The Relationship Between Self-concept and Body Image in Females with Deleterious BRCA1/2 Mutations

Among women in the United States, breast cancer is the second most commonly diagnosed cancer and is the second-leading cause of death (American Cancer Society, 2015b). A subgroup of women with genetic mutations called BRCA1/2 mutations are at a significantly higher lifetime risk of developing breast cancer, among other cancers (Friedman, Sutphen, & Steglio, 2012). While the research base is growing with regard to women with BRCA1/2 mutations, little is known about the psychological experience of having a BRCA1/2 mutation and the challenges and obstacles that having a BRCA1/2 mutation entails throughout the lifetime. This study looked at women with BRCA1/2 mutations who had undergone a prophylactic bilateral mastectomy compared to women who had chosen to undergo surveillance methods only to manage their breast cancer risk. It was hypothesized that women who had undergone a prophylactic bilateral mastectomy would display greater experiences of stigma, greater experiences of vulnerability, and fewer mastery experiences, as well as would rate higher on investment in appearance and investment in body integrity, when compared to women who had not undergone a prophylactic bilateral mastectomy and only underwent surveillance methods. Participants in this study included women who had tested positive for a deleterious BRCA1/2 mutation who spoke and understood English and were older than the age of 18 years. These women completed an online survey that asked demographic questions, as well as questions about body image and self-concept. Two separate MANOVAs were conducted to analyze the results. No significant differences were found between groups. The implications of these findings are discussed, as well as limitations of the study and the need for more research on this area of study

Orienting Nanoantennas in Three Dimensions To Control Light Scattering Across a Dielectric Interface

The light scattering properties of hemispherical resonant nanoantennas can be used to redirect normal incidence light to propagate within a thin film or thin film-based device, such as a solar cell, for enhanced efficiency. While planar nanoantennas are typically fabricated as simple nanoparticles or nanostructures in the film plane, here we show that a hemispherical nanoantenna with its symmetry axis tilted out of the plane accomplishes this task with far greater efficacy. The amount of light scattered into an underlying dielectric by the electric and magnetic dipole response of oriented nanocups can be more than three times that achieved using symmetric antenna structures

Orienting Nanoantennas in Three Dimensions To Control Light Scattering Across a Dielectric Interface

The light scattering properties of hemispherical resonant nanoantennas can be used to redirect normal incidence light to propagate within a thin film or thin film-based device, such as a solar cell, for enhanced efficiency. While planar nanoantennas are typically fabricated as simple nanoparticles or nanostructures in the film plane, here we show that a hemispherical nanoantenna with its symmetry axis tilted out of the plane accomplishes this task with far greater efficacy. The amount of light scattered into an underlying dielectric by the electric and magnetic dipole response of oriented nanocups can be more than three times that achieved using symmetric antenna structures

Orienting Nanoantennas in Three Dimensions To Control Light Scattering Across a Dielectric Interface

The light scattering properties of hemispherical resonant nanoantennas can be used to redirect normal incidence light to propagate within a thin film or thin film-based device, such as a solar cell, for enhanced efficiency. While planar nanoantennas are typically fabricated as simple nanoparticles or nanostructures in the film plane, here we show that a hemispherical nanoantenna with its symmetry axis tilted out of the plane accomplishes this task with far greater efficacy. The amount of light scattered into an underlying dielectric by the electric and magnetic dipole response of oriented nanocups can be more than three times that achieved using symmetric antenna structures

Hot-Electron-Induced Dissociation of H₂ on Gold Nanoparticles Supported on SiO₂

Hot-electron-induced photodissociation of H₂ was demonstrated on small Au nanoparticles (AuNPs) supported on SiO₂. The rate of dissociation of H₂ was found to be almost 2 orders of magnitude higher than that observed on equivalently prepared AuNPs on TiO₂. The rate of H₂ dissociation was found to be linearly dependent on illumination intensity with a wavelength dependence resembling the absorption spectrum of the plasmon of the AuNPs. This result provides strong additional support for the hot-electron-induced mechanism for H₂ dissociation in this photocatalytic system

Health states for schizophrenia and bipolar disorder within the Global Burden of Disease 2010 Study

<p>Abstract</p> <p>A comprehensive revision of the Global Burden of Disease (GBD) study is expected to be completed in 2012. This study utilizes a broad range of improved methods for assessing burden, including closer attention to empirically derived estimates of disability. The aim of this paper is to describe how GBD health states were derived for schizophrenia and bipolar disorder. These will be used in deriving health state-specific disability estimates. A literature review was first conducted to settle on a parsimonious set of health states for schizophrenia and bipolar disorder. A second review was conducted to investigate the proportion of schizophrenia and bipolar disorder cases experiencing these health states. These were pooled using a quality-effects model to estimate the overall proportion of cases in each state. The two schizophrenia health states were acute (predominantly positive symptoms) and residual (predominantly negative symptoms). The three bipolar disorder health states were depressive, manic, and residual. Based on estimates from six studies, 63% (38%-82%) of schizophrenia cases were in an acute state and 37% (18%-62%) were in a residual state. Another six studies were identified from which 23% (10%-39%) of bipolar disorder cases were in a manic state, 27% (11%-47%) were in a depressive state, and 50% (30%-70%) were in a residual state. This literature review revealed salient gaps in the literature that need to be addressed in future research. The pooled estimates are indicative only and more data are required to generate more definitive estimates. That said, rather than deriving burden estimates that fail to capture the changes in disability within schizophrenia and bipolar disorder, the derived proportions and their wide uncertainty intervals will be used in deriving disability estimates.</p

Regional Practice Variation and Outcomes in the Standard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) Trial: A Post Hoc Secondary Analysis.

ObjectivesAmong patients with severe acute kidney injury (AKI) admitted to the ICU in high-income countries, regional practice variations for fluid balance (FB) management, timing, and choice of renal replacement therapy (RRT) modality may be significant.DesignSecondary post hoc analysis of the STandard vs. Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial (ClinicalTrials.gov number NCT02568722).SettingOne hundred-fifty-three ICUs in 13 countries.PatientsAltogether 2693 critically ill patients with AKI, of whom 994 were North American, 1143 European, and 556 from Australia and New Zealand (ANZ).InterventionsNone.Measurements and main resultsTotal mean FB to a maximum of 14 days was +7199 mL in North America, +5641 mL in Europe, and +2211 mL in ANZ (p p p p p p p p = 0.007).ConclusionsAmong STARRT-AKI trial centers, significant regional practice variation exists regarding FB, timing of initiation of RRT, and initial use of continuous RRT. After adjustment, such practice variation was associated with lower ICU and hospital stay and 90-day mortality among ANZ patients compared with other regions

A Bayesian reanalysis of the Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial

Background Timing of initiation of kidney-replacement therapy (KRT) in critically ill patients remains controversial. The Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial compared two strategies of KRT initiation (accelerated versus standard) in critically ill patients with acute kidney injury and found neutral results for 90-day all-cause mortality. Probabilistic exploration of the trial endpoints may enable greater understanding of the trial findings. We aimed to perform a reanalysis using a Bayesian framework. Methods We performed a secondary analysis of all 2927 patients randomized in multi-national STARRT-AKI trial, performed at 168 centers in 15 countries. The primary endpoint, 90-day all-cause mortality, was evaluated using hierarchical Bayesian logistic regression. A spectrum of priors includes optimistic, neutral, and pessimistic priors, along with priors informed from earlier clinical trials. Secondary endpoints (KRT-free days and hospital-free days) were assessed using zero–one inflated beta regression. Results The posterior probability of benefit comparing an accelerated versus a standard KRT initiation strategy for the primary endpoint suggested no important difference, regardless of the prior used (absolute difference of 0.13% [95% credible interval [CrI] − 3.30%; 3.40%], − 0.39% [95% CrI − 3.46%; 3.00%], and 0.64% [95% CrI − 2.53%; 3.88%] for neutral, optimistic, and pessimistic priors, respectively). There was a very low probability that the effect size was equal or larger than a consensus-defined minimal clinically important difference. Patients allocated to the accelerated strategy had a lower number of KRT-free days (median absolute difference of − 3.55 days [95% CrI − 6.38; − 0.48]), with a probability that the accelerated strategy was associated with more KRT-free days of 0.008. Hospital-free days were similar between strategies, with the accelerated strategy having a median absolute difference of 0.48 more hospital-free days (95% CrI − 1.87; 2.72) compared with the standard strategy and the probability that the accelerated strategy had more hospital-free days was 0.66. Conclusions In a Bayesian reanalysis of the STARRT-AKI trial, we found very low probability that an accelerated strategy has clinically important benefits compared with the standard strategy. Patients receiving the accelerated strategy probably have fewer days alive and KRT-free. These findings do not support the adoption of an accelerated strategy of KRT initiation