A Twin Study of Antisocial Behavior and Depression: Methodology, Etiology, and Comorbidity

The etiological connection between internalizing and externalizing disorders is poorly understood. This manuscript aims to investigate the roles of genes and then environment in the development of Major Depressive Disorder (MDD) and Antisocial Personality Disorder (ASPD) and the nature of their comorbidity in young adults. Data from a sample of 2,291 young adult male and female twins from the Young Adult Follow Up Study (YAFU) of the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) were used to estimate the proportion of variation in these traits that can be accounted for by additive genetic, shared environmental, and unique environmental factors. In addition to traditional methods of measurement of psychiatric disorders (symptom sum scores), a more novel approach to measurement through item response theory (IRT) was employed. Through both measurement methods, variation in depression was found to be influenced almost entirely by environmental factors, however IRT analysis revealed genetic influences related to specific symptoms that cannot be gleaned from a traditional univariate analysis. While the symptoms of MDD appear to work well together to define the latent construct, symptoms of ASPD are less cohesive. ASPD item loadings are more disparate and the item response models are somewhat unstable compared with the MDD item analyses. Consistent with the literature, results using traditional sum score data indicated that ASPD was influenced by additive genetic and unique environmental effects. IRT analysis, however, did indicate a role for the shared environment in ASPD variation.ASPD/MDD comorbidity analyses suggest that more than one mechanism may reasonably explain the relationship between the disorders. It appears to be more likely that common genetic factors account for some of the observed comorbidity in females than in males. Conversely, the shared environment is that the most likely link between the two disorders in males. The etiological nature of these disorders is complex and analysis may be further complicated in a population spanning a critical developmental period, such as young adulthood. The item response approach has the potential to provide new insight into how these disorders develop and differ between the sexes and different age groups

Memory Functioning for Personally Experienced and Witnessed Events in Children with Autism and the Implications for Educators, Mental Health Professionals, and the Law

Several researchers have hypothesized a deficit in memory processing to exist in children with a diagnosis of autism spectrum disorder (ASD). This hypothesis has been supported by findings of deficient recall and recognition ability in children with ASD. Specifically, research has pointed to greater deficits in their ability to recall events related to the self as opposed to others. However, such research has not explored how memory functioning would be impacted when an event with an emotional tenor was used and when a forced choice yes/no paradigm was used to extricate what was remembered from the event. The current study aimed to compare recognition memory for personally experienced and witnessed events using a mock stranger-danger scenario. Forty-two children with ASD underwent either a personally experienced or witnessed event. Following the event, the child was administered a survey assessing their recognition of both thematic and detailed content from the event. No statistically significant differences were identified for recognition memory between the personally experienced and witnessed events. While differences between the groups were not found to be significant, it was revealed that there was a trend towards significance for better recognition of details for the witnessed than for the personally experienced event. Implications for future research are discussed as well as the potential impact of such findings in the terms of forensic and educational domains

No-fee school consistently outperforms Progress in International Reading and Literacy benchmarks: Presenting early grade reading data from a case in Makhanda, Eastern Cape

Background: The Progress in International Reading and Literacy 2021 results draw stark attention to an ongoing crisis in primary education in South Africa. Research attempting to understand and address continued underperformance has focused on literacy learning and teaching in schools where the language of learning and teaching (LOLT) is the same as the learners’ home language. What has yet to be addressed is that a significant dilemma still exists for the many English Second Language (ESL) learners who attend schools where the LOLT is English. Aim: To establish to what extent involvement in the Whistle Stop School (WSS) early grade reading programme impacts on reading rate and comprehension performance for ESL learners learning to read in English. Setting: This research examines the WSS programme in partnership with a local quintile three school. Methods: Longitudinal, quantitative secondary data was used from oral reading fluency and comprehension assessments conducted annually over the first six years of the programme. Results: Results showed that involvement in the WSS programme had a significant impact on learner performance, with those learners involved in the programme notably outperforming those not in the programme and existing national benchmarks. Conclusion: Small-scale though the WSS is, the results demonstrate that with the right approach, the national goal to see every 10-year-old learner reading for meaning may be achievable. Contribution: This research aims to contribute to national conversations around early grade reading in South Africa by addressing the paucity of early grade reading learning research, specifically for ESL learners where LOLT is English

An Ounce of Prevention: How Are We Managing the Early Assessment of Residents\u27 Clinical Skills?: A CERA Study

BACKGROUND AND OBJECTIVES: Clinical skills deficits in residents are common but when identified early can result in decreased cost, faculty time, and stress related to remediation. There is currently no accepted best practice for early assessment of incoming residents\u27 clinical skills. This study describes the current state of early PGY-1 clinical skills assessment in US family medicine residencies. METHODS: Eleven questions were embedded in the nationwide CERA survey to US family medicine residency directors regarding the processes, components, and barriers to early PGY-1 assessment. Responses are described, and bivariate analyses of the relationship between assessment variables and percentage of international medical graduates (IMGs), type of program, and barriers to implementation were performed using chi square testing. RESULTS: Almost four of five (78.4%) responding programs conduct formal early assessments to establish baseline clinical skills (89.6%), provide PGY-1 residents with a guide to focus their learning goals (71.6%), and less often, in response to resident performance problems (34.3%). Barriers to implementing PGY-1 early assessment programs include cost of faculty time (56.3%), cost of tools (42.1%), and time for the assessment during the PGY-1 resident\u27s schedule (41.0%). Cost of faculty time and time for assessment from the PGY-1 resident\u27s schedule were statistically significant major/insurmountable barriers for community-based, non-university-affiliated programs. CONCLUSIONS: Early PGY-1 assessments with locally developed tools for direct observation are commonly used in family medicine residency programs. Assessment program development should be targeted toward using existing, validated tools during the PGY-1 resident\u27s patient care schedule

Editor's Choice - Bypass versus Angioplasty for Severe Ischaemia of the Leg (BASIL) Prospective Cohort Study and the Generalisability of the BASIL-2 Randomised Controlled Trial

OBJECTIVE: The Bypass versus Angioplasty in Severe Ischaemia of the Leg-2 (BASIL-2) randomised controlled trial has shown that, for patients with chronic limb threatening ischaemia (CLTI) who require an infrapopliteal (IP) revascularisation a vein bypass (VB) first revascularisation strategy led to a 35% increased risk of major amputation or death when compared with a best endovascular treatment (BET) first revascularisation strategy. The study aims are to place the BASIL-2 trial within the context of the CLTI patient population as a whole and to investigate the generalisability of the BASIL-2 outcome data.METHODS: This was an observational, single centre prospective cohort study. Between 24 June 2014 and 31 July 2018, the BASIL Prospective Cohort Study (PCS) was performed which used BASIL-2 trial case record forms to document the characteristics, initial and subsequent management, and outcomes of 471 consecutive CLTI patients admitted to an academic vascular centre. Ethical approval was obtained, and all patients provided fully informed written consent. Follow up data were censored on 14 December 2022.RESULTS: Of the 238 patients who required an infrainguinal revascularisation, 75 (32%) had either IP bypass (39 patients) or IP BET (36 patients) outside BASIL-2. Seventeen patients were initially randomised to BASIL-2. A further three patients who did not have an IP revascularisation as their initial management were later randomised in BASIL-2. Therefore, 95/471 (20%) of patients had IP revascularisation (16% outside, 4% inside BASIL-2). Differences in amputation free survival, overall survival, and limb salvage between IP bypass and IP BET performed outside BASIL-2 were not subject to hypothesis testing due to the small sample size. Reasons for non-randomisation into the trial were numerous, but often due to anatomical and technical considerations.CONCLUSION: CLTI patients who required an IP revascularisation procedure and were subsequently randomised into BASIL-2 accounted for a small subset of the CLTI population as a whole. For a wide range of patient, limb, anatomical and operational reasons, most patients in this cohort were deemed unsuitable for randomisation in BASIL-2. The results of BASIL-2 should be interpreted in this context.</p

Pilot Study Assessment of Dynamic Vascular Changes in Breast Cancer with Near-Infrared Tomography from Prospectively Targeted Manipulations of Inspired End-Tidal Partial Pressure of Oxygen and Carbon Dioxide

The dynamic vascular changes in the breast resulting from manipulation of both inspired end-tidal partial pressure of oxygen and carbon dioxide were imaged using a 30 s per frame frequency-domain near-infrared spectral (NIRS) tomography system. By analyzing the images from five subjects with asymptomatic mammography under different inspired gas stimulation sequences, the mixture that maximized tissue vascular and oxygenation changes was established. These results indicate maximum changes in deoxy-hemoglobin, oxygen saturation, and total hemoglobin of 21, 9, and 3%, respectively. Using this inspired gas manipulation sequence, an individual case study of a subject with locally advanced breast cancer undergoing neoadjuvant chemotherapy (NAC) was analyzed. Dynamic NIRS imaging was performed at different time points during treatment. The maximum tumor dynamic changes in deoxy-hemoglobin increased from less than 7% at cycle 1, day 5 (C1, D5) to 17% at (C1, D28), which indicated a complete response to NAC early during treatment and was subsequently confirmed pathologically at the time of surgery

A pedestrian's view on interacting particle systems, KPZ universality, and random matrices

These notes are based on lectures delivered by the authors at a Langeoog seminar of SFB/TR12 "Symmetries and universality in mesoscopic systems" to a mixed audience of mathematicians and theoretical physicists. After a brief outline of the basic physical concepts of equilibrium and nonequilibrium states, the one-dimensional simple exclusion process is introduced as a paradigmatic nonequilibrium interacting particle system. The stationary measure on the ring is derived and the idea of the hydrodynamic limit is sketched. We then introduce the phenomenological Kardar-Parisi-Zhang (KPZ) equation and explain the associated universality conjecture for surface fluctuations in growth models. This is followed by a detailed exposition of a seminal paper of Johansson that relates the current fluctuations of the totally asymmetric simple exclusion process (TASEP) to the Tracy-Widom distribution of random matrix theory. The implications of this result are discussed within the framework of the KPZ conjecture.Comment: 52 pages, 4 figures; to appear in J. Phys. A: Math. Theo

Criteria for the use of omics-based predictors in clinical trials.

The US National Cancer Institute (NCI), in collaboration with scientists representing multiple areas of expertise relevant to 'omics'-based test development, has developed a checklist of criteria that can be used to determine the readiness of omics-based tests for guiding patient care in clinical trials. The checklist criteria cover issues relating to specimens, assays, mathematical modelling, clinical trial design, and ethical, legal and regulatory aspects. Funding bodies and journals are encouraged to consider the checklist, which they may find useful for assessing study quality and evidence strength. The checklist will be used to evaluate proposals for NCI-sponsored clinical trials in which omics tests will be used to guide therapy

Tuberculosis in cattle: the results of the four-area project

<p/> <p>The four-area project was undertaken to further assess the impact of badger removal on the control of tuberculosis in cattle herds in Ireland. It was conducted between 1997 and 2002 in matched removal and reference areas in four counties, namely Cork, Donegal, Kilkenny and Monaghan, representing a wide range of Irish farming environments. In the removal areas, a proactive programme of badger removal was conducted, on two or three occasions each year, whereas in the reference areas, badger removal was entirely reactive following severe outbreaks of tuberculosis amongst cattle. A detailed statistical analysis of this study has already been presented by Griffin <it>et al. </it><abbrgrp><abbr bid="B13">13</abbr></abbrgrp>; this paper presents further, mainly descriptive, findings from the study. In total, 2,360 badgers were captured in the removal areas of which 450 (19.5%) were considered positive for tuberculosis and 258 badgers were captured in the reference areas, with 57 (26.1%) positive for tuberculosis. The annual incidence of confirmed herd restrictions was lower in the removal area compared to the reference area in every year of the study period in each of the four counties. These empirical findings were consistent with the hazard ratios found by Griffin <it>et al. </it><abbrgrp><abbr bid="B13">13</abbr></abbrgrp>. Further, the effect of proactive badger removal on cattle tuberculosis in the four-area project and in the earlier east-Offaly project, as measured using the number of reactors per 1,000 cattle tested, were very similar, providing compelling evidence of the role of badgers in the epidemiology of tuberculosis in Irish cattle herds. The validity of the four-area project was discussed in detail. Efforts to minimise badger-to-cattle transmission in Ireland must be undertaken in association with the current comprehensive control programme, which has effectively minimised opportunities for cattle-to-cattle transmission.</p