Objective: To investigate the diagnostic efficiency of the Hospital Anxiety and Depression Scale (HADS) in patients with breast cancer.
Methods: Women (303) recently diagnosed with stage I or II ...breast cancer completed the HADS and were psychiatrically assessed. Recommended cut-off scores for Depression (D) and Anxiety (A) Scales identified probable caseness and the accuracy was compared with DSM-IV diagnoses. Cut-off scores were varied to establish optimal accuracy.
Results: One hundred and eleven (36.6%) met criteria for depressive disorders and 25 (8.3%) met criteria for anxiety disorders. At the recommended cut-off score of 11 for the D scale, positive and negative predictive values were.75 and.64, respectively, while sensitivity and specificity were.05 and.99, respectively. For the A scale, positive predictive value (PPV) was.15; negative predictive value (NPV),.90; sensitivity,.08; and specificity,.87. Reducing the cut-off score to 5 produced PPV of.63, NPV of.74, sensitivity of.49 and specificity of.83 for the D scale;.14,.94,.75 and.45, respectively, for the A scale. Composite scores (cut-off of 22) had a PPV of.92, NPV of.57, sensitivity of.09 and specificity of.99.
Conclusions: Recommended cut-off scores for the HADS may result in under-reporting of psychiatric morbidity among women with early stage breast cancer. These results are consistent with other recent studies of the HADS. The type of constructs measured by the scale is the likely explanation for its limited utility when screening for psychiatric morbidity in early stage breast cancer.
•Habitat models may offer broad insight in managing catch-and-release fisheries.•Twenty years of fishery data parameterized models for Largemouth Bass in Maryland.•When high annual mortality levels ...persisted, high habitat quality protected fish.•Model predictions supported empirical observations.•Habitat conditions and fishing effort affected bass catch-and-release fisheries.
Fishery managers establish limits on the possession of certain sizes or numbers of sportfish to structure populations and manage for sustainability. However, when the vast majority of fish are released, possession limits become less useful for structuring a population because most fish are released alive. I explored a novel approach of coupling environmental modeling with demography and fishery data to determine if environmental habitat capacity influenced abundance in a fishery subjected to differed levels of total annual mortality. Using RAMAS-GIS (Version 6), I constructed models with data from habitat conditions and twenty years of monitoring (2009–2019) the catch-and-release fishery for Largemouth Bass (Micropterus salmoides) in the upper Chesapeake Bay (Maryland, USA). Abundance in the fishery varied with trends in a key environmental indicator of habitat capacity for the fish, submerged aquatic vegetation, and variation in annual mortality (A). Scenarios with average annual mortality levels for the fishery (A = 38 %) had, on average, 8 % greater abundance than scenarios with the highest annual mortality levels observed for a fishery (A = 46 %). The scenario with the highest annual mortality level required a positive environmental trend in habitat capacity in order to support an abundance similar to that for the average annual mortality scenario. Regardless of the trend in habitat carrying capacity, the proportion of fish at or greater than 381 mm in the population decreased from 56 % (no fishery) to 43 % (average fishing mortality) to 35 % (above average fishing mortality), depending on total annual mortality. Model predictions were supportive of that observed for the fishery in that above average levels of annual mortality and catch were sustained at a period with near or above average habitat availability. However, when habitat declined, catch subsequently became more variable and increased following a period of both lower annual mortality and increasing habitat availability. My results indicate that catch-and-release fisheries should be managed by protecting and improving essential habitat conditions, when possible; and if not, then preventing periodically high levels of annual mortality becomes necessary for maintaining consistent abundance.
Perilipin A is the most abundant lipid droplet-associated protein in adipocytes and serves important functions in regulating triacylglycerol levels by reducing rates of basal lipolysis and ...facilitating hormonally stimulated lipolysis. We have previously shown that the central region of perilipin A targets and anchors it to lipid droplets, at least in part via three moderately hydrophobic sequences that embed the protein into the hydrophobic core of the droplet. The current study examines the roles of the amino and carboxyl termini of perilipin A in facilitating triacylglycerol storage. Amino- and carboxyl-terminal truncation mutations of mouse perilipin A were stably expressed in 3T3-L1 preadipocytes, which lack perilipins. Triacylglycerol content of the cells was quantified as a measure of perilipin function and was compared with that of cells expressing full-length perilipin A or control cells lacking perilipins. The amino-terminal sequence between amino acids 122 and 222, including four 10-11-amino acid sequences predicted to form amphipathic β-strands and a consensus site for cAMP-dependent protein kinase, and the carboxyl terminus of 112 amino acids that is unique to perilipin A were critical to facilitate triacylglycerol storage. The precocious expression of full-length perilipin A in 3T3-L1 preadipocytes aided more rapid storage of triacylglycerol during adipose differentiation. By contrast, the expression of highly truncated amino- or carboxyl-terminal mutations of perilipin failed to serve a dominant negative function in lowering triacylglycerol storage during adipose differentiation. We conclude that the amino and carboxyl termini are critical to the function of perilipin A in facilitating triacylglycerol storage.
To explain the emergence of suicidal ideation within an individual we developed the emotion self-confidence model of suicidal ideation (ESC-SI Model). The modelproposes that, when faced with the ...stressor of negative emotionality, an individual with low expectations for coping with or changing the negative emotionality (low emotion self-confidence) is more likely to consider suicidal ideation. A preliminary study in adolescents supported this hypothesis. The present paper investigated the model more fully; following up 71 adolescents 2.2-3.7 years later. The main aims were to: (a) provide further validation of the ESC-SI Model through replication; (b) evaluate stability and change in key variables over time; (c) assess the causal hypothesis that emotion self-confidence appraisals would predict later suicidal ideation. Cross-sectional analysis replicated results obtained at baseline, supporting the model. Longitudinal analysis showed negative emotionality to be moderately stable, emotion self-confidence highly stable, and suicidal ideation highly variable, over time. Baseline emotion self-confidence did not explain unique variance in later suicidal ideation, failing to establish a causal relationship over this time frame. Links between emotion self-confidence and suicidal ideation were strongest during concurrent observations; a future focus on specific emotional experiences is recommended.
American eel (Anguilla rostrata Lesueur) is born in the Atlantic Ocean, but larvae redistribute throughout diverse habitats of North American estuaries and freshwater streams. We hypothesized that ...early stage A. rostrata differed in abundance among sites within a single coastal lagoon, Newport Bay (Maryland) for two sampling seasons (March-May in 2007 and 2008). Catch per unit effort (CPUE) of early stage A. rostrata was usually similar between years at a site, except that it was higher at one site in 2008 than in 2007. The CPUE varied among sites within Newport Bay, but not significantly so because of high, intra-annual variance in CPUE at a site. As reported for New Jersey coastal estuaries, variation in the CPUE tended to be higher in brackish water habitats. Intra-annual variation in CPUE from March until May was partially explained by oxygenation and salinity. The CPUE of settling eels was greatest when water was well-oxygenated (dissolved oxygen >8 mg·L⁻¹) and mildly brackish (0.3-3.2 ppt). While larval supply to a coastal estuary may annually influence the magnitude of potential settlers, temporal differences in habitat conditions within Newport Bay also influenced settlement patterns. Differences in habitat conditions can affect the pigmentation rates of settling early stage eels. We measured rates of pigmentation, which corresponded with age of the fish. However, rates did not differ among sites or vary with habitat conditions. Pigmentation levels from March to May increased at a rate of about 0.02% per week. Monitoring programs for early phase American eel should consider the steepness of habitat gradients within estuaries and habitat covariates when assessing population status.
Validated diagnostic interviews are required to classify depression status and estimate prevalence of disorder, but screening tools are often used instead. We used individual participant data ...meta-analysis to compare prevalence based on standard Hospital Anxiety and Depression Scale – depression subscale (HADS-D) cutoffs of ≥8 and ≥11 versus Structured Clinical Interview for DSM (SCID) major depression and determined if an alternative HADS-D cutoff could more accurately estimate prevalence.
We searched Medline, Medline In-Process & Other Non-Indexed Citations via Ovid, PsycINFO, and Web of Science (inception-July 11, 2016) for studies comparing HADS-D scores to SCID major depression status. Pooled prevalence and pooled differences in prevalence for HADS-D cutoffs versus SCID major depression were estimated.
6005 participants (689 SCID major depression cases) from 41 primary studies were included. Pooled prevalence was 24.5% (95% Confidence Interval (CI): 20.5%, 29.0%) for HADS-D ≥8, 10.7% (95% CI: 8.3%, 13.8%) for HADS-D ≥11, and 11.6% (95% CI: 9.2%, 14.6%) for SCID major depression. HADS-D ≥11 was closest to SCID major depression prevalence, but the 95% prediction interval for the difference that could be expected for HADS-D ≥11 versus SCID in a new study was −21.1% to 19.5%.
HADS-D ≥8 substantially overestimates depression prevalence. Of all possible cutoff thresholds, HADS-D ≥11 was closest to the SCID, but there was substantial heterogeneity in the difference between HADS-D ≥11 and SCID-based estimates. HADS-D should not be used as a substitute for a validated diagnostic interview.
•No studies have compared HADS-D results to prevalence from diagnostic interviews.•We evaluated data from 41 studies (6005 participants, 689 with major depression).•Prevalence based on HADS-D ≥ 8 (24.5%) was more than double the SCID (11.6%).•HADS-D ≥ 11 (10.7%) was similar but single-study differences highly heterogeneous.•The HADS-D should not be used as a substitute for a validated diagnostic interview.
Nontyphoidal salmonellal cholecystitis is a rare complication of nontyphoidal salmonellal enterocolitis. We describe three patients with this complication who were hospitalized in a regional ...infectious disease unit at Ruchill Hospital, Glasgow, Scotland, over a period of 12 months. All three patients were receiving ciprofloxacin therapy before the episodes of cholecystitis became clinically evident, and all required surgical intervention.
Developing and testing theoretical models of suicidal processes is an important step towards designing appropriately targeted interventions. Though numerous correlates of suicidal ideation have been ...identified, little theory articulates exactly how suicidal ideation arises in such contexts. Drawing on empirical and theoretical literature, we present the rationale for a stress-coping model to explain the development of suicidal ideation within an individual (the emotion self-confidence model of suicidal ideation). Negative emotionality is viewed as an internal contextual stressor, potentially leading to the coping response of suicidal ideation, depending on how well an individual believes he/she can cope with or change the negative emotionality (emotion self-confidence). In particular, high levels of negative emotionality coupled with low emotion self-confidence would be expected to predispose towards thoughts of suicide. We discuss the relationship between emotion self-confidence and processes associated with suicidal ideation, such as depression and hopelessness, as well as how emotion self-confidence relates to broader cognitive behavioral constructs involving coping expectations. Accordingly, we outline the benefits of conceptualizing the model within Lazarus and Folkman's (1984; Lazarus, 1999) stress-coping framework.
Introduction
Parastomal hernias (PSH) are the most common complication of stoma creation and can cause significant morbidity. We present a consecutive series of patients receiving prophylactic mesh ...augmentation (PMA) for prevention of PSH.
Methods
This retrospective review evaluates the efficacy and outcomes of PMA for PSH prevention, and retrospectively compares traditional keyhole PMA (tPMA) (
n
= 28) with a prophylactic Stapled Ostomy Reinforcement with Retromuscular Mesh technique (pSTORRM) (
n
= 24).
Results
PMA was performed in 52 cases between January 2015 and July 2018. All cases used a large-pore, non-coated, mid-weight polypropylene mesh placed in the retrorectus space. With a median follow-up of 16 mos, parastomal hernia was confirmed in 11.5% (
n
= 6), 5 of whom were symptomatic. patient-reported outcomes (PRO) indicated 6 additional patients with symptoms associated with PSH without clinical or radiographic confirmation. Patients had similar comorbidities and operative characteristics between tPMA and pSTORRM techniques, and no difference in a median follow-up. pSTORRM patients had fewer surgical site infections (8.3 vs 32.1%;
p
= 0.046) and occurrences (12.5 vs 46.4%;
p
= 0.015), and lower rate of PSH, though not statistically significant (4.2 vs 17.9%;
p
= 0.195).
Conclusion
Permanent synthetic mesh placed as a sublay in the retromuscular space is safe and appears to decrease the risk of PSH formation after the creation of permanent stomas. A stapled technique may provide advantages over a traditional keyhole technique.
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