Functional impairment in PDD-NOS: Predicting outcome at a two-year follow-up.

Examined the early history characteristics and symptom patterns of children with an initial diagnosis of either Pervasive Developmental Disorder, Not Otherwise Specified (PDD NOS) or Autistic Disorder, and identified predictors of changing functional ability. Participants were 59 children (48 male, 11 female) who were first assessed at 3 to 4 years of age, and re-assessed two years later (M = 26.00 months, SD = 12.43). Based on the results of the follow-up assessment three groups were identified: children with a stable diagnosis of PDD-NOS (Stable PDD-NOS), a stable diagnosis of autism (Stable Autism), and those whose diagnosis changed from PDD-NOS to autism (Change). Overall, the Stable PDD-NOS group demonstrated a significantly better outcome than the Stable Autism group in all areas examined, including early history characteristics, symptom severity, and measures of functional ability. In contrast, the performance of the Change group was more variable and suggested a relative decline over time (i.e., an increase in symptom severity and a decline in functional ability). In terms of early history, the Change group appeared to experience greater impairments and more atypical behaviors than did the Stable PDD-NOS group. Results suggest that early history characteristics and patterns of PDD symptoms are predictive of later outcome for children initially diagnosed with PDD-NOS. Implications for research and practice are discussed.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2004 .F74. Source: Dissertation Abstracts International, Volume: 65-07, Section: B, page: 3706. Adviser: Sylvia Voelker. Thesis (Ph.D.)--University of Windsor (Canada), 2004

Maternal perceptions of support from professionals and daily care-giving burden as determinants of distress in mothers of children with developmental disabilities.

This study investigated whether the current movement toward family-centred health care service delivery effectively addresses the distress associated with the daily care-giving burden experienced by mothers of children with developmental disabilities. Participants were 37 mothers of children with developmental disabilities who are limited in their ability to perform daily activities independently. Participants were contacted by mail through the Children\u27s Rehabilitation Centre (CRC). Participants provided demographic information and completed self-report questionnaires measuring maternal distress (i.e., Malaise Inventory, Mental Health Inventory) and perceptions of parent-professional interactions (i.e., Enabling Practices Scale). The Vineland Adaptive Behavior Scales, Classroom Edition was completed by teachers or primary therapists to assess child functional status. Restricted range in the obtained measures obscured the expected association between child functional status and both maternal distress and perceptions of parent-professional interactions. Trends in the results indicated that greater functional impairment was associated with greater stress in parent-child relationships and more stressful life circumstances (p \u3c .05); however, psychological symptoms of distress were less for mothers of severely impaired children, than for mothers of moderately impaired children. Implications for research and practice are discussed.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis1998 .F74. Source: Masters Abstracts International, Volume: 39-02, page: 0594. Adviser: Sylvia Voelker. Thesis (M.A.)--University of Windsor (Canada), 1998

The Glial Regenerative Response to Central Nervous System Injury Is Enabled by Pros-Notch and Pros-NFκB Feedback

Organisms are structurally robust, as cells accommodate changes preserving structural integrity and function. The molecular mechanisms underlying structural robustness and plasticity are poorly understood, but can be investigated by probing how cells respond to injury. Injury to the CNS induces proliferation of enwrapping glia, leading to axonal re-enwrapment and partial functional recovery. This glial regenerative response is found across species, and may reflect a common underlying genetic mechanism. Here, we show that injury to the Drosophila larval CNS induces glial proliferation, and we uncover a gene network controlling this response. It consists of the mutual maintenance between the cell cycle inhibitor Prospero (Pros) and the cell cycle activators Notch and NFκB. Together they maintain glia in the brink of dividing, they enable glial proliferation following injury, and subsequently they exert negative feedback on cell division restoring cell cycle arrest. Pros also promotes glial differentiation, resolving vacuolization, enabling debris clearance and axonal enwrapment. Disruption of this gene network prevents repair and induces tumourigenesis. Using wound area measurements across genotypes and time-lapse recordings we show that when glial proliferation and glial differentiation are abolished, both the size of the glial wound and neuropile vacuolization increase. When glial proliferation and differentiation are enabled, glial wound size decreases and injury-induced apoptosis and vacuolization are prevented. The uncovered gene network promotes regeneration of the glial lesion and neuropile repair. In the unharmed animal, it is most likely a homeostatic mechanism for structural robustness. This gene network may be of relevance to mammalian glia to promote repair upon CNS injury or disease

Bistable Percepts in the Brain: fMRI Contrasts Monocular Pattern Rivalry and Binocular Rivalry

The neural correlates of binocular rivalry have been actively debated in recent years, and are of considerable interest as they may shed light on mechanisms of conscious awareness. In a related phenomenon, monocular rivalry, a composite image is shown to both eyes. The subject experiences perceptual alternations in which the two stimulus components alternate in clarity or salience. The experience is similar to perceptual alternations in binocular rivalry, although the reduction in visibility of the suppressed component is greater for binocular rivalry, especially at higher stimulus contrasts. We used fMRI at 3T to image activity in visual cortex while subjects perceived either monocular or binocular rivalry, or a matched non-rivalrous control condition. The stimulus patterns were left/right oblique gratings with the luminance contrast set at 9%, 18% or 36%. Compared to a blank screen, both binocular and monocular rivalry showed a U-shaped function of activation as a function of stimulus contrast, i.e. higher activity for most areas at 9% and 36%. The sites of cortical activation for monocular rivalry included occipital pole (V1, V2, V3), ventral temporal, and superior parietal cortex. The additional areas for binocular rivalry included lateral occipital regions, as well as inferior parietal cortex close to the temporoparietal junction (TPJ). In particular, higher-tier areas MT+ and V3A were more active for binocular than monocular rivalry for all contrasts. In comparison, activation in V2 and V3 was reduced for binocular compared to monocular rivalry at the higher contrasts that evoked stronger binocular perceptual suppression, indicating that the effects of suppression are not limited to interocular suppression in V1

Between Antagonism and Eros: The Feud as Couple Form and Netflix’s GLOW

A feud is an antagonism that is continuous and extended; “a state of prolonged mutual hostility” (OED). Historically, feuds take place between families or communities, or result from failed couples. Considered as a couple form in its own right, however, the feud is associated with aesthetic forms often coded as camp, queer, or feminized. In such popular, serialized forms, the feud must be open ended and of unforeseen futurity, for resolution brings an end to the feud as such and dissolves the couple. Thus, feuds reject normative modes of coupling (such as the nuclear family) that center harmonious or happy feelings. The article begins with the political economy of the feud through an examination of the pre-modern form of the blood feud and continues with its late-modern presence in popular culture. We rehearse the idea of the feud as it emerges from anthropology and philosophy, especially as it impacts notions of debt and alternative economies, before thinking through the contemporary “coupling” of the feud in popular culture, fandom, and, via the performance form of professional wrestling and Netflix’s GLOW

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden