6,679 research outputs found
Response to a behavioural treatment, biofeedback, in constipated patients is associated with improved gut transit and autonomic innervation
Background: Although behavioural treatment (biofeedback) successfully treats the pelvic floor abnormalities in patients with idiopathic constipation, many patients also normalise their impaired bowel frequency. We postulated that a response may be associated with altered cerebral outflow via extrinsic autonomic nerves to the gut. We investigated whether treatment changes extrinsic innervation, using mucosal laser Doppler flowmetry, whether autonomic changes are gut specific, and whether it changes gut transit.
Materials and methods: Forty nine patients (44 female, mean age 39 years) with idiopathic constipation were studied before and after biofeedback treatment (mean five sessions). Rectal mucosal blood flow was measured by laser Doppler flowmetry to assess direct extrinsic gut nerve autonomic activity. To assess general autonomic activity, RR (interval between successive R waves on the electrocardiogram) variability, Valsalva ratio, orthostatic adjustment ratio, and phase II:IV blood pressure ratio (II:IV) of the Valsalva manoeuvre were measured. All autonomic tests were compared with those of 26 healthy volunteers (19 female, mean age 37 years).
Results: Twenty nine of 49 patients were symptomatically improved. Treatment reduced those with 3 bowel actions per week (27 v 9, pre v post), need to strain (26 v 9), and laxative or suppository use (34 v 9). Biofeedback reduced retained markers by 32% in those with slow transit and by 20% in those with normal transit. Twenty two had slow transit before treatment14 felt symptomatic improvement of whom 13 developed normal transit. There was a significantly greater increase in rectal mucosal blood flow in patients who subjectively improved compared with those who did not (29% v 7%; p<0.03) and in those with improved bowel frequency (33% v 9%, increased v unchanged bowel frequency; p<0.05). Thirty five patients had abnormal RR variability and 33 an abnormal Valsalva ratio; one had an abnormal orthostatic adjustment ratio and one an abnormal II:IV ratio. None of the general cardiorespiratory autonomic reflexes was changed by treatment.
Conclusions: Biofeedback treatment affects more than the pelvic floor. Successful outcome after biofeedback treatment is associated with improved activity of the direct cerebral innervation to the gut and improved gut transit. This effect is gut specific; cardiovascular autonomic reflexes were not altered
Relationship between psychological state and level of activity of extrinsic gut innervation in patients with a functional gut disorder
Background: Anxiety and depression are known to be associated with alterations in central autonomic activity, and this may manifest as a functional gut disturbance. However, the final expression of motility disturbance is non-specific and non-quantifiable. This study examines the relationship between psychological state and psychosocial functioning with a new direct measure of the level of activity of extrinsic autonomic gut innervation, rectal mucosal Doppler blood flow.
Materials and methods: Thirty four female patients (mean age 36 years, range 19-45) with constipation for greater than five years and 19 healthy women (mean age 38 years, range 21-60) were studied. They completed the general health questionnaire28 point scale (GHQ-28; psychosocial functioning) and the Bem sex role inventory (BSRI; an index of women's psychological feelings about their own femininity). On the same day they underwent measurement of rectal mucosal Doppler blood flow, a new validated measure of the activity of gut extrinsic nerve innervation. Measurements were made during the follicular phase and in the fasted state.
Results: Women with constipation scored higher on the total GHQ-28 score and the somatisation (p=0.05) and anxiety (p=0.05) subscales of the GHQ-28. There was a negative correlation between mucosal blood flow and GHQ somatisation subscale (r=0.45, p<0.005), anxiety (r=0.38, p<0.05), and depression (r=0.40, p<0.01) scores in women with constipation. Although constipated women scored no higher than controls on the BSRI, there was a significant negative correlation between blood flow and BSRI score (r=0.49, p<0.005) for constipated women.
Conclusions: General psychosocial function, somatisation, anxiety, depression, and feelings about female role are impaired in women with constipation and associated with altered rectal mucosal blood flow, a measure of extrinsic gut innervation. These findings suggest that psychological factors are likely to influence gut function via autonomic efferent neural pathways
Decoding coalescent hidden Markov models in linear time
In many areas of computational biology, hidden Markov models (HMMs) have been
used to model local genomic features. In particular, coalescent HMMs have been
used to infer ancient population sizes, migration rates, divergence times, and
other parameters such as mutation and recombination rates. As more loci,
sequences, and hidden states are added to the model, however, the runtime of
coalescent HMMs can quickly become prohibitive. Here we present a new algorithm
for reducing the runtime of coalescent HMMs from quadratic in the number of
hidden time states to linear, without making any additional approximations. Our
algorithm can be incorporated into various coalescent HMMs, including the
popular method PSMC for inferring variable effective population sizes. Here we
implement this algorithm to speed up our demographic inference method diCal,
which is equivalent to PSMC when applied to a sample of two haplotypes. We
demonstrate that the linear-time method can reconstruct a population size
change history more accurately than the quadratic-time method, given similar
computation resources. We also apply the method to data from the 1000 Genomes
project, inferring a high-resolution history of size changes in the European
population.Comment: 18 pages, 5 figures. To appear in the Proceedings of the 18th Annual
International Conference on Research in Computational Molecular Biology
(RECOMB 2014). The final publication is available at link.springer.co
The structure, function, and pathology of the thyroid gland
This item was digitized by the Internet Archive. Thesis (M.A.)--Boston Universityhttps://archive.org/details/thestructurefunc00kam
A Study of Patient Satisfaction at Big Horn Basin Orthopedic Clinic, P. C. Therapy Center in Powell, Wyoming
The purpose of this study was to design and distribute a patient satisfaction survey that identifies the needs of the patients of Big Horn Basin Orthopedic Clinic, P.C. Therapy Center in Powell, Wyoming (Clinic). The survey gathered information in 4 areas related to patient satisfaction: overall satisfaction, patient-therapist interactions, clinic operations, and billing procedures. During the summer of 2000, 150 surveys were sent out to discharged patients of the Clinic and 75 were returned. The mean scores for all of the questions on the survey scored near the high end of the scale. The questions related to clinic operations had the highest mean score while the billing questions had the lowest mean score. The data from this study was compared to the results of different patient satisfaction studies. It was found that the results from this study were consistent with other studies in physical therapy settings. However, patient satisfaction ratings from this study were much higher when compared to nonphysical therapy settings. Patient satisfaction remains an important indicator of quality in health care. As health care providers become more knowledgeable concerning patient expectations, corrections can be made in the health care delivery process to ensure satisfaction for everyone
Baselines and Compensation
The first problem that we shall examine is raised by the cases in which by our tortious wrong act someone is either (1) made no worse off than he would have been because the injury is one he would have suffered anyway by another means or (2) made better off because, though the act produces an injury, it benefits him by interfering with an upcoming greater injury. Should we assign liability based on the fact that an injury was caused relative to how the person was in his prior uninjured state (namely, the causal approach)? Or, should we take account of the fact that the person either was made no worse off or received a benefit relative to how he would have been in the future had there been no tortious act (namely, the counterfatual approach)
Turvalisel ĂŒhisarvutusel pĂ”hinev privaatsust sĂ€ilitav statistiline analĂŒĂŒs
VĂ€itekirja elektrooniline versioon ei sisalda publikatsioone.Kaasaegses ĂŒhiskonnas luuakse inimese kohta digitaalne kirje kohe pĂ€rast tema sĂŒndi. Sellest hetkest alates jĂ€lgitakse tema kĂ€itumist ning kogutakse andmeid erinevate eluvaldkondade kohta. Kui kasutate poes kliendikaarti, kĂ€ite arsti juures, tĂ€idate maksudeklaratsiooni vĂ”i liigute lihtsalt ringi mobiiltelefoni taskus kandes, koguvad ning salvestavad firmad ja riigiasutused teie tundlikke
andmeid.
Vahel anname selliseks jÀlitustegevuseks vabatahtlikult loa, et saada mingit kasu. NÀiteks vÔime saada soodustust, kui kasutame kliendikaarti. Teinekord on meil vaja teha keeruline otsus, kas loobuda vÔimalusest teha mobiiltelefonikÔnesid
vÔi lubada enda jÀlgimine mobiilimastide kaudu edastatava info abil. Riigiasutused haldavad infot meie tervise, hariduse ja sissetulekute kohta, et meid paremini ravida, harida ja meilt makse koguda. Me loodame, et meie andmeid kasutatakse mÔistlikult, aga samas eeldame, et meie privaatsus on tagatud.
KĂ€esolev töö uurib, kuidas teostada statistilist analĂŒĂŒsi nii, et tagada ĂŒksikisiku
privaatsus. Selle eesmĂ€rgi saavutamiseks kasutame turvalist ĂŒhisarvutust. See krĂŒptograafiline meetod lubab analĂŒĂŒsida andmeid nii, et ĂŒksikuid vÀÀrtuseid ei ole kunagi vĂ”imalik nĂ€ha. Hoolimata sellest, et turvalise ĂŒhisarvutuse kasutamine on aeganĂ”udev protsess, nĂ€itame, et see on piisavalt kiire ja seda on vĂ”imalik kasutada isegi vĂ€ga suurte andmemahtude puhul.
Me oleme teinud vĂ”imalikuks populaarseimate statistilise analĂŒĂŒsi meetodite kasutamise turvalise ĂŒhisarvutuse kontekstis. Me tutvustame privaatsust sĂ€ilitavat statistilise analĂŒĂŒsi tööriista Rmind, mis sisaldab kĂ”iki töö kĂ€igus loodud funktsioone. Rmind sarnaneb tööriistadele, millega statistikud on harjunud. See lubab neil viia lĂ€bi uuringuid ilma, et nad peaksid ĂŒksikasjalikult tundma allolevaid krĂŒptograafilisi protokolle.
Kasutame dissertatsioonis kirjeldatud meetodeid, et valmistada ette statistiline
uuring, mis ĂŒhendab kaht Eesti riiklikku andmekogu. Uuringu eesmĂ€rk on teada saada, kas Eesti tudengid, kes töötavad ĂŒlikooliĂ”pingute ajal, lĂ”petavad nominaalajaga vĂ€iksema tĂ”enĂ€osusega kui nende Ă”pingutele keskenduvad kaaslased.In a modern society, from the moment a person is born, a digital record is created. From there on, the personâs behaviour is constantly tracked and data are collected about the different aspects of his or her life. Whether one is swiping a customer loyalty card in a store, going to the doctor, doing taxes or simply moving around with a mobile phone in oneâs pocket, sensitive data are being gathered and stored by governments and companies.
Sometimes, we give our permission for this kind of surveillance for some benefit. For instance, we could get a discount using a customer loyalty card. Other times we have a difficult choice â either we cannot make phone calls or our movements are tracked based on cellular data. The government tracks information about our health, education and income to cure us, educate us and collect taxes. We hope that the data are used in a meaningful way, however, we also have an
expectation of privacy.
This work focuses on how to perform statistical analyses in a way that preserves the privacy of the individual. To achieve this goal, we use secure multi-Ââparty computation. This cryptographic technique allows data to be analysed without seeing the individual values. Even though using secure multi-Ââparty computation is a time-Ââconsuming process, we show that it is feasible even for large-Ââscale databases.
We have developed ways for using the most popular statistical analysis methods with secure multi-Ââparty computation. We introduce a privacy-Ââpreserving statistical analysis tool called Rmind that contains all of our resulting implementations. Rmind is similar to tools that statistical analysts are used to. This allows them to carry out studies on the data without having to know the details of the underlying cryptographic protocols.
The methods described in the thesis are used in practice to prepare for running a statistical study on large-Ââscale real-Ââlife data to find out whether Estonian students who are working during university studies are less likely to graduate in nominal time
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