979 research outputs found

    Underdiagnosis of mild cognitive impairment: A consequence of ignoring practice effects

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    INTRODUCTION: Longitudinal testing is necessary to accurately measure cognitive change. However, repeated testing is susceptible to practice effects, which may obscure true cognitive decline and delay detection of mild cognitive impairment (MCI). METHODS: We retested 995 late-middle-aged men in a ∼6-year follow-up of the Vietnam Era Twin Study of Aging. In addition, 170 age-matched replacements were tested for the first time at study wave 2. Group differences were used to calculate practice effects after controlling for attrition effects. MCI diagnoses were generated from practice-adjusted scores. RESULTS: There were significant practice effects on most cognitive domains. Conversion to MCI doubled after correcting for practice effects, from 4.5% to 9%. Importantly, practice effects were present although there were declines in uncorrected scores. DISCUSSION: Accounting for practice effects is critical to early detection of MCI. Declines, when lower than expected, can still indicate practice effects. Replacement participants are needed for accurately assessing disease progression.Published versio

    Best practice in maternity and mental health services? A service user's perspective

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    The birth of a baby is a much-anticipated event. However, for some women diagnosed with mental health needs their pregnancy and potential parenting are seen as problematic. Even if the child is much wanted and the pregnancy is planned, this news can be greeted with uncertainty and concern by the medical and maternity services. They need to plan how they will “manage” the mother’s behavior and protect the child from her potentially risky behavior. Most literature focuses on the negative impact that mental illness has on the development of the baby and the young child.1,2 It emphasizes the risk factors that specific mental illness diagnoses might have and the mother’s potential for abuse of her offspring.3,4 However, qualitative literature, which has been undertaken with mothers with a diagnosis, introduces a different perspective. Indeed fear of removal of the child,5 a perception of the intrusiveness of services5,6 and the stigma of mental ill health dominate their contact with mental health and child development services.7,8 In this article, I use a synthesis of first person narrative and research to explore the experience of being a both a pregnant woman and new mother who has a diagnosis of schizophrenia and my relationship with both mental health and maternity services. I describe the best practice care I received from the mental health services and the reactive, diagnosis led service that was set in motion by the maternity services. I intertwine the 2 elements of research and experience to explore how service provision can be more effective when it is built on a model that promotes shared decision-making and a sense of trust with shared responsibility. I seek to challenge the process led nature of care that leads professionals to become unquestioning actors in a game of risk management and discuss how practitioners can work with people as individuals. In this discussion, I highlight the importance of the strengths led approach, which is underpinned by a belief in clients’ capabilities and strengths, not their deficits

    Attachment and temperament revisited: infant distress, attachment disorganisation and the serotonin transporter polymorphism

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    Objective: This study’s aim was to evaluate whether infant disorganised attachment and infant proneness to distress exhibited differential relations to infant genetic factors as indexed by the serotonin transporter polymorphism. Background: The role of the short allele of the serotonin transporter polymorphism (5-HTTLPR) in enhancing sensitivity to fearful and negative affect has been well-established. In the current study, we used this known property of the short allele to provide a test of an important postulate of attachment theory, namely that infant attachment security or disorganisation is not a function of the infant’s proneness to distress. Methods: Participants were 39 parents and infants assessed between 12 and 18 months in the Strange Situation Procedure. Genotype categories for the 5-HTTLPR (and rs25531) were created by both the original and the reclassified grouping system; infant proneness to distress was assessed directly in the Strange Situation Procedure. We also assessed maternal behaviour at 18 months to evaluate whether any observed genetic effect indicated a passive effect through the mother. Results: Consistent with previous findings, the 5-HTTLPR short allele was significantly related to the infant’s wariness and distress, but was not related to attachment security or attachment disorganisation. In addition, maternal disrupted interaction with the infant was not related to infant genotype or infant distress. Conclusion: Results support the concept that infant proneness to distress is associated with serotonergic factors while infant attachment security or disorganisation is not a function of either 5-HTTLPR or behaviourally rated proneness to distress. © 2015 Society for Reproductive and Infant Psychology

    Leukocyte and serum S100A8/S100A9 expression reflects disease activity in ANCA-associated vasculitis and glomerulonephritis.

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    Antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) commonly results in glomerulonephritis, in which neutrophils and monocytes have important roles. The heterodimer calprotectin (S100A8/S100A9, mrp8/14) is a Toll-like receptor-4 ligand found in neutrophils and monocytes and is elevated in inflammatory conditions. By immunohistochemistry of renal biopsies, patients with focal or crescentic glomerular lesions were found to have the highest expression of calprotectin and those with sclerotic the least. Serum levels of calprotectin as measured by ELISA were elevated in patients with active AAV and the levels decreased but did not normalize during remission, suggesting subclinical inflammation. Calprotectin levels in patients with limited systemic disease increased following treatment withdrawal and were significantly elevated in patients who relapsed compared with those who did not. As assessed by flow cytometry, patients with AAV had higher monocyte and neutrophil cell surface calprotectin expression than healthy controls, but this was not associated with augmented mRNA expression in CD14(+) monocytes or CD16(+) neutrophils. Thus, serum calprotectin is a potential disease biomarker in patients with AAV, and may have a role in disease pathogenesis

    Identification of incident poisoning, fracture and burn events using linked primary care, secondary care, and mortality data from England: implications for research and surveillance

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    Background: English national injury data collection systems are restricted to hospitalisations and deaths. With recent linkage of a large primary care database, the Clinical Practice Research Datalink (CPRD), with secondary care and mortality data we aimed to assess the utility of linked data for injury research and surveillance by examining recording patterns and comparing incidence of common injuries across data sources. Methods: The incidence of poisonings, fractures and burns was estimated for a cohort of 2,147,853 0-24 year olds using CPRD linked to Hospital Episode Statistics (HES) and Office for National Statistics (ONS) mortality data between 1997-2012. Time-based algorithms were developed to identify incident events, distinguishing between repeat follow-up records for the same injury, and those for a new event. Results: We identified 42,985 poisoning, 185,517 fracture and 36,719 burn events in linked CPRD-HES-ONS data; incidence rates were 41.9 per 10,000 person-years (95% confidence interval 41.4–42.4), 180.8 (179.8–181.7) and 35.8 (35.4–36.1), respectively. Of the injuries, 22,628(53%) poisonings, 139,662(75%) fractures, and 33,462(91%) burns were only recorded within CPRD. Only 16% of deaths from poisoning (n=106) or fracture (n=58) recorded in ONS were recorded within CPRD and/or HES records. None of the 10 deaths from burns were recorded in CPRD or HES records. Conclusion: It is essential to use linked primary care, hospitalisation and deaths data to estimate injury burden, as many injury events are only captured within a single data source. Linked routinely-collected data offer an immediate and affordable mechanism for injury surveillance and analyses of population based injury epidemiology in England

    A second transmissible cancer in Tasmanian devils.

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    Clonally transmissible cancers are somatic cell lineages that are spread between individuals via the transfer of living cancer cells. There are only three known naturally occurring transmissible cancers, and these affect dogs, soft-shell clams, and Tasmanian devils, respectively. The Tasmanian devil transmissible facial cancer was first observed in 1996, and is threatening its host species with extinction. Until now, this disease has been consistently associated with a single aneuploid cancer cell lineage that we refer to as DFT1. Here we describe a second transmissible cancer, DFT2, in five devils located in southern Tasmania in 2014 and 2015. DFT2 causes facial tumors that are grossly indistinguishable but histologically distinct from those caused by DFT1. DFT2 bears no detectable cytogenetic similarity to DFT1 and carries a Y chromosome, which contrasts with the female origin of DFT1. DFT2 shows different alleles to both its hosts and DFT1 at microsatellite, structural variant, and major histocompatibility complex (MHC) loci, confirming that it is a second cancer that can be transmitted between devils as an allogeneic, MHC-discordant graft. These findings indicate that Tasmanian devils have spawned at least two distinct transmissible cancer lineages and suggest that transmissible cancers may arise more frequently in nature than previously considered. The discovery of DFT2 presents important challenges for the conservation of Tasmanian devils and raises the possibility that this species is particularly prone to the emergence of transmissible cancers. More generally, our findings highlight the potential for cancer cells to depart from their hosts and become dangerous transmissible pathogens.We thank Bill Brown, Phil Iles, Billie Lazenby, Jacinta Marr, Jane McGee, Sarah Peck, Holly Wiersma and Phil Wise for assistance with sample collection and curation. Adrian Baez-Ortega, Andrew Davis, Jo Hanuszewicz, Gina Kalodimos, Amanda Patchett, Narelle Phillips, Elizabeth Reid Swainscoat, Jim Richley, Rachel Stivicic and Jim Taylor assisted with surveying, laboratory analysis, data processing and display. We are grateful for support received from Mike Stratton, the Wellcome Trust Sanger Institute (WTSI) sequencing and informatics teams and the WTSI Cancer Genome Project. This work was supported by a Wellcome Trust Investigator Award (102942/Z/13/Z) and by grants from the Australian Research Council (ARC-DP130100715; ARC-LP130100218). Support was provided by Dr Eric Guiler Tasmanian Devil Research Grants and by the Save the Tasmanian Devil Program. JMCT was partly supported by a Marie Curie Fellowship (FP7-PEOPLE- 2012-IEF, 328364). Sequences associated with this paper have been deposited in Genbank with accession numbers KT188437 and KT188438

    BioSunMS: a plug-in-based software for the management of patients information and the analysis of peptide profiles from mass spectrometry

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    <p>Abstract</p> <p>Background</p> <p>With wide applications of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS), statistical comparison of serum peptide profiles and management of patients information play an important role in clinical studies, such as early diagnosis, personalized medicine and biomarker discovery. However, current available software tools mainly focused on data analysis rather than providing a flexible platform for both the management of patients information and mass spectrometry (MS) data analysis.</p> <p>Results</p> <p>Here we presented a plug-in-based software, BioSunMS, for both the management of patients information and serum peptide profiles-based statistical analysis. By integrating all functions into a user-friendly desktop application, BioSunMS provided a comprehensive solution for clinical researchers without any knowledge in programming, as well as a plug-in architecture platform with the possibility for developers to add or modify functions without need to recompile the entire application.</p> <p>Conclusion</p> <p>BioSunMS provides a plug-in-based solution for managing, analyzing, and sharing high volumes of MALDI-TOF or SELDI-TOF MS data. The software is freely distributed under GNU General Public License (GPL) and can be downloaded from <url>http://sourceforge.net/projects/biosunms/</url>.</p

    Canfam GSD: De novo chromosome-length genome assembly of the German Shepherd Dog (Canis lupus familiaris) using a combination of long reads, optical mapping, and Hi-C

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    Background: The German Shepherd Dog (GSD) is one of the most common breeds on earth and has been bred for its utility and intelligence. It is often first choice for police and military work, as well as protection, disability assistance, and search-and-rescue. Yet, GSDs are well known to be susceptible to a range of genetic diseases that can interfere with their training. Such diseases are of particular concern when they occur later in life, and fully trained animals are not able to continue their duties. Findings: Here, we provide the draft genome sequence of a healthy German Shepherd female as a reference for future disease and evolutionary studies. We generated this improved canid reference genome (CanFam GSD) utilizing a combination of Pacific Bioscience, Oxford Nanopore, 10X Genomics, Bionano, and Hi-C technologies. The GSD assembly is ∼80 times as contiguous as the current canid reference genome (20.9 vs 0.267 Mb contig N50), containing far fewer gaps (306 vs 23,876) and fewer scaffolds (429 vs 3,310) than the current canid reference genome CanFamv3.1. Two chromosomes (4 and 35) are assembled into single scaffolds with no gaps. BUSCO analyses of the genome assembly results show that 93.0% of the conserved single-copy genes are complete in the GSD assembly compared with 92.2% for CanFam v3.1. Homology-based gene annotation increases this value to ∼99%. Detailed examination of the evolutionarily important pancreatic amylase region reveals that there are most likely 7 copies of the gene, indicative of a duplication of 4 ancestral copies and the disruption of 1 copy. Conclusions: GSD genome assembly and annotation were produced with major improvement in completeness, continuity, and quality over the existing canid reference. This resource will enable further research related to canine diseases, the evolutionary relationships of canids, and other aspects of canid biology
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