Elektronische Datenbanken wurden systematisch durchsucht, um Peer‐Review‐Studien zu identifizieren, die eine Intervention für die psychische Gesundheit von Vätern in der perinatalen Phase beschrieben. Als Ergebnismaße für die psychische Gesundheit wurden Depression, Angst, Stress sowie allgemeinere Messungen des psychologischen Funktionsniveaus eingeschlossen. Elf Studien wurden identifiziert. Drei von fünf psychosozialen Interventionen und drei Massage‐Interventionen berichteten signifikante Effekte. Keine der paar‐basierten Interventionen berichtete signifikante Effekte. Eine Reihe methodischer Limitationen wurden identifiziert, darunter eine unzureichende Berichterstattung über das Studiendesign und Probleme mit dem Zeitablauf der Interventionen. Die Variabilität in den Ergebnismaßen der Studien erschwerte eine Bewertung der allgemeinen Wirksamkeit der Interventionen. Väterorientierte Interventionen zur Prävention perinataler Stimmungsprobleme könnten verbessert werden, wenn zukünftige Studien strengere Forschungsstrategien nutzen würden.
抄録
周産期に親の精神保健をターゲットにした介入は、周産期の精神疾患が親、乳児および家族にとって影響与える可能性のために、極めて重要である。今まで、大部分のプログラムは母親をターゲットにして来た。この系統的レビューは、周産期の父親の精神疾患の予防または治療を目的とした介入プログラムのための、現在の状態と根拠を探索する。周産期の父親の精神保健をターゲットにした介入を記述する、査読された研究を見つけるために、電子的なデータベースが系統的に探索された。精神保健の転帰には、抑うつ、不安、ストレスならびにより一般的な心理機能の測定が含まれた。11の研究が見つかった。 5 つの心理社会的介入のうち 3 つと、 3 つのマッサージ技法介入が有意な効果を報告した。カップルに対する介入はどれも有意な効果を報告しなかった。多くの方法論的限界が見つけられた。それらには研究デザインの報告の不適切さや、介入のタイミングの問題が含まれた。研究間の結果の測定法のばらつきのために、介入の全体としての有効性を評価することが難しくなった。周産期の気分の問題の予防を目的とする、父親に焦点づけた介入は、より厳格な研究戦略を用いた一層の研究があれば、改善するだろう。
摘要
在圍產期針對家長心理健康的干預是重要的, 因為圍產期精神病對父母丶嬰兒和他們的家人有潛在後果。迄今為止, 大多數干預都針對母親。此系統審查探討防止或治療圍產期父親的精神疾病干預方案的當前狀態和證據。 作者用電子數據庫進行系統檢索, 以確定描述在圍產期針對父親心理健康的干預之同行評議研究。心理健康結果包括抑鬱, 焦慮, 緊張和更普遍的心理機能。 十一項研究鑑定。五分之三的心理干預和三個按摩手法干預報導顯著的成果。以夫婦為本的干預措施無顯著的成果。作者鑑定了一些方法的局限性, 包括研究設計的報告不足, 以及干預的時機問題。因各項研究結果的變化性, 很難評估干預措施的整體效果。 如果未來的研究利用更嚴格的研究策略, 以父親為重點防止圍產期情緒問題的干預措施將得到改善。
Many subjects with neuropathologically-confirmed dementia with Lewy bodies (DLB) are never diagnosed during life, instead being categorized as Alzheimer's disease dementia (ADD) or unspecified ...dementia. Unrecognized DLB therefore is a critical impediment to clinical studies and treatment trials of both ADD and DLB. There are studies that suggest that olfactory function tests may be able to distinguish DLB from ADD, but few of these had neuropathological confirmation of diagnosis. We compared University of Pennsylvania Smell Identification Test (UPSIT) results in 257 subjects that went on to autopsy and neuropathological examination. Consensus clinicopathological diagnostic criteria were used to define ADD and DLB, as well as Parkinson's disease with dementia (PDD), with (PDD+AD) or without (PDD-AD) concurrent AD; a group with ADD and Lewy body disease (LBD) not meeting criteria for DLB (ADLB) and a clinically normal control group were also included. The subjects with DLB, PDD+AD and PDD-AD all had lower (one-way ANOVA p < 0.0001, pairwise Bonferroni p < 0.05) first and mean UPSIT scores than the ADD, ADLB or control groups. For DLB subjects with first and mean UPSIT scores less than 20 and 17, respectively, Firth logistic regression analysis, adjusted for age, gender and mean MMSE score, conferred statistically significant odds ratios of 17.5 and 18.0 for the diagnosis, vs ADD. For other group comparisons (PDD+AD and PDD-AD vs ADD) and UPSIT cutoffs of 17, the same analyses resulted in odds ratios ranging from 16.3 to 31.6 (p < 0.0001). To our knowledge, this is the largest study to date comparing olfactory function in subjects with neuropathologically-confirmed LBD and ADD. Olfactory function testing may be a convenient and inexpensive strategy for enriching dementia studies or clinical trials with DLB subjects, or conversely, reducing the inclusion of DLB subjects in ADD studies or trials.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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