ABSTRACT
Introduction: Invasive aspergillosis (IA) is the most prevalent infectious complication in patients with chronic granulomatous disease (CGD). Yet, understanding of fungal pathogenesis in the CGD host remains limited, particularly with regards to A. nidulans infection. Methods: We have used a murine model of X-linked CGD to investigate how the pathogenesis of IA varies between A. fumigatus and A. nidulans, comparing infection in both X-linked CGD (gp91-/-) mice and their parent C57BL/6 (WT) mice. A 14-colour flow cytometry panel was used to assess the cell dynamics over the course of infection, with parallel assessment of pulmonary cytokine production and lung histology. Results: We observed a lack of association between pulmonary pathology and infection outcome in gp91-/- mice, with no significant mortality in A. nidulans infected mice. An overwhelming and persistent neutrophil recruitment and IL-1 release in gp91-/- mice following both A. fumigatus and A. nidulans infection was observed, with divergent macrophage, dendritic cell and eosinophil responses and distinct cytokine profiles between the two infections. Conclusion: We have provided an in-depth characterisation of the immune response to pulmonary aspergillosis in an X-linked CGD murine model. This provides the first description of distinct pulmonary inflammatory environments in A. fumigatus and A. nidulans infection in X-linked CGD and identifies several new avenues for further research.
Subject(s)
Aspergillosis , Aspergillus nidulans , Granulomatous Disease, Chronic , Invasive Fungal Infections , Animals , Mice , Mice, Inbred C57BL , Aspergillus fumigatus/genetics , Aspergillus nidulans/genetics , Granulomatous Disease, Chronic/complications , Disease Models, Animal , CytokinesABSTRACT
Although some researchers recommend minimizing extraneous visual information in multimedia lessons, others have demonstrated that features such as visual cues and instructor videos can enhance learning. However, variability in selective attention skills may influence students' ability to benefit from these additional features. This study investigated links between college students' selective attention skills and their learning from video lessons that varied in the use of visual cues and the instructor video. Learning outcomes depended on both the visual features available and students' effort and selective attention skills. Among students who reported increased effort during the lessons, those with more efficient selective attention benefited most when a single additional feature (i.e., either visual cues or the instructor video) was used. All students, regardless of attention skills, benefited when both visual cues and the instructor were combined. These findings suggest that learning during multimedia lessons may depend on the visual features of the lessons and the student's effort and attention skills.
Subject(s)
Cues , Individuality , Humans , Students , Multimedia , AttentionSubject(s)
Empyema, Pleural , Child , Humans , Empyema, Pleural/microbiology , Streptococcus pneumoniae , Streptococcus pyogenesABSTRACT
Attending to distracting or competing information is typically considered detrimental to learning, but the presence of competing information can also facilitate learning when it is relevant to ongoing task goals. Educational settings often contain contextual elements such as classroom decorations or visual aids to enhance student learning. Despite this, most research examining effects of contextual information on children's learning has only utilized lesson-irrelevant stimuli. While this research has shown that increased looking to task-irrelevant information hinders learning, the extent to which looking to lesson-relevant information can benefit children's learning is unknown. We addressed this question by examining 3- to 5-year-old children's attention to and learning from lesson-relevant contextual information. We recorded children's eye movements as they viewed video science lessons while lesson-relevant and -irrelevant images appeared in the periphery. We assessed learning based on improvements in content knowledge following the video lessons and separately measured selective attention skills using the Track-It task. Children overall spent more time looking at lesson-relevant versus -irrelevant images, and those with more initial knowledge of the lesson topics or more advanced selective attention skills showed increased preferential looking to the relevant images. This increased preferential looking to lesson-relevant images related to more effective learning during trials in which both relevant and irrelevant images were present. These results suggest that the effects of competing contextual information on early learning depend on the relationship between information content and task goals, as well as children's ability to actively select task-relevant information from their environment.
Subject(s)
Eye Movements , Schools , Child, Preschool , Humans , Knowledge , Longitudinal StudiesABSTRACT
Nutrient homeostasis relates ambient stoichiometric conditions in an environment to the stoichiometry of living entities of that ecosystem. Plant nutrient sequestration in wetland ecosystems is a key process for downstream water quality. However, few studies have examined stoichiometric homeostasis of aquatic vegetation despite the importance of stoichiometry to plant nutrient uptake efficiency. This study investigated stoichiometric homeostasis of dominant emergent and submerged aquatic vegetation (EAV and SAV, respectively) within two treatment flow-ways of Everglades Stormwater Treatment Area 2 (STA-2). These flow-ways encompass a large gradient in plant nutrient availability. This study hypothesizes that wetland vegetation is homeostatic relative to ambient nutrients and consequently nutrient resorption does not vary along the nutrient gradient. We developed a framework to investigate how vegetation uptake and resorption of nutrients contribute separately to homeostasis. Overall, we determined that the wetland vegetation in this study was non-homeostatic with respect to differential uptake of nitrogen (N) versus phosphorus (P). In EAV, P resorption was relatively high and N resorption was moderate, and resorption efficiency did not vary significantly along the gradient. In separating the proportional contribution of resorption and uptake to the degree of homeostasis, resorption did not affect overall homeostatic status in EAV.
Subject(s)
Water Purification , Wetlands , Ecosystem , Homeostasis , Nitrogen , Nutrients , Phosphorus , Rain , Water SupplyABSTRACT
Efficient selective attention is critical for engaging in task-oriented behavior but may also limit our processing of potentially meaningful, task-irrelevant details. Both older adults and younger children demonstrate poor selective attention skills but show increased processing of task-irrelevant information. This broader attention to non-targets can benefit learning among older adults when the non-target information is relevant to a primary learning goal. Although young children show similar patterns of attention to non-targets, it is unknown whether relevant non-targets similarly benefit their learning. This study examined the relationship between 4- to 8-year-old children's selective attention skills and their learning from incidental exposure to relevant non-targets. In Experiment 1, children completed an incidental encoding phase, followed by a visual search task and then a final recognition memory task. During the search task, participants identified a target within arrays containing 0, 5, 10, or 15 non-targets. Half of the images from the encoding phase appeared in the search as "relevant" non-targets, whereas the remainder never appeared during the search task. Participants showed better memory for images presented as relevant non-targets. However, children showed the largest memory benefit when efficient selective attention allowed for increased scanning of the relevant non-targets after target detection. Experiment 2 confirmed that children showed similarly efficient selective attention skills but no longer showed enhanced learning when they could not scan relevant non-targets following target detection. These results suggest that children's incidental learning from relevant non-targets is an active process that depends on how children use selective attention to engage in effective information gathering.
Subject(s)
Attention/physiology , Individuality , Pattern Recognition, Visual/physiology , Recognition, Psychology/physiology , Child , Child, Preschool , Female , Humans , MaleABSTRACT
PURPOSE: To quantify and compare normative catabolic and anabolic factor concentrations in leukocyte-rich platelet-rich plasma (LR-PRP) at various time points, including baseline, 1 week after initiating naproxen use, and after a 1-week washout period. METHODS: Asymptomatic healthy donors aged between 18 and 70 years were recruited (average age, 36.6 years; range, 25-64 years). Subjects were excluded from the study if they were actively taking any prescribed medications or nonsteroidal anti-inflammatory drugs (NSAIDs) or if they had any of the following at present or previously: blood or immunosuppression disorders, cancer, osteonecrosis, rheumatoid arthritis, avascular necrosis, NSAID intolerance, gastrointestinal or peptic ulcer disease, or kidney dysfunction. The anabolic factors vascular endothelial growth factor, fibroblast growth factor 2, platelet-derived growth factor AB (PDGF-AB), and platelet-derived growth factor AA (PDGF-AA) and the catabolic factors interleukin (IL) 1ß, IL-6, IL-8, and tumor necrosis factor α in LR-PRP were measured. Peripheral blood was drawn at 3 time points: baseline, after 1 week of naproxen use, and after a 1-week washout period. RESULTS: The angiogenic factors PDGF-AA (44% decrease in median) and PDGF-AB (47% decrease) significantly declined from baseline (P < .05) after 1 week of naproxen use. There was a significant recovery (P < .05) of PDGF-AA (94% increase) and PDGF-AB (153% increase) levels after the 1-week washout period, with a return to baseline levels. The catabolic factor IL-6 also had a significant decline from baseline (77% decrease in median, P < .05) after 1 week of naproxen use. After a 1-week washout period, the IL-6 level was similar to the baseline level (130% increase, P < .05). CONCLUSIONS: Naproxen use diminished several biological factors in LR-PRP; however, a 1-week washout period was sufficient for the recovery of PDGF-AA, PDGF-AB, and IL-6 to return to baseline levels. Tumor necrosis factor α, IL-1ß, IL-8, vascular endothelial growth factor, and fibroblast growth factor 2 did not show differences between the 3 time points of data collection. Discontinuing NSAIDs for a minimum of 1 week before LR-PRP treatment may improve certain biological factor levels. LEVEL OF EVIDENCE: Level II, prospective comparative study.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Biological Factors/metabolism , Naproxen/pharmacology , Platelet-Rich Plasma/metabolism , Adult , Cytokines/metabolism , Female , Humans , Male , Middle Aged , Platelet-Derived Growth Factor/metabolism , Prospective Studies , Vascular Endothelial Growth Factor A/metabolismABSTRACT
Food image fMRI paradigms are used widely for investigating the neural basis of ingestive behavior. However, these paradigms have not been validated in terms of ingestive behavior constructs, engagement of food-relevant neural systems, or test-retest reliability, making the generalizability of study findings unclear. Therefore, we validated the Macronutrient Picture System (MaPS) (McClernon et al., 2013), which includes food images from the six categories represented in the Geiselman Food Preference Questionnaire (FPQ) (Geiselman et al., 1998). Twenty-five healthy young adults (n = 21 female, mean age = 20.6 ± 1.1 years, mean BMI = 22.1 ± 1.9 kg/m2) rated the MaPS images in terms of visual interest, appetitive quality, nutrition, emotional valence, liking, and frequency of consumption, and completed the FPQ. In a second study, 12 individuals (n=8 female, mean age = 25.0 ± 6.5 years, mean BMI = 28.2 ± 8.7 kg/m2) viewed MaPS and control images (vegetables and non-food) during two separate 3T BOLD fMRI scans after fasting overnight. Intuitively, high fat/high sugar (HF/HS) and high fat/high complex carbohydrate (HF/HCCHO) images achieved higher liking and appetitive ratings, and lower nutrition ratings, than low fat/low complex carbohydrate/high protein (LF/LCHO/HP) images on average. Within each food category, FPQ scores correlated strongly with MaPS image liking ratings (p < 0.001). Brain activation differences between viewing images of HF/HS and vegetables, and between HF/HCCHO and vegetables, were seen in several reward-related brain regions (e.g., putamen, insula, and medial frontal gyrus). Intra-individual, inter-scan agreement in a summary measure of brain activation differences in seven reward network regions of interest was high (ICC = 0.61), and was even higher when two distinct sets of food images with matching visual ratings were shown in the two scans (ICC = 0.74). These results suggest that the MaPS provides valid representation of food categories and reliably activates food-reward-relevant neural systems.
ABSTRACT
Invasive fungal diseases (IFDs) are devastating opportunistic infections that result in significant morbidity and death in a broad range of pediatric patients, particularly those with a compromised immune system. Recognizing them can be difficult, because nonspecific clinical signs and symptoms or isolated fever are frequently the only presenting features. Therefore, a high index of clinical suspicion is necessary in patients at increased risk of IFD, which requires knowledge of the pediatric patient population at risk, additional predisposing factors within this population, and the clinical signs and symptoms of IFD. With this review, we aim to summarize current knowledge regarding the recognition and clinical presentation of IFD in neonates and children.
Subject(s)
Invasive Fungal Infections/diagnosis , Aspergillosis/diagnosis , Candidiasis/diagnosis , Child , Critical Illness , Cross Infection/diagnosis , Cross Infection/microbiology , Hematologic Neoplasms/complications , Hospitalization , Humans , Immunocompromised Host , Immunologic Deficiency Syndromes/complications , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/diagnosis , Intensive Care Units, Pediatric , Mucormycosis/diagnosis , Opportunistic Infections/diagnosis , Opportunistic Infections/microbiology , Risk Factors , Transplant RecipientsABSTRACT
Aspergillus fumigatus is an opportunistic fungal pathogen causing invasive infections in immunocompromised hosts with a high case-fatality rate. Research investigating immunological responses against A. fumigatus has been limited by the lack of consistent and reliable assays for measuring the antifungal activity of specific immune cells in vitro. A new method is described to assess the antifungal activity of primary monocytes and neutrophils from human donors against A. fumigatus using FLuorescent Aspergillus REporter (FLARE) conidia. These conidia contain a genetically encoded dsRed reporter, which is constitutively expressed by live FLARE conidia, and are externally labeled with Alexa Fluor 633, which is resistant to degradation within the phagolysosome, thus allowing a distinction between live and dead A. fumigatus conidia. Video microscopy and flow cytometry are subsequently used to visualize the interaction between conidia and innate immune cells, assessing fungicidal activity whilst also providing a wealth of information on phagocyte migration, phagocytosis and the inhibition of fungal growth. This novel technique has already provided exciting new insights into the host-pathogen interaction of primary immune cells against A. fumigatus. It is important to note the laboratory setup required to perform this assay, including the necessary microscopy and flow cytometry facilities, and the capacity to work with human donor blood and genetically manipulated fungi. However, this assay is capable of generating large amounts of data and can reveal detailed insights into the antifungal response. This protocol has successfully been used to study the host-pathogen interaction of primary immune cells against A. fumigatus. It is important to note the laboratory setup required to perform this assay, including the necessary microscopy and flow cytometry facilities, and the capacity to work with human donor blood and genetically manipulated fungi. However, this assay is capable of generating large amounts of data and can reveal detailed insights into the antifungal response. This protocol has successfully been used to study the host-pathogen interaction of primary immune cells against A. fumigatus.
Subject(s)
Aspergillus fumigatus/pathogenicity , Host-Pathogen Interactions/physiology , Microscopy, Video/methods , Monocytes/microbiology , Neutrophils/microbiology , Aspergillus fumigatus/genetics , Flow Cytometry/methods , Genes, Reporter/drug effects , Humans , Luminescent Proteins/genetics , Monocytes/immunology , Neutrophils/immunology , Phagocytes/immunology , Phagocytes/microbiology , Phagocytosis , Spores, Fungal/geneticsABSTRACT
Patients with cystic fibrosis (CF) suffer from chronic lung infection and airway inflammation. Respiratory failure secondary to chronic or recurrent infection remains the commonest cause of death and accounts for over 90% of mortality. Bacteria as Staphylococcus aureus, Pseudomonas aeruginosa and Burkholderia cepacia complex have been regarded the main CF pathogens and their role in progressive lung decline has been studied extensively. Little attention has been paid to the role of Aspergillus spp. and other filamentous fungi in the pathogenesis of non-ABPA (allergic bronchopulmonary aspergillosis) respiratory disease in CF, despite their frequent recovery in respiratory samples. It has become more apparent however, that Aspergillus spp. may play an important role in chronic lung disease in CF. Research delineating the underlying mechanisms of Aspergillus persistence and infection in the CF lung and its link to lung deterioration is lacking. This review summarizes the Aspergillus disease phenotypes observed in CF, discusses the role of CFTR (cystic fibrosis transmembrane conductance regulator)-protein in innate immune responses and new treatment modalities.
Subject(s)
Aspergillosis, Allergic Bronchopulmonary/microbiology , Cystic Fibrosis/complications , Cystic Fibrosis/microbiology , Pulmonary Aspergillosis/microbiology , Aspergillosis, Allergic Bronchopulmonary/etiology , Aspergillosis, Allergic Bronchopulmonary/immunology , Aspergillosis, Allergic Bronchopulmonary/therapy , Aspergillus fumigatus/isolation & purification , Aspergillus fumigatus/pathogenicity , Chronic Disease , Cystic Fibrosis/immunology , Cystic Fibrosis Transmembrane Conductance Regulator/genetics , Cystic Fibrosis Transmembrane Conductance Regulator/metabolism , Humans , Immunity, Innate , Lung/microbiology , Lung/physiopathology , Phenotype , Pulmonary Aspergillosis/etiology , Pulmonary Aspergillosis/immunology , Pulmonary Aspergillosis/therapyABSTRACT
Patients with chronic granulomatous disease (CGD) have the highest life-time incidence of invasive aspergillosis and despite the availability of antifungal prophylaxis, infections by Aspergillus species remain the single most common infectious cause of death in CGD. Recent developments in curative treatment options, such as haematopoietic stem cell transplantation, will change the prevalence of infectious complications including invasive aspergillosis in CGD patients. However, invasive aspergillosis in a previously healthy host is often the first presenting feature of this primary immunodeficiency. Recognizing the characteristic clinical presentation and understanding how to diagnose and treat invasive aspergillosis in CGD is of utmost relevance to improve clinical outcomes. Significant differences exist in fungal epidemiology, clinical signs and symptoms, and the usefulness of non-culture based diagnostic tools between the CGD host and neutropenic patients, reflecting underlying differences in the pathogenesis of invasive aspergillosis shaped by the nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase deficiency.
ABSTRACT
RATIONALE AND OBJECTIVES: To assess radiologists' perceptions of how the new Breast Density Notification Act (BDNA) of Pennsylvania would affect their breast density reporting and their actual reporting patterns after implementation. MATERIALS AND METHODS: Under an institutional review board-approved protocol, we surveyed 21 radiologists about how they believe the new law affected their breast density reporting patterns and analyzed actual changes for 16 respondents before and after the law took effect. Three hundred consecutive reports were assessed for each radiologist before and after the effective date. The distributions of reported density Breast Imaging Reporting and Data System (BI-RADS) (1-4) were compared using a type III test in the context of an ordinal mixed model accounting for between-reader variability and adjusting for age (PROC GLIMMIX, SAS, version 9.3) using a two-sided .05 significance level. RESULTS: Seventeen radiologists responded to the survey; however, one retired shortly after responding. Of the 16 respondents, 56% (nine of 16) did not favor the law, 13% (two of 16) were in favor, and 31% (five of 16) were neutral. The fraction perceived that after implementation, they rated more, equally, or less frequently breasts as scattered fibroglandular densities (BI-RADS 2) versus heterogeneously dense rating (BI-RADS 3) was 50% (eight of 16), 44% (seven of 16), and 6% (one of 16), respectively. In practice, 44% (seven of 16) performed differently than their survey answers. Fourteen of 16 radiologists increased the frequency of reported BI-RADS 2 scores after BDNA implementation with seven having statistically significant (P < .05) increases after adjusting for age differences. CONCLUSIONS: Radiologists' reporting patterns changed, at least for a short duration, after the new density reporting law and for some of the radiologists in an unexpected way.
Subject(s)
Attitude of Health Personnel , Breast Neoplasms/diagnostic imaging , Mammary Glands, Human/abnormalities , Mammography/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Radiology/legislation & jurisprudence , Aged , Breast Density , Female , Humans , Middle Aged , Pennsylvania , Practice Patterns, Physicians'/legislation & jurisprudence , Radiographic Image Interpretation, Computer-AssistedABSTRACT
Repeated, high-dose methamphetamine (METH) administrations cause persistent dopaminergic deficits in rodents, nonhuman primates, and humans. In rats, this treatment also causes the formation of high-molecular mass (greater than approximately 120 kDa) dopamine transporter (DAT)-associated complexes, the loss of DAT monomer immunoreactivity, and a decrease in DAT function, as assessed in striatal synaptosomes prepared 24 h after METH treatment. The present study extends these findings by demonstrating the regional selectivity of DAT complex formation and monomer loss because these changes in DAT immunoreactivity were not observed in the nucleus accumbens. Furthermore, DAT complex formation was not a consequence limited to METH treatment because it was also caused by intrastriatal administration of 6-hydroxydopamine. Pretreatment with the D2 receptor antagonist, eticlopride [S-(-)-3-chloro-5-ethyl-N-[(1-ethyl-2-pyrrolidinyl)methyl]-6-hydroxy-2-methoxybenzamide hydrochloride], but not the D1 receptor antagonist, SCH23390 [R(+)-7-chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzazepine hydrochloride], attenuated METH-induced DAT complex formation. Eticlopride pretreatment also attenuated METH-induced DAT monomer loss and decreases in DAT function; however, the attenuation was much less pronounced than the effect on DAT complex formation. Finally, results also revealed a negative correlation between METH-induced DAT complex formation and DAT activity. Taken together, these data further elucidate the underlying mechanisms and the functional consequences of repeated administrations of METH on the DAT protein. Furthermore, these data suggest a multifaceted role for D2 receptors in mediating METH-induced alterations of the DAT and its function.
Subject(s)
Dopamine Plasma Membrane Transport Proteins/biosynthesis , Dopamine Uptake Inhibitors/pharmacology , Methamphetamine/pharmacology , Animals , Benzazepines/pharmacology , Blotting, Western , Data Interpretation, Statistical , Dopamine/metabolism , Dopamine Antagonists/pharmacology , Dopamine D2 Receptor Antagonists , In Vitro Techniques , Male , Neostriatum/drug effects , Neostriatum/metabolism , Nucleus Accumbens/drug effects , Nucleus Accumbens/metabolism , Oxidopamine , Rats , Rats, Sprague-Dawley , Receptors, Dopamine D1/antagonists & inhibitors , Receptors, Dopamine D2/drug effects , Salicylamides/pharmacology , Sympathectomy, Chemical , Synaptosomes/drug effects , Synaptosomes/metabolismABSTRACT
The authors investigated radiologists, performances during retrospective interpretation of screening mammograms when using a binary decision whether to recall a woman for additional procedures or not and compared it with their receiver operating characteristic (ROC) type performance curves using a semi-continuous rating scale. Under an Institutional Review Board approved protocol nine experienced radiologists independently rated an enriched set of 155 examinations that they had not personally read in the clinic, mixed with other enriched sets of examinations that they had individually read in the clinic, using both a screening BI-RADS rating scale (recall/not recall) and a semi-continuous ROC type rating scale (0 to 100). The vertical distance, namely the difference in sensitivity levels at the same specificity levels, between the empirical ROC curve and the binary operating point were computed for each reader. The vertical distance averaged over all readers was used to assess the proximity of the performance levels under the binary and ROC-type rating scale. There does not appear to be any systematic tendency of the readers towards a better performance when using either of the two rating approaches, namely four readers performed better using the semi-continuous rating scale, four readers performed better with the binary scale, and one reader had the point exactly on the empirical ROC curve. Only one of the nine readers had a binary "operating point" that was statistically distant from the same reader's empirical ROC curve. Reader-specific differences ranged from -0.046 to 0.128 with an average width of the corresponding 95% confidence intervals of 0.2 and p-values ranging for individual readers from 0.050 to 0.966. On average, radiologists performed similarly when using the two rating scales in that the average distance between the run in individual reader's binary operating point and their ROC curve was close to zero. The 95% confidence interval for the fixed-reader average (0.016) was (-0.0206, 0.0631) (two-sided p-value 0.35). In conclusion the authors found that in retrospective observer performance studies the use of a binary response or a semi-continuous rating scale led to consistent results in terms of performance as measured by sensitivity-specificity operating points.
Subject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/epidemiology , Mammography/statistics & numerical data , Radiographic Image Interpretation, Computer-Assisted/methods , Radiographic Image Interpretation, Computer-Assisted/statistics & numerical data , Task Performance and Analysis , Female , Humans , Laboratories , Observer Variation , Pennsylvania/epidemiology , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
In vivo methylphenidate (MPD) administration increases vesicular monoamine transporter-2 (VMAT-2) immunoreactivity, VMAT-2-mediated dopamine (DA) transport, and DA content in a nonmembrane-associated (referred to herein as cytoplasmic) vesicular subcellular fraction purified from rat striatum: a phenomenon attributed to a redistribution of VMAT-2-associated vesicles within nerve terminals. In contrast, the present study elucidated the nature of, and the impact of MPD on, VMAT-2-associated vesicles that cofractionate with synaptosomal membranes after osmotic lysis (referred to herein as membrane-associated vesicles). Results revealed that, in striking contrast to the cytoplasmic vesicles, DA transport velocity versus substrate concentration curves in the membrane-associated vesicles were sigmoidal, suggesting positive cooperativity with respect to DA transport. Additionally, DA transport into membrane-associated vesicles was greater in total capacity in the presence of high DA concentrations than transport into cytoplasmic vesicles. Of potential therapeutic relevance, MPD increased DA transport into the membrane-associated vesicles despite rapidly decreasing (presumably by redistributing) VMAT-2 immunoreactivity in this fraction. Functional relevance was suggested by findings that MPD treatment increased both the DA content of the membrane-associated vesicle fraction and K(+)-stimulated DA release from striatal suspensions. In summary, the present data demonstrate the existence of a previously uncharacterized pool of membrane-associated VMAT-2-containing vesicles that displays novel transport kinetics, has a large sequestration capacity, and responds to in vivo pharmacological manipulation. These findings provide insight into both the regulation of vesicular DA sequestration and the mechanism of action of MPD, and they may have implications regarding treatment of disorders involving abnormal DA disposition, including Parkinson's disease and substance abuse.
Subject(s)
Cytoplasm/metabolism , Dopamine Uptake Inhibitors/pharmacology , Methylphenidate/pharmacology , Synaptic Vesicles/metabolism , Vesicular Monoamine Transport Proteins/drug effects , Animals , Biological Transport/drug effects , Dopamine/metabolism , Male , Rats , Rats, Sprague-Dawley , Vesicular Monoamine Transport Proteins/physiologyABSTRACT
RATIONALE AND OBJECTIVES: We sought to assess whether or not prevalence levels affected the confidence ratings of readers during the interpretation of cases in a laboratory receiver operating characteristic-type observer performance study. MATERIALS AND METHODS: We reanalyzed a previously conducted observer performance study that included 14 readers and 5 different levels of prevalence. The previous study yielded the observation that in the laboratory we could not detect a "prevalence effect" in terms of differences in areas under the receiver operating characteristic curves. The detection ratings (for presence or absence) of lung nodules, interstitial disease, and pneumothorax for the five prevalence levels were compared, and a test for trend in averaged ratings as a function of abnormality prevalence was performed within a mixed-model setting that accounts for different sources of variability and correlations induced by the study design. RESULTS: The ratings of the cases in terms of confidence that the specific abnormality in question is present tend, on average, to be larger when actual disease prevalence is lower. The rate of the increase of the average confidence ratings with the decreasing prevalence of a specific abnormality is very similar for actually positive and actually negative cases for every considered abnormality. The observed trend in the changes of the average confidence ratings as a function of prevalence levels was statistically significant (p < 0.01). CONCLUSION: Expectations of disease prevalence in the case mix during a laboratory observer performance study may systematically affect the behavior of observers in terms of their actual confidence ratings.
Subject(s)
Obsessive Behavior , ROC Curve , Radiography , Humans , Laboratories , PrevalenceABSTRACT
PURPOSE: To prospectively survey women undergoing screening mammography to assess their attitudes toward and preference for the level of recall rates given the possibility that an increase in recall rates may result in earlier detection of cancer. MATERIALS AND METHODS: This HIPAA-compliant survey was performed with an institutional review board-approved protocol. Women who arrived for their routine screening mammographic examination from November 2004 to March 2005 were informed before they consented to participate. The distribution of responses for each survey question was summarized, and proportions for the entire group and different subgroups were computed. The z score statistic was used to assess significant differences between subgroups. RESULTS: Fifteen hundred seventy anonymized questionnaires were collected; 1171 (75%) were from women between 40 and 59 years of age. Of 1528 respondents, 1486 (97%) believed that a false-positive result would not deter them from continuing with regular screening, and most would have been willing to be recalled more often for either a noninvasive (86% [1308 of 1519 respondents]) or an invasive (82% [1248 of 1515 respondents]) procedure if it might increase the chance of detecting a cancer (if present) earlier. Compared with respondents undergoing their initial screening mammographic examination, women who had undergone at least one prior screening examination reported that they were more likely to continue with screening if they had received a previous false-positive result (P = .02). Women younger than 60 years and those previously recalled were more willing to be called back more often for a noninvasive or, when indicated, an invasive procedure (P < .05). CONCLUSION: A substantial fraction of women in this study would have preferred the inconvenience of and anxiety associated with a higher recall rate if it resulted in the possibility of detecting breast cancer earlier.
Subject(s)
Attitude to Health , Breast Neoplasms/diagnostic imaging , Mammography , Patient Acceptance of Health Care/psychology , Adult , Anxiety/psychology , Breast Neoplasms/psychology , Early Diagnosis , Female , Humans , Mass Screening , Middle Aged , Prospective Studies , Surveys and QuestionnairesABSTRACT
RATIONALE AND OBJECTIVE: Our goal was to investigate the effect of the displayed image size on variance components during the performance of an observer performance study to detect masses on abdominal computed tomography (CT) examinations. MATERIALS AND METHODS: A previously performed receiver operating characteristic (ROC) study with eight observers to detect abdominal masses on 166 CT examinations was reanalyzed to assess variance components when comparing two similar modes with displayed image sizes varying by a factor of 2. Case, mode, and reader-related variance components were estimated for the group of eight observers and subsets of readers after excluding each of the participants. RESULTS: There was no significant difference in the average area under the ROC curves between the two modes using the two image sizes (P > .05). Reader and reader-by-case variability were substantially larger for the mode displaying enlarged images for the group and all subsets formed by excluding a single reader. Reader variability was affected by one observer who actually performed better with the enlarged images. CONCLUSION: Sequential viewing of enlarged CT images for the detection of abdominal masses did not improve performance and increased reader variability.
Subject(s)
Abdominal Neoplasms/diagnostic imaging , Diagnostic Imaging/methods , Image Enhancement/methods , Image Interpretation, Computer-Assisted/methods , Task Performance and Analysis , User-Computer Interface , Visual Perception , Abdominal Neoplasms/epidemiology , Algorithms , Analysis of Variance , Data Display , Humans , Observer Variation , Radiography, Thoracic/statistics & numerical data , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
RATIONALE AND OBJECTIVES: The aim of the study is to assess variance components in observer performance studies and the possible impact on study results and conclusions. MATERIALS AND METHODS: Two previously performed retrospective receiver operating characteristic-type observer performance studies to evaluate the performance of seven radiologists in detecting interstitial disease on conventional posteroanterior chest films and nine radiologists in detecting interstitial disease on a high-resolution workstation were reanalyzed by using the Beiden, Wagner, and Campbell nine-component model to estimate the different variance components. We estimated case-, reader-, and mode-related components of the variance for the group as a whole and after excluding (round robin) each reader. Overall variance was evaluated, and the effect of individual readers on overall study conclusions was assessed. RESULTS: Overall results and conclusions of the reanalysis agreed with the original one in that, as a group, radiologists performed significantly better when using conventional films (P < .05) in both studies. Reader variability was large compared with all other components, and in one study, it was substantially larger for the workstation reading mode. Reader variability was affected substantially by one observer in each study, and in one study, reader-by-mode variability was affected by another reader who performed better on the workstation. CONCLUSION: Estimates of variance components can shed light on the appropriateness of study design, as well as the sensitivity of results to the inclusion (or exclusion) of individual observers.