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An increased incidence of CHD has been noted in twin gestations and in infants conceived using assisted reproductive technologies. However, CHD in these populations remains understudied and the mechanisms underlying these phenomena remain unclear. We present the case of twins conceived via in vitro fertilisation both with Tetralogy of Fallot and additional cardiac and extracardiac malformations.
An improved understanding of diagnostic and treatment practices for patients with rare primary mitochondrial disorders can support benchmarking against guidelines and establish priorities for evaluative research. We aimed to describe physician care for patients with mitochondrial diseases in Canada, including variation in care.
We conducted a cross-sectional survey of Canadian physicians involved in the diagnosis and/or ongoing care of patients with mitochondrial diseases. We used snowball sampling to identify potentially eligible participants, who were contacted by mail up to five times and invited to complete a questionnaire by mail or internet. The questionnaire addressed: personal experience in providing care for mitochondrial disorders; diagnostic and treatment practices; challenges in accessing tests or treatments; and views regarding research priorities.
We received 58 survey responses (52% response rate). Most respondents (83%) reported spending 20% or less of their clinical practice time caring for patients with mitochondrial disorders. We identified important variation in diagnostic care, although assessments frequently reported as diagnostically helpful (e.g., brain magnetic resonance imaging, MRI/MR spectroscopy) were also recommended in published guidelines. Approximately half (49%) of participants would recommend “mitochondrial cocktails” for all or most patients, but we identified variation in responses regarding specific vitamins and cofactors. A majority of physicians recommended studies on the development of effective therapies as the top research priority.
While Canadian physicians’ views about diagnostic care and disease management are aligned with published recommendations, important variations in care reflect persistent areas of uncertainty and a need for empirical evidence to support and update standard protocols.
The field of Molecular Astrophysics or “Astrochemistry” has grown considerably since its inception in the late 1930’s. Molecules have been observed in astronomical environments as diverse as comets in the solar system and galaxies at the highest redshifts. The common thread in these studies is that molecules are excellent probes of the physical structure and dynamics of such regions, owing to the complexity of their energy level structure and the resulting emission and absorption spectra. In addition, the chemical characteristics provide a powerful tool to study the evolution of astrophysical regions. Molecules also play an active role in the energy balance of clouds. Interstellar space is a unique laboratory in which chemical processes can occur that are not normally found on Earth. Indeed, astrochemistry is a highly interdisciplinary subject, linking the macrocosm (galaxies, stars, planets) with the microcosm (basic chemical processes and spectroscopy). The increased potential of ground- and space-based observational facilities over the full wavelength range provides a wealth of information about the physical environments in which molecules occur and makes it possible to study the development of molecular complexity throughout the Universe.
Although additional surveys with large Schmidt telescopes continue to yield small catches of additional planetaries (Kohoutek) one cannot escape the conclusion that most planetaries available to existing equipment have been detected. Much remains to be done with powerful Schmidt equipment in the southern hemisphere, especially in the Magellanic Clouds. A vast body of photometric and spectroscopic observation needs to be garnered for the numerous faint nebulae so far discovered.
Spectroscopic and spectrophotometric studies have been carried out for most bright planetaries (λ < 5800) but much remains to be done in the red and near infrared. Important advances have been made in the far infrared (~10μ) (Gillett, Low, Stein, Woolf) where a number of planetaries seem to show abnormally strong continua. This abnormally intense radiation has been attributed to non-thermal emission, effects of many faint lines, and to thermal emission by dust grains (Krishna Swamy, O’Dell) with perhaps the bulk of the evidence favoring the last-mentioned hypothesis. An increasing number of radio observations from 9·5 mm to 73 cm (Thompson, Colvin, Stanley, LeMarne, Kaftan-Kassim, Babieri and Ficarra, Terzian, L. Aller and Milne, Hughes) all indicate that planetaries are thermal sources.
Influenza A (H1N1) pdm09 became the predominant circulating strain in the United States during the 2013–2014 influenza season. Little is known about the epidemiology of severe influenza during this season.
A retrospective cohort study of severely ill patients with influenza infection in intensive care units in 33 US hospitals from September 1, 2013, through April 1, 2014, was conducted to determine risk factors for mortality present on intensive care unit admission and to describe patient characteristics, spectrum of disease, management, and outcomes.
A total of 444 adults and 63 children were admitted to an intensive care unit in a study hospital; 93 adults (20.9%) and 4 children (6.3%) died. By logistic regression analysis, the following factors were significantly associated with mortality among adult patients: older age (>65 years, odds ratio, 3.1 [95% CI, 1.4–6.9], P=.006 and 50–64 years, 2.5 [1.3–4.9], P=.007; reference age 18–49 years), male sex (1.9 [1.1–3.3], P=.031), history of malignant tumor with chemotherapy administered within the prior 6 months (12.1 [3.9–37.0], P<.001), and a higher Sequential Organ Failure Assessment score (for each increase by 1 in score, 1.3 [1.2–1.4], P<.001).
Risk factors for death among US patients with severe influenza during the 2013–2014 season, when influenza A (H1N1) pdm09 was the predominant circulating strain type, shifted in the first postpandemic season in which it predominated toward those of a more typical epidemic influenza season.
Infect. Control Hosp. Epidemiol. 2015;36(11):1251–1260
Research of military personnel who deployed to the conflicts in Iraq or
Afghanistan has suggested that there are differences in mental health
outcomes between UK and US military personnel.
To compare the prevalence of post-traumatic stress disorder (PTSD),
hazardous alcohol consumption, aggressive behaviour and multiple physical
symptoms in US and UK military personnel deployed to Iraq.
Data were from one US (n = 1560) and one UK
(n = 313) study of post-deployment military health of
army personnel who had deployed to Iraq during 2007–2008. Analyses were
stratified by high- and low-combat exposure.
Significant differences in combat exposure and sociodemographics were
observed between US and UK personnel; controlling for these variables
accounted for the difference in prevalence of PTSD, but not in the total
symptom level scores. Levels of hazardous alcohol consumption (low-combat
exposure: odds ratio (OR) = 0.13, 95% CI 0.07–0.21; high-combat exposure:
OR = 0.23, 95% CI 0.14–0.39) and aggression (low-combat exposure: OR =
0.36, 95% CI 0.19–0.68) were significantly lower in US compared with UK
personnel. There was no difference in multiple physical symptoms.
Differences in self-reported combat exposures explain most of the
differences in reported prevalence of PTSD. Adjusting for self-reported
combat exposures and sociodemographics did not explain differences in
hazardous alcohol consumption or aggression.
Experts have proposed removing obsessive–compulsive disorder (OCD) from the anxiety disorders section and grouping it with putatively related conditions in DSM-5. The current study uses co-morbidity and familiality data to inform these issues.
Case family data from the OCD Collaborative Genetics Study (382 OCD-affected probands and 974 of their first-degree relatives) were compared with control family data from the Johns Hopkins OCD Family Study (73 non-OCD-affected probands and 233 of their first-degree relatives).
Anxiety disorders (especially agoraphobia and generalized anxiety disorder), cluster C personality disorders (especially obsessive–compulsive and avoidant), tic disorders, somatoform disorders (hypochondriasis and body dysmorphic disorder), grooming disorders (especially trichotillomania and pathological skin picking) and mood disorders (especially unipolar depressive disorders) were more common in case than control probands; however, the prevalences of eating disorders (anorexia and bulimia nervosa), other impulse-control disorders (pathological gambling, pyromania, kleptomania) and substance dependence (alcohol or drug) did not differ between the groups. The same general pattern was evident in relatives of case versus control probands. Results in relatives did not differ markedly when adjusted for demographic variables and proband diagnosis of the same disorder, though the strength of associations was lower when adjusted for OCD in relatives. Nevertheless, several anxiety, depressive and putative OCD-related conditions remained significantly more common in case than control relatives when adjusting for all of these variables simultaneously.
On the basis of co-morbidity and familiality, OCD appears related both to anxiety disorders and to some conditions currently classified in other sections of DSM-IV.
The electronic transport properties of ZnSe layers grown by MBE on GaAs sub- strates are studied by small-signal ac admittance, dc current-voltage, and Hall effect measurements. This work is supplemented by a study of TEM and x-ray rocking curve data. We find that the transport characteristics are strongly affected by the proper- ties of the ZnSe/GaAs interface. From the dc and ac measurements, we determine the total barrier height at the interface of thick (1-6 µm) ZnSe layers on n+-GaAs, and find that it is in general voltage dependent. While some samples are found to have a very high peak mobility (> 10,000cm2 /Vsec), an anomalous reduction in the mobility in a large fraction of the samples is found, and attributed to the presence of non- uniform space charge regions.
It was found that severe plastic deformation of orthorhombic alloys caused phase transformations of the displacement type and those associated with a change in the degree of long-range order, namely B2→ω(B82 ), B2→B19 and B2→β (BCC) (in the case of alloy with initial B2-phase structure) and O→B19→A20 (initial O-phase structure, Ti2AlNb). Unlike to ordinary metals, severe plastic deformation of the titanium aluminum intermetallics leads to decreasing of the strength of the material. The B19 and A20 phases are metastable. They are absent in the equilibrium phase diagrams of the compounds under investigation. The formation of the disordered phase states with extensive sliding and having great plasticity under severe deformation makes possible to consider severe deformation as the way for increasing of plasticity of the titanium aluminides.
Crosslinked polyamide barrier layers made by a self-limiting interfacial polymerization (IP) process are extremely thin (= 1000 Å), relatively defect-free and possess excellent perm selective properties which enable their commercial application in thin film composite (TFC) membranes. Little information has been reported in the open literature concerning the physical as well as mechanical properties of these polyamide IP films due to the substantial difficulties in making direct measurements on such thin crosslinked materials. Consequently, the development of IP-TFC membranes for commercial separations has been largely a trial-and-error process.
We are developing a novel experimental technique, Pendant Drop Mechanical Analysis (PDMA) that utilizes the capabilities of the pendant-drop tensiometer for in-situ measurements of the mechanical behavior of the IP films. The current effort focuses on relating the mechanical behavior of the IP films to their structure, which in turn will be related to the permselective performance. Preliminary PDMA results indicate significant differences in the mechanical behavior of the IP films as a function of composition and contact time. These differences can be related to changes in the network characteristics.
I really bust my butt now that I’m District Manager. I’m doing the same stuff that I did as Assistant District Manager – but that title, you know, I gotta work harder now that people look up to me.
District manager of a retail chain
If she were another manager around here, I would have asked her about the hours she wanted. But Trish is only a waitress, so I just scheduled her however I wanted. There’s nothing wrong with that.
I explained the problem thoroughly and respectfully to my General Manager but not the technicians. There’s no reason to involve any of the techs in making decisions. It’s okay just to tell them what to do.
Service manager at auto dealership
The above comments, culled from the senior author’s notes from workplace interviews over the years, suggest that managers are implicitly aware of a connection between justice and status. The district manager suggested that he was attuned to distributive justice when expressing the need to be deserving of his prestigious title. The restaurant manager did not think she was violating procedural justice by failing to give voice in the scheduling process to a lower status person, although she would have given voice to a higher status person. Finally, the service manager was sensitive to satisfying interactional justice by explaining outcomes to his superiors but not to his subordinates.
Not surprisingly, scholars are also familiar with connections between justice (or fairness) perceptions and status. This is particularly evident among sociologists (e.g., McClendon, 1976), who have studied how positions in occupational status hierarchies dictate the shares of rewards to which individuals feel fairly entitled, and psychologists (e.g., Van Prooijen, Van den Bos, and Wilke, 2002), who have examined how people’s thoughts about status led them to be concerned with following fair procedures. Despite such disciplinary links – and in keeping with the general observation that “status occupies a rather minor place in the … organizational behavior literature” (Pearce, Ramirez, and Branyiczki, 2001, p. 155) – connections between justice and status noted in the literature are not fully developed. However, scattered studies suggest that justice and status are interrelated in complex ways. Based on the belief that there is much to be learned about both justice and status by developing a rapprochement between them, we review their interrelationship in the present chapter. To this end, we juxtapose the various theoretical perspectives that shed light on the psychological processes underlying these connections and we also examine several of the most promising research directions stemming from them.
Obsessive–compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes.
Seven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated.
Two and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive–compulsive personality disorder (OCPD) features, high scores on the ‘taboo’ factor of OCD symptoms, and low conscientiousness.
OCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors.