89 research outputs found
Neuropsychological diagnostics in Ethiopia - challenges and chances among considerations regarding differential diagnosis (literature overview)
Background Neuropsychological tests can provide crucial information regarding the consideration of psychiatric differential diagnosis. This is especially important in developing countries like Ethiopia where advanced imaging is not widely available.Methods A detailed literature search was conducted using the search engines Pubmed, Science Direct, Web of Science and Google Scholar from February 2013 until May 2014. Selecting the identified studies pragmatically depending on the content, twenty-six studies were included.Results The administration of tests developed in Western-European settings to the African culture presents enormous challenge. Among these are especially the influence of low level of literacy, familiarity with the testing material, cultural aspects regarding social behavior and sense of time, cultural differences regarding cognitive functions and lack of norms. At the same time, there are opportunities for different fields of application, especially when considering the diagnosis of dementia and in the assessment of frontal lobe lesions. Assessment of cognitive flexibility appears to be an important way to differentiate between affective disorders and schizophrenia.Conclusions In conclusion, we suggest a „basic set of neuropsychological tests“ for application in psychiatric facilities in low income countries like Ethiopia, which mostly includes nonverbal tests. By using these tests, some of the challenges found during the literature search can be overcome. Additionally, they might provide extra information for diagnostic issues. However, they might have to be adapted to the Ethiopian culture.Key words: Cognition; Culture-fair; Ethiopian; Low-Income; Neuropsychology; Psychiatr
a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union
Background Women’s participation in medicine and the need for gender equality
in healthcare are increasingly recognised, yet little attention is paid to
leadership and management positions in large publicly funded academic health
centres. This study illustrates such a need, taking the case of four large
European centres: Charité – Universitätsmedizin Berlin (Germany), Karolinska
Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford
Academic Health Science Centre (United Kingdom). Case The percentage of female
medical students and doctors in all four countries is now well within the
40–60% gender balance zone. Women are less well represented among specialists
and remain significantly under-represented among senior doctors and full
professors. All four centres have made progress in closing the gender
leadership gap on boards and other top-level decision-making bodies, but a
gender leadership gap remains relevant. The level of achieved gender balance
varies significantly between the centres and largely mirrors country-specific
welfare state models, with more equal gender relations in Sweden than in the
other countries. Notably, there are also similar trends across countries and
centres: gender inequality is stronger within academic enterprises than within
hospital enterprises and stronger in middle management than at the top level.
These novel findings reveal fissures in the ‘glass ceiling’ effects at top-
level management, while the barriers for women shift to middle-level
management and remain strong in academic positions. The uneven shifts in the
leadership gap are highly relevant and have policy implications. Conclusion
Setting gender balance objectives exclusively for top-level decision-making
bodies may not effectively promote a wider goal of gender equality. Academic
health centres should pay greater attention to gender equality as an issue of
organisational performance and good leadership at all levels of management,
with particular attention to academic enterprises and newly created management
structures. Developing comprehensive gender-sensitive health workforce
monitoring systems and comparing progress across academic health centres in
Europe could help to identify the gender leadership gap and utilise health
human resources more effectively
An EKF observer to estimate semi-autogenous grinding mill hold-ups
A non-linear observer model of a semi-autogenous grinding mill is developed. The observer model distinguishes
between the volumetric hold-up of water, solids, and the grinding media in the mill. Solids
refer to all ore small enough to discharge through the end-discharge grate, and grinding media refers to
the rocks and steel balls. The rocks are all ore too large to discharge from the mill. The observer model
uses the accumulation rate of solids and the mill’s discharge rate as parameters. It is shown that with
mill discharge flow-rate, discharge density, and volumetric hold-up measurements, the model states and
parameters are linearly observable. Although instrumentation at the mill discharge is not yet included
in industrial circuits because of space restrictions, this study motivates the benefits to be gained from
including such instrumentation. An extended Kalman filter is applied in simulation to estimate the model
states and parameters from data generated by a semi-autogenous mill simulation model from literature.
Results indicate that if sufficiently accurate measurements are available, especially at the discharge of
the mill, it is possible to reliably estimate grinding media, solids and water hold-ups within the mill. Such
an observer can be used as part of an advanced process control strategy.The first author gratefully appreciates support from the University of Pretoria postgraduate study abroad bursary programme. The
second author gratefully acknowledges financial support provided by the Austrian Academy of Sciences in the form of an APART-fellowship
at the Automation and Control Institute of Vienna University of Technology. The third author gratefully acknowledges financial support
provided by the Austrian Federal Ministry of Science, Research and Economy, and the National Foundation for Research, Technology and Development. The fourth author would like to acknowledge the support of the National Research Foundation of South Africa (Grant No.90533).http://www.elsevier.com/locate/jprocont2018-03-31hb2017Electrical, Electronic and Computer Engineerin
Stress Alters Rates and Types of Loss of Heterozygosity in Candida albicans
Genetic diversity is often generated during adaptation to stress, and in eukaryotes some of this diversity is thought to arise via recombination and reassortment of alleles during meiosis. Candida albicans, the most prevalent pathogen of humans, has no known meiotic cycle, and yet it is a heterozygous diploid that undergoes mitotic recombination during somatic growth. It has been shown that clinical isolates as well as strains passaged once through a mammalian host undergo increased levels of recombination. Here, we tested the hypothesis that stress conditions increase rates of mitotic recombination in C. albicans, which is measured as loss of heterozygosity (LOH) at specific loci. We show that LOH rates are elevated during in vitro exposure to oxidative stress, heat stress, and antifungal drugs. In addition, an increase in stress severity correlated well with increased LOH rates. LOH events can arise through local recombination, through homozygosis of longer tracts of chromosome arms, or by whole-chromosome homozygosis. Chromosome arm homozygosis was most prevalent in cultures grown under conventional lab conditions. Importantly, exposure to different stress conditions affected the levels of different types of LOH events, with oxidative stress causing increased recombination, while fluconazole and high temperature caused increases in events involving whole chromosomes. Thus, C. albicans generates increased amounts and different types of genetic diversity in response to a range of stress conditions, a process that we term “stress-induced LOH” that arises either by elevating rates of recombination and/or by increasing rates of chromosome missegregation
Evaluation of Presumably Disease Causing SCN1A Variants in a Cohort of Common Epilepsy Syndromes
A. Palotie on työryhmän jäsen.Objective The SCN1A gene, coding for the voltage-gated Na+ channel alpha subunit NaV1.1, is the clinically most relevant epilepsy gene. With the advent of high-throughput next-generation sequencing, clinical laboratories are generating an ever-increasing catalogue of SCN1A variants. Variants are more likely to be classified as pathogenic if they have already been identified previously in a patient with epilepsy. Here, we critically re-evaluate the pathogenicity of this class of variants in a cohort of patients with common epilepsy syndromes and subsequently ask whether a significant fraction of benign variants have been misclassified as pathogenic. Methods We screened a discovery cohort of 448 patients with a broad range of common genetic epilepsies and 734 controls for previously reported SCN1A mutations that were assumed to be disease causing. We re-evaluated the evidence for pathogenicity of the identified variants using in silico predictions, segregation, original reports, available functional data and assessment of allele frequencies in healthy individuals as well as in a follow up cohort of 777 patients. Results and Interpretation We identified 8 known missense mutations, previously reported as pathogenic, in a total of 17 unrelated epilepsy patients (17/448; 3.80%). Our re-evaluation indicates that 7 out of these 8 variants (p.R27T; p.R28C; p.R542Q; p.R604H; p.T1250M; p.E1308D; p.R1928G; NP_001159435.1) are not pathogenic. Only the p. T1174S mutation may be considered as a genetic risk factor for epilepsy of small effect size based on the enrichment in patients (P = 6.60 x 10(-4); OR = 0.32, fishers exact test), previous functional studies but incomplete penetrance. Thus, incorporation of previous studies in genetic counseling of SCN1A sequencing results is challenging and may produce incorrect conclusions.Peer reviewe
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