Measurement of the psoas muscle area has been applied to estimate lean muscle mass as a surrogate marker of sarcopenia, but there is a paucity of evidence regarding the influence of sarcopenia on ...clinical outcomes following inflammatory bowel disease surgery. The aim of this study was to evaluate the association between MRI enterography defined sarcopenia and postoperative complications in patients undergoing elective ileocaecal resection for Crohn’s disease. To obtain cross sectional area measurement of the psoas muscle, the freehand area tool was used to trace the margin of each psoas muscle at the level of L4, with the sum recorded as Total Psoas Area (TPA). The total cross sectional muscle area of the abdominal wall was recorded as Skeletal Muscle Area (SMA), while myosteatosis was measured by normalising the psoas muscle intensity with the mean intensity of the cerebrospinal fluid. The primary outcome was the incidence of 30-day postoperative complications in patients in the lowest quartile of TPA and SMA. 31 patients were included and ten patients (32.25%) developed postoperative complications within 30 days of surgery. The cut-off values for the lowest quartile for TPA were 11.93 cm
2
in men and 9.77 cm
2
in women, including a total of 8 patients (25.8%) with 5 patients in this group (62.5%) developing postoperative complications and 3 patients (37.5%) Clavien-Dindo class ≥ 3 complications. The cut-off values for the lowest quartile for SMA were 73.49 cm
2
in men and 65.85 cm
2
in women, with 4 patients out of 8 (50%) developing postoperative complications. Psoas muscle cross sectional area and skeletal mass area can be estimated on Magnetic Resonance Enterography as surrogate markers of sarcopenia with high inter-observer agreement.
Although skeletal pain plays a major role in reducing the quality of life in patients suffering from osteoarthritis, Paget’s disease, sickle cell anemia and bone cancer, little is known about the ...mechanisms that generate and maintain this pain. To define the peripheral fibers involved in transmitting and modulating skeletal pain, we used immunohistochemistry with antigen retrieval, confocal microscopy and three-dimensional image reconstruction of the bone to examine the sensory and sympathetic innervation of mineralized bone, bone marrow and periosteum of the normal mouse femur. Thinly myelinated and unmyelinated peptidergic sensory fibers were labeled with antibodies raised against calcitonin gene-related peptide (CGRP) and the unmyelinated, non-peptidergic sensory fibers were labeled with the isolectin B4 (
Bandeira simplicifolia). Myelinated sensory fibers were labeled with an antibody raised against 200-kDa neurofilament H (clone RT-97). Sympathetic fibers were labeled with an antibody raised against tyrosine hydroxylase. CGRP, RT-97, and tyrosine hydroxylase immunoreactive fibers, but not isolectin B4 positive fibers, were present throughout the bone marrow, mineralized bone and the periosteum. While the periosteum is the most densely innervated tissue, when the total volume of each tissue is considered, the bone marrow receives the greatest total number of sensory and sympathetic fibers followed by mineralized bone and then periosteum.
Understanding the sensory and sympathetic innervation of bone should provide a better understanding of the mechanisms that drive bone pain and aid in developing therapeutic strategies for treating skeletal pain.
Organizational Socialization Chao, Georgia T; O'Leary-Kelly, Anne M; Wolf, Samantha ...
Journal of applied psychology,
10/1994, Volume:
79, Issue:
5
Journal Article
Peer reviewed
Content dimensions of the socialization domain were defined in order to determine relationships between learning particular features of a job/organization and the process and outcomes of ...socialization. Six socialization dimensions-performance proficiency, politics, language, people, organizational goals/values, and history-were supported by a factor analysis on data from 594 full-time professionals. The socialization process was then examined by comparing three groups of respondents who did not change jobs, changed jobs within the organization, or changed jobs and organizations. Results showed these groups had significantly different response patterns on all dimensions. Finally, relationships between socialization content and career outcomes showed the dimensions accounted for more variance in all criteria than typical tenure operationalizations of socialization. Furthermore, socialization changes were significantly related to changes in career outcomes for 1-, 2-, and 3-year time intervals.
It remains difficult to distinguish between complicated appendicitis (CAP) and uncomplicated appendicitis (UAP). There is a paucity of studies utilizing inflammatory markers to stratify the severity ...of acute appendicitis. This study aimed to evaluate and demonstrate the potential clinical utility of inflammatory markers as adjuncts in distinguishing CAP and UAP.
A comparative observational study was performed. Patients diagnosed with acute appendicitis were categorized as (a) complicated (necrosis, perforation, abscess) and (b) uncomplicated (inflamed, edematous). Hematological indices were combined to generate the following ratios: white cell lymphocyte ratio (WLR), white cell neutrophil ratio (WNR) and neutrophil lymphocyte ratio (NLR). Parameter accuracy was assessed using summary receiver operating characteristic (sROC) curves, classification and regression tree analysis and confusion matrix generation.
On sROC analysis, neutrophils (area under the curve (AUC) 0.79, p < 0.001), WLR (AUC 0.79, p < 0.001) and NLR (AUC 0.79, p < 0.001) were the most accurate parameters in distinguishing CAP and UAP. White cell count (WCC; AUC 0.76, p < 0.001) and C-reactive protein (AUC 0.75, p < 0.001) were less accurate. WCC >12.25 (sensitivity 70%, specificity 68%) and NLR >5.47 (sensitivity 78%, specificity 70%) were the most accurate in identifying CAP.
Inflammatory marker cutoff points can be generated and utilized to differentiate between UAP and CAP. This may be useful when deciding between conservative and operative management.
Therapeutic Alliance Brown, Pamela D; O'Leary, K. Daniel
Journal of consulting and clinical psychology
68, Issue:
2
Journal Article
Peer reviewed
This study examined the role of the therapeutic alliance between client and therapist on group treatment outcome in 70 husband-to-wife violent couples. Strength of husbands' alliance assessed at ...Session 1 was positively associated with treatment outcome, as measured by decreased husband-to-wife mild and severe psychological and physical aggression. Strength of wives' alliance was unrelated to treatment outcome. Finally, although alliance was related to treatment outcome, it was unrelated to treatment completion.
Focal cortical dysplasia (FCD), hemimegalencephaly, and megalencephaly constitute a spectrum of malformations of cortical development with shared neuropathologic features. These disorders are ...associated with significant childhood morbidity and mortality.
To identify the underlying molecular cause of FCD, hemimegalencephaly, and diffuse megalencephaly.
Patients with FCD, hemimegalencephaly, or megalencephaly (mean age, 11.7 years; range, 2-32 years) were recruited from Pediatric Hospital A. Meyer, the University of Hong Kong, and Seattle Children's Research Institute from June 2012 to June 2014. Whole-exome sequencing (WES) was performed on 8 children with FCD or hemimegalencephaly using standard-depth (50-60X) sequencing in peripheral samples (blood, saliva, or skin) from the affected child and their parents and deep (150-180X) sequencing in affected brain tissue. Targeted sequencing and WES were used to screen 93 children with molecularly unexplained diffuse or focal brain overgrowth. Histopathologic and functional assays of phosphatidylinositol 3-kinase-AKT (serine/threonine kinase)-mammalian target of rapamycin (mTOR) pathway activity in resected brain tissue and cultured neurons were performed to validate mutations.
Whole-exome sequencing and targeted sequencing identified variants associated with this spectrum of developmental brain disorders.
Low-level mosaic mutations of MTOR were identified in brain tissue in 4 children with FCD type 2a with alternative allele fractions ranging from 0.012 to 0.086. Intermediate-level mosaic mutation of MTOR (p.Thr1977Ile) was also identified in 3 unrelated children with diffuse megalencephaly and pigmentary mosaicism in skin. Finally, a constitutional de novo mutation of MTOR (p.Glu1799Lys) was identified in 3 unrelated children with diffuse megalencephaly and intellectual disability. Molecular and functional analysis in 2 children with FCD2a from whom multiple affected brain tissue samples were available revealed a mutation gradient with an epicenter in the most epileptogenic area. When expressed in cultured neurons, all MTOR mutations identified here drive constitutive activation of mTOR complex 1 and enlarged neuronal size.
In this study, mutations of MTOR were associated with a spectrum of brain overgrowth phenotypes extending from FCD type 2a to diffuse megalencephaly, distinguished by different mutations and levels of mosaicism. These mutations may be sufficient to cause cellular hypertrophy in cultured neurons and may provide a demonstration of the pattern of mosaicism in brain and substantiate the link between mosaic mutations of MTOR and pigmentary mosaicism in skin.
Fast-beam collinear laser spectroscopy experiments on rubidium have been performed at the ISAC radioactive ion beam facility at TRIUMF. Most recently, the neutron-rich
98
Rb isotope has been studied ...for the investigation of shape coexistence. Two long-lived nuclear states in
98
Rb have been clearly observed for the first time: a low-spin state, assigned a spin of
I
= 0, and a high-spin state. The high-spin state is tentatively assigned a spin of
I
= 3 based on this analysis in combination with gamma decay results. The measured nuclear properties of the two states are presented, alongside unpublished values of the neutron-deficient isotopes investigated previously. The mean-square charge radii of both states in
98
Rb are observed to continue along the isodeformation line present after the
N
= 60 onset of deformation.
Understanding the behavior of particles subjected to forces is a basic theme in physics. The simplest system is a set of particles confined to motion along a line, but even this type of system ...presents computational challenges. For the harmonic oscillator, a particle is subjected to a force directed toward the origin and proportional to the distance between the particle and the origin. The resulting potential is V(x) = 1/2 /spl alpha/x/sup 2/ where /spl alpha/ is a constant. This system is quite thoroughly understood, and quantities of interest can be computed in closed form. Alternatively, the Ginzburg-Landau anharmonic potential, - 1/2 /spl alpha/x/sup 2/ + 1/4 /spl beta/x/sup 4/ (/spl alpha/ and /spl beta/ are constant), is related to solution of the Schrodinger equation, and quantities of interest are computed approximately. One method of obtaining such approximations is numerical integration, which is our focus in this assignment.
The pool of β-Amyloid (Aβ) length variants detected in preclinical and clinical Alzheimer disease (AD) samples suggests a diversity of roles for Aβ peptides. We examined how a naturally occurring ...variant, e.g. Aβ(1-38), interacts with the AD-related variant, Aβ(1-42), and the predominant physiological variant, Aβ(1-40). Atomic force microscopy, Thioflavin T fluorescence, circular dichroism, dynamic light scattering, and surface plasmon resonance reveal that Aβ(1-38) interacts differently with Aβ(1-40) and Aβ(1-42) and, in general, Aβ(1-38) interferes with the conversion of Aβ(1-42) to a β-sheet-rich aggregate. Functionally, Aβ(1-38) reverses the negative impact of Aβ(1-42) on long-term potentiation in acute hippocampal slices and on membrane conductance in primary neurons, and mitigates an Aβ(1-42) phenotype in Caenorhabditis elegans. Aβ(1-38) also reverses any loss of MTT conversion induced by Aβ(1-40) and Aβ(1-42) in HT-22 hippocampal neurons and APOE ε4-positive human fibroblasts, although the combination of Aβ(1-38) and Aβ(1-42) inhibits MTT conversion in APOE ε4-negative fibroblasts. A greater ratio of soluble Aβ(1-42)/Aβ(1-38) and Aβ(1-42)/Aβ(1-40) in autopsied brain extracts correlates with an earlier age-at-death in males (but not females) with a diagnosis of AD. These results suggest that Aβ(1-38) is capable of physically counteracting, potentially in a sex-dependent manner, the neuropathological effects of the AD-relevant Aβ(1-42).
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