6,908 research outputs found
Creating a âCircle of Trustâ to Further Digital Privacy and Cybersecurity Goals
Article published in the Michigan State Law Review
Pilot Investigation of Correlations Between Supragingival Plaque, Subgingival Plaque and Gingival Crevice Depth
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141157/1/jper0636.pd
Further developments in stress initialization in geomechanics via FEM and a two-step procedure involving airy functions
The in-situ stress field in rock masses is a key aspect when a numerical analysis of a rock mass is carried out in any area of geo-engineering, such as civil, mining, or Oil & Gas. A method for the numerical generation of the in-situ stress state in the FE context, based on Airy stress functions was previously introduced. It involves two steps: 1) an estimate of the stress state at each Gauss point is generated, and 2) global equilibrium is verified and re-balancing nodal forces are applied as needed. In this paper, new developments towards improving the accuracy of the stress proposal are discussed. A real application example has been used to illustrate the results achieved with the new implementation
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Disparity between General Symptom Relief and Remission Criteria in the Positive and Negative Syndrome Scale (PANSS): A Post-treatment Bifactor Item Response Theory Model.
Objective: Total scale scores derived by summing ratings from the 30-item PANSS are commonly used in clinical trial research to measure overall symptom severity, and percentage reductions in the total scores are sometimes used to document the efficacy of treatment. Acknowledging that some patients may have substantial changes in PANSS total scores but still be sufficiently symptomatic to warrant diagnosis, ratings on a subset of 8 items, referred to here as the "Remission set," are sometimes used to determine if patients' symptoms no longer satisfy diagnostic criteria. An unanswered question remains: is the goal of treatment better conceptualized as reduction in overall symptom severity, or reduction in symptoms below the threshold for diagnosis? We evaluated the psychometric properties of PANSS total scores, to assess whether having low symptom severity post-treatment is equivalent to attaining Remission. Design: We applied a bifactor item response theory (IRT) model to post-treatment PANSS ratings of 3,647 subjects diagnosed with schizophrenia assessed at the termination of 11 clinical trials. The bifactor model specified one general dimension to reflect overall symptom severity, and five domain-specific dimensions. We assessed how PANSS item discrimination and information parameters varied across the range of overall symptom severity (Ξ), with a special focus on low levels of symptoms (i.e., Ξ<-1), which we refer to as "Relief" from symptoms. A score of Ξ=-1 corresponds to an expected PANSS item score of 1.83, a rating between "Absent" and "Minimal" for a PANSS symptom. Results: The application of the bifactor IRT model revealed: (1) 88% of total score variation was attributable to variation in general symptom severity, and only 8% reflected secondary domain factors. This implies that a general factor may provide a good indicator of symptom severity, and that interpretation is not overly complicated by multidimensionality; (2) Post-treatment, 534 individuals (about 15% of the whole sample) scored in the "Relief" range of general symptom severity, but more than twice that number (n = 1351) satisfied Remission criteria (37%). 2 in 3 Remitted patients had scores that were not in a low symptom range (corresponding to Absent or Minimal item scores); (3) PANSS items vary greatly in their ability to measure the general symptom severity dimension; while many items are highly discriminating and relatively "pure" indicators of general symptom severity (delusions, conceptual disorganization), others are better indicators of specific dimensions (blunted affect, depression). The utility of a given PANSS item for assessing a patient depended on the illness level of the patient. Conclusion: Satisfying conventional Remission criteria was not strongly associated with low levels of symptoms. The items providing the most information for patients in the symptom Relief range were Delusions, Preoccupation, Suspiciousness Persecution, Unusual Thought Content, Conceptual Disorganization, Stereotyped Thinking, Active Social Avoidance, and Lack of Judgment and Insight. Lower scores on these items (item scores â€2) were strongly associated with having a low latent trait Ξ or experiencing overall symptom relief. The inter-rater agreement between Remission and Relief subjects suggested that these criteria identified different subsets of patients. Alternative subsets of items may offer better indicators of general symptom severity and provide better discrimination (and lower standard errors) for scaling individuals and judging symptom relief, where the "best" subset of items ultimately depends on the illness range and treatment phase being evaluated
Sfp1 and Rtg3 reciprocally modulate carbon source-conditional stress adaptation in the pathogenic yeast Candida albicans
Acknowledgements We thank Aaron Mitchell, Dominique Sanglard and Suzanne Noble for their generosity in providing mutant collections, and Linghuo Jiang for generously providing strains. We also thank Susan Budge for her support and excellent technical assistance. We also thank the qPCR Facility in the Institute of Medical Sciences, and particularly Fiona Saunders for her great advice and help. SLK was supported by a PhD scholarship from the University of Aberdeen. AJPB was supported by the UK Biotechnology and Biological Research Council (BB/F00513X/1; BB/K017365/1), by the European Research Council (STRIFE Advanced Grant; ERC-2009-AdG-249793), and by the UK Medical Research Council (MR/M026663/1). AJPB and CAM were also supported by the Wellcome Trust (088858; 097377), and by the MRC Centre for Medical Mycology and the University of Aberdeen (MR/N006364/1).Peer reviewedPublisher PD
GPsâ perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research
Objective To synthesise the existing published literature on the perceptions of general practitioners (GPs) or their equivalent on the clinical management of multimorbidity and determine targets for future research that aims to improve clinical care in multimorbidity. Design Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore GPsâ experiences of clinical management of multimorbidity or multiple chronic diseases. Data sources EMBASE, MEDLINE, CINAHL, PsycInfo, Academic Search Complete, SocIndex, Social Science Full Text and digital theses/online libraries (database inception to September 2012) to identify literature using qualitative methods (focus groups or interviews). Review methods The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. Results Of 1805 articles identified, 37 were reviewed in detail and 10 were included, using a total of 275 GPs in 7 different countries. Four areas of difficulty specific to the management of multimorbidity emerged from these papers: disorganisation and fragmentation of healthcare; the inadequacy of guidelines and evidence-based medicine; challenges in delivering patient-centred care; and barriers to shared decision-making. A âline of argumentâ was drawn which described GPsâ sense of isolation in decision-making for multimorbid patients. Conclusions This systematic review shows that the problem areas for GPs in the management of multimorbidity may be classified into four domains. There will be no âone size fits allâ intervention for multimorbidity but these domains may be useful targets to guide the development of interventions that will assist and improve the provision of care to multimorbid patients
Testing the Hydrogen Peroxide-Water Hypothesis for Life on Mars with the TEGA instrument on the Phoenix Lander
Since Viking has conducted its life detection experiments on Mars, many
missions have enhanced our knowledge about the environmental conditions on the
Red Planet. However, the Martian surface chemistry and the Viking lander
results remain puzzling. Non-biological explanations that favor a strong
inorganic oxidant are currently favored (e.g., Mancinelli, 1989; Quinn and
Zent, 1999; Klein, 1999, Yen et al., 2000), but problems remain regarding the
life time, source, and abundance of that oxidant to account for the Viking
observations (Zent and McKay, 1994). Alternatively, a hypothesis favoring the
biological origin of a strong oxidizer has recently been advanced (Houtkooper
and Schulze-Makuch, 2007). Here, we report about laboratory experiments that
simulate the experiments to be conducted by the Thermal and Evolved Gas
Analyzer (TEGA) instrument of the Phoenix lander, which is to descend on Mars
in May 2008. Our experiments provide a baseline for an unbiased test for
chemical versus biological responses, which can be applied at the time the
Phoenix Lander transmits its first results from the Martian surface.Comment: 11 pages and 3 figure
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