1,654 research outputs found
Examining the Relationship between Self-Efficacy and Stimulus processing
Stimulus processing is an essential cognitive process that plays a vital role in our decision making and task execution. Since stimulus processing has been shown to be an important factor in task performance and cognitive well-being, it is necessary to explore the relationship it has with other psychological variables related to performance, as well as assess ways in which stimulus processing may be enhanced. The authors hypothesized that self-efficacy (SE) may improve performance by enhancing stimulus processing during task completion. To test this hypothesis, we examined the relationships between SE, behavioral measures of task performance, and neural indices of stimulus processing during the completion of two sessions of a modified flanker task. Behavioral measures included response accuracy and response time (RT), and neural indices included the P3b, an event-related brain potential associated with stimulus processing. Results showed that higher SE was associated with greater response accuracy and P3b amplitude during task execution in the first session. After SE manipulation, results indicated a significant effect of the feedback manipulation on SE, but no significant influences on P3b, accuracy, reaction time, or changes in those measures across sessions. These findings suggest that SE is beneficially related to neural indices of stimulus processing, and improved stimulus processing may help explain the association between SE and improved task performance. However, our specific manipulations of task-related SE are not sufficient to significantly improve subsequent stimulus processing
Shoreline Dynamics Along a Developed River Mouth Barrier Island: Multi-Decadal Cycles of Erosion and Event-Driven Mitigation
Human modifications in response to erosion have altered the natural transport of sediment to and across the coastal zone, thereby potentially exacerbating the impacts of future erosive events. Using a combination of historical shoreline-change mapping, sediment sampling, three-dimensional beach surveys, and hydrodynamic modeling of nearshore and inlet processes, this study explored the feedbacks between periodic coastal erosion patterns and associated mitigation responses, focusing on the open-ocean and inner-inlet beaches of Plum Island and the Merrimack River Inlet, Massachusetts, United States. Installation of river-mouth jetties in the early 20th century stabilized the inlet, allowing residential development in northern Plum Island, but triggering successive, multi-decadal cycles of alternating beach erosion and accretion along the inner-inlet and oceanfront beaches. At a finer spatial scale, the formation and southerly migration of an erosion “hotspot” (a setback of the high-water line by ∼100 m) occurs regularly (every 25–40 years) in response to the refraction of northeast storm waves around the ebb-tidal delta. Growth of the delta progressively shifts the focus of storm wave energy further down-shore, replenishing updrift segments with sand through the detachment, landward migration, and shoreline-welding of swash bars. Monitoring recent hotspot migration (2008–2014) demonstrates erosion (\u3e30,000 m3 of sand) along a 350-m section of beach in 6 months, followed by recovery, as the hotspot migrated further south. In response to these erosion cycles, local residents and governmental agencies attempted to protect shorefront properties with a variety of soft and hard structures. The latter have provided protection to some homes, but enhanced erosion elsewhere. Although the local community is in broad agreement about the need to plan for long-term coastal changes associated with sea-level rise and increased storminess, real-time responses have involved reactions mainly to short-term (years) erosion threats. A collective consensus for sustainable management of this area is lacking and the development of a longer-term adaptive perspective needed for proper planning has been elusive. With a deepening understanding of multi-decadal coastal dynamics, including a characterization of the relative contributions of both nature and humans, we can be more optimistic that adaptations beyond mere reactions to shoreline change are achievable
Endoscopic repair of high-flow cranial base defects using a bilayer button.
OBJECTIVES/HYPOTHESIS: Repair of the skull base still begins with a direct repair of the dural defect. We present a new button closure for primary repair of the dura for high flow defects.
STUDY DESIGN: Retrospective review.
METHODS: We reviewed our 20 cases of primary button grafts and compared the results to the previous 20 high-flow open-cistern cerebrospinal fluid (CSF) cases. Subjects were excluded if they had no violation of the arachnoid space or potential for low-flow CSF leak. The button is constructed so that the inlay portion is at least 25% larger than the dural defect, and the onlay portion is just large enough to cover the dural defect. The two grafts are sutured together using two 4-0 Neurolon sutures and placed with the inlay portion intradurally and the onlay portion extradurally.
RESULTS: The button graft repair of open-cisternal defects had a drop in CSF leak complications to 10% (2/20), and these two leaks were repaired with the button technique as the salvage surgery. This is a significant improvement over the 45% leak rate in the prebutton graft group (P \u3c .03). In our button graft group we used nasoseptal flaps on 16/20 repairs, and 1/2 repairs that leaked in the button group did not have a nasoseptal flap. Lumbar drains were used in approximately 38% in both groups (P = .83).
CONCLUSIONS: The button graft can be used in conjunction with the nasal septal flap or as a stand-alone repair with good results reducing the postoperative leak rate to 10% for high-flow CSF repairs
Bendamustine combined with rituximab for patients with relapsed or refractory diffuse large B cell lymphoma
Patients with relapsed or refractory diffuse large B cell lymphoma (DLBCL) are treated with salvage regimens and may be considered for high-dose chemotherapy and autologous stem cell transplantation if disease is chemosensitive. Bendamustine is active in indolent B cell lymphomas and chronic lymphocytic leukemia but has not been extensively studied in aggressive lymphomas. This trial examines the combination of bendamustine and rituximab in patients with relapsed and refractory DLBCL. Patients received bendamustine at 90 mg/m2 (n = 2) or 120 mg/m2 (n = 57) on days 1 and 2 and rituximab at 375 mg/m2 on day 1 every 28 days for up to 6 cycles. The study evaluated objective response rate (ORR), duration of response (DOR), progression-free survival (PFS), and treatment safety. Fifty-nine patients were treated, and 48 were evaluable for response. Median age was 74; 89 % had stage III or IV disease, and 63 % had high revised International Prognostic Index scores; the median number of prior therapies was 1. Based on analysis using the intent-to-treat population, the ORR was 45.8 % (complete response, 15.3 %; partial response, 30.5 %). The median DOR was 17.3 months, and the median PFS was 3.6 months. Grade 3 or 4 hematological toxicities included neutropenia (36 %), leukopenia (29 %), thrombocytopenia (22 %), and anemia (12 %). The combination of bendamustine and rituximab showed modest activity in patients with relapsed and refractory DLBCL and has an acceptable toxicity profile
Diffusion of published cost-utility analyses in the field of health policy and practice
OBJECTIVES: The diffusion of cost-utility analyses (CUAs) through the medical literature was examined, documenting visible patterns and determining how they correspond with expectations about the diffusion of process innovations.
METHODS: This study used 539 CUAs from a registry. It includes data elements comprising year of publication, the research center in which the study was performed, the clinical area covered by the CUA, and the specific journal. Finally, each paper was assigned to a journal type that could be one of the three categories: health services research, general medicine, or clinical specialty.
RESULTS: When the average number of publications is plotted against time, the plot reveals an S-shaped curve. It appears that, whereas CUAs initially were published more frequently in general medical or health services research journals, there was a clear increase in the diffusion of CUA into subspecialty journals over time. The concentration ratio for research centers as measured by the Herfindhal-Hirschman Index decreased over time.
CONCLUSIONS: The spread of CUA through the medical literature follows patterns identified for the diffusion of other new technologies and processes. Future research should focus on what impact this spread has had on the practice of medicine and formulation of health policy
Generalized Symmetries of Impulsive Gravitational Waves
We generalize previous \cite{AiBa2} work on the classification of
() symmetries of plane-fronted waves with an impulsive profile. Due
to the specific form of the profile it is possible to extend the group of
normal-form-preserving diffeomorphisms to include non-smooth transformations.
This extension entails a richer structure of the symmetry algebra generated by
the (non-smooth) Killing vectors.Comment: 18 pages, latex2e, no figure
Cost-utility analyses in orthopaedic surgery
BACKGROUND: The rising cost of health care has increased the need for the orthopaedic community to understand and apply economic evaluations. We critically reviewed the literature on orthopaedic cost-utility analysis to determine which subspecialty areas are represented, the cost-utility ratios that have been utilized, and the quality of the present literature.
METHODS: We searched the English-language medical literature published between 1976 and 2001 for orthopaedic-related cost-utility analyses in which outcomes were reported as cost per quality-adjusted life year. Two trained reviewers independently audited each article to abstract data on the methods and reporting practices used in the study as well as the cost-utility ratios derived by the analysis.
RESULTS: Our search yielded thirty-seven studies, in which 116 cost-utility ratios were presented. Eleven of the studies were investigations of treatment strategies in total joint arthroplasty. Study methods varied substantially, with only five studies (14%) including four key criteria recommended by the United States Panel on Cost-Effectiveness in Health and Medicine. According to a reader-assigned measure of study quality, cost-utility analyses in orthopaedics were of lower quality than those in other areas of medicine (p = 0.04). While the number of orthopaedic studies has increased in the last decade, the quality did not improve over time and did not differ according to subspecialty area or journal type. For the majority of the interventions that were studied, the cost-utility ratio was below the commonly used threshold of $50,000 per quality-adjusted life year for acceptable cost-effectiveness.
CONCLUSIONS: Because of limitations in methodology, the current body of literature on orthopaedic cost-utility analyses has a limited ability to guide policy, but it can be useful for setting priorities and guiding research. Future research with clear and transparent reporting is needed in all subspecialty areas of orthopaedic practice
Best Management Practices for Nitrogen Use: Irrigated Potatoes
This archival publication may not reflect current scientific knowledge or recommendations. Current information available from the University of Minnesota Extension: https://www.extension.umn.edu
Hyalocyte origin, structure, and imaging
Hyalocytes have been recognized as resident tissue macrophages of the vitreous body since the mid-19th century. Despite this, knowledge about their origin, turnover, and dynamics is limited. Historically, initial studies on the origin of hyalocytes used light and electron microscopies. Modern investigations across species including rodents and humans will be described. Novel imaging is now available to study human hyalocytes in vivo. The shared ontogeny with retinal microglia and their eventual interdependence as well as differences will be discussed. Owing to a common origin as myeloid cells, hyalocytes and retinal microglia have similarities, but hyalocytes appear to be distinct as resident macrophages of the vitreous body.</p
- …