ABSTRACT
BACKGROUND AND PURPOSE
Human immunodeficiency virus (HIV)‐infected patients commonly have abnormalities in cerebral white matter that are visible on magnetic resonance imaging (MRI) as ...hyperintensities (WMHs). Visual rating scales (VRSs) have been used to quantify WMH in other diseases such as cerebral small vessel disease (CSVD), but not in HIV. Such scales are advantageous because they are applicable to routinely acquired MRIs and so are suitable for large‐scale studies and clinical care. We sought to establish the utility of three VRSs (the Fazekas, Scheltens, and van Sweiten scales) in HIV.
METHODS
The Manhattan HIV Brain Bank (MHBB) is a longitudinal cohort study that performs serial neurologic examinations and neuropsychological testing. All brain MRIs (n = 73) performed for clinical purposes on MHBB participants were scored using the three VRSs. We assessed reliability, validity, and correlation of the VRS with clinical factors relevant to HIV and CSVD.
RESULTS
The VRSs all showed acceptable internal consistency and interrater reliability and were highly correlated with one another (r = 0.836‐0.916, P < .001). The Fazekas and Scheltens scales demonstrated more WMH in periventricular regions, and the Scheltens scale also suggested a frontal to occipital gradient, with greater WMH frontally. All three VRSs correlated significantly with cognitive impairment (global T score). Age and hepatitis C virus antibody serostatus were the strongest clinical/demographic correlates of WMH, followed by African‐American race.
CONCLUSIONS
VRSs reliably quantify WMH in HIV‐infected individuals and correlate with cognitive impairment. Future studies may find routinely acquired brain MRI quantified by VRS to be an accessible and meaningful neurologic outcome measure in HIV.
Achieving integration Robinson, Jessica L.; Manrodt, Karl; Murfield, Monique Lynn ...
The international journal of logistics management,
10/2018, Letnik:
29, Številka:
4
Journal Article
Recenzirano
Purpose
The purpose of this paper is to propose and test a dual pathway model whereby addressing the question, “What are the effects of supply chain orientation and organizational identification on ...internal integration and supplier integration?”.
Design/methodology/approach
A survey design was performed to collect data from supply chain professionals regarding their organization’s supply chain orientation (SCO), organizational identification (OI) and achieved states of both internal and supplier integration. Partial least squares-structural equation modeling was performed to test the dual mediating pathways.
Findings
The results show that internal integration partially mediates relationships between SCO and supplier integration and for OI and supplier integration. In comparing the mediating effects to test competing theories, the SCO path yields stronger complementary partial mediation. This supports the proposition that SCO and OI mutually exist within an organization and influence achieved integrative behaviors. Additionally, results suggest the behavioral spillover effect exists for an internally integrated organization that has also achieved supplier integration.
Originality/value
This research makes several contributions to extant literature, including finding that SCO contributes to levels of achieved integration. Also, this research theoretically integrates literature on the social dilemma associated with supplier integration and the behavioral spillover effect, suggesting that SCO allows for positive internal integrative behaviors to spillover to integrated suppliers. Finally, this research contributes to research on OI by finding achieved integration is an outcome, which refutes a dominate theory that explains OI facilitates negative behaviors toward external organizations.
Standardly collected clinical and pathological patient information has demonstrated only moderate ability to predict risk of biochemical recurrence (BCR) of prostate cancer in men undergoing salvage ...radiation therapy (SRT) for a rising PSA after radical prostatectomy (RP). Although elevated FOXA1 staining has been associated with poor patient outcomes following RP, it has not been studied in the specific setting of SRT after RP. The aim of this study was to evaluate the association between FOXA1 staining level and BCR after SRT for recurrent prostate cancer.
A total of 141 men who underwent SRT at our institution were included. FOXA1 staining levels in primary tumor samples were detected using immunohistochemistry. FOXA1 staining percentage and intensity were measured and multiplied together to obtain a FOXA1 H-score (range 0-12) which was our primary staining measure. P-values ≤ 0.0056 were considered as statistically significant after applying a Bonferroni correction for multiple comparisons.
There was not a significant association between FOXA1 H-score and risk of BCR when considering H-score as an ordinal variable or as a categorical variable (all P ≥ 0.090). Similarly, no significant associations with BCR were observed for FOXA1 staining percentage or staining intensity (all P ≥ 0.14).
FOXA1 staining level does not appear to have a major impact on risk of BCR after SRT.
Non-cephalgic symptoms including orthostatic intolerance, fatigue, and cognitive impairment, are common in patients with chronic headache disorders and may result from alterations in the autonomic ...nervous system. However, little is known about the function of autonomic reflexes, which regulate cardiovascular homeostasis and cerebral perfusion in patients with headache.
Autonomic function testing data from patients with headache collected between January 2018 and April 2022 was retrospectively analyzed. Through review of EMR we determined headache pain chronicity and patient self-report of orthostatic intolerance, fatigue, and cognitive impairment. Composite Autonomic Severity Score (CASS), CASS subscale scores, and cardiovagal and adrenergic baroreflex sensitivities were used to quantify autonomic reflex dysfunction. Descriptive analyses (Mann-Whitney-
or χ
, as appropriate) determined associations between autonomic reflex dysfunction and POTS as well as chronic headache. Binomial logistic regression adjusted for age and sex. Spearman's rank correlation determined the association between the total CASS score and the number of painless symptoms reported by each participant.
We identified 34 patients meeting inclusion criteria, of whom there were 16 (47.0%) with orthostatic intolerance, 17 (50.0%) with fatigue, 11 (32.4%) with cognitive complaints, and 11 (32.4%) with Postural Orthostatic Tachycardia Syndrome (POTS). The majority of participants had migraine (
= 24, 70.6%), were female (
= 23, 67.6%) and had a chronic (>15 headache days in a month) headache disorder (
= 26, 76.5%). Reduced cardiovagal baroreflex sensitivity (BRS-V) independently predicted chronic headache aOR: 18.59 (1.16, 297.05),
= 0.039 and POTS aOR: 5.78 (1.0, 32.5),
= 0.047. The total CASS was correlated with the total number of non-painful features in the expected direction (
= 0.46,
= 0.007).
Abnormal autonomic reflexes may play an important role in pain chronification and the development of POTS in patients with headache.
Across Europe, negative public opinion has and may continue to limit the deployment of renewable energy infrastructure required for the transition to net‐zero energy systems. Understanding public ...sentiment and its spatio‐temporal variations is as such important for decision‐making and for developing socially accepted energy systems. In this study, we apply a sentiment classification model based on a machine learning framework for natural language processing, NorBERT, on data collected from Twitter between 2006 and 2022 to analyse the case of wind power opposition in Norway. From the 68,828 tweets with geospatial information, we show how discussions about wind power intensified in 2018/2019 together with a trend of more negative tweets up until 2020, both on a regional level and for Norway as a whole. Furthermore, we find weak geographical clustering in our data, indicating that discussions are country wide and not dominated by specific regional events or developments. Twitter data allow for detailed insight into the temporal nature of public sentiments and extending this research to additional case studies of technologies, countries and sources of data (e.g. newspapers, other social media) may prove important to complement traditional survey research and the understanding of public sentiment.
For Christian colleges and universities, students' spiritual formation and character development are important outcomes. However, unlike academic outcomes of retention and graduation, systematic ...efforts to measure outcomes of faith and character are far from ubiquitous. The purpose of this article is to report the efforts of Baylor University to address the gap between mission and measurement. Guided by prevailing theories, an interdisciplinary research team launched the Baylor Faith and Character Study in August 2018. Data collection for the broader project involved surveys and interviews at three points in time: a student's first semester at Baylor, a student's final semester at Baylor, and 10 years after degree completion. Preliminary, cross-sectional findings from survey data reveal that levels of religious belief and practice were nearly equivalent for first-year students, seniors, and alumni, while seniors exhibited stronger character in several areas than first-year students. A discussion of conclusions and implications closes the article.
Background: Breast cancer (BC) treatment is rapidly evolving with new and costly therapeutics. Existing costing models have a limited ability to capture current treatment costs. We used an ...Activity-Based Costing (ABC) method to determine a per-case cost for BC treatment by stage and molecular subtype. Methods: ABC was used to proportionally integrate multidisciplinary evidence-based patient and provider treatment options for BC, yielding a per-case cost for the total duration of treatment by stage and molecular subtype. Diagnostic imaging, pathology, surgery, radiation therapy, systemic therapy, inpatient, emergency, home care and palliative care costs were included. Results: BC treatment costs were higher than noted in previous studies and varied widely by molecular subtype. Cost increased exponentially with the stage of disease. The per-case cost for treatment (2023C$) for DCIS was C$ 14,505, and the mean costs for all subtypes were C$ 39,263, C$ 76,446, C$ 97,668 and C$ 370,398 for stage I, II, III and IV BC, respectively. Stage IV costs were as high as C$ 516,415 per case. When weighted by the proportion of molecular subtype in the population, case costs were C$ 31,749, C$ 66,758, C$ 111,368 and C$ 289,598 for stage I, II, III and IV BC, respectively. The magnitude of cost differential was up to 10.9 times for stage IV compared to stage I, 4.4 times for stage III compared to stage I and 35.6 times for stage IV compared to DCIS. Conclusion: The cost of BC treatment is rapidly escalating with novel therapies and increasing survival, resulting in an exponential increase in treatment costs for later-stage disease. We provide real-time, case-based costing for BC treatment which will allow for the assessment of health system economic impacts and an accurate understanding of the cost-effectiveness of screening.
The mechanism producing psychosis appears to include hippocampal inflammation, which could be associated with the microbiome-gut-brain-axis (MGBS). To test this hypothesis we are conducting a ...multidisciplinary study, herein described. The procedures are illustrated with testing of a single subject and group level information on the impact of C-section birth are presented.
Study subjects undergo research diagnostic interviews and symptom assessments to be categorized into one of 3 study groups: psychosis, nonpsychotic affective disorder or healthy control. Hippocampal volume and metabolite concentrations are assessed using 3-dimensional, multi-voxel H1 Magnetic Resonance Imaging (MRSI) encompassing all gray matter in the entire hippocampal volume. Rich self-report information is obtained with the PROMIS interview, which was developed by the NIH Commons for research in chronic conditions. Early trauma is assessed and cognition is quantitated using the MATRICS. The method also includes the most comprehensive autonomic nervous system (ANS) battery used to date in psychiatric research. Stool and oral samples are obtained for microbiome assessments and cytokines and other substances are measured in blood samples.
Group level preliminary data shows that C-section birth is associated with higher concentrations of GLX, a glutamate related hippocampal neurotransmitter in psychotic cases, worse symptoms in affective disorder cases and smaller hippocampal volume in controls.
Mode of birth appears to have persistent influences through adulthood. The methodology described for this study will define pathways through which the MGBA may influence the risk for psychiatric disorders.
Southwestern British Columbia (BC) is exposed to the highest seismic hazard in Canada. Ocean Networks Canada (ONC) has developed an Earthquake Early Warning (EEW) system for the region. The system ...successfully utilizes offshore cabled seismic instruments in addition to land-based seismic sensors and integrates displacement data from Global Navigation Satellite Systems (GNSS). The seismic and geodetic data are processed in real-time onsite at 40 different stations along the coast of BC. The processing utilizes P-wave and S-wave detection algorithms for epicentre calculations as well as incorporation of geodetic and seismic displacement data into a Kalman filter to provide magnitude estimates. The system is currently in its commissioning phase and has successfully detected over 60 earthquakes since being deployed in October 2018. To increase the coverage of the EEW system, we are in the process of incorporating detection parameters from neighbouring networks (e.g., the Pacific Northwest Seismic Network (PNSN)) to provide additional information for future event notifications.
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