The anxiety disorders are robust correlates/predictors of suicidal ideation, but it is unclear whether (a) the anxiety disorders are specifically associated with suicidal ideation or (b) the ...association is due to co-morbidity with depression and other disorders. One means of modeling co-morbidity is through the personality traits neuroticism/negative emotionality (N/NE) and extraversion/positive emotionality (E/PE), which account for substantial shared variance among the internalizing disorders. The current study examines the association between the internalizing disorders and suicidal ideation, after controlling for co-morbidity via N/NE and E/PE.
The sample consisted of 327 psychiatric out-patients. Multiple self-report and interview measures were collected for internalizing disorders depression, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), social anxiety, panic and specific phobia and suicidal ideation, as well as self-report measures for N/NE and E/PE. A model was hypothesized in which each disorder and suicidal ideation was regressed on N/NE, and depression and social anxiety were regressed on E/PE. Structural equation modeling (SEM) was used to examine the unique association of suicidality with each disorder, beyond shared variance with N/NE and E/PE.
The hypothesized model was an acceptable fit to the data. Although zero-order analyses indicated that suicidal ideation was moderately to strongly correlated with all of the disorders, only depression and PTSD remained significantly associated with suicidal ideation in the SEM analyses.
In a latent variable model that accounts for measurement error and a broad source of co-morbidity, only depression and PTSD were uniquely associated with suicidal ideation; panic, GAD, social anxiety and specific phobia were not.
Anxiety disorders are highly prevalent disorders associated with substantial psychosocial impairment, but few studies have examined impairment within specific anxiety disorders. Furthermore, it is ...unclear how change in different types of anxiety has an impact on change in impairment, particularly given high rates of co-morbidity. The current study assessed the temporal associations of impairment and symptoms of three common anxiety disorders in a large, diagnostically heterogeneous clinical sample.
Data were collected from 606 treatment-seeking individuals at an anxiety clinic, most of whom subsequently enrolled in cognitive-behavioral therapy. Symptoms of panic, social anxiety and generalized anxiety disorder (GAD), as well as levels of impairment, were assessed three times over 2 years. In addition to examining levels of impairment across diagnostic groups, latent growth modeling was used to evaluate the longitudinal associations of anxiety symptoms and impairment.
Those with a principal diagnosis of GAD reported higher levels of impairment in some domains at baseline; however, at follow-up assessments individuals with social anxiety disorder reported greater impairment than those with panic disorder. Anxiety symptoms and impairment both declined over time. Change in all three anxiety symptoms was closely associated with change in impairment, but only GAD remained a significant (positive) predictor of change in impairment after accounting for co-morbidity.
Impairment and all three anxiety disorders were closely associated, both cross-sectionally and longitudinally. Because change in GAD was most specifically related to change in impairment, treatment for those with multiple anxiety disorders could focus on treating GAD symptoms first or treating transdiagnostic processes.
The increasing use of artificial intelligence (AI) in public service delivery presents important yet unanswered questions about citizens' views of AI. Are citizens' perceptions of decisions made by ...AI different from those made by bureaucrats? We answer this question by conducting a conjoint experiment. Our results show that individuals prefer minority bureaucrats over AI to make decisions. This is particularly true for racially minoritized citizens. However, when passive representation within the bureaucracy is unavailable, racially minoritized individuals do not have a clear-cut preference between AI and out-group bureaucrats. Our findings provide insight into the interaction between automation, representation, and equity.
Our objective was to elicit clinicians' and parents' perspectives about decision-making related to hospitalization for children with bronchiolitis and the use of shared decision-making (SDM) to guide ...these decisions.
We conducted individual, semistructured interviews with purposively sampled clinicians (pediatric emergency medicine physicians and nurses) at 2 children's hospitals and parents of children age <2 years with bronchiolitis evaluated in the emergency department at 1 hospital. Interviews elicited clinicians' and parents' perspectives on decision-making and SDM for bronchiolitis. We conducted an inductive analysis following the principles of grounded theory until data saturation was reached for both groups.
We interviewed 24 clinicians (17 physicians, 7 nurses) and 20 parents. Clinicians identified factors in 3 domains that contribute to hospitalization decision-making for children with bronchiolitis: demographics, clinical factors, and social-emotional factors. Although many clinicians supported using SDM for hospitalization decisions, most reported using a clinician-guided decision-making process in practice. Clinicians also identified several barriers to SDM, including the unpredictable course of bronchiolitis, perceptions of parents' preferences for engaging in SDM, and parents' emotions, health literacy, preferred language, and comfort with discharge. Parents wanted the opportunity to express their opinions during decision-making about hospitalization, although they often felt comfortable with the clinician's decision when adequately informed.
Although clinicians and parents of children with bronchiolitis are supportive of SDM, most hospitalization decision-making is clinician guided. Future investigation should evaluate how to address barriers and implement SDM in practice, including training clinicians in this SDM approach.
Mucositis is a significant dose-limiting toxicity associated with fluorouracil (5FU), particularly when it is combined with leucovorin. We hypothesized that oral cryotherapy would cause local ...vasoconstriction and would temporarily decrease blood flow to the oral mucous membranes. If cryotherapy were used during the time of peak serum 5FU levels, then the oral mucous membranes would have less exposure to 5FU and thus develop less mucositis. To test this hypothesis, 95 patients scheduled to receive their first cycle of 5FU plus leucovorin were randomized to have oral cryotherapy at the time of chemotherapy administration or to serve as a control group. Subsequent mucositis was significantly reduced in the group assigned to receive cryotherapy as judged by the attending physicians (P = .0002) and by the patients themselves (P = .0001). We now routinely recommend this cryotherapy procedure for our patients receiving daily bolus 5FU plus leucovorin.
We present the direct imaging discovery of an extrasolar planet, or possible low-mass brown dwarf, at a projected separation of 55 + or - 2 AU (1".58 + or - 07007) from the B9-type star Kappa And. ...The planet was detected with Subaru/HiCIAO during the SEEDS survey and confirmed as a bound companion via common proper motion measurements. Observed near-infrared magnitudes of J = 16.3 + or - 0.3, H = 15.2 + or - 0.2, K sub(s) = 14.6 + or - 0.4, and L' = 13.12 + or - 0.09 indicate a temperature of ~1700 K. The galactic kinematics of the host star are consistent with membership in the Columba Association, implying a corresponding age of (ProQuest: Formulae and/or non-USASCII text omitted) Myr. The system's age, combined with the companion photometry, points to a model-dependent companion mass ~12.8 M sub(Jup). The host star's estimated mass of 2.4-2.5 M sub(middot in circle) places it among the most massive stars ever known to harbor an extrasolar planet or low-mass brown dwarf. While the mass of the companion is close to the deuterium burning limit, its mass ratio, orbital separation, and likely planet-like formation scenario imply that it may be best defined as a "super-Jupiter" with properties similar to other recently discovered companions to massive stars.
We developed and tested a quantitative geographic information system (GIS)-based approach for selecting wetland restoration sites. Our approach uses a combination of an existing wetland function ...evaluation program, a GIS and integer programming methodology with an objective to minimize cost of restoration subject to meet environmental requirements. Investigations were conducted on the formulation to examine the effects of problem size, site ordering for input, and restoration targets. The formulation could be solved for the largest problem size tested of 996 integer variables. The larger the problem, the more time it took to solve. Larger restoration targets usually took more sites and more time to solve. Sorting sites by size was found to lead to inefficient and often unfeasible solutions. Random sorting of sites was found to be the more efficient method of inputting restoration sites into analysis.PUBLICATION ABSTRACT
Pursuant to a promising report suggesting that an allopurinol mouthwash could have a protective effect against 5‐fluorouracil (5‐FU)‐induced stomatitis, the authors performed a randomized, ...placebo‐controlled, double‐blind, crossover study. Seventy‐seven patients, receiving their first 5‐day course of chemotherapy with 5‐FU ± leucovorin, were assigned to use a mouthwash containing 20 mg of allopurinol or a placebo. The mouthwash was administered every hour for four doses commencing with each chemotherapy dose. The severity of subsequent mucositis was graded (on a 0‐4 scale) by the attending physician and also by a patient‐completed questionnaire. There was trend toward less mucositis in the placebo group with mean physician‐judged mucositis scores of 1.3 for placebo and 1.8 for allopurinol (P = 0.07) and mean patient‐judged mucositis scores of 1.5 for placebo and 1.9 for allopurinol (P = 0.15). There were no substantial differences in mucositis attributable to the two mouthwashes in the patients who crossed‐over on their second cycle of chemotherapy. These data demonstrate that the tested allopurinol mouthwash regimen does not offer any protective effect against 5‐FU‐induced mucositis.
We present the direct imaging discovery of an extrasolar planet, or possible low-mass brown dwarf, at a projected separation of 55 {+-} 2 AU (1.''058 {+-} 0.''007) from the B9-type star {kappa} And. ...The planet was detected with Subaru/HiCIAO during the SEEDS survey and confirmed as a bound companion via common proper motion measurements. Observed near-infrared magnitudes of J = 16.3 {+-} 0.3, H = 15.2 {+-} 0.2, K{sub s} = 14.6 {+-} 0.4, and L' = 13.12 {+-} 0.09 indicate a temperature of {approx}1700 K. The galactic kinematics of the host star are consistent with membership in the Columba Association, implying a corresponding age of 30{sup +20}{sub -10} Myr. The system's age, combined with the companion photometry, points to a model-dependent companion mass {approx}12.8 M{sub Jup}. The host star's estimated mass of 2.4-2.5 M{sub Sun} places it among the most massive stars ever known to harbor an extrasolar planet or low-mass brown dwarf. While the mass of the companion is close to the deuterium burning limit, its mass ratio, orbital separation, and likely planet-like formation scenario imply that it may be best defined as a 'super-Jupiter' with properties similar to other recently discovered companions to massive stars.
We present the direct imaging discovery of an extrasolar planet, or possible low-mass brown dwarf, at a projected separation of 55 plus or minus 2 AU (1."058 plus or minus 0."007) from the B9-type ...star K And. The planet was detected with Subaru/HiCIAO (Subaru/High Contrast Instrument for the Subaru Next Generation Adaptive Optics) during the SEEDS (Strategic Exploration of Exoplanets and Disks with Subaru Telescope/HiCIAO) survey and confirmed as a bound companion via common proper motion measurements. Observed near-infrared magnitudes of J equals 16.3 plus or minus 0.3, H equals 15.2 plus or minus 0.2, K (sub s) = 14.6 plus or minus 0.4, and L prime equals 13.12 plus or minus 0.09 indicate a temperature of approximately 1700 degrees Kelvin. The galactic kinematics of the host star are consistent with membership in the Columba Association, implying a corresponding age of 30 (exp from plus 20 to minus10) Myr. The systems age, combined with the companion photometry, points to a model-dependent companion mass approximately 12.8 times the mass of Jupiter. The host stars estimated mass of 2.4 to 2.5 times the mass of the sun places it among the most massive stars ever known to harbor an extrasolar planet or low-mass brown dwarf. While the mass of the companion is close to the deuterium burning limit, its mass ratio, orbital separation, and likely planet-like formation scenario imply that it may be best defined as a super-Jupiter with properties similar to other recently discovered companions to massive stars.
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