Objective The purpose of this study was to estimate the total annual societal cost of uterine fibroid tumors in the United States, based on direct and indirect costs that include associated obstetric ...complications. Study Design A systematic review of the literature was conducted to estimate the number of women who seek treatment for symptomatic fibroid tumors annually, the costs of medical and surgical treatment, the amount of work time lost, and obstetric complications that are attributable to fibroid tumors. Total annual costs were converted to 2010 US dollars. A sensitivity analysis was performed. Results The estimated annual direct costs (surgery, hospital admissions, outpatient visits, and medications) were $4.1-9.4 billion. Estimated lost work-hour costs ranged from $1.55–17.2 billion annually. Obstetric outcomes that were attributed to fibroid tumors resulted in a cost of $238 million to $7.76 billion annually. Uterine fibroid tumors were estimated to cost the United States $5.9-34.4 billion annually. Conclusion Obstetric complications that are associated with fibroid tumors contributed significantly to their economic burden. Lost work-hour costs may account for the largest proportion of societal costs because of fibroid tumors.
Top-down control of responses is a key construct in cognitive science that is thought to be critical for self-control. It is typically measured by subtracting performance in experimental conditions ...in which top-down control is theoretically present against performance in matched conditions in which it is assumed to be absent. Recently, however, subtraction-based metrics of top-down control have been criticized for having low test-retest reliability, weak intercorrelations, and little relation to self-report measures of self-control. Concurrently, there is growing evidence that task-general cognitive efficiency, indexed by the drift rate parameter of the diffusion model (Ratcliff, 1978), constitutes a cohesive, reliable individual difference dimension relevant to self-control. However, no previous studies have directly compared latent factors for top-down control (derived from subtraction metrics) with factors for task-general efficiency “head-to-head” in the same sample in terms of their cohesiveness, temporal stability, and relation to self-control. In this re-analysis of a large open data set (Eisenberg et al., 2019; N = 522), we find that top-down control metrics fail to form cohesive latent factors, that the resulting factors have poor temporal stability, and that they exhibit tenuous connections to questionnaire measures of self-control. In contrast, cognitive efficiency measures—drawn from conditions of the same tasks that both are, and are not, assumed to demand top-down control—form a robust, temporally stable factor that correlates with questionnaire measures of self-control. These findings suggest that task-general efficiency is a central individual difference dimension relevant to self-control. Moreover, they go beyond recent measurement-based critiques of top-down control metrics, and instead suggest problems with key theoretical assumptions that have long guided this research paradigm.
The current status of High K dielectrics in Very Large Scale Integrated circuit (VLSI) manufacturing for leading edge Dynamic Random Access Memory (DRAM) and Complementary Metal Oxide Semiconductor ...(CMOS) applications is summarized along with the deposition methods and general equipment types employed. Emerging applications for High K dielectrics in future CMOS are described as well for implementations in 10 nm and beyond nodes. Additional emerging applications for High K dielectrics include Resistive RAM memories, Metal-Insulator-Metal (MIM) diodes, Ferroelectric logic and memory devices, and as mask layers for patterning. Atomic Layer Deposition (ALD) is a common and proven deposition method for all of the applications discussed for use in future VLSI manufacturing.
Discrete choice experiments (DCEs) are increasingly used in health economics to address a wide range of health policy-related concerns.
Broadly adopting the methodology of an earlier systematic ...review of health-related DCEs, which covered the period 2001-2008, we report whether earlier trends continued during 2009-2012.
This paper systematically reviews health-related DCEs published between 2009 and 2012, using the same database as the earlier published review (PubMed) to obtain citations, and the same range of search terms.
A total of 179 health-related DCEs for 2009-2012 met the inclusion criteria for the review. We found a continuing trend towards conducting DCEs across a broader range of countries. However, the trend towards including fewer attributes was reversed, whilst the trend towards interview-based DCEs reversed because of increased computer administration. The trend towards using more flexible econometric models, including mixed logit and latent class, has also continued. Reporting of monetary values has fallen compared with earlier periods, but the proportion of studies estimating trade-offs between health outcomes and experience factors, or valuing outcomes in terms of utility scores, has increased, although use of odds ratios and probabilities has declined. The reassuring trend towards the use of more flexible and appropriate DCE designs and econometric methods has been reinforced by the increased use of qualitative methods to inform DCE processes and results. However, qualitative research methods are being used less often to inform attribute selection, which may make DCEs more susceptible to omitted variable bias if the decision framework is not known prior to the research project.
The use of DCEs in healthcare continues to grow dramatically, as does the scope of applications across an expanding range of countries. There is increasing evidence that more sophisticated approaches to DCE design and analytical techniques are improving the quality of final outputs. That said, recent evidence that the use of qualitative methods to inform attribute selection has declined is of concern.
Adaptive sampling is a method of software-controlled enrichment unique to nanopore sequencing platforms. To test its potential for enrichment of rarer species within metagenomic samples, we create a ...synthetic mock community and construct sequencing libraries with a range of mean read lengths. Enrichment is up to 13.87-fold for the least abundant species in the longest read length library; factoring in reduced yields from rejecting molecules the calculated efficiency raises this to 4.93-fold. Finally, we introduce a mathematical model of enrichment based on molecule length and relative abundance, whose predictions correlate strongly with mock and complex real-world microbial communities.
In this article, we review the theoretical and empirical literature on racial microaggressions from 2007 to 2020 (N = 138 articles). First, we refine racial microaggressions theory and update the ...definition to address mischaracterizations in the literature and clarify the term (i.e., “micro” refers to microlevel interactions rather than degree of harm). Next, we used four superordinate categories (i.e., pathologizing differences, denigrating and pigeonholing, excluding or rendering invisible, and perpetuating color-blind racial attitudes) in which to situate racial microaggression themes from the extant literature. Moreover, we consolidated and renamed existing themes to privilege targets’ perspectives (e.g., facing assumptions of inferior status and enduring exoticization). We then synthesized qualitative and quantitative research that shows harmful sequelae of racial microaggressions (i.e., psychological and physiological symptoms). Extending prior research on coping with gendered racial microaggressions, we describe empirical findings on collective, resistance, and self-protective strategies to mitigate the harmful impact of racial microaggressions. We conclude with directions for future research.
Understanding the resilience of aquatic ectothermic animals to climate warming has been hindered by the absence of experimental systems experiencing warming across relevant timescales (for example, ...decades). Here, we examine European perch (Perca fluviatilis, L.) from the Biotest enclosure, a unique coastal ecosystem that maintains natural thermal fluctuations but has been warmed by 5-10 °C by a nuclear power plant for over three decades. We show that Biotest perch grow faster and display thermally compensated resting cardiorespiratory functions compared with reference perch living at natural temperatures in adjacent waters. However, maximum cardiorespiratory capacities and heat tolerance limits exhibit limited or no thermal compensation when compared with acutely heated reference perch. We propose that while basal energy requirements and resting cardiorespiratory functions (floors) are thermally plastic, maximum capacities and upper critical heat limits (ceilings) are much less flexible and thus will limit the adaptive capacity of fishes in a warming climate.
Empirically supported psychological treatments have been developed for a range of psychiatric disorders but there is evidence that patients are not receiving them in routine clinical care. ...Furthermore, even when patients do receive these treatments there is evidence that they are often not well delivered. The aim of this paper is to identify the barriers to the dissemination of evidence-based psychological treatments and then propose ways of overcoming them, hence potentially bridging the gap between research findings and clinical practice.
A self-rated measure of health anxiety should be sensitive across the full range of intensity (from mild concern to frank hypochondriasis) and should differentiate people suffering from health ...anxiety from those who have actual physical illness but who are not excessively concerned about their health. It should also encompass the full range of clinical symptoms characteristic of clinical hypochondriasis. The development and validation of such a scale is described.
Three studies were conducted. First, the questionnaire was validated by comparing the responses of patients suffering from hypochondriasis with those suffering from hypochondriasis and panic disorder, panic disorder, social phobia and non-patient controls. Secondly, a state version of the questionnaire was administered to patients undergoing cognitive-behavioural treatment or wait-list in order to examine the measure's sensitivity to change. In the third study, a shortened version was developed and validated in similar types of sample, and in a range of samples of people seeking medical help for physical illness.
The scale was found to be reliable and to have a high internal consistency. Hypochondriacal patients scored significantly higher than anxiety disorder patients, including both social phobic patients and panic disorder patients as well as normal controls. In the second study, a 'state' version of the scale was found to be sensitive to treatment effects, and to correlate very highly with a clinician rating based on an interview of present clinical state. A development and refinement of the scale (intended to reflect more fully the range of symptoms of and reactions to hypochondriasis) was found to be reliable and valid. A very short (14 item) version of the scale was found to have comparable properties to the full length scale.
The HAI is a reliable and valid measure of health anxiety. It is likely to be useful as a brief screening instrument, as there is a short form which correlates highly with the longer version.
Evidence suggests that Epstein-Barr virus (EBV) plays a role in triggering or perpetuating disease activity in multiple sclerosis (MS).
We investigated 100 subjects (50 clinically isolated syndrome ...CIS, 25 relapsing-remitting RR MS, 25 primary progressive PP MS) for 1) evidence of EBV reactivation and 2) disease activity as indicated by serial gadolinium (Gd)-enhanced MRIs over a 5-year period. EBV DNA in blood was quantified by real-time quantitative PCR and EBV serology for anti-Epstein-Barr virus nuclear antigen 1 (EBNA-1) immunoglobulin G (IgG), anti-viral capsid antigen (VCA) IgG, and anti-EBV IgM. Data were analyzed using repeated measures analysis, analysis of variance, and logistic regression analysis.
All subjects had serologic evidence of previous EBV infection, but no lytic reactivation was detected. Significant differences in EBNA-1 IgG titers were found between subgroups, highest in the RRMS cohort compared with PPMS (p < 0.001) and CIS (p < 0.001). Gd-enhancing lesions on MRI correlated with EBNA-1 IgG (r = 0.33, p < 0.001) and EBNA-1:VCA IgG ratio (r = 0.36, p < 0.001). EBNA-1 IgG also correlated with change in T2 lesion volume (r = 0.27, p = 0.044) and Expanded Disability Status Scale score (r = 0.3, p = 0.035).
The correlation between elevated Epstein-Barr virus nuclear antigen 1 (EBNA-1) immunoglobulin G (IgG) and gadolinium-enhancing lesions suggests an association between Epstein-Barr virus (EBV) infection and multiple sclerosis (MS) disease activity. The heightened immune response to EBV in MS is specifically related to EBNA-1 IgG, a marker of the latent phase of the virus. The lack of association between acute viral reactivation in the peripheral blood and Gd(+) lesions suggests a limited role of the former in driving disease activity.
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