Confirmatory Factor Analysis of the Pain Care Quality Surveys (Pain CQ © )

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98233/1/hesr12014-sup-0001-Author_matrix.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/98233/2/hesr12014.pd

Moderators and Processes of Change in Traditional Exposure and Response Prevention (ERP) Versus Acceptance and Commitment Therapy-Informed ERP for Obsessive-Compulsive Disorder

The present study evaluated moderators and processes of change in a randomized controlled trial comparing exposure and response prevention (ERP) delivered from a traditional framework versus ERP from an acceptance and commitment therapy framework (ACT+ERP) for obsessive-compulsive disorder (OCD). This paper presents baseline, weekly session, posttreatment, and follow-up data from the study. We examined (a) moderation effects of anxiety, depression, psychological inflexibility, and interpretation of intrusions and (b) the role of psychological inflexibility and interpretation of intrusions respectively as processes of change. Participants with less dysfunctional appraisals at pretreatment performed consistently better in ERP relative to ACT+ERP. In process analyses, psychological inflexibility and interpretation of intrusions positively influenced OCD severity over time in both conditions but OCD symptom severity also positively influenced psychological inflexibility and interpretation of intrusions in both conditions. Furthermore, whereas OCD symptom severity strongly and positively predicted dysfunctional appraisals over the course of treatment in ERP, symptom severity had a weaker positive effect on dysfunctional appraisals in ACT+ERP. Clinical and theoretical implications as well as study limitations are discussed

Genetic Variants Associated With Vincristine‐Induced Peripheral Neuropathy in Two Populations of Children With Acute Lymphoblastic Leukemia

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149215/1/cpt1324_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149215/2/cpt1324.pd

Genetic variation in EPHA contributes to sensitivity to paclitaxel‐induced peripheral neuropathy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154957/1/bcp14192.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154957/2/bcp14192_am.pd

Magnetic Field Diagnostics Based on Far-Infrared Polarimetry: Tests Using Numerical Simulations

The dynamical state of star-forming molecular clouds cannot be understood without determining the structure and strength of their magnetic fields. Measurements of polarized far-infrared radiation from thermally aligned dust grains are used to map the orientation of the field and estimate its strength, but the accuracy of the results has remained in doubt. In order to assess the reliability of this method, we apply it to simulated far-infrared polarization maps derived from three-dimensional simulations of supersonic magnetohydrodynamical turbulence, and compare the estimated values to the known magnetic field strengths in the simulations. We investigate the effects of limited telescope resolution and self-gravity on the structure of the maps. Limited observational resolution affects the field structure such that small scale variations can be completely suppressed, thus giving the impression of a very homogeneous field. The Chandrasekhar-Fermi method of estimating the mean magnetic field in a turbulent medium is tested, and we suggest an extension to measure the rms field. Both methods yield results within a factor of 2 for field strengths typical of molecular clouds, with the modified version returning more reliable estimates for slightly weaker fields. However, neither method alone works well for very weak fields, missing them by a factor of up to 150. Taking the geometric mean of both methods estimates even the weakest fields accurately within a factor of 2.5. Limited telescope resolution leads to a systematic overestimation of the field strengths for all methods. We discuss the effects responsible for this overestimation and show how to extract information on the underlying (turbulent) power spectrum.Comment: 30 pages, 15 figures (figs 1, 4, 5 reduced quality), submitted to ApJ Hires version of figs 1, 4, 5 see ftp://ftp.mpia-hd.mpg.de/pub/heitsch/HZM00/hiresfigs.tar.g

T2 FLAIR hyperintensity volume Is associated with cognitive function and quality of life in clinically stable patients with lower grade gliomas

Survival outcomes for patients with lower grade gliomas (LrGG) continue to improve. However, damage caused both by tumor growth and by the consequences of treatment often leads to significantly impaired cognitive function and quality of life (QoL). While neuropsychological testing is not routine, serial clinical MRIs are standard of care for patients with LrGG. Thus, having a greater understanding of MRI indicators of cognitive and QoL impairment risk could be beneficial to patients and clinicians. In this work we sought to test the hypothesis that in clinically stable LrGG patients, T2 FLAIR hyperintensity volumes at the time of cognitive assessment are associated with impairments of cognitive function and QoL and could be used to help identify patients for cognitive and QoL assessments and interventions. We performed anatomical MR imaging, cognitive testing and QoL assessments cross-sectionally in 30 clinically stable grade 2 and 3 glioma patients with subjective cognitive concerns who were 6 or more months post-treatment. Larger post-surgical T2 FLAIR volume at testing was significantly associated with lower cognitive performance, while pre-surgical tumor volume was not. Older patients had lower cognitive performance than younger patients, even after accounting for normal age-related declines in performance. Patients with Astrocytoma, IDH mutant LrGGs were more likely to show lower cognitive performance than patients with Oligodendroglioma, IDH mutant 1p19q co-deleted LrGGs. Previous treatment with combined radiation and chemotherapy was associated with poorer self-reported QoL, including self-reported cognitive function. This study demonstrates the importance of appreciating that LrGG patients may experience impairments in cognitive function and QoL over their disease course, including during periods of otherwise sustained clinical stability. Imaging factors can be helpful in identifying vulnerable patients who would benefit from cognitive assessment and rehabilitation

Attitudes and Biases of Health Professionals Toward Individuals with Disabilities: An Evidence-Based Practice Project

This Evidence-Based Practice (EBP) project considered the following question: What are the attitudes and biases of health professionals toward individuals with disabilities and what are the implications for training

Head-to-head comparison of BAM15, semaglutide, rosiglitazone, NEN, and calorie restriction on metabolic physiology in female <i>db/db</i> mice

Metabolic disorders such as type 2 diabetes, fatty liver disease, hyperlipidemia, and obesity commonly co-occur but clinical treatment options do not effectively target all disorders. Calorie restriction, semaglutide, rosiglitazone, and mitochondrial uncouplers have all demonstrated efficacy against one or more obesity-related metabolic disorders, but it currently remains unclear which therapeutic strategy best targets the combination of hyperglycaemia, liver fat, hypertriglyceridemia, and adiposity. Herein we performed a head-to-head comparison of 5 treatment interventions in the female db/db mouse model of severe metabolic disease. Treatments included ∼60 % calorie restriction (CR), semaglutide, rosiglitazone, BAM15, and niclosamide ethanolamine (NEN). Results showed that BAM15 and CR improved body weight and liver steatosis to levels superior to semaglutide, NEN, and rosiglitazone, while BAM15, semaglutide, and rosiglitazone improved glucose tolerance better than CR and NEN. BAM15, CR, semaglutide, and rosiglitazone all had efficacy against hypertriglyceridaemia. These data provide a comprehensive head-to-head comparison of several key treatment strategies for metabolic disease and highlight the efficacy of mitochondrial uncoupling to correct multiple facets of the metabolic disease milieu in female db/db mice.</p

Research Priorities to Increase Confidence in and Acceptance of Health Preference Research:What Questions Should be Prioritized Now?

Background and Objective: There has been an increase in the study and use of stated-preference methods to inform medicine development decisions. The objective of this study was to identify prioritized topics and questions relating to health preferences based on the perspective of members of the preference research community. Methods: Preference research stakeholders from industry, academia, consultancy, health technology assessment/regulatory, and patient organizations were recruited using professional networks and preference-targeted e-mail listservs and surveyed about their perspectives on 19 topics and questions for future studies that would increase acceptance of preference methods and their results by decision makers. The online survey consisted of an initial importance prioritization task, a best-worst scaling case 1 instrument, and open-ended questions. Rating counts were used for analysis. The best-worst scaling used a balanced incomplete block design. Results: One hundred and one participants responded to the survey invitation with 66 completing the best-worst scaling. The most important research topics related to the synthesis of preferences across studies, transferability across populations or related diseases, and method topics including comparison of methods and non-discrete choice experiment methods. Prioritization differences were found between respondents whose primary affiliation was academia versus other stakeholders. Academic researchers prioritized methodological/less studied topics; other stakeholders prioritized applied research topics relating to consistency of practice. Conclusions: As the field of health preference research grows, there is a need to revisit and communicate previous work on preference selection and study design to ensure that new stakeholders are aware of this work and to update these works where necessary. These findings might encourage discussion and alignment among different stakeholders who might hold different research priorities. Research on the application of previous preference research to new contexts will also help increase the acceptance of health preference information by decision makers.</p

Targeted genetic testing for familial hypercholesterolaemia using next generation sequencing:a population-based study

Background&lt;p&gt;&lt;/p&gt; Familial hypercholesterolaemia (FH) is a common Mendelian condition which, untreated, results in premature coronary heart disease. An estimated 88% of FH cases are undiagnosed in the UK. We previously validated a method for FH mutation detection in a lipid clinic population using next generation sequencing (NGS), but this did not address the challenge of identifying index cases in primary care where most undiagnosed patients receive healthcare. Here, we evaluate the targeted use of NGS as a potential route to diagnosis of FH in a primary care population subset selected for hypercholesterolaemia.&lt;p&gt;&lt;/p&gt; Methods&lt;p&gt;&lt;/p&gt; We used microfluidics-based PCR amplification coupled with NGS and multiplex ligation-dependent probe amplification (MLPA) to detect mutations in LDLR, APOB and PCSK9 in three phenotypic groups within the Generation Scotland: Scottish Family Health Study including 193 individuals with high total cholesterol, 232 with moderately high total cholesterol despite cholesterol-lowering therapy, and 192 normocholesterolaemic controls.&lt;p&gt;&lt;/p&gt; Results&lt;p&gt;&lt;/p&gt; Pathogenic mutations were found in 2.1% of hypercholesterolaemic individuals, in 2.2% of subjects on cholesterol-lowering therapy and in 42% of their available first-degree relatives. In addition, variants of uncertain clinical significance (VUCS) were detected in 1.4% of the hypercholesterolaemic and cholesterol-lowering therapy groups. No pathogenic variants or VUCS were detected in controls.&lt;p&gt;&lt;/p&gt; Conclusions&lt;p&gt;&lt;/p&gt; We demonstrated that population-based genetic testing using these protocols is able to deliver definitive molecular diagnoses of FH in individuals with high cholesterol or on cholesterol-lowering therapy. The lower cost and labour associated with NGS-based testing may increase the attractiveness of a population-based approach to FH detection compared to genetic testing with conventional sequencing. This could provide one route to increasing the present low percentage of FH cases with a genetic diagnosis