Change of functions of the first person pronouns in Chinese

Selected papers from the 18th International Conference on Historical Linguistics, Montreal, 6-11 August 200

Ergativity, Number, and Agreement

Proceedings of the Eleventh Annual Meeting of the Berkeley Linguistics Society (1985), pp. 96-10

Toward a better understanding of urinary fistula repair prognosis: Results from a multi-country prospective cohort study

This dissertation addresses several critical gaps in the evidence-base with regard to urinary fistula care and treatment in developing countries. First, I systematically reviewed and synthesized the small but growing body of literature examining the patient, fistula and facility-level factors that influence repair outcomes in developing countries. There was insufficient evidence to support a role of patient characteristics in influencing repair outcomes. In contrast, the weight of evidence suggested that some fistula characteristics, particularly scarring and urethral involvement, may influence the risk of failure to close the fistula, residual incontinence following closure and any incontinence. Results from randomized controlled trials examining prophylactic antibiotic use and repair outcomes were inconclusive, and observational studies examining the influence of peri-operative procedures were limited by small sample sizes and lack of statistical adjustment for potential confounding factors. Secondly, using data from a multi-country facility-based prospective cohort study, I examined the prognostic value of five existing classification systems - those developed by Lawson, Tafesse, Goh, the World Health Organization (WHO) and Waaldijk - for predicting fistula closure, and evaluated the prognostic value of a score derived empirically from the data from this study. The scoring systems representing the Tafesse, Goh and WHO and empirically-derived classification systems were similar, and had the highest predictive values. However, none of the scores evaluated achieved good discriminatory ability (AUC > 0.70), suggesting that other factors unrelated to fistula characteristics may be equally or more important in predicting repair outcomes. Finally, I examined several issues surrounding two peri-operative procedures related to fistula surgery: abdominal versus vaginal route of repair, and catheterization duration greater than 14 days (compared to 14 days or less). Specifically, I explored the factors influencing the choice of these procedures, the influence of each of these procedures on repair outcomes independent of indication for repair or repair prognosis, and whether indication for the procedure or fistula prognosis moderates the influence of each of these procedures on repair outcomes. Abdominal route of repair was independently associated with site, parity > 3, and having a fistula that met indications for an abdominal route of repair (limited vaginal access due to extensive scarring or tissue loss, genital infibulation, ureteric involvement, or trigonal, supra-trigonal, vesico-uterine or intracervical location, or other abdominal pathology). Surgeon experience conducting complex repairs and mid-vaginal location were inversely associated with abdominal route of repair. Increased prognostic score was independently associated with catheterization > 14 days, as were site and surgeon experience doing complex repairs. Vaginal route of repair was independently associated with increased risk of failure to close the fistula, relative to abdominal route of repair; however, stratified analyses suggested that the risk of failed repair among those repaired vaginally may be particularly elevated among women who met common indications for abdominal route of repair. Duration of catheterization > 14 days was associated with failure to close the fistula, after adjusting for repair prognosis and surgeon experience; however, residual confounding by indication and reverse causation cannot be excluded as explanations for this finding. Additional research is needed to confirm our findings regarding the discriminatory value of the classification systems evaluated. Further, since the value of a classification system lies not only in its discriminatory ability but also its reliability and ease of use, tests of inter- and intra-rater reliability of these systems are priority area for future research. Given the cost and health implications associated with abdominal route of repair and longer duration catheterization, additional studies examining the influence of these procedures on repair outcomes are warranted. Such studies must ensure adequate control of confounding by indication and prognosis of repair

Panzi score as a parsimonious indicator of urogenital fistula severity derived from Goh and Waaldijk classifications

ObjectiveTo derive a comprehensive system that allows a single score to define relative fistula severity.MethodsThe present observational study included women with urogenital fistula treated at the Panzi Hospital, Democratic Republic of Congo, or its outreach clinics across the Democratic Republic of Congo between September 1, 2013, and December 31, 2014. Fistula severity was assessed by Goh and Waaldijk classifications and surgical success was ascertained. Logistic regression was used to select fistula characteristics predictive of surgical failure, and to preliminarily verify the newly derived Panzi score.ResultsOverall, 837 women were included in the analysis. Goh or Waaldijk fistula descriptors associated with a higher probability of poor surgical outcomes in the unadjusted bivariate analysis were circumferential defect (P=0.007), proximity to the external urethral orifice (P=0.001), and size (P=0.001). These fistula characteristics were used to construct the Panzi score, which varied from 3 (most severe) to 0 (minor fistula). For each increase above 0, the odds of surgical failure increase by a factor of 1.65 (P<0.001).ConclusionThe Panzi score of urogenital fistula provided a data‐driven, simple, comprehensive, and parsimonious score. It could be used to report group data, to provide continuous level data for use in higher order statistics, and to resolve issues such as the cut‐off point for referring women to hospital in accordance with fistula complexity.The Panzi score is presented as an evidence‐based fistula severity indicator that is simple, comprehensive, and parsimonious, and will facilitate summative and predictive statistics.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144588/1/ijgo12514_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144588/2/ijgo12514.pd

An Evaluation of the Effectiveness of Risk Minimization Measures for Tigecycline in the European Union

Background: Risk minimization measures (RMM) were implemented from February 2011 in the European Union to address risks of superinfection, off-label use and lack of efficacy associated with tigecycline. The objective of this study was to evaluate RMM effectiveness by describing prescription patterns among adults and children treated with any dose of tigecycline for any indication pre- and post-RMM implementation; incidence proportions of superinfection and lack of efficacy among adults treated with approved doses of tigecycline for complicated intra-abdominal infection and complicated skin and soft tissue infection were also evaluated. Methods: This was an observational, retrospective chart-abstraction study, including charts from 777 patients (399 pre-RMM, 378 post-RMM) at 13 sites across Austria, Germany, Italy, Greece and the United Kingdom (UK). Potential superinfection and lack of efficacy cases among those using tigecycline for on-label indication, age, dose, and duration were adjudicated. The distribution of indications for tigecycline was analyzed overall (i.e. across both study periods) and stratified by study period. Numbers and incidence proportions of superinfection and lack of efficacy cases (potential and adjudicated) were calculated overall and by study period. Results: Off-label use (indication or age) decreased from 54.2% [95% confidence interval (95% CI): 49.0, 59.3%] pre-RMM to 35.7% (95% CI 30.4, 41.2%) post-RMM. Overall, 45.7% (95% CI 41.9, 49.5%) of patients were prescribed tigecycline off-label; the most commonly reported off-label indications were characterized as \u201cother\u201d (25.5%), hospital acquired pneumonia (8.2%), other pneumonia (6.3%), bacteremia (5.2%) and diabetic foot infection (1.5%). Across study periods, incidence proportions of definite or probable superinfection and lack of efficacy in adults treated for approved indications, authorized treatment doses and duration were 4.5% (95% CI 2.1, 8.4%) and 5.5% (95% CI 2.8, 9.7%), respectively. Conclusions: Off-label use of tigecycline decreased following RMM implementation. Overall incidence proportions of definite or probable superinfection and lack of efficacy were low. EU PAS register number: EUPAS3674

Benefit-risk profile of tofacitinib in patients with moderate-to-severe chronic plaque psoriasis : pooled analysis across six clinical trials

Altres ajuts: This study was funded by Pfizer Inc. The authors would like to thank Maryam Asgari and Charlie Quesenberry, principal investigators of the KPNC database cohort study, and Kevin Winthrop and Jeffrey Curtis, principal investigators of the Medicare database cohort. This study was supported by Pfizer Inc. Medical writing support under the guidance of the authors was provided by Sandrine M. Dupré, PhD, and Carole Evans, PhD, at and on behalf of Complete Medical Communications, Manchester, U.K., and was funded by Pfizer Inc., New York, NY, U.S.A., in accordance with the Good Publication Practice (GPP3) guidelines.Background: Although existing psoriasis treatments are effective and well tolerated in many patients, there is still a need for new effective targeted treatment options. Tofacitinib is an oral Janus kinase inhibitor that has been investigated in patients with moderate-to-severe chronic plaque psoriasis. Objectives: To consider the benefits and risks of tofacitinib in patients with moderate-to-severe psoriasis. Methods: Data were pooled from one phase II, four phase III and one long-term extension study comprising 5204 patient-years of tofacitinib treatment. Efficacy end points included patients achieving Physician's Global Assessments of 'clear' or 'almost clear', ≥ 75% and ≥ 90% reduction in Psoriasis Area and Severity Index (coprimary end points) and improvements in Dermatology Life Quality Index score, Hospital Anxiety and Depression Scale depression score and Itch Severity Item score, at weeks 16 and 52. Safety data were summarized for 3 years of tofacitinib exposure. Results: Tofacitinib 5 and 10 mg twice daily (BID) showed superiority over placebo for all efficacy end points at week 16, with response maintained for 52 weeks of continued treatment. Tofacitinib improved patients' quality of life and was well tolerated. Rates of safety events of interest (except herpes zoster) were similar to those in the published literature and healthcare databases for other systemic psoriasis therapies. Tofacitinib 10 mg BID demonstrated greater efficacy than 5 mg BID. Conclusions: Tofacitinib has a benefit-risk profile in moderate-to-severe psoriasis consistent with that of other systemic treatments

The nanosyntax of spatial deixis

This paper provides a fine-grained morphosyntactic analysis of spatial deixis. We propose that the universal core of spatial deixis is a three-way contrast: Proximal close to speaker', Medial close to hearer', and Distal far from speaker and hearer'. This system arises from three features merged as heads in a single universal functional sequence: Dx(3) > Dx(2) > Dx(1). The hierarchy is understood in terms of superset-subset relations, such that Proximal [Dx(1)] is a subset of Medial [Dx(2) [Dx(1)]], which in turn is a subset of Distal [Dx(3) [Dx(2) [Dx(1)]]]. Evidence comes from patterns of syncretism and morphological containment in the demonstrative systems of a number of genetically diverse languages. Regarding syncretisms, languages can show a transparent three-way morphological contrast, or some sort of syncretism: Medial/Proximal vs. Distal, Distal/Medial vs. Proximal, or a totally syncretic Distal/Medial/Proximal (i.e. a neutral demonstrative). These syncretisms entail that the features responsible for the Proximal and Medial readings be adjacent and that the features responsible for the Distal and Medial readings be adjacent in the fseq. Regarding containment, we show that Proximal can be structurally contained within Medial and that Medial can be structurally contained within Distal, meaning that Medial structures are larger than Proximal structures, and that Distal structures are larger than Medial structures, confirming our hierarchy. We show that these facts are naturally accounted for by nanosyntactic principles of spellout. We end the paper by accounting for potential counterexamples and other issues

Longitudinal Determinants of Consistent Condom Use by Partner Type Among Young Injection Drug Users: The Role of Personal and Partner Characteristics

We investigated the longitudinal influence of individual-, relationship- and social-level factors on condom use by partner type among young injections drug users (IDUs) enrolled in the Collaborative Injection Drug Users Study-III/Drug Users Intervention Trial (CIDUS-III/DUIT) from 2002 to 2004. Based on longitudinal analysis using generalized estimating equations (GEE), consistent condom use with main partners was more commonly reported among males and those with greater self-efficacy for condom use; main partner’s desire for pregnancy and needle sharing were negatively associated with consistent condom use. Among those with casual partners, having fewer sex partners was associated with consistent condom use. Positive attitudes toward condom use and partner norms supporting condom use were associated with greater consistent condom use with both partner types. These findings suggest that intervention strategies targeting individual- and partner-level factors may provide avenues for intervening upon sexual risks among young IDUs

Population Frequencies of the Triallelic 5HTTLPR in Six Ethnicially Diverse Samples from North America, Southeast Asia, and Africa

Genetic differences between populations are a potentially an important contributor to health disparities around the globe. As differences in gene frequencies influence study design, it is important to have a thorough understanding of the natural variation of the genetic variant(s) of interest. Along these lines, we characterized the variation of the 5HTTLPR and rs25531 polymorphisms in six samples from North America, Southeast Asia, and Africa (Cameroon) that differ in their racial and ethnic composition. Allele and genotype frequencies were determined for 24,066 participants. Results indicated higher frequencies of the rs25531 G-allele among Black and African populations as compared with White, Hispanic and Asian populations. Further, we observed a greater number of ‘extra-long’ (‘XL’) 5HTTLPR alleles than have previously been reported. Extra-long alleles occurred almost entirely among Asian, Black and Non-White Hispanic populations as compared with White and Native American populations where they were completely absent. Lastly, when considered jointly, we observed between sample differences in the genotype frequencies within racial and ethnic populations. Taken together, these data underscore the importance of characterizing the L-G allele to avoid misclassification of participants by genotype and for further studies of the impact XL alleles may have on the transcriptional efficiency of SLC6A4