25 research outputs found

    Childrenā€™s episodic and generic reports of alleged abuse

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    With the present data, we explored the relations between the language of interviewer questions, childrenā€™s reports, and case and child characteristics in forensic interviews. Results clearly indicated that the type of questions posed by interviewers ā€“ either probing generic or episodic features of an event ā€“ was related to the specificity of information reported by children. Further, interviewers appeared to adjust their questioning strategies based on the frequency of the alleged abuse. Children alleging single instances of abuse were asked more episodic questions than those alleging multiple abuses. In contrast, children alleging multiple incidents of abuse were asked a greater proportion of generic questions. Given that investigators often seek forensically-relevant episodic information, it is recommended that training for investigators focus on recognition of prompt selection tendencies and developing strategies for posing non-suggestive, episodically focused questions

    Improving treatment and survival: a populationā€based study of current outcomes after a hepatic resection in patients with metastatic colorectal cancer

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    AbstractBackgroundPopulationā€based studies historically report underutilization of a resection in patients with colorectal metastases to the liver. Recent data suggest limitations of the methods in the historical analysis. The present study examines trends in a hepatic resection and survival among Medicare recipients with hepatic metastases.MethodsMedicare recipients with incident colorectal cancer diagnosed between 1991 and 2009 were identified in the SEER(Surveillance, Epidemiology and End Results)ā€Medicare dataset. Patients were stratified into historical (1991ā€“2001) and current (2002ā€“2009) cohorts. Analyses compared treatment, periā€operative outcomes and survival.ResultsOf 31Ā 574 patients with metastatic colorectal cancer to the liver, 14Ā 859 were in the current cohort treated after 2002 and 16Ā 715 comprised the historical control group. The overall proportion treated with a hepatic resection increased significantly during the study period (P<Ā 0.001) with pre/post change from 6.5% preā€2002 to 7.5% currently (P < 0.001). Over time, haemorrhagic and infectious complications declined (both P ā‰¤ 0.047), but 30ā€day mortality was similar (3.5% versus 3.9%, P = 0.660). After adjusting for predictors of survival, the use of a hepatic resection [hazard ratio (HR) = 0.40, 95% confidence interval (CI): 0.38ā€“0.42, P < 0.001] and treatment after 2002 (HR = 0.88, 95% CI: 0.86ā€“0.90, P < 0.001) were associated with a reduced risk of death.ConclusionsCase identification using International Classification of Diseases, 9th Revision (ICDā€9) codes is imperfect; however, comparison of trends over time suggests an improvement in multimodality therapy and survival in patients with colorectal metastases to the liver

    Scavenger Receptor CD36 Directs Nonclassical Monocyte Patrolling Along the Endothelium During Early Atherogenesis

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    ObjectiveNonclassical monocytes (NCM) function to maintain vascular homeostasis by crawling or patrolling along the vessel wall. This subset of monocytes responds to viruses, tumor cells, and other pathogens to aid in protection of the host. In this study, we wished to determine how early atherogenesis impacts NCM patrolling in the vasculature.Approach and resultsTo study the role of NCM in early atherogenesis, we quantified the patrolling behaviors of NCM in ApoE-/- (apolipoprotein E) and C57BL/6J mice fed a Western diet. Using intravital imaging, we found that NCM from Western diet-fed mice display a 4-fold increase in patrolling activity within large peripheral blood vessels. Both human and mouse NCM preferentially engulfed OxLDL (oxidized low-density lipoprotein) in the vasculature, and we observed that OxLDL selectively induced NCM patrolling in vivo. Induction of patrolling during early atherogenesis required scavenger receptor CD36, as CD36-/- mice revealed a significant reduction in patrolling activity along the femoral vasculature. Mechanistically, we found that CD36-regulated patrolling was mediated by a SFK (src family kinase) through DAP12 (DNAX activating protein of 12KDa) adaptor protein.ConclusionsOur studies show a novel pathway for induction of NCM patrolling along the vascular wall during early atherogenesis. Mice fed a Western diet showed increased NCM patrolling activity with a concurrent increase in SFK phosphorylation. This patrolling activity was lost in the absence of either CD36 or DAP12. These data suggest that NCM function in an atheroprotective manner through sensing and responding to oxidized lipoprotein moieties via scavenger receptor engagement during early atherogenesis
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