2D-3D registration of CT vertebra volume to fluoroscopy projection: A calibration model assessment (doi:10.1155/2010/806094)

This study extends a previous research concerning intervertebral motion registration by means of 2D dynamic fluoroscopy to obtain a more comprehensive 3D description of vertebral kinematics. The problem of estimating the 3D rigid pose of a CT volume of a vertebra from its 2D X-ray fluoroscopy projection is addressed. 2D-3D registration is obtained maximising a measure of similarity between Digitally Reconstructed Radiographs (obtained from the CT volume) and real fluoroscopic projection. X-ray energy correction was performed. To assess the method a calibration model was realised a sheep dry vertebra was rigidly fixed to a frame of reference including metallic markers. Accurate measurement of 3D orientation was obtained via single-camera calibration of the markers and held as true 3D vertebra position; then, vertebra 3D pose was estimated and results compared. Error analysis revealed accuracy of the order of 0.1 degree for the rotation angles of about 1?mm for displacements parallel to the fluoroscopic plane, and of order of 10?mm for the orthogonal displacement.<br/

The challenge of perioperative pain management in opioid-tolerant patients

The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal. Clinicians are encouraged to plan perioperative pain medications and to refer these patients to psychiatrists and addiction specialists for their evaluation. The aim of this review was to give practical suggestions for perioperative management of surgical opioid-tolerant patients, together with schemes of opioid conversion for chronic pain patients assuming oral or transdermal opioids, and patients under maintenance programs with methadone, buprenorphine, or naltrexone

(+/-)-Gelliusines A and B, two diastereomeric brominated tris-indole alkaloids from a deep water New Caledonian marine sponge (Gellius or Orina sp.)

Two new diastereomeric brominated tris-indole alkaloids occurring as enantiomeric pairs, (±)-gelliusine A (I) and its isomer (±)-gelliusine B, have been isolated from a deep water New Caledonian sponge (Gellius or Orina sp.), whose crude ext. exhibited cytotoxicity against KB cells. Their structures were elucidated by spectroscopic methods including one- and two-dimensional NMR spectroscopy. The major compd., I, which showed very weak cytotoxicity, proved to be active at the serotonin receptor

The long-term effects of childhood neglect or abuse. Implications for child and family services in the UK

Childhood neglect or abuse is damaging, with lifelong impacts on functioning, clinical and physical health. It can also transmit risk to the next generation. Child abuse is related to social deprivation, a source of family breakup, common in families under stress and is associated with other social ills such as domestic violence, and parental mental health problems. It is therefore costly to society financially, emotionally and in terms of family wellbeing. It is increasingly seen as a major public health issue given its wide prevalence. Contemporary issues in the UK concern not only ongoing neglect or abuse of children, but also the impact of historical abuse, a psychological burden to a significant number of adults. Often untreated, and occurring before adequate child protection policies were in place, the impacts of historical abuse is an ongoing concern both for health and social care services. This paper will describe the Childhood Experience of Care and Abuse (CECA) interview research findings and application in child and family services. It enables an accurate assessment of historical abuse, and its scoring system can be used on ongoing case files for children for better classification. A social and attachment model are described as explaining how damage from neglect and abuse can extend into later life

Family history and searching for hidden trauma—a personal commentary

Background: Searching family history is now popular through increased internet access coinciding with a need for understanding identity. Prior unresolved war trauma can help explain impacts on subsequent generations and the need to search for family narrative, particularly in refugee families. This paper explores the search for trauma narratives through personal family history research, with links to community groups. Method: The author’s own Polish family history research provides examples of trauma and loss from World War II in Poland. This is supplemented by quotes from an existing interview study of second-generation Poles to amplify themes and indicate their wider community relevance

Author's reply to: Comment on "Web-based measure of life events using Computerized Life Events and Assessment Record (CLEAR): preliminary cross-sectional study of reliability, validity, and association with depression": validity and methodological issues

I thank the editors of JMIR Mental Health for the opportunity to respond to the Letter to the Editor [1] critiquing the methodology of the Computerised Online Life events Record (CLEAR) [2] published in this journal. While appreciating the critique, it expands on only one of the validity findings, comparing CLEAR with a life event interview and checklist questionnaire. There are significant points not outlined in the letter [1] and these are addressed here. Without questioning the additional statistical analyses provided by the sensitivity and specificity, the conclusion that this is unacceptable for a “diagnostic tool” is refuted. CLEAR is not a clinical diagnostic tool but owing to its high predictive validity with regard to depression and superiority to the checklist life events test (LTE-Q) [3], it retains value as a method for identifying environmental stressors related to clinical models

Assessing child abuse: "We need to talk!"

This discussion paper adds to the recent critical debate concerning retrospective measurement of childhood abuse and adverse experiences. A series of recent articles found only modest overlap of prospective informant-based records with retrospective self-report questionnaires, with biases evident in the latter. However, this literature has omitted the use of investigator-based interviews as an alternative retrospective tool for triangulation of measurement. Validated interview approaches can ascertain accurate data using expert scoring that can be used to test both dose-effect and specificity analyses for further research and treatment purposes. Arguments for the retention and further promotion of intensive interview measures for retrospective assessment of childhood neglect and abuse in relation to lifetime clinical outcomes are presented, with illustrative analyses. A network analytic approach is outlined, with six types of childhood abuse or neglect experiences scored via a well-validated interview (the Childhood Experiences of Care and Abuse). This indicates distinct pathways between types of neglect and abuse, but also from more common emotional abuse (antipathy, critical parenting) through to more pernicious psychological abuse (coercive, sadistic control) involving physical abuse or sexual abuse pathways. This is supplemented by a case vignette to illustrate the different pathways indicated. The interview approach gives victims a voice with their narrative (chance to talk) needed for better understanding of the specific dynamics of child abuse and neglect and for an entry into psychotherapeutic work. We need to ensure that such methods are retained in the research and practitioner portfolio of measurement tools. [Abstract copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

Interview investigation of insecure attachment styles as mediators between poor childhood care and schizophrenia-spectrum phenomenology

Background Insecure attachment styles have received theoretical attention and some initial empirical support as mediators between childhood adverse experiences and psychotic phenomena; however, further specificity needs investigating. The present interview study aimed to examine (i) whether two forms of poor childhood care, namely parental antipathy and role reversal, were associated with subclinical positive and negative symptoms and schizophrenia-spectrum personality disorder (PD) traits, and (ii) whether such associations were mediated by specific insecure attachment styles. Method A total of 214 nonclinical young adults were interviewed for subclinical symptoms (Comprehensive Assessment of At-Risk Mental States), schizophrenia-spectrum PDs (Structured Clinical Interview for DSM-IV Axis II Disorders), poor childhood care (Childhood Experience of Care and Abuse Interview), and attachment style (Attachment Style Interview). Participants also completed the Beck Depression Inventory-II and all the analyses were conducted partialling out the effects of depressive symptoms. Results Both parental antipathy and role reversal were associated with subclinical positive symptoms and with paranoid and schizotypal PD traits. Role reversal was also associated with subclinical negative symptoms. Angry-dismissive attachment mediated associations between antipathy and subclinical positive symptoms and both angry-dismissive and enmeshed attachment mediated associations of antipathy with paranoid and schizotypal PD traits. Enmeshed attachment mediated associations of role reversal with paranoid and schizotypal PD traits. Conclusions Attachment theory can inform lifespan models of how adverse developmental environments may increase the risk for psychosis. Insecure attachment provides a promising mechanism for understanding the development of schizophrenia-spectrum phenomenology and may offer a useful target for prophylactic intervention

Pituitary block with gonadotrophin-releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta-analysis of randomised controlled trials

BACKGROUND: Several randomised controlled trials (RCTs) have investigated the usefulness of pituitary block with gonadotrophin-releasing hormone (GnRH) antagonists during intrauterine insemination (IUI) cycles, with conflicting results. OBJECTIVE: The aim of the present systematic review and meta-analysis of RCTs was to evaluate the effectiveness of GnRH antagonist administration as an intervention to improve the success of IUI cycles. SEARCH STRATEGY: Electronic databases (MEDLINE, Scopus, EMBASE, Sciencedirect) and clinical registers were searched from their inception until October 2017. SELECTION CRITERIA: Randomised controlled trials of infertile women undergoing one or more IUI stimulated cycles with GnRH antagonists compared with a control group. DATA COLLECTION AND ANALYSIS: The primary outcomes were ongoing pregnancy/live birth rate (OPR/LBR) and clinical pregnancy rate (CPR). Pooled results were expressed as odds ratio (OR) or mean differences with 95% confidence interval (95% CI). Sources of heterogeneity were investigated through sensitivity and subgroups analysis. The body of evidence was rated using GRADE methodology. Publication bias was assessed with funnel plot, Begg's and Egger's tests. MAIN RESULTS: Fifteen RCTs were included (3253 IUI cycles, 2345 participants). No differences in OPR/LBR (OR 1.14, 95% CI 0.82-1.57, P = 0.44) and CPR (OR 1.28, 95% CI 0.97-1.69, P = 0.08) were found. Sensitivity and subgroup analyses did not provide statistical changes in pooled results. The body of evidence was rated as low (GRADE 2/4). No publication bias was detected. CONCLUSION: Pituitary block with GnRH antagonists does not improve OPR/LBR and CPR in women undergoing IUI cycles. TWEETABLE ABSTRACT: Pituitary block with GnRH antagonists does not improve the success of IUI cycles

Exploring disorganized attachment style among Malay mothers in Malaysia: a study using the Attachment Style Interview

This article explores emerging themes involving disorganized attachment style among Malay Muslim mothers using the Attachment Style Interview (ASI). Analysis of the 18 mothers with disorganized attachment style (those with combined anxious and avoidant styles) utilized themes deemed important from the attachment research literature and selected based on a careful reading of the narrative cases. These include more extreme negative interpersonal experiences than found in other insecure attachment style descriptors, and included partner violence and related isolation/social exclusion. It also indicated more complex cognitive-affective disturbance including mixed or contradictory dependency patterns and both angry and fearful attitudes to others. We discuss the concept of disorganized attachment style in relation to abuse, social exclusion, and its implication for psychopathology, intervention, and treatment