Multi-model mapping of phonemic fluency

The voluntary generation of non-overlearned responses is usually assessed with phonemic fluency. Like most frontal tasks, it draws upon different complex processes and systems whose precise nature is still incompletely understood. Many claimed aspects regarding the pattern of phonemic fluency performance and its underlying anatomy remain controversial. Major limitations of past investigations include small sample size, scant analysis of phonemic output and methodologically insufficient lesion analysis approaches. We investigated a large number of patients with focal unilateral right or left frontal (n = 110) or posterior (n = 100) or subcortical (n = 65) lesions imaged with magnetic resonance or computed tomography and compared their performance on the number of overall responses, words produced over time, extremely infrequent/unknown words and inappropriate words generated. We also employed, for the first time parcel‐based lesion-symptom mapping, tract-wise statistical analysis as well as Bayesian multi-variate analysis based on meta-analytically defined functional region of interest, including their interactions. We found that left frontal damage was associated with greater impairment than right frontal or posterior damage on overall fluency performance, suggesting that phonemic fluency shows specificity to frontal lesions. We also found that subcorticals, similar to frontals, performed significantly worse than posteriors on overall performance suggesting that subcortical regions are also involved. However, only frontal effects were found for words produced over time, extremely infrequent/unknown and inappropriate words. Parcel‐based lesion-symptom mapping analysis found that worse fluency performance was associated with damage to the posterior segment of the left frontal middle and superior gyrus, the left dorsal anterior cingulate gyrus and caudate nucleus. Tract-wise statistical analysis revealed that disconnections of left frontal tracts are critical. Bayesian multi-variate models of lesions and disconnectome maps implicated left middle and inferior frontal and left dorsomedial frontal regions. Our study suggests that a set of well localized left frontal areas together with subcortical regions and several left frontal tracts are critical for word generation. We speculate that a left lateralized network exists. It involves medial, frontal regions supporting the process of ‘energization’, which sustains activation for the duration of the task and middle and inferior frontal regions concerned with ‘selection’, required due to the competition produced by associated stored words, respectively. The methodology adopted represents a promising and empirically robust approach in furthering our understanding of the neurocognitive architecture underpinning executive processes

A web-based and mobile health social support intervention to promote adherence to inhaled asthma medications: randomized controlled trial

Background: Online communities hold great potential as interventions for health, particularly for the management of chronic illness. The social support that online communities can provide has been associated with positive treatment outcomes, including medication adherence. There are few studies that have attempted to assess whether membership of an online community improves health outcomes using rigorous designs. Objective: Our objective was to conduct a rigorous proof-of-concept randomized controlled trial of an online community intervention for improving adherence to asthma medicine. Methods: This 9-week intervention included a sample of asthmatic adults from the United Kingdom who were prescribed an inhaled corticosteroid preventer. Participants were recruited via email and randomized to either an “online community” or “no online community” (diary) condition. After each instance of preventer use, participants (N=216) were required to report the number of doses of medication taken in a short post. Those randomized to the online community condition (n=99) could read the posts of other community members, reply, and create their own posts. Participants randomized to the no online community condition (n=117) also posted their medication use, but could not read others’ posts. The main outcome measures were self-reported medication adherence at baseline and follow-up (9 weeks postbaseline) and an objective measure of adherence to the intervention (visits to site). Results: In all, 103 participants completed the study (intervention: 37.8%, 39/99; control: 62.2%, 64/117). MANCOVA of self-reported adherence to asthma preventer medicine at follow-up was not significantly different between conditions in either intention-to-treat (P=.92) or per-protocol (P=.68) analysis. Site use was generally higher in the control compared to intervention conditions. Conclusions: Joining an online community did not improve adherence to preventer medication for asthma patients. Without the encouragement of greater community support or more components to sustain engagement over time, the current findings do not support the use of an online community to improve adherence

Decellularization reduces the immune response to aortic valve allografts in the rat

ObjectivesCryopreserved valve allografts used in congenital cardiac surgery are associated with a significant cellular and humoral immune response. This might be reduced by removal of antigenic cellular elements (decellularization). The aim of this study was to determine the immunologic effect of decellularization in a rat allograft valve model.MethodsBrown Norway and Lewis rat aortic valves were decellularized with a series of hypotonic and hypertonic buffers, protease inhibitors, gentle detergents (Triton X-100), and phosphate-buffered saline. Valves were implanted into Lewis rats in syngeneic and allogeneic combinations. Cellular (CD3 and CD8) infiltrates were assessed with morphometric analysis, and the humoral response was assessed with flow cytometry.ResultsMorphometric analysis identified a significant reduction in CD3+ cell infiltrates (cells per square millimeter of leaflet tissue) in decellularized allografts compared with that seen in nondecellularized allografts at 1 (79 ± 29 vs 3310 ± 223, P < .001), 2 (26 ± 11 vs 109 ± 20, P = .004), and 4 weeks (283 ± 122 vs 984 ± 145, P < .001). Anti-CD8 staining confirmed the majority of infiltrates were cytotoxic T cells. Flow cytometric mean channel fluorescence intensity identified a negative shift (abrogated antibody formation) for decellularized allografts compared with nondecellularized allografts at 2 (19 ± 1 vs 27 ± 3, P = .033), 4 (35 ± 2 vs 133 ± 29, P = .001), and 16 weeks (28 ± 2 vs 166 ± 54, P = .017).ConclusionsDecellularization significantly reduces the cellular and humoral immune response to allograft tissue. This could prolong the durability of valve allografts and might prevent immunologic sensitization of allograft recipients

The effects of perceived and received support on objective performance outcome.

This is a postprint of an article published in European Journal of Sport Science, 2008, Vol. 8, Issue 6, pp. 359 – 368 © 2008 copyright Taylor & Francis. European Journal of Sport Science is available online at: http://www.tandfonline.com/loi/tejs20In this study, we examined the main and stress-buffering effects of perceived and received support upon objective performance outcome. The sample consisted of 123 male British high performance golfers, mean age 25.3 years (SD = 5.4). Participants completed measures of perceived support, stressors, stress, and received support before competitions. After the competitions, performance outcome (number of shots) was recorded. When both types of support were considered separately, there were significant main effects for perceived (ΔR2 = .08, b = -.81, p < .01) and received support (ΔR2 = .05, b = -.68, p < .01) on performance. There were also significant stress-buffering effects for perceived (ΔR2 = .03, b = -.48, p = .02) and received support (ΔR2 = .06, b = -.61, p < .01). When both types of support were considered simultaneously, the significant main effect (DR2 = .09, p < .01) was primarily attributable to perceived support (b = -.63, p = .02). The significant stress-buffering effect (DR2 = .06, p = .01) was primarily attributable to received support (b = -.56, p = .04). These results demonstrate the beneficial influence of social support on performance. The findings highlight the need to recognise the distinction between perceived and received support, both in terms of theory and the design of social support interventions with athletes

Comparison of selected foreign plans and practices for spent fuel and high-level waste management

This report describes the major parameters for management of spent nuclear fuel and high-level radioactive wastes in selected foreign countries as of December 1989 and compares them with those in the United States. The foreign countries included in this study are Belgium, Canada, France, the Federal Republic of Germany, Japan, Sweden, Switzerland, and the United Kingdom. All the countries are planning for disposal of spent fuel and/or high-level wastes in deep geologic repositories. Most countries (except Canada and Sweden) plan to reprocess their spent fuel and vitrify the resultant high-level liquid wastes; in comparison, the US plans direct disposal of spent fuel. The US is planning to use a container for spent fuel as the primary engineered barrier. The US has the most developed repository concept and has one of the earliest scheduled repository startup dates. The repository environment presently being considered in the US is unique, being located in tuff above the water table. The US also has the most prescriptive regulations and performance requirements for the repository system and its components. 135 refs., 8 tabs

Comparison of Selected Foreign Plans and Practices for Spent Fuel and High-Level Waste Management

This report describes the major parameters for management of spent nuclear fuel and high-level radioactive wastes in selected foreign countries as of December 1989 and compares them with those in the United States. The foreign countries included in this study are Belgium, Canada, France, the Federal Republic of Germany, Japan, Sweden, Switzerland, and the United Kingdom. All the countries are planning for disposal of spent fuel and/or high-level wastes in deep geologic repositories. Most countries (except Canada and Sweden) plan to reprocess their spent fuel and vitrify the resultant high-level liquid wastes; in comparison, the US plans direct disposal of spent fuel. The US is planning to use a container for spent fuel as the primary engineered barrier. The US has the most developed repository concept and has one of the earliest scheduled repository startup dates. The repository environment presently being considered in the US is unique, being located in tuff above the water table. The US also has the most prescriptive regulations and performance requirements for the repository system and its components. 135 refs., 8 tabs

Formation of Composite Endothelial Cell–Mesenchymal Stem Cell Islets: A Novel Approach to Promote Islet Revascularization

OBJECTIVE—Mesenchymal stem cells (MSCs) contribute to endothelial cell (EC) migration by producing proteases, thereby paving the way into the tissues for ECs. MSCs were added to our previously described composite EC islets as a potential means to improve their capacity for islet angiogenesis

Job searching with a history of drugs and crime

This article explores the experiences and aspirations of offenders with histories of substance misuse in job searching. The analysis is based upon qualitative data from a localised study of 27 men and two women who were undertaking community-based court orders in Scotland. Their perspectives on job searching, job-readiness and aspirations for sustained employment including the role of self-employment are presented. The article concludes that with adequate support, greater tolerance and flexibility by employers and job searchers could contribute to reducing the vicious cycle of suspicion and dishonesty. Policy action needs to be sustained and possibly augmented to include enterprise training

How Does Perceived Support Lead to Better Performance? An Examination of Potential Mechanisms

This is a postprint of an article published in Journal of Applied Sport Psychology, 2009, Vol. 21, pp. 421 – 429 © 2009 copyright Taylor & Francis. Journal of Applied Sport Psychology is available online at: http://www.tandfonline.com/toc/uasp20/currentUsing a high-performance sample of 118 golfers, we examined the relationship between perceived support and performance. Observed variable path analysis revealed that the beneficial effects of perceived support were primarily attributable to esteem support. High levels of esteem support were associated with appraising a competition as less of a threat. Esteem support was also positively associated with situational control, which was positively associated with challenge appraisals and negatively associated with threat appraisals. Challenge appraisals were associated with better performance and threat appraisals with poorer performance. These results highlight possible mechanisms underlying the relationship between esteem support and performance

Measuring the quality and quantity of professional intrapartum support: Testing a computerised systematic observation tool in the clinical setting

Background: Continuous support in labour has a significant impact on a range of clinical outcomes, though whether the quality and quantity of support behaviours affects the strength of this impact has not yet been established. To identify the quality and quantity of support, a reliable means of measurement is needed. To this end, a new computerised systematic observation tool, the &lsquo;SMILI' (Supportive Midwifery in Labour Instrument) was developed. The aim of the study was to test the validity and usability of the &lsquo;Supportive Midwifery in Labour Instrument' (SMILI) and to test the feasibility and acceptability of the systematic observation approach in the clinical intrapartum setting. Methods: Systematic observation was combined with a postnatal questionnaire and the collection of data about clinical processes and outcomes for each observed labour. The setting for the study was four National Health Service maternity units in Scotland, UK. Participants in this study were forty five midwives and forty four women. The SMILI was used by trained midwife observers to record labour care provided by midwives. Observations were undertaken for an average of two hours and seventeen minutes during the active first stage of labour and, in 18 cases, the observation included the second stage of labour. Content validity of the instrument was tested by the observers, noting the extent to which the SMILI facilitated the recording of all key aspects of labour care and interactions. Construct validity was tested through exploration of correlations between the data recorded and women's feelings about the support they received. Feasibility and usability data were recorded following each observation by the observer. Internal reliability and construct validity were tested through statistical analysis of the data. Results: One hundred and four hours of labour care were observed and recorded using the SMILI during forty nine labour episodes. Conclusion: The SMILI was found to be a valid and reliable instrument in the intrapartum setting in which it was tested. The study identified that the SMILI could be used to test correlations between the quantity and quality of support and outcomes. The systematic observational approach was found to be an acceptable and feasible method of enquiry