Prince was an artist who challenged many conventional notions of race, sexuality, and music. His music, characterized as the Minneapolis Sound, is a continuation and extension of America's indigenous ...music, the blues. This article is an explanation of the designation “Minneapolis Sound.” The first part establishes the Minneapolis milieu, specifically that of the black neighborhoods, and how it formed Prince and his cohort, such as James “Jimmy Jam” Harris Jr., Terry Lewis, André Cymone, Morris Day, and others. The second part is a close analysis of Prince's music and its sonic effects and how Prince engages and extends the blues idiom.
IntroductionPost-COVID-19 complications require simultaneous characterisation and management to plan policy and health system responses. We describe the 12-month experience of the first UK dedicated ...post-COVID-19 clinical service to include hospitalised and non-hospitalised patients.MethodsIn a single-centre, observational analysis, we report the demographics, symptoms, comorbidities, investigations, treatments, functional recovery, specialist referral and rehabilitation of 1325 individuals assessed at the University College London Hospitals post-COVID-19 service between April 2020 and April 2021, comparing by referral route: posthospitalised (PH), non-hospitalised (NH) and post emergency department (PED). Symptoms associated with poor recovery or inability to return to work full time were assessed using multivariable logistic regression.Results1325 individuals were assessed (PH: 547, 41.3%; PED: 212, 16%; NH: 566, 42.7%). Compared with the PH and PED groups, the NH group were younger (median 44.6 (35.6–52.8) years vs 58.3 (47.0–67.7) years and 48.5 (39.4–55.7) years), more likely to be female (68.2%, 43.0% and 59.9%), less likely to be of ethnic minority (30.9%, 52.7% and 41.0%) or seen later after symptom onset (median (IQR): 194 (118–298) days, 69 (51–111) days and 76 (55–128) days; all p<0.0001). All groups had similar rates of onward specialist referral (NH 18.7%, PH 16.1% and PED 18.9%, p=0.452) and were more likely to require support for breathlessness (23.7%, 5.5% and 15.1%, p<0.001) and fatigue (17.8%, 4.8% and 8.0%, p<0.001). Hospitalised patients had higher rates of pulmonary emboli, persistent lung interstitial abnormalities and other organ impairment. 716 (54.0%) individuals reported <75% optimal health (median 70%, IQR 55%–85%). Less than half of employed individuals could return to work full time at first assessment.ConclusionPost-COVID-19 symptoms were significant in PH and NH patients, with significant ongoing healthcare needs and utilisation. Trials of interventions and patient-centred pathways for diagnostic and treatment approaches are urgently required.
Summary Background Impulse oscillometry system (IOS) assesses pulmonary resistance and reactance. We set out to investigate which IOS measurements are related to airflow obstruction, airway ...conductance and lung volumes in chronic obstructive pulmonary disease (COPD). Methods Ninety-four COPD patients were recruited and 58 agreed to follow up after 1 year. IOS measurements (R5, R20, X5 & Fres), body plethysmography (sGaw, FRC, TLC, RV & IC) and spirometry (FEV1 ) were performed. Pearson or Spearman correlation determined the relationships between IOS and other measurements. Results R5, X5 and Fres were all significantly associated ( p < 0.05) with FEV1 , sGaw, TLC, RV and IC. However, R20 was not related to any of these measurements except for RV. The strongest associations were observed between FEV1 and the reactance measurements X5 ( r = 0.48) and Fres ( r = −0.44), and sGaw with X5 ( r = 0.47) and Fres ( r = 0.51). The r values for the associations with TLC and IC were all <0.25. There was no statistically significant change in the FEV1 , R5, X5 or Fres after 1 year, but R20 significantly increased over the year. The changes in R5 and R20 did not significantly correlate with the changes in FEV1 . In contrast, X5 changes were significantly related to FEV1 changes over 1 year ( r = −0.27, p = 0.05), while for Fres changes there was a trend to statistical significance ( p = 0.08). Conclusions IOS reactance measurements are more closely related than resistance measurements to other pulmonary function measurements in COPD patients. The IOS reactance measurements appear to be indicative of changes in pulmonary compliance caused by airflow obstruction.
Self-management interventions in COPD aim to improve patients' knowledge, skills and confidence to make correct decisions, thus improving health status and outcomes. myCOPD is a web-based ...self-management app known to improve inhaler use and exercise capacity in individuals with more severe COPD.
We explored the impact of myCOPD in patients with mild–moderate or recently diagnosed COPD through a 12-week, open-label, parallel-group, randomised controlled trial of myCOPD compared with usual care. The co-primary outcomes were between-group differences in mean COPD assessment test (CAT) score at 90 days and critical inhaler errors. Key secondary outcomes were app usage and patient activation measurement (PAM) score.
Sixty patients were randomised (29 myCOPD, 31 usual care). Groups were balanced for forced expiratory volume in 1 s (FEV
1
% pred) but there was baseline imbalance between groups for exacerbation frequency and CAT score. There was no significant adjusted mean difference in CAT score at study completion, −1.27 (95% CI −4.47–1.92, p=0.44) lower in myCOPD. However, an increase in app use was associated with greater CAT score improvement. The odds of ≥1 critical inhaler error was lower in the myCOPD arm (adjusted OR 0.30 (95% CI 0.09–1.06, p=0.061)). The adjusted odds ratio for being in a higher PAM level at 90 days was 1.65 (95% CI 0.46–5.85) in favour of myCOPD.
The small sample size and phenotypic difference between groups limited our ability to demonstrate statistically significant evidence of benefit beyond inhaler technique. However, our findings provide important insights into associations between increased app use and clinically meaningful benefit warranting further study in real world settings.
Airway inflammation in COPD can be measured using biomarkers such as induced sputum and Fe(NO). This study set out to explore the heterogeneity of COPD using biomarkers of airway and systemic ...inflammation and pulmonary function by principal components analysis (PCA).
In 127 COPD patients (mean FEV1 61%), pulmonary function, Fe(NO), plasma CRP and TNF-alpha, sputum differential cell counts and sputum IL8 (pg/ml) were measured. Principal components analysis as well as multivariate analysis was performed.
PCA identified four main components (% variance): (1) sputum neutrophil cell count and supernatant IL8 and plasma TNF-alpha (20.2%), (2) Sputum eosinophils % and Fe(NO) (18.2%), (3) Bronchodilator reversibility, FEV1 and IC (15.1%) and (4) CRP (11.4%). These results were confirmed by linear regression multivariate analyses which showed strong associations between the variables within components 1 and 2.
COPD is a multi dimensional disease. Unrelated components of disease were identified, including neutrophilic airway inflammation which was associated with systemic inflammation, and sputum eosinophils which were related to increased Fe(NO). We confirm dissociation between airway inflammation and lung function in this cohort of patients.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Many of the systemic manifestations of chronic obstructive pulmonary disease (COPD) are mediated through increased systemic levels of inflammatory proteins. We assessed the long term repeatability of ...interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein (CRP) over one year and examined the relationships between these systemic markers in COPD.
Fifty-eight stable COPD patients completed a baseline and one-year visit. Serum IL-6, plasma CRP, and plasma TNF-alpha were measured. Repeatability was expressed by intraclass correlation coefficient (R(i)) and the Bland-Altman method. Pearson correlations were used to determine the relationships between the systemic markers at both visits.
There was moderate repeatability with a very high degree of statistical significance (p <or= 0.001) between the two visits for all the systemic biomarkers (IL-6, CRP, and TNF-alpha). CRP was significantly associated with IL-6 at both visits (r = 0.55, p = 0.0001, r = 0.51, p = 0.0002, respectively). There were no other significant associations between the systemic markers at either of the visits.
Systemic inflammatory biomarkers IL-6, CRP, and TNF-alpha were moderately repeatable over a twelve month period in COPD patients. We have also shown that a robust and repeatable association between IL-6 and CRP exists.
For centuries, Psalm 68:31 Princes shall come forth out of Egypt; Ethiopia shall soon stretch forth her hands unto God, also known as the Ethiopian prophecy, has served as a pivotal and seminal text ...for those of African descent in the Americas.
Originally, it was taken to mean that the slavery of African Americans was akin to the slavery of the Hebrews in Egypt, and thus it became an articulation of the emancipation struggle. However, it has also been used as an impetus for missionary work in Africa, as an inspirational backbone for the civil rights movement, and as a call for a separate black identity during the twentieth century.
Utilizing examples from Richard Allen, Maria W. Stewart, Kate Drumgoold, Phillis Wheatley, Martin Delany, W.E.B. DuBois, Marcus Garvey, and Ralph Ellison, Kay reveals the wide variety of ways this verse has been interpreted and conceptualized in African American history and letters for more than two hundred years.
Atypical Depression: A Reappraisal Parker, Gordon; Roy, Kay; Mitchell, Philip ...
The American journal of psychiatry,
09/2002, Letnik:
159, Številka:
9
Journal Article
Recenzirano
OBJECTIVE: The study evaluated the DSM-IV definition of the atypical features specifier for a major depressive episode in major depressive disorder. METHOD: Nonpsychotic patients with major ...depressive disorder were assessed to determine if the DSM-IV model and decision rules for the atypical features specifier for a major depressive episode could be supported. RESULTS: The five clinical features of the DSM-IV atypical features specifier for a major depressive episode showed weak internal consistency, and the mandatory criterion A feature of mood reactivity did not show specificity in relation to any of the four criterion B accessory symptoms. The more severe the depression, the less likely the patient was to report criterion A and hence to meet criteria for the atypical features specifier. Remodeling the five features favored the personality style descriptor of interpersonal rejection sensitivity as an alternate primary feature. A reformulated model also suggested lifetime panic disorder and social phobia as higher-order determinants of atypical features in major depressive disorder. Additional analyses of criteria suggested that interpersonal rejection sensitivity and leaden paralysis had a phenomenological base in anxiety, that mood reactivity was linked with irritability, and that neither weight gain nor hypersomnia were clearly aligned with anxiety or depression, raising questions about their status as symptoms. CONCLUSIONS: The current definition and modeling of the DSM-IV atypical features specifier for a major depressive episode in major depressive disorder appears problematic. As suggested by earlier descriptions of atypical depression, certain expressions of anxiety may have primacy, and some clinical features associated with the DSM-IV model may be adaptive homeostatic responses rather than pathological symptoms.
* Medicines Evaluation Unit, North West Lung Centre, The University of Manchester, Wythenshawe Hospital, Manchester, UK # Dept of Mathematics, Manchester University, Manchester, UK
CORRESPONDENCE: ...Kay Roy, Research Registrar, Medicines Evaluation Unit, North West Lung Centre, Wythenshawe Hospital, Manchester, UK
Multiple flow rates Fe NO data two-compartment mathematical modelling can estimate NO airway wall concentration (Caw NO ), airway wall diffusing capacity (Daw NO ), alveolar concentration (Calv NO ) and maximal NO flux (Jaw NO ). To compare modelling based on linear, non linear and mixed linear and non linear analyses in COPD. Fe NO was measured using the Niox analyser (Aerocrine) at flow rates: 10, 30, 50, 100 and 200ml/s in 50 COPD patients and the data applied to 4 different methods. All methods showed that current smoking reduced Caw NO . Jaw NO data differed between methods (Table 1). All the methods showed that current smoking did not affect Calv NO or Daw NO . Comparison of the methods showed that Calv NO and Daw NO data were significantly different between all methods, Jaw NO was different for most between method comparisons, while there was agreement between all the methods for Caw NO . Smoking in COPD reduces Caw NO , but not Calv NO and Daw NO . Jaw NO, Calv NO and Daw NO data are model dependent parameters. Caw NO findings were model independent, and hence the most robust modelled parameter.
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