3,810 research outputs found

    PCVII COST EFFECTIVENESS OF ADDING NIASPANTO ATORVASTATIN TREATMENT IN THE SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE IN PATIENTS WITH DYSLIPIDEMIA IN THE UK

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    Breaking down automaticity: Case ambiguity and the shift to reflective approaches in clinical reasoning

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    Context: Two modes of case processing have been shown to underlie diagnostic judgements: analytical and non-analytical reasoning. An optimal form of clinical reasoning is suggested to combine both modes. Conditions leading doctors to shift from the usual mode of non-analytical reasoning to reflective reasoning have not been identified. This paper reports a study aimed at exploring these conditions by investigating the effects of ambiguity of clinical cases on clinical reasoning. Methods: Participants were 16 internal medicine residents in the Brazilian state of Ceará. They were asked to diagnose 20 clinical cases and recall case information. The independent variable was the degree of ambiguity of clinical cases, with 2 levels: straightforward (i.e. non-ambiguous) and ambiguous. Dependent variables were processing time, diagnostic accuracy and proposition per category recalled. Data were analysed using a repeated measures design. Results: Participants processed straightforward cases faster and more accurately than ambiguous ones. The proportion of text propositions recalled was significantly lower (t[15] = 2.29, P = 0.037) in ambiguous cases, and an interaction effect between case version and proposition category was also found (F[5, 75] = 4.52, P = 0.001, d = 0.232, observed power = 0.962). Furthermore, participants recalled significantly more literal propositions from the ambiguous cases than from the straightforward cases (t[15] = 2.28, P = 0.037). Conclusions: Ambiguity of clinical cases was shown to lead residents to switch from automatic to reflective reasoning, as indicated by longer processing time, and more literal propositions recalled in ambiguous cases

    Oxidative stress and immunosenescence in spleen of obese mice can be reversed by 2-hydroxyoleic acid.

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    We aimed to investigate the effects of obesity on oxidative stress and leukocyte function in spleen of mice, and to assess whether supplementation with 2-hydroxyoleic acid (2-OHOA) or n-3 polyunsaturated fatty acids (PUFA) could reverse those effects. Female ICR/CD1 mice (8 weeks old, n = 24) received an obesogenic diet (22% fat for 4 weeks and 60% fat for 14 weeks). After 6 weeks, mice were split in three groups (n = 8/group): no supplementation, 2-OHOA supplementation (1500 mg kg(-1) ) and n-3 PUFA supplementation (EPA + DHA, 3000 mg kg(-1) diet). Eight mice were fed standard diet for the whole duration of the study (control group). At the end of the experiment, the following variables were assessed in spleens: levels of reduced (GSH) and oxidized (GSSG) glutathione, GSH/GSSG, xanthine oxidase (XO) activity, lipid peroxidation, lymphocyte chemotaxis, natural killer (NK) activity and mitogen (ConA and LPS)-induced lymphocyte proliferation. Obese animals presented higher GSSG levels (P = 0.003), GSSG/GSH ratio (P = 0.013), lipid peroxidation (P = 0.004), XO activity (P = 0.015) and lymphocyte chemotaxis (P < 0.001), and lower NK activity (P = 0.003) and proliferation in response to ConA (P < 0.001) than controls. 2-OHOA reversed totally or partially most of the changes (body weight, fat content, GSSG levels, GSH/GSSG, lipid peroxidation, chemotaxis and proliferation, all P < 0.05), while n-3 PUFA reversed the increase in XO activity (P = 0.032). In conclusion, 2-OHOA, and to a lesser extent n-3 PUFA, could ameliorate the oxidative stress and alteration of leukocyte function in spleen of obese mice. Our findings support a link between obesity and immunosenescence and suggest a potential therapeutic tool for obesity-related immune dysfunction. This article is protected by copyright. All rights reserved

    PubMed related articles: a probabilistic topic-based model for content similarity

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    <p>Abstract</p> <p>Background</p> <p>We present a probabilistic topic-based model for content similarity called <it>pmra </it>that underlies the related article search feature in PubMed. Whether or not a document is about a particular topic is computed from term frequencies, modeled as Poisson distributions. Unlike previous probabilistic retrieval models, we do not attempt to estimate relevance–but rather our focus is "relatedness", the probability that a user would want to examine a particular document given known interest in another. We also describe a novel technique for estimating parameters that does not require human relevance judgments; instead, the process is based on the existence of MeSH <sup>® </sup>in MEDLINE <sup>®</sup>.</p> <p>Results</p> <p>The <it>pmra </it>retrieval model was compared against <it>bm25</it>, a competitive probabilistic model that shares theoretical similarities. Experiments using the test collection from the TREC 2005 genomics track shows a small but statistically significant improvement of <it>pmra </it>over <it>bm25 </it>in terms of precision.</p> <p>Conclusion</p> <p>Our experiments suggest that the <it>pmra </it>model provides an effective ranking algorithm for related article search.</p

    Evidence of fatal skeletal injuries on Malapa Hominins 1 and 2

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    Malapa is one of the richest early hominin sites in Africa and the discovery site of the hominin species, Australopithecus sediba. The holotype and paratype (Malapa Hominin 1 and 2, or MH1 and MH2, respectively) skeletons are among the most complete in the early hominin record. Dating to approximately two million years BP, MH1 and MH2 are hypothesized to have fallen into a natural pit trap. All fractures evident on MH1 and MH2 skeletons were evaluated and separated based on wet and dry bone fracture morphology/characteristics. Most observed fractures are post-depositional, but those in the right upper limb of the adult hominin strongly indicate active resistance to an impact, while those in the juvenile hominin mandible are consistent with a blow to the face. The presence of skeletal trauma independently supports the falling hypothesis and supplies the first evidence for the manner of death of an australopith in the fossil record that is not attributed to predation or natural death

    Implementation of GIS-Based Applications in Water Governance

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    __Abstract__ Geographical Information Systems (GIS) are computer programs that are able to bring large amounts of data of both the physical and the social system together in one comprehensive overview shown digitally. GIS occurred very rapidly on the Dutch policy agenda. In this paper we analyze how the fast introduction process of GIS-based instruments in water management and more specifically in river flood management can be explained. By applying a range of classical models on agenda-setting, we show the important contribution of GIS to the water and flood issue in current spatial planning and policy development in the Netherland
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