363 research outputs found
Measuring the Core Components of Maladaptive Personality: Severity Indices of Personality Problems (SIPP-118)
This report describes a series of studies among 2231 subjects on the development of the Severity Indices for Personality Problems (SIPP), a self-report questionnaire measuring the core components of (mal)adaptive personality functioning. Results show that the 16 facets have good psychometric properties and test-retest reliability, are generic across various types of personality disorders, and have good discriminative validity between various populations. The facets fit well into a common factor model with five higher-order domains (i.e., self-control, identity integration, responsibility, relational capacities, and social concordance) that are eminently interpretable, and replicable across various populations. Domain scorThis report is the first document to describe the development of the SIPP-118: Severity Indices of Personality Problems, 118 items. It provides details about the items selection, validations and reliability studies and norm values. The report is meant as a detailed description of our investigation and is made directly after the data collection in order to allow for fast communication between researchers.
Although the report will probably remain the most detailed description of our research effort, it must not be seen as the final interpretation of the results. The report now serves as an easy accessible collection of research data, on which basis we hope to write peer-reviewed articles. This original report will remain available on request, for those researchers who would like to have a detailed description of the research and the data. Note that parts of the report still reveal the early thoughts and interpretations, which are characteristic for a first report written just after finishing the data collection.
Up-to-date information, norm scores, and translations of the SIPP-118 in Dutch, English, Norwegian, Argentinean, and Italian language, are freely available at www.vispd.nl
Effectiveness of outpatient, day hospital, and inpatient psychotherapeutic treatment for patients with cluster B personality disorders
Abstract
Background: For patients with cluster B personality disor-
ders there is no consensus regarding the optimal treatment
setting. The aim of this study was to compare the effective-
ness of different psychotherapeutic settings for patient
Effectiveness of different modalities of psychotherapeutic treatment for patients with cluster C personality disorders: results of a large prospective multicentre study.
Abstract
BACKGROUND: No previous studies have compared the effectiveness of different modalities of psychotherapeutic treatment, as defined by different settings and durations, for patients with cluster C personality disorders. The aim of this multicentre study wa
Systemic Steroid Exposure Is Associated with Differential Methylation in Chronic Obstructive Pulmonary Disease
Rationale: Systemic glucocorticoids are used therapeutically to treat a variety of medical conditions. Epigenetic processes such as DNA methylation may reflect exposure to glucocorticoids and may be involved in mediating the responses and side effects associated with these medications
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Candidate glutamatergic and dopaminergic pathway gene variants do not influence Huntington’s disease motor onset
Huntington’s disease (HD) is a neurodegenerative disorder characterized by motor, cognitive, and behavioral disturbances. It is caused by the expansion of the HTT CAG repeat, which is the major determinant of age at onset (AO) of motor symptoms. Aberrant function of N-methyl-D-aspartate receptors and/or overexposure to dopamine has been suggested to cause significant neurotoxicity, contributing to HD pathogenesis. We used genetic association analysis in 1,628 HD patients to evaluate candidate polymorphisms in N-methyl-D-aspartate receptor subtype genes (GRIN2A rs4998386 and rs2650427, and GRIN2B rs1806201) and functional polymorphisms in genes in the dopamine pathway (DAT1 3′ UTR 40-bp variable number tandem repeat (VNTR), DRD4 exon 3 48-bp VNTR, DRD2 rs1800497, and COMT rs4608) as potential modifiers of the disease process. None of the seven polymorphisms tested was found to be associated with significant modification of motor AO, either in a dominant or additive model, after adjusting for ancestry. The results of this candidate-genetic study therefore do not provide strong evidence to support a modulatory role for these variations within glutamatergic and dopaminergic genes in the AO of HD motor manifestations
Prevalence and characteristics of progressive fibrosing interstitial lung disease in a prospective registry
Rationale
Progressive fibrosing interstitial lung disease (PF-ILD) is characterized by progressive
physiologic, symptomatic, and/or radiographic worsening. The real-world prevalence and
characteristics of PF-ILD remain uncertain.
Methods
Patients were enrolled from the Canadian Registry for Pulmonary Fibrosis between 2015-2020.
PF-ILD was defined as a relative forced vital capacity (FVC) decline ≥10%, death, lung
transplantation, or any 2 of: relative FVC decline ≥5 and <10%, worsening respiratory
symptoms, or worsening fibrosis on computed tomography of the chest, all within 24 months of
diagnosis. Time-to-event analysis compared progression between key diagnostic subgroups.
Characteristics associated with progression were determined by multivariable regression.
Results
Of 2,746 patients with fibrotic ILD (mean age 65±12 years, 51% female), 1,376 (50%) met PFILD criteria in the first 24 months of follow-up. PF-ILD occurred in 427 (59%) patients with
idiopathic pulmonary fibrosis (IPF), 125 (58%) with fibrotic hypersensitivity pneumonitis (HP),
281 (51%) with unclassifiable ILD (U-ILD), and 402 (45%) with connective tissue diseaseassociated ILD (CTD-ILD). Compared to IPF, time to progression was similar in patients with
HP (hazard ratio [HR] 0.96, 95% confidence interval, CI 0.79-1.17), but was delayed in patients
with U-ILD (HR 0.82, 95% CI 0.71-0.96) and CTD-ILD (HR 0.65, 95% CI 0.56-0.74).
Background treatment varied across diagnostic subtypes with 66% of IPF patients receiving
antifibrotic therapy, while immunomodulatory therapy was utilized in 49%, 61%, and 37% of
patients with CHP, CTD-ILD, and U-ILD respectively. Increasing age, male sex,
gastroesophageal reflux disease, and lower baseline pulmonary function were independently
associated with progression.
Interpretation
Progression is common in patients with fibrotic ILD, and is similarly prevalent in HP and IPF.
Routinely collected variables help identify patients at risk for progression and may guide
therapeutic strategie
Hundreds of variants clustered in genomic loci and biological pathways affect human height
Most common human traits and diseases have a polygenic pattern of inheritance: DNA sequence variants at many genetic loci influence the phenotype. Genome-wide association (GWA) studies have identified more than 600 variants associated with human traits, but these typically explain small fractions of phenotypic variation, raising questions about the use of further studies. Here, using 183,727 individuals, we show that hundreds of genetic variants, in at least 180 loci, influence adult height, a highly heritable and classic polygenic trait. The large number of loci reveals patterns with important implications for genetic studies of common human diseases and traits. First, the 180 loci are not random, but instead are enriched for genes that are connected in biological pathways (P = 0.016) and that underlie skeletal growth defects (P < 0.001). Second, the likely causal gene is often located near the most strongly associated variant: in 13 of 21 loci containing a known skeletal growth gene, that gene was closest to the associated variant. Third, at least 19 loci have multiple independently associated variants, suggesting that allelic heterogeneity is a frequent feature of polygenic traits, that comprehensive explorations of already-discovered loci should discover additional variants and that an appreciable fraction of associated loci may have been identified. Fourth, associated variants are enriched for likely functional effects on genes, being over-represented among variants that alter amino-acid structure of proteins and expression levels of nearby genes. Our data explain approximately 10% of the phenotypic variation in height, and we estimate that unidentified common variants of similar effect sizes would increase this figure to approximately 16% of phenotypic variation (approximately 20% of heritable variation). Although additional approaches are needed to dissect the genetic architecture of polygenic human traits fully, our findings indicate that GWA studies can identify large numbers of loci that implicate biologically relevant genes and pathways.
Predicting Outcomes in Men With Metastatic Nonseminomatous Germ Cell Tumors (NSGCT): Results From the IGCCCG Update Consortium
Purpose: The classification of the International Germ Cell Cancer Collaborative Group (IGCCCG) plays a pivotal role in the management of metastatic germ cell tumors but relies on data of patients treated between 1975 and 1990. Materials and methods: Data on 9,728 men with metastatic nonseminomatous germ cell tumors treated with cisplatin- and etoposide-based first-line chemotherapy between 1990 and 2013 were collected from 30 institutions or collaborative groups in Europe, North America, and Australia. Clinical trial and registry data were included. Primary end points were progression-free survival (PFS) and overall survival (OS). The survival estimates were updated for the current era. Additionally, a novel prognostic model for PFS was developed in 3,543 patients with complete information on potentially relevant variables. The results were validated in an independent data set. Results: Compared with the original IGCCCG publication, 5-year PFS remained similar in patients with good prognosis with 89% (87%-91%) versus 90% (95% CI, 89 to 91), but the 5-year OS increased from 92% (90%-94%) to 96% (95%-96%). In patients with intermediate prognosis, PFS remained similar with 75% (71%-79%) versus 78% (76%-80%) and the OS increased from 80% (76%-84%) to 89% (88%-91%). In patients with poor prognosis, the PFS increased from 41% (95% CI, 35 to 47) to 54% (95% CI, 52 to 56) and the OS from 48% (95% CI, 42 to 54) to 67% (95% CI, 65 to 69). A more granular prognostic model was developed and independently validated. This model identified a new cutoff of lactate dehydrogenase at a 2.5 upper limit of normal and increasing age and presence of lung metastases as additional adverse prognostic factors. An online calculator is provided (https://www.eortc.org/IGCCCG-Update). Conclusion: The IGCCCG Update model improves individual prognostication in metastatic nonseminomatous germ cell tumors. Increasing age and lung metastases add granularity to the original IGCCCG classification as adverse prognostic factors
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