Mothers\u27 Sleep Deficits and Cognitive Performance: Moderation by Stress and Age

There are well-known associations between stress, poor sleep, and cognitive deficits, but little is known about their interactive effects, which the present study explored in a sample of mothers of toddlers. Since certain types of cognitive decline start during the 20s and continue into later ages, we also explored whether mothers\u27 age interacted with stress and sleep in the prediction of cognitive functioning. We hypothesized that poorer sleep [measured using one week of 24-hour wrist actigraphy data] and having more chronic stressors [e.g., life events, household chaos, work/family role conflict] would be linked with poorer cognitive performance [both executive function and standardized cognitive ability tasks], and that the interactive combination of poorer sleep and more stressors would account for the effect. We also explored whether this process operated differently for younger versus older women. In a socioeconomically and geographically diverse community sample of 227 women with toddler-age children [age, M = 32.73 yrs, SD = 5.15 yrs], poorer cognitive performance was predicted by greater activity during the sleep period, shorter sleep duration, and lower night-to-night consistency in sleep; it was not associated with higher levels of stress. The interactive effects hypothesis was supported for sleep activity [fragmented sleep] and sleep timing [when mothers went to bed]. The combination of more exposure to stressors and frequent night waking was particularly deleterious for older women\u27s performance. For younger women, going to bed late was associated with poorer performance if they were experiencing high levels of stress; for those experiencing low levels of stress, going to bed late was associated with better performance

Prion diseases are efficiently transmitted by blood transfusion in sheep

The emergence of variant Creutzfeld-Jakob disease, following on from the bovine spongiform encephalopathy (BSE) epidemic, led to concerns about the potential risk of iatrogenic transmission of disease by blood transfusion and the introduction of costly control measures to protect blood supplies. We previously reported preliminary data demonstrating the transmission of BSE and natural scrapie by blood transfusion in sheep. The final results of this experiment, reported here, give unexpectedly high transmission rates by transfusion of 36% for BSE and 43% for scrapie. A proportion of BSE-infected tranfusion recipients (3 of 8) survived for up to 7 years without showing clinical signs of disease. The majority of transmissions resulted from blood collected from donors at more than 50% of the estimated incubation period. The high transmission rates and relatively short and consistent incubation periods in clinically positive recipients suggest that infectivity titers in blood were substantial and/or that blood transfusion is an efficient method of transmission. This experiment has established the value of using sheep as a model for studying transmission of variant Creutzfeld-Jakob disease by blood products in humans. (Blood. 2008; 112: 4739-4745

Posttraumatic stress symptoms in young people with cancer and their siblings: results from a UK sample

Purpose: This study investigated levels of posttraumatic stress symptoms (PTSS) in children with cancer and their siblings from a British sample. It also examined aspects of the Ehlers and Clark model of posttraumatic stress disorder in the current population. Methods: Sixty participants (34 children with cancer and 26 siblings) aged between 8 and 18 years completed measures of PTSS, maladaptive appraisals, trauma-centered identity, perceived social support and family functioning. Results: Over a quarter of the sample scored above the clinical cutoff on the Impact of Events Scale-Revised. No differences were observed between patients and siblings with respect to levels of PTSS. Maladaptive appraisals and age were found to account for unique variance in levels of PTSS for the overall sample. Conclusions: Rates of PTSS in the sample were relatively high. Support was found for aspects of the Ehlers and Clark model in explaining PTSS for the current population

Using Real-World Data to Guide Ustekinumab Dosing Strategies for Psoriasis: A Prospective Pharmacokinetic-Pharmacodynamic Study.

Variation in response to biologic therapy for inflammatory diseases, such as psoriasis, is partly driven by variation in drug exposure. Real-world psoriasis data were used to develop a pharmacokinetic/pharmacodynamic (PK/PD) model for the first-line therapeutic antibody ustekinumab. The impact of differing dosing strategies on response was explored. Data were collected from a UK prospective multicenter observational cohort (491 patients on ustekinumab monotherapy, drug levels, and anti-drug antibody measurements on 797 serum samples, 1,590 measurements of Psoriasis Area Severity Index (PASI)). Ustekinumab PKs were described with a linear one-compartment model. A maximum effect (Emax ) model inhibited progression of psoriatic skin lesions in the turnover PD mechanism describing PASI evolution while on treatment. A mixture model on half-maximal effective concentration identified a potential nonresponder group, with simulations suggesting that, in future, the model could be incorporated into a Bayesian therapeutic drug monitoring "dashboard" to individualize dosing and improve treatment outcomes

A multicentre study of the evidence for customized margins in photon breast boost radiotherapy

Objective:To determine if subsets of patients may benefit from smaller or larger margins when using laser setup and bony anatomy verification of breast tumour bed (TB) boost radiotherapy (RT).Methods: Verification imaging data acquired using cone-beam CT, megavoltage CT or two-dimensional kilovoltage imaging on 218 patients were used (1574 images). TB setup errors for laser-only setup (dlaser) and for bony anatomy verification (dbone) were determined using clips implanted into the TB as a gold standard for the TB position. Cases were grouped by centre-, patient- and treatment-related factors, including breast volume, TB position, seroma visibility and surgical technique. Systematic (?) and random (?) TB setup errors were compared between groups, and TB planning target volume margins (MTB) were calculated.Results: For the study population, ?laser was between 2.8 and 3.4?mm, and ?bone was between 2.2 and 2.6?mm, respectively. Females with larger breasts (p?=?0.03), easily visible seroma (p???0.02) and open surgical technique (p???0.04) had larger ?laser. ?bone was larger for females with larger breasts (p?=?0.02) and lateral tumours (p?=?0.04). Females with medial tumours (p?<?0.01) had smaller ?bone.Conclusion:If clips are not used, margins should be 8 and 10?mm for bony anatomy verification and laser setup, respectively. Individualization of TB margins may be considered based on breast volume, TB and seroma visibility.Advances in knowledge:Setup accuracy using lasers and bony anatomy is influenced by patient and treatment factors. Some patients may benefit from clip-based image guidance more than others

Gender Differences in Compensation, Job Satisfaction and Other Practice Patterns in Urology

The proportion of women in urology has increased from <0.5% in 1981 to 10% today. Furthermore, 33% of students matching in urology are now female. This analysis sought to characterize the female workforce in urology in comparison to men with regard to income, workload, and job satisfaction

An Examination of General Aggression and Intimate Partner Violence in Women With Posttraumatic Stress Disorder

Research has documented significant relationships between PTSD, aggression and intimate partner violence (IPV). Most of these studies have focused on men and measured violence by self-report. The current study examined (1) the association between PTSD and general aggression among women, (2) the association between IPV and PTSD among married and/or cohabitating couples, and (3) the concordance between self and collateral reports of IPV. One hundred twenty participants provided information about PTSD symptoms and general aggression towards others, and 43 married and/or cohabitating couples provided information about PTSD and IPV. Women with PTSD reported more general aggression, IPV perpetration, and IPV victimization. Collateral informants of those with and without PTSD did not differ significantly in their report of IPV. Concordance between participants and spouses or partners was low to moderate. These results are discussed within the context of extant IPV literature

The growth of a mountain belt forced by base-level fall: Tectonics and surface processes during the evolution of the Alborz Mountains, N Iran

The idea that climatically modulated erosion may impact orogenic processes has challenged geoscientists for decades. Although modeling studies and physical calculations have provided a solid theoretical basis supporting this interaction, to date, field-based work has produced inconclusive results. The central-western Alborz Mountains in the northern sectors of the Arabia-Eurasia collision zone constitute a promising area to explore these potential feedbacks. This region is characterized by asymmetric precipitation superimposed on an orogen with a history of spatiotemporal changes in exhumation rates, deformation patterns, and prolonged, km-scale base-level changes. Our analysis suggests that despite the existence of a strong climatic gradient at least since 17.5 Ma, the early orogenic evolution (from ~ 36 to 9-6 Ma) was characterized by decoupled orographic precipitation and tectonics. In particular, faster exhumation and sedimentation along the more arid southern orogenic flank point to a north-directed accretionary flux and underthrusting of Central Iran. Conversely, from ~ 6 to 3 Ma, erosion rates along the northern orogenic flank became higher than those in the south, where they dropped to minimum values. This change occurred during a ~3-Myr-long, km-scale base-level lowering event in the Caspian Sea. We speculate that mass redistribution processes along the northern flank of the Alborz and presumably across all mountain belts adjacent to the South Caspian Basin and more stable areas of the Eurasian plate increased the sediment load in the basin and ultimately led to the underthusting of the Caspian Basin beneath the Alborz Mountains. This underthrusting in turn triggered a new phase of northward orogenic expansion, transformed the wetter northern flank into a new pro-wedge, and led to the establishment of apparent steady-state conditions along the northern orogenic flank (i.e., rock uplift equal to erosion rates). Conversely, the southern mountain front became the retro-wedge and experienced limited tectonic activity. These observations overall raise the possibility that mass-distribution processes during a pronounced erosion phase driven by base-level changes may have contributed to the inferred regional plate-tectonic reorganization of the northern Arabia-Eurasia collision during the last ~ 5 Ma.Keywords: rock uplift, knickpoints, base-level fall, surface processes, orogenic processes, erosio