1,109 research outputs found
CMV in the gut: a critical review of CMV detection in the immunocompetent host with colitis.
As scientific techniques for the detection of cytomegalovirus (CMV) improve, we are able to detect small amounts of CMV in the mucosal wall. As clinicians, we are unsure how to interpret the results of this novel test. There is controversy in the literature as to the significance of the detection of CMV in the gut. Whilst the importance of CMV and reactivation of the virus is clear in those patients such as allograft recipients with established immune compromise, the role is less clear in patients with less damaged immune systems. We explore whether the detection of CMV in such cases influences outcome and how it should be optimally managed. We discuss the optimal management of such cases, according to current guidelines, with a review of the literature
PCV107 PATIENT ADHERENCE TO CHRONIC DISEASE MEDICATIONS IN A MEDICATION THERAPY MANAGEMENT PROGRAM
The characteristic blue spectra of accretion disks in quasars as uncovered in the infrared
Quasars are thought to be powered by supermassive black holes accreting
surrounding gas. Central to this picture is a putative accretion disk which is
believed to be the source of the majority of the radiative output. It is well
known, however, that the most extensively studied disk model -- an optically
thick disk which is heated locally by the dissipation of gravitational binding
energy -- is apparently contradicted by observations in a few major respects.
In particular, the model predicts a specific blue spectral shape asymptotically
from the visible to the near-infrared, but this is not generally seen in the
visible wavelength region where the disk spectrum is observable. A crucial
difficulty was that, toward the infrared, the disk spectrum starts to be hidden
under strong hot dust emission from much larger but hitherto unresolved scales,
and thus has essentially been impossible to observe. Here we report
observations of polarized light interior to the dust-emiting region that enable
us to uncover this near-infrared disk spectrum in several quasars. The revealed
spectra show that the near-infrared disk spectrum is indeed as blue as
predicted. This indicates that, at least for the outer near-infrared-emitting
radii, the standard picture of the locally heated disk is approximately
correct. The model problems at shorter wavelengths should then be directed
toward a better understanding of the inner parts of the revealed disk. The
newly uncovered disk emission at large radii, with more future measurements,
will also shed totally new light on the unanswered critical question of how and
where the disk ends.Comment: published in Nature, 24 July 2008 issue. Supplementary Information
can be found at
http://www.mpifr-bonn.mpg.de/div/ir-interferometry/suppl_info.pdf Published
version can be accessed from
http://www.nature.com/nature/journal/v454/n7203/pdf/nature07114.pd
A rocky planet transiting a nearby low-mass star
M-dwarf stars -- hydrogen-burning stars that are smaller than 60 per cent of
the size of the Sun -- are the most common class of star in our Galaxy and
outnumber Sun-like stars by a ratio of 12:1. Recent results have shown that M
dwarfs host Earth-sized planets in great numbers: the average number of M-dwarf
planets that are between 0.5 to 1.5 times the size of Earth is at least 1.4 per
star. The nearest such planets known to transit their star are 39 parsecs away,
too distant for detailed follow-up observations to measure the planetary masses
or to study their atmospheres. Here we report observations of GJ 1132b, a
planet with a size of 1.2 Earth radii that is transiting a small star 12
parsecs away. Our Doppler mass measurement of GJ 1132b yields a density
consistent with an Earth-like bulk composition, similar to the compositions of
the six known exoplanets with masses less than six times that of the Earth and
precisely measured densities. Receiving 19 times more stellar radiation than
the Earth, the planet is too hot to be habitable but is cool enough to support
a substantial atmosphere, one that has probably been considerably depleted of
hydrogen. Because the host star is nearby and only 21 per cent the radius of
the Sun, existing and upcoming telescopes will be able to observe the
composition and dynamics of the planetary atmosphere.Comment: Published in Nature on 12 November 2015, available at
http://dx.doi.org/10.1038/nature15762. This is the authors' version of the
manuscrip
Paramedic clinical decision making during high acuity emergency calls: design and methodology of a Delphi study
<p>Abstract</p> <p>Background</p> <p>The scope of practice of paramedics in Canada has steadily evolved to include increasingly complex interventions in the prehospital setting, which likely have repercussions on clinical outcome and patient safety. Clinical decision making has been evaluated in several health professions, but there is a paucity of work in this area on paramedics. This study will utilize the Delphi technique to establish consensus on the most important instances of paramedic clinical decision making during high acuity emergency calls, as they relate to clinical outcome and patient safety.</p> <p>Methods and design</p> <p>Participants in this multi-round survey study will be paramedic leaders and emergency medical services medical directors/physicians from across Canada. In the first round, participants will identify instances of clinical decision making they feel are important for patient outcome and safety. On the second round, the panel will rank each instance of clinical decision making in terms of its importance. On the third and potentially fourth round, participants will have the opportunity to revise the ranking they assigned to each instance of clinical decision making. Consensus will be considered achieved for the most important instances if 80% of the panel ranks it as important or extremely important. The most important instances of clinical decision making will be plotted on a process analysis map.</p> <p>Discussion</p> <p>The process analysis map that results from this Delphi study will enable the gaps in research, knowledge and practice to be identified.</p
Prediction of 7-year psychopathology from mother-infant joint attention behaviours: a nested case–control study
<br>Background: To investigate whether later diagnosis of psychiatric disorder can be predicted from analysis of mother-infant joint attention (JA) behaviours in social-communicative interaction at 12 months.</br>
<br>Method:
Using data from a large contemporary birth cohort, we examined 159 videos of a mother-infant interaction for joint attention behaviour when children were aged one year, sampled from within the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Fifty-three of the videos involved infants who were later considered to have a psychiatric disorder at seven years and 106 were same aged controls. Psychopathologies included in the case group were disruptive behaviour disorders, oppositional-conduct disorder, attention-deficit/hyperactivity disorder, pervasive development disorder, anxiety and depressive disorders. Psychiatric diagnoses were obtained using the Development and Wellbeing Assessment when the children were seven years old.</br> <br>Results: None of the three JA behaviours (shared look rate, shared attention rate and shared attention intensity) showed a significant association with the primary outcome of case–control status. Only shared look rate predicted any of the exploratory sub-diagnosis outcomes and was found to be positively associated with later oppositional-conduct disorders (OR [95% CI]: 1.5 [1.0, 2.3]; p = 0.041).</br><br>Conclusions: JA behaviours did not, in general, predict later psychopathology. However, shared look was positively associated with later oppositional-conduct disorders. This suggests that some features of JA may be early markers of later psychopathology. Further investigation will be required to determine whether any JA behaviours can be used to screen for families in need of intervention.</br>
Investigation of attentional bias in obsessive compulsive disorder with and without depression in visual search
Copyright: © 2013 Morein-Zamir et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedWhether Obsessive Compulsive Disorder (OCD) is associated with an increased attentional bias to emotive stimuli remains controversial. Additionally, it is unclear whether comorbid depression modulates abnormal emotional processing in OCD. This study examined attentional bias to OC-relevant scenes using a visual search task. Controls, non-depressed and depressed OCD patients searched for their personally selected positive images amongst their negative distractors, and vice versa. Whilst the OCD groups were slower than healthy individuals in rating the images, there were no group differences in the magnitude of negative bias to concern-related scenes. A second experiment employing a common set of images replicated the results on an additional sample of OCD patients. Although there was a larger bias to negative OC-related images without pre-exposure overall, no group differences in attentional bias were observed. However, OCD patients subsequently rated the images more slowly and more negatively, again suggesting post-attentional processing abnormalities. The results argue against a robust attentional bias in OCD patients, regardless of their depression status and speak to generalized difficulties disengaging from negative valence stimuli. Rather, post-attentional processing abnormalities may account for differences in emotional processing in OCD.Peer reviewedFinal Published versio
The challenge of comprehensively mapping children's health in a nation-wide health survey: Design of the German KiGGS-Study
<p>Abstract</p> <p>Background</p> <p>From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Aim of this first nationwide interview and examination survey was to collect comprehensive data on the health status of children and adolescents aged 0 to 17 years.</p> <p>Methods/Design</p> <p>Participants were enrolled in two steps: first, 167 study locations (sample points) were chosen; second, subjects were randomly selected from the official registers of local residents. The survey involved questionnaires filled in by parents and parallel questionnaires for children aged 11 years and older, physical examinations and tests, and a computer assisted personal interview performed by study physicians. A wide range of blood and urine testing was carried out at central laboratories. A total of 17 641 children and adolescents were surveyed – 8985 boys and 8656 girls. The proportion of sample neutral drop-outs was 5.3%. The response rate was 66.6%.</p> <p>Discussion</p> <p>The response rate showed little variation between age groups and sexes, but marked variation between resident aliens and Germans, between inhabitants of cities with a population of 100 000 or more and sample points with fewer inhabitants, as well as between the old West German states and the former East German states. By analysing the short non-responder questionnaires it was proven that the collected data give comprehensive and nationally representative evidence on the health status of children and adolescents aged 0 to 17 years.</p
Evolutionary History of the HAP2/GCS1 Gene and Sexual Reproduction in Metazoans
The HAP2/GCS1 gene first appeared in the common ancestor of plants, animals, and protists, and is required in the male gamete for fusion to the female gamete in the unicellular organisms Chlamydomonas and Plasmodium. We have identified a HAP2/GCS1 gene in the genome sequence of the sponge Amphimedon queenslandica. This finding provides a continuous evolutionary history of HAP2/GCS1 from unicellular organisms into the metazoan lineage. Divergent versions of the HAP2/GCS1 gene are also present in the genomes of some but not all arthropods. By examining the expression of the HAP2/GCS1 gene in the cnidarian Hydra, we have found the first evidence supporting the hypothesis that HAP2/GCS1 was used for male gamete fusion in the ancestor of extant metazoans and that it retains that function in modern cnidarians
Direct detection of dark matter in models with a light Z'
We discuss the direct detection signatures of dark matter interacting with
nuclei via a Z' mediator, focussing on the case where both the dark matter and
the have mass of a few GeV. Isospin violation (i.e. different couplings to
protons and neutrons) arises naturally in this scenario. In particular it is
possible to reconcile the preferred parameter regions inferred from the
observed DAMA and CoGeNT modulations with the bounds from XENON100, which
requires f_n/f_p = -0.7. Moreover, the Z' mediator can also yield a large
spin-dependent cross-section which could contribute to the DAMA signal, while
the spin-independent cross-section is adequate to explain the CoGeNT signal.Comment: 20 pages, 3 figures. v2: matches published versio
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