222 research outputs found
Measurement of the I-V characteristics of superconducting dipoles : automatic compensation of low frequency drift
The impact of chorionicity on pregnancy outcome and neurodevelopment at 2 years old among twins born preterm: the EPIPAGE-2 cohort study
OBJECTIVE
To compare the shortâ and midâterm outcomes of preterm twins by chorionicity of pregnancy.
DESIGN
Prospective nationwide populationâbased EPIPAGEâ2 cohort study.
SETTING
546 maternity units in France, between March and December 2011.
POPULATION
A total of 1700 twin neonates born between 24 and 34 weeks of gestation.
METHODS
The association of chorionicity with outcomes was analysed using multivariate regression models.
MAIN OUTCOME MEASURES
First, survival at 2âyear corrected age with or without neurosensory impairment, and second, perinatal, shortâ, and midâterm outcomes (survival at discharge, survival at discharge without severe morbidity) were described and compared by chorionicity.
RESULTS
In the EPIPAGE 2 cohort, 1700 preterm births were included (850 twin pregnancies). In all, 1220 (71.8%) were from dichorionic (DC) pregnancies and 480 from monochorionic (MC) pregnancies. MC pregnancies had three times more medical terminations than DC pregnancies (1.67 versus 0.51%, P < 0.001), whereas there were three times more stillbirths in MC than in DC pregnancies (10.09 versus 3.78%, P < 0.001). Both twins were alive at birth in 86.6% of DC pregnancies compared with 80.0% among MC pregnancies (P = 0.008). No significant difference according to chorionicity was found regarding neonatal deaths and morbidities. Likewise, for children born earlier than 32 weeks, the 2âyear followâup neurodevelopmental results were not significantly different between DC and MC twins.
CONCLUSIONS
This study confirms that MC pregnancies have a higher risk of adverse outcomes. However, the outcomes among preterm twins admitted to neonatal intensive care units are similar irrespective of chorionicity
Social pathways for Ebola Virus Disease in rural Sierra Leone, and some implications for containment
The current outbreak of Ebola Virus Disease in Upper West Africa is the largest ever recorded. Molecular evidence suggests spread has been almost exclusively through human-to-human contact. Social factors are thus clearly important to understand the epidemic and ways in which it might be stopped, but these factors have so far been little analyzed. The present paper focuses on Sierra Leone, and provides cross sectional data on the least understood part of the epidemic-the largely undocumented spread of Ebola in rural areas. Various forms of social networking in rural communities and their relevance for understanding pathways of transmission are described. Particular attention is paid to the relationship between marriage, funerals and land tenure. Funerals are known to be a high-risk factor for infection. It is suggested that more than a shift in awareness of risks will be needed to change local patterns of behavior, especially in regard to funerals, since these are central to the consolidation of community ties. A concluding discussion relates the information presented to plans for halting the disease. Local consultation and access are seen as major challenges to be addressed
âCare Co-ordinator In My Pocketâ. A Feasibility study of Mobile-Assessment and Therapy for Psychosis (TechCare).
Objectives: The research aimed to examine the acceptability and feasibility of a mobile phone Application (App) based intervention âTechCareâ, for individuals with psychosis in the North West of England. The main objectives were to determine whether appropriate individuals could be identified and recruited to the study and whether the TechCare App would be an acceptable intervention for individuals with psychosis.
Methods: This was a mixed methods feasibility study, consisting of a test-run and feasibility evaluation of the TechCare App intervention.
Setting: Early Intervention Services for psychosis, within an NHS Trusts in the North West of England.
Participants: Sixteen participants (Test-run n=4, feasibility study n=12) aged between 18-65, recruited from the East, Central and North Lancashire Early Intervention Service (EIS).
Intervention: A 6-week intervention, with the TechCare App assessing participantsâ symptoms and responses in real-time and providing a personalised guided self-help based psychological intervention based on the principles of CBT.
Results: A total of 83.33% (n=10) of participants completed the 6-week feasibility study, with 70% of completers achieving the set compliance threshold of â„33% engagement with the TechCare App system. Analysis of the qualitative data suggested that participants held the view that the TechCare was both an acceptable and feasible means of delivering interventions in real-time.
Conclusion: Innovative digital clinical technologies such as the TechCare App may have the potential to increase access to psychological interventions, reduce health inequality, and promote self-management with a real-time intervention, through enabling access to mental health resources in a stigma-free, evidence-based, and time-independent manner.
Trial registration number: ClinicalTrials.gov Identifier: NCT0243961
TechCare: Mobile-assessment and therapy for psychosis: An intervention for clients within the early intervention service
In the UK, mental illness is a major source of disease burden costing in the region of ÂŁ105 billion pounds. mHealth is a novel and emerging field in psychiatric and psychological care for the treatment of mental health difficulties such as psychosis
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Enhanced methods for unbiased deep sequencing of Lassa and Ebola RNA viruses from clinical and biological samples
We have developed a robust RNA sequencing method for generating complete de novo assemblies with intra-host variant calls of Lassa and Ebola virus genomes in clinical and biological samples. Our method uses targeted RNase H-based digestion to remove contaminating poly(rA) carrier and ribosomal RNA. This depletion step improves both the quality of data and quantity of informative reads in unbiased total RNA sequencing libraries. We have also developed a hybrid-selection protocol to further enrich the viral content of sequencing libraries. These protocols have enabled rapid deep sequencing of both Lassa and Ebola virus and are broadly applicable to other viral genomics studies. Electronic supplementary material The online version of this article (doi:10.1186/s13059-014-0519-7) contains supplementary material, which is available to authorized users
Chromosomal imbalances associated with anaplastic transformation of follicular thyroid carcinomas
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Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak
In its largest outbreak, Ebola virus disease is spreading through Guinea, Liberia, Sierra Leone, and Nigeria. We sequenced 99 Ebola virus genomes from 78 patients in Sierra Leone to ~2000Ă coverage. We observed a rapid accumulation of interhost and intrahost genetic variation, allowing us to characterize patterns of viral transmission over the initial weeks of the epidemic. This West African variant likely diverged from central African lineages around 2004, crossed from Guinea to Sierra Leone in May 2014, and has exhibited sustained human-to-human transmission subsequently, with no evidence of additional zoonotic sources. Because many of the mutations alter protein sequences and other biologically meaningful targets, they should be monitored for impact on diagnostics, vaccines, and therapies critical to outbreak response.Organismic and Evolutionary Biolog
Clinical Illness and Outcomes in Patients with Ebola in Sierra Leone
Background
Limited clinical and laboratory data are available on patients with Ebola virus disease (EVD). The Kenema Government Hospital in Sierra Leone, which had an existing infrastructure for research regarding viral hemorrhagic fever, has received and cared for patients with EVD since the beginning of the outbreak in Sierra Leone in May 2014.
Methods
We reviewed available epidemiologic, clinical, and laboratory records of patients in whom EVD was diagnosed between May 25 and June 18, 2014. We used quantitative reverse-transcriptaseâpolymerase-chain-reaction assays to assess the load of Ebola virus (EBOV, Zaire species) in a subgroup of patients.
Results
Of 106 patients in whom EVD was diagnosed, 87 had a known outcome, and 44 had detailed clinical information available. The incubation period was estimated to be 6 to 12 days, and the case fatality rate was 74%. Common findings at presentation included fever (in 89% of the patients), headache (in 80%), weakness (in 66%), dizziness (in 60%), diarrhea (in 51%), abdominal pain (in 40%), and vomiting (in 34%). Clinical and laboratory factors at presentation that were associated with a fatal outcome included fever, weakness, dizziness, diarrhea, and elevated levels of blood urea nitrogen, aspartate aminotransferase, and creatinine. Exploratory analyses indicated that patients under the age of 21 years had a lower case fatality rate than those over the age of 45 years (57% vs. 94%, P=0.03), and patients presenting with fewer than 100,000 EBOV copies per milliliter had a lower case fatality rate than those with 10 million EBOV copies per milliliter or more (33% vs. 94%, P=0.003). Bleeding occurred in only 1 patient.
Conclusions
The incubation period and case fatality rate among patients with EVD in Sierra Leone are similar to those observed elsewhere in the 2014 outbreak and in previous outbreaks. Although bleeding was an infrequent finding, diarrhea and other gastrointestinal manifestations were common. (Funded by the National Institutes of Health and others.
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