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This brief examination of casualty patterns suggests that differences may exist in the numbers of immediately dead and critical patients, depending on the nature of the disaster. More data must be collected from future disasters to more accurately define relationships between critical patients and total numbers injured. Such characterization is essential for hospital disaster planning because critical patients require great resources and optimal hospital functioning.
Knowledge of casualty patterns can make disaster planning more practical, disaster drills more realistic, and disasters less disastrous.
Candidate gene studies have been a key approach to the genetics of schizophrenia (SCZ). However, the results of these studies are confusing and no genes have been unequivocally implicated. The hypothesis-driven candidate gene literature can be appraised by comparison with the results of genome-wide association studies (GWAS).
We describe the characteristics of hypothesis-driven candidate gene studies from the SZGene database, and use pathway analysis to compare hypothesis-driven candidate genes with GWAS results from the International Schizophrenia Consortium (ISC).
SZGene contained 732 autosomal genes evaluated in 1374 studies. These genes had poor statistical power to detect genetic effects typical for human diseases, assessed only 3.7% of genes in the genome, and had low marker densities per gene. Most genes were assessed once or twice (76.9%), providing minimal ability to evaluate consensus across studies. The ISC studies had 89% power to detect a genetic effect typical for common human diseases and assessed 79% of known autosomal common genetic variation. Pathway analyses did not reveal enrichment of smaller ISC p values in hypothesis-driven candidate genes, nor did a comprehensive evaluation of meta-hypotheses driving candidate gene selection (SCZ as a disease of the synapse or neurodevelopment). The most studied hypothesis-driven candidate genes (COMT, DRD3, DRD2, HTR2A, NRG1, BDNF, DTNBP1 and SLC6A4) had no notable ISC results.
We did not find support for the idea that the hypothesis-driven candidate genes studied in the literature are enriched for the common genetic variation involved in the etiology of SCZ. Larger samples are required to evaluate this conclusion definitively.
Recent data provide strong support for a substantial common polygenic contribution (i.e. many alleles each of small effect) to genetic susceptibility for schizophrenia and overlapping susceptibility for bipolar disorder.
To test hypotheses about the relationship between schizophrenia and psychotic types of bipolar disorder.
Using a polygenic score analysis to test whether schizophrenia polygenic risk alleles, en masse, significantly discriminate between individuals with bipolar disorder with and without psychotic features. The primary sample included 1829 participants with bipolar disorder and the replication sample comprised 506 people with bipolar disorder.
The subset of participants with Research Diagnostic Criteria schizoaffective bipolar disorder (n = 277) were significantly discriminated from the remaining participants with bipolar disorder (n = 1552) in both the primary (P = 0.00059) and the replication data-sets (P = 0.0070). In contrast, those with psychotic bipolar disorder as a whole were not significantly different from those with non-psychotic bipolar disorder in either data-set.
Genetic susceptibility influences at least two major domains of psychopathological variation in the schizophrenia–bipolar disorder clinical spectrum: one that relates to expression of a ‘bipolar disorder-like’ phenotype and one that is associated with expression of ‘schizophrenia-like’ psychotic symptoms.
This study details development of hybrid mesoporous materials in which molecular transport through mesopores can be precisely controlled and reversibly modulated. Mesoporous silica materials formed by surfactant templating were modified by surface initiated atom transfer radical polymerization of poly(N-isopropyl acrylamide) (PNIPAAm) a stimuli responsive polymer (SRP) within the porous network. Thermo gravimetric analysis and FTIR spectroscopy were used to confirm the presence of PNIPAAm on the silica surface. Nitrogen porosimetry, transmission electron microscopy and X-ray diffraction analyses confirmed that polymerization occurred uniformly within the porous network. Uptake and release of fluorescent dyes from the particles was monitored by spectrofluorimetry and scanning laser confocal microscopy. Results suggest that the presence of PNIPAAm, a SRP, in the porous network can be used to modulate the transport of aqueous solutes. At low temperature, (e.g., room temperature) the PNIPAAm is hydrated and extended and inhibits transport of analytes; at higher temperatures (e.g., 50°C) it is hydrophobic and is collapsed within the pore network, thus allowing solute diffusion into or out of the mesoporous silica. The transition form hydrophilic to hydrophobic state on polymer grafted mesoporous membranes was determined by contact angle measurements. This work has implications for the development of materials for the selective control of transport of molecular solutes in a variety of applications.
The objectives of this study were to determine compliance rate in a uniform, urban African-American patient population at environmental risk for adverse neurodevelopmental outcome and to define risk factors for non-compliance with neurodevelopmental follow-up. A retrospective chart review was performed which included 481 infants with birth weight (BW) of 495–4195 g and gestational ages (GAs) between 23 and 42 weeks born at our hospital. Statistical analysis was performed using the Jonckheere–Terpstra test for ordinal variables. For 2 × 2 tables, χ2 test and Fisher’s exact test (P < 0.05) were used. To determine significant predictive variables, data were analyzed by multiple logistic regression with one independent variable at a time. Infants compliant with follow-up had significantly more morbidities in the very low BW category (⩽1500 g) than infants with larger BW. The highest compliance rate (70%) was found among the smallest and most immature (GA ⩽28 weeks) infants. Based on this finding, we postulate that the number of infants with severe disability is not likely to be underestimated. The significantly more frequent developmental anomalies found in the largest BW (⩽2500 g) category raises significant concern, though findings in this subset of infants may not be representative of the whole population. There was no significant difference between the compliant and non-compliant groups regarding socio-economic status. Severe or multiple morbidities and prolonged hospital stay may provide parents with greater opportunity to learn and understand about the infant’s condition which may lead to greater compliance.
Dave R. Lal, Department of Surgery and Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA,
Charles A. Sklar, Department of Surgery and Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA,
Michael P. LaQuaglia, Department of Surgery and Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
Soft tissue sarcomas are the sixth most common malignancy of childhood, with rhabdomyosarcoma (RMS) by far the most frequent. In the United States, approximately 350 cases of RMS are diagnosed per year. Since 1975, the yearly incidence of RMS has remained stable at approximately 4 per 1 million children younger than 20 years of age.
Over the last 30 years, improved survival and decreased morbidity in treatment of RMS have been accomplished through collaborative clinical trials in both the United States and Europe. In the United States the Intergroup Rhabdomyosarcoma Study Group (IRSG) was established in 1972. Their mission has been to enroll all children diagnosed in North America into randomized prospective clinical trials. This has largely been accomplished with over 80% of North American children diagnosed with RMS enrolled in one of four completed IRSG studies. Since the inception of the IRSG, the overall survival for patients with RMS has improved from about 25% to over 70%. Much of this improvement has been the result of a multidisciplinary approach to rhabdomyosarcoma including surgeons, oncologists, and radiation oncologists. The IRSG (now called the Children's Oncology Group soft tissue sarcoma committee) continues to strive for improved survival with decreasing patient morbidity, and is currently accruing patients for its fifth trial (IRS-V).
Currently, orbital tumors have the best prognosis with a 5-year survival of approximately 95%.
Some neglected turn-of-the century American economists, who influenced or participated in the formation of U.S. foreign policy, argued that modern capitalism tended toward recurrent crises as a result of oversaving and surplus capital. These economists held that the construction of an international investment system offered a partial solution to the surplus-capital problem. Focusing on China, U.S. foreign policy at the outset of the twentieth century sought to install the gold-exchange standard in monetary relations between industrial and nonindustrial countries as a condition of such an international investment system.
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