Somatostatin: Diverse Physiological Roles and Therapeutic Implications

In its brief lifetime as a known peptide, somatostatin has provided a truly remarkable story filled with surprising developments from unexpected quarters. The foundation was set in 1969, when Krulich and McCann reported that fractions of a crude hypothalamic extract inhibited the secretion of growth hormone. In 1973, Guillemin\u27s laboratory reported the sequence and synthesis of a fourteen amino acid peptide with the same inhibitory effect. It occurs in both a cyclic and linear form, each displaying equal biological activity. Somatostatin was assigned as its name, but it is also commonly referred to as growth hormone release inhibitory factor (GHRIF) or somatotropin-release inhibiting factor (SRIF)

Using machine learning techniques to automate sky survey catalog generation

We describe the application of machine classification techniques to the development of an automated tool for the reduction of a large scientific data set. The 2nd Palomar Observatory Sky Survey provides comprehensive photographic coverage of the northern celestial hemisphere. The photographic plates are being digitized into images containing on the order of 10(exp 7) galaxies and 10(exp 8) stars. Since the size of this data set precludes manual analysis and classification of objects, our approach is to develop a software system which integrates independently developed techniques for image processing and data classification. Image processing routines are applied to identify and measure features of sky objects. Selected features are used to determine the classification of each object. GID3* and O-BTree, two inductive learning techniques, are used to automatically learn classification decision trees from examples. We describe the techniques used, the details of our specific application, and the initial encouraging results which indicate that our approach is well-suited to the problem. The benefits of the approach are increased data reduction throughput, consistency of classification, and the automated derivation of classification rules that will form an objective, examinable basis for classifying sky objects. Furthermore, astronomers will be freed from the tedium of an intensely visual task to pursue more challenging analysis and interpretation problems given automatically cataloged data

Fractal Characterizations of MAX Statistical Distribution in Genetic Association Studies

Two non-integer parameters are defined for MAX statistics, which are maxima of $d$ simpler test statistics. The first parameter, $d_{MAX}$, is the fractional number of tests, representing the equivalent numbers of independent tests in MAX. If the $d$ tests are dependent, $d_{MAX} < d$. The second parameter is the fractional degrees of freedom $k$ of the chi-square distribution $\chi^2_k$ that fits the MAX null distribution. These two parameters, $d_{MAX}$ and $k$, can be independently defined, and $k$ can be non-integer even if $d_{MAX}$ is an integer. We illustrate these two parameters using the example of MAX2 and MAX3 statistics in genetic case-control studies. We speculate that $k$ is related to the amount of ambiguity of the model inferred by the test. In the case-control genetic association, tests with low $k$ (e.g. $k=1$) are able to provide definitive information about the disease model, as versus tests with high $k$ (e.g. $k=2$) that are completely uncertain about the disease model. Similar to Heisenberg's uncertain principle, the ability to infer disease model and the ability to detect significant association may not be simultaneously optimized, and $k$ seems to measure the level of their balance

Results of the MRI substudy of the intravenous magnesium efficacy in stroke trial

&lt;p&gt;&lt;b&gt;Background and Purpose:&lt;/b&gt;Although magnesium is neuroprotective in animal stroke models, no clinical benefit was confirmed in the Intravenous Magnesium Efficacy in Stroke (IMAGES) trial of acute stroke patients. The Magnetic Resonance in IMAGES (MR IMAGES) substudy investigated the effects of magnesium on the imaging surrogate outcome of infarct growth.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; IMAGES trial patients in participating centers were randomized to receive either intravenous magnesium or placebo within 12 hours of stroke onset. Infarct growth was defined as volume difference between baseline diffusion-weighted imaging and day 90 fluid-attenuated inversion recovery image lesions. Patients who died were imputed the largest infarct growth observed.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Among the 90 patients included in the primary analysis, there was no difference in infarct growth (median absolute growth, P=0.639; median percentage growth, P=0.616; proportion with any growth, P=0.212) between the 46 treated with magnesium and 44 with placebo. Infarct growth correlated with NIHSS score change from baseline to day 90. There was a trend showing baseline serum glucose correlated with infarct growth with magnesium treatment, but not in the placebo group. The mismatch frequency was reduced from 73% to 47% by increasing the mismatch threshold from &#62;20% to &#62;100% of core volume.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Infarct growth, confirmed here as a surrogate for clinical progression, was similar between magnesium and placebo treatment, paralleling the main IMAGES trial clinical outcomes. Glucose was a covariate for infarct growth with magnesium treatment. A more stringent mismatch threshold to define penumbra more appropriately would have excluded half of the patients in this 12-hour time window stroke study.&lt;/p&gt

Results from the third Scottish National Prevalence Survey: is a population health approach now needed to prevent healthcare-associated infections?

Summary Background Healthcare associated infections (HAI) are a major public health concern and a significant cause of morbidity and mortality. A robust and current evidence base that is specific to local, national and Europe-wide settings is necessary to inform the development of strategies to reduce HAI and contain antimicrobial resistance (AMR). Aim To measure the prevalence of HAI and antimicrobial prescribing and identify key priority areas for interventions to reduce the burden of infection. Methods A national rolling PPS in National Health Service (NHS) acute, NHS non-acute, NHS paediatric and independent hospitals was carried out between September and November 2016 using the European Centre for Disease Prevention and Control protocol designed for the European PPS. Findings The prevalence of HAI was 4.6%, 2.7% and 3.2% in acute adults, paediatric and non-acute patient groups, respectively. The most common HAI types reported in adult patients were urinary tract infection and pneumonia. The prevalence of antimicrobial prescribing was 35.7%, 29.3% and 13.8% in acute adults, paediatric and non-acute patient groups, respectively. Respiratory, skin and soft tissue, gastrointestinal and urinary tract infections were the most common infections being treated at the time of survey. Conclusion HAI continues to be a public health concern in Scotland. UTI and pneumonia continue to place a significant burden on patients and on healthcare delivery, including those that develop in the community and require hospital admission. A broader population health approach which focuses on reducing the risk of infection upstream would reduce these infections in both community and hospital settings

Refinement of the Reflective Function Questionnaire for Youth (RFQY) Scale B using item response theory

We conducted item response theory (IRT) analyses to refine the Reflective Function Questionnaire for Youth (RFQY) Scale B. Data from a non-clinical sample of young people (n = 737; ages 18-25) was used to derive a shortened version of the RFQY. Results were replicated in a clinical sample of inpatient adolescents (n = 467; ages 12-17), resulting in a five-item measure, thereafter named the RFQY-5. The RFQY-5 item set was then scrutinized for construct validity against the original 23-item RFQY item set in a randomly selected sample of 100 inpatient adolescents not included in the IRT replication, and 186 healthy adolescents drawn from the community. Results showed that the RFQY-5 performed similarly as the long version in terms of associations with criterion variables, and outperformed the longer version in discriminating between inpatient and community-dwelling adolescents who differed in their levels of borderline traits. The study provides evidence in support of the use of the RFQY-5 in research and clinical settings

Management of Children With Chronic Wet Cough and Protracted Bacterial Bronchitis CHEST Guideline and Expert Panel Report

BACKGROUND: Wet or productive cough is common in children with chronic cough. We formulated recommendations based on systematic reviews related to the management of chronic wet cough in children (aged METHODS: We used the CHEST expert cough panel\u27s protocol for systematic reviews and the American College of Chest Physicians (CHEST) methodologic guidelines and GRADE framework (the Grading of Recommendations Assessment, Development and Evaluation). Data from the systematic reviews in conjunction with patients\u27 values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus for the recommendations/suggestions made. RESULTS: Combining data from the systematic reviews, we found high-quality evidence in children aged 4 weeks\u27 duration) wet/productive cough that using appropriate antibiotics improves cough resolution, and further investigations (eg, flexible bronchoscopy, chest CT scans, immunity tests) should be undertaken when specific cough pointers (eg, digital clubbing) are present. When the wet cough does not improve following 4 weeks of antibiotic treatment, there is moderate-quality evidence that further investigations should be considered to look for an underlying disease. New recommendations include the recognition of the clinical diagnostic entity of protracted bacterial bronchitis. CONCLUSIONS: Compared with the 2006 Cough Guidelines, there is now high-quality evidence for some, but not all, aspects of the management of chronic wet cough in specialist settings. However, further studies (particularly in primary health) are required