A variety of methodological paradigms, including dot probe and eye movement tasks, have been used to examine attentional biases to threat in anxiety disorders. Unfortunately, little attention has ...been devoted to the psychometric properties of measures from these paradigms. In the current study, participants selected for high and low social anxiety completed a dot probe and eye movement task using angry, disgust and happy facial expressions paired with neutral expressions. Results indicated that dot probe bias scores, eye movement first fixation indices, and eye movement proportions of viewing time in the first 1,500 ms had unacceptably low reliability. However, eye movement indices of attentional bias over the full 5,000 ms time course had excellent reliability. Individuals’ dot probe and eye movement biases were largely uncorrelated across the two tasks and demonstrated little relation with social anxiety scores. Implications for future research are discussed.
Drinking water distribution systems throughout the world supply water intermittently, leaving pipes without pressure between supply cycles. Understanding the multiple mechanisms that affect ...contamination in these intermittent water supplies (IWS) can be used to develop strategies to improve water quality. To study these effects, we tested water quality in an IWS system with infrequent and short water delivery periods in Hubli-Dharwad, India. We continuously measured pressure and physicochemical parameters and periodically collected grab samples to test for total coliform and E. coli throughout supply cycles at 11 sites. When the supply was first turned on, water with elevated turbidity and high concentrations of indicator bacteria was flushed out of pipes. At low pressures (<10 psi), elevated indicator bacteria were frequently detected even when there was a chlorine residual, suggesting persistent contamination had occurred through intrusion or backflow. At pressures between 10 and 17 psi, evidence of periodic contamination suggested that transient intrusion, backflow, release of particulates, or sloughing of biofilms from pipe walls had occurred. Few total coliform and no E. coli were detected when water was delivered with a chlorine residual and at pressures >17 psi.
Background
Complete (full‐thickness) rectal prolapse is a lifestyle‐altering disability that commonly affects older people. The range of surgical methods available to correct the underlying pelvic ...floor defects in full‐thickness rectal prolapse reflects the lack of consensus regarding the best operation.
Objectives
To assess the effects of different surgical repairs for complete (full‐thickness) rectal prolapse.
Search methods
We searched the Cochrane Incontinence Group Specialised Register up to 3 February 2015; it contains trials from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE in process, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) as well as trials identified through handsearches of journals and conference proceedings. We also searched EMBASE and EMBASE Classic (1947 to February 2015) and PubMed (January 1950 to December 2014), and we specifically handsearched theBritish Journal of Surgery (January 1995 to June 2014), Diseases of the Colon and Rectum (January 1995 to June 2014) and Colorectal Diseases (January 2000 to June 2014), as well as the proceedings of the Association of Coloproctology meetings (January 2000 to December 2014). Finally, we handsearched reference lists of all relevant articles to identify additional trials.
Selection criteria
All randomised controlled trials (RCTs) of surgery for managing full‐thickness rectal prolapse in adults.
Data collection and analysis
Two reviewers independently selected studies from the literature searches, assessed the methodological quality of eligible trials and extracted data. The four primary outcome measures were the number of patients with recurrent rectal prolapse, number of patients with residual mucosal prolapse, number of patients with faecal incontinence and number of patients with constipation.
Main results
We included 15 RCTs involving 1007 participants in this third review update. One trial compared abdominal with perineal approaches to surgery, three trials compared fixation methods, three trials looked at the effects of lateral ligament division, one trial compared techniques of rectosigmoidectomy, two trials compared laparoscopic with open surgery, and two trials compared resection with no resection rectopexy. One new trial compared rectopexy versus rectal mobilisation only (no rectopexy), performed with either open or laparoscopic surgery. One new trial compared different techniques used in perineal surgery, and another included three comparisons: abdominal versus perineal surgery, resection versus no resection rectopexy in abdominal surgery and different techniques used in perineal surgery.
The heterogeneity of the trial objectives, interventions and outcomes made analysis difficult. Many review objectives were covered by only one or two studies with small numbers of participants. Given these caveats, there is insufficient data to say which of the abdominal and perineal approaches are most effective. There were no detectable differences between the methods used for fixation during rectopexy. Division, rather than preservation, of the lateral ligaments was associated with less recurrent prolapse but more postoperative constipation. Laparoscopic rectopexy was associated with fewer postoperative complications and shorter hospital stay than open rectopexy. Bowel resection during rectopexy was associated with lower rates of constipation. Recurrence of full‐thickness prolapse was greater for mobilisation of the rectum only compared with rectopexy. There were no differences in quality of life for patients who underwent the different kinds of prolapse surgery.
Authors' conclusions
The lack of high quality evidence on different techniques, together with the small sample size of included trials and their methodological weaknesses, severely limit the usefulness of this review for guiding practice. It is impossible to identify or refute clinically important differences between the alternative surgical operations. Longer follow‐up with current studies and larger rigorous trials are needed to improve the evidence base and to define the optimum surgical treatment for full‐thickness rectal prolapse.
Abstract
Aims
To date, clinical evidence of microvascular dysfunction in patients with heart failure (HF) with preserved ejection fraction (HFpEF) has been limited. We aimed to investigate the ...prevalence of coronary microvascular dysfunction (CMD) and its association with systemic endothelial dysfunction, HF severity, and myocardial dysfunction in a well defined, multi-centre HFpEF population.
Methods and results
This prospective multinational multi-centre observational study enrolled patients fulfilling strict criteria for HFpEF according to current guidelines. Those with known unrevascularized macrovascular coronary artery disease (CAD) were excluded. Coronary flow reserve (CFR) was measured with adenosine stress transthoracic Doppler echocardiography. Systemic endothelial function reactive hyperaemia index (RHI) was measured by peripheral arterial tonometry. Among 202 patients with HFpEF, 151 75% (95% confidence interval 69–81%) had CMD (defined as CFR <2.5). Patients with CMD had a higher prevalence of current or prior smoking (70% vs. 43%; P = 0.0006) and atrial fibrillation (58% vs. 25%; P = 0.004) compared with those without CMD. Worse CFR was associated with higher urinary albumin-to-creatinine ratio (UACR) and NTproBNP, and lower RHI, tricuspid annular plane systolic excursion, and right ventricular (RV) free wall strain after adjustment for age, sex, body mass index, atrial fibrillation, diabetes, revascularized CAD, smoking, left ventricular mass, and study site (P < 0.05 for all associations).
Conclusions
PROMIS-HFpEF is the first prospective multi-centre, multinational study to demonstrate a high prevalence of CMD in HFpEF in the absence of unrevascularized macrovascular CAD, and to show its association with systemic endothelial dysfunction (RHI, UACR) as well as markers of HF severity (NTproBNP and RV dysfunction). Microvascular dysfunction may be a promising therapeutic target in HFpEF.
The emergence of clinically efficacious prescription drugs to treat pain, anxiety, and learning disorders is accompanied by the potential for nonmedical use. Prescription drug abuse has become a ...modern‐day epidemic in the United States and is now second only to marijuana use across all age groups. This article reviews the various data collection, analysis, and reporting systems that have been developed in response to the growing concern for nonmedical prescription drug use. The terminology used to categorize prescription drugs that are abused and the various definitions for abuse, misuse, and nonmedical use are discussed. The epidemiology of nonmedical prescription drug use and an overview of each class of prescription drug that is at risk for nonmedical use are presented along with details of specific drugs that are associated with significant morbidity or mortality.
Clinical Pharmacology & Therapeutics (2010) 88 3, 307–317. doi: 10.1038/clpt.2010.154
Large volumes of non-resuscitation fluids are often administered to critically ill children. We hypothesize that excess maintenance fluid is a significant contributor to non-resuscitation fluid and ...that non-resuscitation fluid administered beyond hydration requirements is associated with worse clinical outcomes in critically ill children.
We evaluated all patients admitted to two large urban pediatric intensive care units (PICU) between January 2010-August 2016 and January 2010-August 2018, respectively, who survived and remained in the hospital for at least 3 days following PICU admission. The primary outcome was in-hospital mortality. Association of excess fluid with outcomes was adjusted for confounders (age, Pediatric Risk of Mortality III score, study site, day 3 acute kidney injury, PICU era, resuscitation volume, and volume output) using multivariable regression.
We evaluated 14,483 patients; 52% received non-resuscitation fluid in excess of hydration requirements. Non-resuscitation fluid in excess of hydration requirements was associated with higher in-hospital mortality after adjustment for confounders (adjusted odds ratio 1.01 per 10 mL/kg in excess fluid, 95% confidence interval: 1.002-1.02).
Non-resuscitation fluid in excess of hydration requirements is associated with increased mortality in critically ill children. Excess maintenance fluid is a modifiable contributor to this fluid volume. Strategies to reduce excess maintenance fluids warrant further study.
Critically ill children frequently receive non-resuscitation fluid in excess of their estimated hydration requirements. Non-resuscitation fluid volume in excess of estimated hydration requirements is associated with higher morbidity and mortality in critically ill children. Critically ill children receive a large volume burden from maintenance fluid. Maintenance fluid represents a modifiable contributor of non-resuscitation fluid in excess of hydration requirements. Strategies focused on limitation of maintenance fluid warrant further study.
Long-persistent luminescence (LPL), also known as afterglow, is a phenomenon in which the material shows long-lasting luminescence after the cessation of the excitation source. The research of LPL ...continues to attract much interest due to its fundamental nature and its potential in the development of the next generation of functional materials. However, most of the current LPL materials are multicomponent inorganic systems obtained after harsh synthetic procedures and often use rare-earth metals. Recently, metal free organic long-persistent luminescence (OLPL) has gained much interest because it can bypass many of the disadvantages of inorganic systems. To date, the most successful method to generate OLPL systems is to access charge-separated states through binary donor–acceptor exciplex systems. However, it has been reported that the ratios of the binary systems affect OLPL properties, complicating the reproducibility and large-scale production of OLPL materials. Simpler OLPL systems can overcome these issues for the benefit of the development and adoption of OLPL systems. Here, we report on the rational design and synthesis of a single-component OLPL system with detectable afterglow for at least 12 min under ambient conditions. This work exemplifies an easy design principle for new OLPL materials. The investigation of the material provides valuable insights toward the generation of OLPL from a single-component system.
Unmanned aerial vehicles (UAVs) or drones have been used by disaster relief organizations in the United States since 2005. However, their place in the disaster response ecosystem-the standardization, ...utility, ethical, and legal challenges of drone use-remains largely unstudied. This case series describes how UAVs were used by two teams of responders for damage assessment purposes during the 2017 southeastern US Hurricanes Harvey and Irma. Data streams ranged from social media, direct observation, participant-observation and semi-directed interviews. Qualitative analysis was performed for thematic content derived from field observation and from post-hoc interviews. Outcomes of the qualitative analysis emphasize the barriers to deploying drones in the disaster context, their tactical implementation, programmatic integration, and ethical and legal challenges. These observations lay the groundwork for both future research on the utilization of drones and the prudent and ethical implementation of programs that employ drones in post-disaster settings.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The RV 144 HIV vaccine efficacy study showed a reduction in HIV-1 infection risk in Thai volunteers who received two priming vaccinations of vCP1521 ALVAC (attenuated recombinant canarypox virus ...expressing HIV group-specific antigen, polymerase, and envelope genes) followed by two additional ALVAC vaccinations and coadministration of purified bivalent gp120 proteins (AIDSVAX B/E). In this issue of the JCI, Rouphael et al. build on these results by substituting a DNA plasmid cocktail expressing HIV-1 subtype C group-specific antigen, polymerase, and envelope antigen genes (DNA-HIV-PT123) for ALVAC in a phase 1b safety and immunogenicity study. The results indicate that the vaccine regimen is safe, elicits promising cross-subtype humoral and cellular responses, and opens up potentially simplified approaches to HIV-1 vaccine development.
The development of molecular machines requires new building blocks which are easy to characterize and visualize to realize a complexity comparable to their natural counterparts such as biological ...enzymes. Furthermore, with the desire to build functional nanobots capable of navigating living organisms, it is necessary that the building blocks show mobility even in the solid state. Herein we report a system which is emissive in the amorphous state but is non‐fluorescent in the crystalline state due to the formation of extensive π‐π interactions. This dual nature could be exploited for easy visualization of its solid‐state molecular rearrangement. The emission of the amorphous film was quenched as the molecules spontaneously formed π‐π interactions even in the solid state. Scratching the non‐emissive film destroyed the interactions and restored the emission of the film. The emission quickly disappeared with an average lifetime of 20 s as the compound reformed the π‐network even at room temperature.
Beacons lit by molecular motion: Intermolecular forces drive the formation of π‐π interactions even in the solid state. Shear forces/scratching disrupt the interactions, turning on emission. The quenched π‐π‐interactions quickly reform even in a film, allowing the visualization of the molecular motions. Theoretical calculations show that the formation of π‐interactions is highly favorable and driving this motion.
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