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1.
Behav Brain Sci ; 46: e320, 2023 10 04.
Article de Anglais | MEDLINE | ID: mdl-37789555

RÉSUMÉ

Fitouchi et al.'s moral disciplining approach highlights the significant role social evaluations of self-control appear to play in human moral judgment. At the same time, attributing the wide range of puritanical concerns to a singular focus on self-control seems unwarranted. A more pluralistic approach would enrich understanding of moral judgment in all its cultural and historical diversity.


Sujet(s)
Jugement , Sens moral , Humains
2.
Psychol Health Med ; 28(4): 1030-1038, 2023 04.
Article de Anglais | MEDLINE | ID: mdl-35607734

RÉSUMÉ

This study examined the predictive role of emotional reaction to pain on depression and investigated if there are significant age differences in depression among people living with sickle cell disease. A cross-sectional design carried out at Obafemi Awolowo University Health Centre (OAUHC) in Osun State, Nigeria, was conveniently used to select 71 respondents (females = 70.4%), with a median age of 19 years (SD = 5.94). Beck Depression Inventory (BDI) and Short-Form McGill Pain Questionnaire (SF-MPQ) were used to collect data from the respondents from 11 January to 15 February 2019. Simple linear regression analysis revealed that emotional reaction to pain significantly predicts depression among individuals living with sickle cell disease (R2 = 0.16, F(1, 69) = 16.70, p < .05)). One-way ANOVA results also showed a significant influence of age on depression (F(2, 68) = 4.439; p <.05)). The study concluded that emotional reaction to pain and age play significant roles in depression among people living with sickle cell disease in the study setting.


Sujet(s)
Drépanocytose , Dépression , Adulte , Femelle , Humains , Jeune adulte , Drépanocytose/épidémiologie , Études transversales , Dépression/épidémiologie , Douleur/épidémiologie , Mâle , Adolescent
3.
Niger J Clin Pract ; 25(7): 1038-1045, 2022 Jul.
Article de Anglais | MEDLINE | ID: mdl-35859462

RÉSUMÉ

Background: Cancers are a disease of growing public health importance in Africa, but cancer research capacity in the region is underdeveloped. The quest to foster and promote locally conceptualized and conducted oncology research in Africa have informed the African Research Group for Oncology's (ARGO) research capacity-building efforts in Nigeria. Aim: To evaluate the effectiveness of oncology research capacity-building initiatives among Nigerian senior trainees and junior faculty physicians. Subjects and Methods: Panel study design was employed to study Nigerian senior trainees and junior faculty physicians who participated in two research capacity-building symposia. Data were collected pre-and immediate post-symposia, and 3-month post-first symposium. Changes in knowledge were assessed using the Chi-square test and confidence levels using the Wilcoxon signed rank test. A P value of <0.05 was considered statistically significant. Results: : In the first symposium, the participants' pass rate in the knowledge-based questions improved from 9.8% to 46.7% to 81.5% at the baseline, immediate post-symposium, and 3-month post-symposium, respectively (P < 0.001). Likewise, the participants' confidence level in carrying out certain research-related activities increased after the second symposium (P < 0.001). Conclusion: The study concludes that building capacity for oncology research in low- and middle-income countries is possible with focused symposia and educational programs.


Sujet(s)
Renforcement des capacités , Médecins , Corps enseignant , Humains , Nigeria
4.
Child Dev ; 92(6): 2235-2243, 2021 11.
Article de Anglais | MEDLINE | ID: mdl-34432889

RÉSUMÉ

Using Hard et al.'s (2011) dwell-time paradigm, 85 preschoolers (aged 2.5-4.5; 43 female; primarily from white families) advanced at their own pace through one of three slideshows. All slideshows depicted an actor reaching toward, grasping, and retrieving a ball. However, motion patterns differed for one slideshow (straight-reach) relative to the other two (arcing-reaches), and one of the arcing-reach slideshows depicted a violation of typical goal-related motion. Preschoolers' knowledge of goal structure systematically modulated attention to event boundaries across slideshows despite surface differences, even when controlling for pixel change (an index of changes in motion). These findings showcase the value of the dwell time paradigm, and illuminate how children deploy attention as goal-related expectations shape their analysis of continuously unfolding activity.


Sujet(s)
Objectifs , Motivation , Enfant , Femelle , Humains
5.
Ann N Y Acad Sci ; 1498(1): 116-132, 2021 08.
Article de Anglais | MEDLINE | ID: mdl-34101212

RÉSUMÉ

Women reliant on mostly rice-based diets can have inadequate thiamine intake, placing breastfed infants at risk of thiamine deficiency and, in turn, physical and cognitive impairments. We investigated the impact of maternal thiamine supplementation doses on infants' cognitive, motor, and language development across the first year. In this double-blind, four-parallel-arm, randomized controlled trial, healthy mothers of exclusively breastfed newborn infants were recruited in Kampong Thom, Cambodia. At 2 weeks postnatal, women (n = 335) were randomized to one of four treatment groups to consume one capsule/day with varying amounts of thiamine for 22 weeks: 0, 1.2, 2.4, and 10 mg. At 2, 12, 24, and 52 weeks of age, infants were assessed with the Mullen Scales of Early Learning (MSEL) and the Caregiver Reported Early Development Instrument (CREDI). Multiple regression and mixed effects modeling suggest that by 6 months of age, the highest maternal thiamine dose (10 mg/day) held significant benefits for infants' language development, but generally not for motor or visual reception development. Despite having achieved standardized scores on the MSEL that approximated U.S. norms by 6 months, infants showed a significant drop relative to these norms in both language domains following trial completion, indicating that nutritional interventions beyond 6 months may be necessary.


Sujet(s)
Allaitement naturel , Développement de l'enfant , Cognition , Compléments alimentaires , Carence en thiamine/épidémiologie , Carence en thiamine/prévention et contrôle , Thiamine/administration et posologie , Facteurs âges , Cambodge/épidémiologie , Femelle , Évaluation des impacts sur la santé , Humains , Nourrisson , Nouveau-né , Surveillance de la santé publique , Thiamine/métabolisme , Carence en thiamine/étiologie
6.
Br J Surg ; 108(9): 1072-1081, 2021 09 27.
Article de Anglais | MEDLINE | ID: mdl-33963377

RÉSUMÉ

BACKGROUND: Ischaemia-reperfusion (IR) injury makes a major contribution to graft damage during kidney transplantation. Oxidative damage to mitochondria is an early event in IR injury. Therefore, the uptake, safety, and efficacy of the mitochondria-targeted antioxidant MitoQ were investigated in models of transplant IR injury. METHODS: MitoQ uptake by warm and cooled pairs of pig and declined human kidneys was measured when preserved in cold static storage or by hypothermic machine perfusion. Pairs of pigs' kidneys were exposed to defined periods of warm and cold ischaemia, flushed and stored at 4°C with or without MitoQ (50 nmol/l to 250 µmol/l), followed by reperfusion with oxygenated autologous blood in an ex vivo normothermic perfusion (EVNP). Pairs of declined human kidneys were flushed and stored with or without MitoQ (5-100 µmol/l) at 4°C for 6 h and underwent EVNP with ABO group-matched blood. RESULTS: Stable and concentration-dependent uptake of MitoQ was demonstrated for up to 24 h in pig and human kidneys. Total blood flow and urine output were significantly greater in pig kidneys treated with 50 µmol/l MitoQ compared with controls (P = 0.006 and P = 0.007 respectively). In proof-of-concept experiments, blood flow after 1 h of EVNP was significantly greater in human kidneys treated with 50 µmol/l MitoQ than in controls (P ≤ 0.001). Total urine output was numerically higher in the 50-µmol/l MitoQ group compared with the control, but the difference did not reach statistical significance (P = 0.054). CONCLUSION: Mitochondria-targeted antioxidant MitoQ can be administered to ischaemic kidneys simply and effectively during cold storage, and may improve outcomes after transplantation.


Sujet(s)
Transplantation rénale/effets indésirables , Rein/vascularisation , Conservation d'organe/méthodes , Composés organiques du phosphore/pharmacologie , Lésion d'ischémie-reperfusion/thérapie , Ubiquinones/analogues et dérivés , Animaux , Antioxydants/pharmacologie , Modèles animaux de maladie humaine , Humains , Suidae , Ubiquinones/pharmacologie
7.
Am J Clin Nutr ; 114(1): 90-100, 2021 07 01.
Article de Anglais | MEDLINE | ID: mdl-33829271

RÉSUMÉ

BACKGROUND: Infantile beriberi-related mortality is still common in South and Southeast Asia. Interventions to increase maternal thiamine intakes, and thus human milk thiamine, are warranted; however, the required dose remains unknown. OBJECTIVES: We sought to estimate the dose at which additional maternal intake of oral thiamine no longer meaningfully increased milk thiamine concentrations in infants at 24 wk postpartum, and to investigate the impact of 4 thiamine supplementation doses on milk and blood thiamine status biomarkers. METHODS: In this double-blind, 4-parallel arm randomized controlled dose-response trial, healthy mothers were recruited in Kampong Thom, Cambodia. At 2 wk postpartum, women were randomly assigned to consume 1 capsule, containing 0, 1.2 (estimated average requirement), 2.4, or 10 mg of thiamine daily from 2 through 24 weeks postpartum. Human milk total thiamine concentrations were measured using HPLC. An Emax curve was plotted, which was estimated using a nonlinear least squares model in an intention-to-treat analysis. Linear mixed-effects models were used to test for differences between treatment groups. Maternal and infant blood thiamine biomarkers were also assessed. RESULTS: In total, each of 335 women was randomly assigned to1 of the following thiamine-dose groups: placebo (n = 83), 1.2 mg (n = 86), 2.4 mg (n = 81), and 10 mg (n = 85). The estimated dose required to reach 90% of the maximum average total thiamine concentration in human milk (191 µg/L) is 2.35 (95% CI: 0.58, 7.01) mg/d. The mean ± SD milk thiamine concentrations were significantly higher in all intervention groups (183 ± 91, 190 ± 105, and 206 ± 89 µg/L for 1.2, 2.4, and 10 mg, respectively) compared with the placebo group (153 ± 85 µg/L; P < 0.0001) and did not significantly differ from each other. CONCLUSIONS: A supplemental thiamine dose of 2.35 mg/d was required to achieve a milk total thiamine concentration of 191 µg/L. However, 1.2 mg/d for 22 wk was sufficient to increase milk thiamine concentrations to similar levels achieved by higher supplementation doses (2.4 and 10 mg/d), and comparable to those of healthy mothers in regions without beriberi. This trial was registered at clinicaltrials.gov as NCT03616288.


Sujet(s)
Compléments alimentaires , Lait humain/composition chimique , Thiamine/administration et posologie , Thiamine/métabolisme , Complexe vitaminique B/administration et posologie , Complexe vitaminique B/métabolisme , Adulte , Cambodge , Méthode en double aveugle , Femelle , Humains , Thiamine/composition chimique , Complexe vitaminique B/composition chimique , Jeune adulte
8.
Ann N Y Acad Sci ; 1498(1): 85-95, 2021 08.
Article de Anglais | MEDLINE | ID: mdl-33415757

RÉSUMÉ

Thiamine deficiency is a public health issue in Cambodia. Thiamine fortification of salt has been proposed; however, the salt intake of lactating women, the target population, is currently unknown. We estimated salt intakes among lactating women (<6 months postpartum) using three methods: repeat observed-weighed intake records and 24-h urinary sodium excretions (n = 104), and household salt disappearance (n = 331). Usual salt intake was estimated by adjusting for intraindividual intakes using the National Cancer Institute method, and a thiamine salt fortification scenario was modeled using a modified estimated average requirement (EAR) cut-point method. Unadjusted salt intake from observed intakes was 9.3 (8.3-10.3) g/day, which was not different from estimated salt intake from urinary sodium excretions, 9.0 (8.4-9.7) g/day (P = 0.3). Estimated salt use from household salt disappearance was 11.3 (10.7-11.9) g/person/day. Usual (adjusted) salt intake from all sources was 7.7 (7.4-8.0) g/day. Assuming no stability losses, a modeled fortification dose of 275 mg thiamine/kg salt could increase thiamine intakes from fortified salt to 2.1 (2.0-2.2) mg/day, with even low salt consumers reaching the EAR of 1.2 mg/day from fortified salt alone. These findings, in conjunction with future sensory and stability research, can inform a potential salt fortification program in Cambodia.


Sujet(s)
Compléments alimentaires , Aliment enrichi , Chlorure de sodium alimentaire/administration et posologie , Carence en thiamine/épidémiologie , Carence en thiamine/prévention et contrôle , Thiamine/administration et posologie , Adulte , Cambodge/épidémiologie , Prise en charge de la maladie , Prédisposition aux maladies , Caractéristiques familiales , Femelle , Humains , Mâle , Grossesse , Surveillance de la santé publique , Facteurs sociodémographiques , Thiamine/sang , Thiamine/métabolisme , Carence en thiamine/étiologie
9.
Top Cogn Sci ; 13(1): 79-105, 2021 01.
Article de Anglais | MEDLINE | ID: mdl-32529736

RÉSUMÉ

Events-the experiences we think we are having and recall having had-are constructed; they are not what actually occurs. What occurs is ongoing dynamic, multidimensional, sensory flow, which is somehow transformed via psychological processes into structured, describable, memorable units of experience. But what is the nature of the redescription processes that fluently render dynamic sensory streams as event representations? How do such processes cope with the ubiquitous novelty and variability that characterize sensory experience? How are event-rendering skills acquired and how do event representations change with development? This review considers emerging answers to these questions, beginning with evidence that an implicit tendency to monitor predictability structure via statistical learning is key to event rendering. That is, one way that the experience of bounded events (e.g., actions within behavior, words within speech) arises is with the detection of "troughs" in sensory predictability. Interestingly, such troughs in predictability are often predictable; these regions of predictable-unpredictability provide articulation points to demarcate one event from another in representations derived from the actual streaming information. In our information-optimization account, a fluent event-processor predicts such troughs and selectively attends to them-while suppressing attention to other regions-as sensory streams unfold. In this way, usage of attentional resources is optimized for efficient sampling of the most relevant, information-rich portions of the unfolding flow of sensation. Such findings point to the development of event-processing fluency-whether in action, language, or other domains-depending crucially on rapid and continual cognitive reorganization. As knowledge of predictability grows, attention is adaptively redeployed. Accordingly, event experiences undergo continuous alteration.


Sujet(s)
Apprentissage , Parole , Humains , Langage , Rappel mnésique
10.
World J Surg ; 44(10): 3237-3244, 2020 10.
Article de Anglais | MEDLINE | ID: mdl-32462217

RÉSUMÉ

INTRODUCTION: Surgical care is an integral part of any healthcare system, yet there is a paucity of data on the burden of surgical disease, surgical capacity and access to surgical services in the Pacific region. This study aimed to evaluate access to surgical care through a pilot household survey in the Vanuatu island of Efate and five of its surrounding islands. METHODS: The 2009 Vanuatu census' GPS coordinates were used to randomly select 150 rural and 150 urban households from Efate and its surrounding islands. A total of 143 urban households and 142 rural households were available for inclusion in this study. A household questionnaire was developed to evaluate access to surgical care and included information regarding household demographics, socio-economic indicators and perceived and realised barriers to accessing care. The questionnaire was administered by local health workers, and data were collected electronically. RESULTS: Questionnaires were completed by 285 households. Two hundred and forty-one out of 254 (94.8%) households reported being able to access Port Vila Hospital, if required. The most commonly cited potential barriers to accessing surgical care were financial constraints (42.4%) and transport (26.4%). CONCLUSION: Our results provide important insights into the geographic, sociocultural and economic barriers to seeking, reaching and receiving surgical care in this region of Vanuatu. Identifying specific areas and communities with poor access to care, alongside the determinants of access, will help in designing both clinical and policy interventions to improve access to surgical care.


Sujet(s)
Accessibilité des services de santé , Adulte , Prestations des soins de santé , Caractéristiques familiales , Femelle , Humains , Mâle , Population rurale , Enquêtes et questionnaires , Vanuatu
11.
World J Surg ; 43(12): 2979-2985, 2019 12.
Article de Anglais | MEDLINE | ID: mdl-31549203

RÉSUMÉ

BACKGROUND: The Lancet Commission on Global Surgery proposed that population access to essential surgical care within 2 h is a core indicator of health system preparedness. Little evidence exists to characterise access to surgical care for island nations, including Vanuatu, a lower middle-income country in the Western Pacific. METHODS: A descriptive, facility-based, survey of surgical inpatients was undertaken over a 6-month period at Northern Provincial Hospital (NPH), Espiritu Santo, Vanuatu. This evaluated demographics, access to surgical care using the 'three delays' framework and clinical outcomes. RESULTS: A total of 121 participants were surveyed (60% of all surgical admissions), of which 31% required emergency surgery. Only 20% of emergency surgical cases accessed care within 2 h. There were no emergency cases from Torba or Malekula. The first delay (delay in seeking care) had the biggest impact on timely access. There was a geographic gradient to access, gender preponderance (males), and a delay in seeking surgical care due to a preference for traditional healers. CONCLUSION: There is urgent need to improve access to surgical care in Vanuatu, particularly for Torba and Malekula catchments. Demographic, geographic, sociocultural, and economic factors impact on timely access to surgical care within the northern regions of Vanuatu and support the notion that addressing access barriers is more complex than ensuring the availability of surgical resources. Future priorities should include efforts to reduce the first delay, address the role of traditional medicine, and review the geographic disparities in access.


Sujet(s)
Accessibilité des services de santé/normes , Procédures de chirurgie opératoire/normes , Adolescent , Adulte , Sujet âgé , Enfant , Enfant d'âge préscolaire , Urgences , Femelle , Géographie médicale , Enquêtes sur les soins de santé , Accessibilité des services de santé/statistiques et données numériques , Recherche sur les services de santé/méthodes , Humains , Nourrisson , Nouveau-né , Mâle , Adulte d'âge moyen , Acceptation des soins par les patients/statistiques et données numériques , Mesures des résultats rapportés par les patients , Facteurs socioéconomiques , Procédures de chirurgie opératoire/statistiques et données numériques , Vanuatu , Jeune adulte
12.
Neurosurgery ; 82(2): E52-E54, 2018 02 01.
Article de Anglais | MEDLINE | ID: mdl-29309638

RÉSUMÉ

Target Population: Adults with histologically proven or suspected vestibular schwannomas with neurofibromatosis type 2 (NF2). Question: What is the role of bevacizumab in the treatment of patients with vestibular schwannomas? Recommendations: Level 3: It is recommended that bevacizumab be administered in order to radiographically reduce the size or prolong tumor stability in patients with NF2 without surgical options. Level 3: It is recommended that bevacizumab be administered to improve hearing or prolong time to hearing loss in patients with NF2 without surgical options. Question: Is there a role for lapatinib, erlotinib, or everolimus in the treatment of patients with vestibular schwannomas? Recommendations: Level 3: Lapatinib may be considered for use in reducing vestibular schwannoma size and improvement in hearing in NF2. Level 3: Erlotinib is not recommended for use in reducing vestibular schwannoma size or improvement in hearing in patients with NF2. Level 3: Everolimus is not recommended for use in reducing vestibular schwannoma size or improvement in hearing in NF2. Question: What is the role of aspirin, to augment inflammatory response, in the treatment of patients with vestibular schwannomas? Target Population: Any patient with a vestibular schwannoma undergoing observation. Recommendation: Level 3: It is recommended that aspirin administration may be considered for use in patients undergoing observation of their vestibular schwannomas. Question: Is there a role for treatment of vasospasm, ie, nimodipine or hydroxyethyl starch, perioperatively to improve facial nerve outcomes in patients with vestibular schwannomas? Target Population: Adults with histologically proven or suspected vestibular schwannomas. Recommendation: Level 3: Perioperative treatment with nimodipine (or with the addition of hydroxyethyl starch) should be considered to improve postoperative facial nerve outcomes and may improve hearing outcomes. Question: Is there a role for preoperative vestibular rehab or vestibular ablation with gentamicin for patients surgically treated for vestibular schwannomas? Target Population: Adults with histologically proven or suspected vestibular schwannomas. Recommendations: Level 3: Preoperative vestibular rehabilitation is recommended to aid in postoperative mobility after vestibular schwannoma surgery. Level 3: Preoperative gentamicin ablation of the vestibular apparatus should be considered to improve postoperative mobility after vestibular schwannoma surgery. Question: Does endoscopic assistance make a difference in resection or outcomes in patients with vestibular schwannomas? Target Population: Vestibular schwannoma patients, who are surgical candidates. Inclusion in this analysis required resection utilizing the endoscope, either as the primary operative visualization or microscopic assistance with more than 20 patients treated. Recommendation: Level 3: Endoscopic assistance is a surgical technique that the surgeon may choose to use in order to aid in visualization. The full guideline can be found at: https://www.cns.org/guidelines/guidelines-management-patients-vestibular-schwannoma/chapter_9.


Sujet(s)
Neurologie/méthodes , Neurologie/tendances , Neurinome de l'acoustique/thérapie , Adulte , Humains , Résultat thérapeutique
13.
Br J Surg ; 103(11): 1453-61, 2016 Oct.
Article de Anglais | MEDLINE | ID: mdl-27428044

RÉSUMÉ

BACKGROUND: Approximately 30 per cent of the global burden of disease is surgical, and nearly one-quarter of individuals who undergo surgery each year face financial hardship because of its cost. The Lancet Commission on Global Surgery has proposed the elimination of impoverishment due to surgery by 2030, but no country-level estimates exist of the financial burden of surgical access. METHODS: Using publicly available data, the incidence and risk of financial hardship owing to surgery was estimated for each country. Four measures of financial catastrophe were examined: catastrophic expenditure, and impoverishment at the national poverty line, at 2 international dollars (I$) per day and at I$1·25 per day. Stochastic models of income and surgical costs were built for each country. Results were validated against available primary data. RESULTS: Direct medical costs of surgery put 43·9 (95 per cent posterior credible interval 2·2 to 87·1) per cent of the examined population at risk of catastrophic expenditure, and 57·0 (21·8 to 85·1) per cent at risk of being pushed below I$2 per day. The risk of financial hardship from surgery was highest in sub-Saharan Africa. Correlations were found between the risk of financial catastrophe and external financing of healthcare (positive correlation), national measures of well-being (negative correlation) and the percentage of a country's gross domestic product spent on healthcare (negative correlation). The model performed well against primary data on the costs of surgery. CONCLUSION: Country-specific estimates of financial catastrophe owing to surgical care are presented. The economic benefits projected to occur with the scale-up of surgery are placed at risk if the financial burden of accessing surgery is not addressed in national policies.


Sujet(s)
Coûts indirects de la maladie , Santé mondiale/économie , Procédures de chirurgie opératoire/économie , Coûts directs des services , Dépenses de santé , Humains , Modèles économiques , Pauvreté/économie , Caractéristiques de l'habitat/statistiques et données numériques , Appréciation des risques
14.
World J Surg ; 40(8): 1865-73, 2016 Aug.
Article de Anglais | MEDLINE | ID: mdl-27142621

RÉSUMÉ

BACKGROUND: The Pacific island nation of Vanuatu faces a number of challenges in delivering surgical care to its population. We aimed to understand and document the barriers, opportunities and required actions to improve surgical care in the country using a mixed methods analysis which incorporated the perspectives of local health stakeholders. METHODS: A baseline quantitative assessment of surgical capacity in Vanuatu was carried out using the WHO situational analysis tool. Twenty semi-structured interviews were then conducted on the two main islands (Efate and Espiritu Santo) with surgeons, allied health staff, health managers, policy-makers and other key stakeholders, using a grounded theory qualitative case study methodology. Initial informants were identified by purposive sampling followed by snowball sampling until theoretical saturation was reached. Interviews were open and axially coded with subsequent thematic analysis. RESULTS: Vanuatu faces deficits in surgical infrastructure, equipment and human resources, especially in the rural provinces. Geographic isolation, poverty and culture-including the use of traditional medicine and low health literacy-all act as barriers to patients accessing timely surgical care. Issues with governance, human resourcing and perioperative care were commonly identified by stakeholders as key challenges facing surgical services. Increasing outreach clinics, developing efficient referral systems, building provincial surgical capacity and undertaking locally led research were identified as key actions that can improve surgical care. CONCLUSION: Documenting locally identified challenges and opportunities for surgical care in Vanuatu is an important first step towards developing formal strategies for improving surgical services at the country level.


Sujet(s)
Prestations des soins de santé/organisation et administration , Chirurgie générale/organisation et administration , Urgences , Accessibilité des services de santé , Humains , Recherche qualitative , Services de santé ruraux/organisation et administration , Vanuatu , Organisation mondiale de la santé
15.
Open Neurol J ; 10: 155-163, 2016.
Article de Anglais | MEDLINE | ID: mdl-28217182

RÉSUMÉ

BACKGROUND: Aneurysmal subarachnoid hemorrhages are frequently complicated by hypertension and neurogenic myocardial stunning. Beta blockers may be used for management of these complications. We sought to investigate sympathetic nervous system modulation by beta blockers and their effect on radiographic vasospasm, delayed cerebral infarction, discharge destination and death. METHODS: Retrospective chart review of 218 adults admitted to the ICU between 8/2004 and 9/2010 was performed. Groups were identified relevant to beta blockade: 77 were never beta blocked (No/No), 123 received post-admission beta blockers (No/Yes), and 18 were continued on their home beta blockers (Yes/Yes). Records were analyzed for baseline characteristics and the development of vasospasm, delayed cerebral infarction, discharge destination and death, expressed as adjusted odds ratio. RESULTS: Of the 218 patients 145 patients developed vasospasm, 47 consequently infarcted, and 53 died or required care in a long-term facility. When compared to No/No patients, No/Yes patients had significantly increased vasospasm (OR 2.11 (1.06-4.16)). However, these patients also had significantly fewer deaths or need for long term care (OR 0.17 (0.05-0.64)), with decreased tendency for infarcts (OR 0.70 (0.32-1.55)). When compared to No/No patients, Yes/Yes patients demonstrated a trend toward increased vasospasm (OR 1.61 (0.50-5.29)) that led to infarction (OR 1.51 (0.44-5.13)), but with decreased mortality or need for long term care in a facility (OR 0.13 (0.01-1.30)). CONCLUSION: Post-admission beta blockade in aneurysmal subarachnoid hemorrhage patients was associated with increased incidence of vasospasm. However, despite the increased occurrence of vasospasm, beta blockers were associated with improved discharge characteristics and fewer deaths.

16.
J Phys Condens Matter ; 26(1): 015306, 2014 Jan 08.
Article de Anglais | MEDLINE | ID: mdl-24292208

RÉSUMÉ

The time-dependent transport through a nanoscale device consisting of a single spin-degenerate orbital with on-site Coulomb interaction, coupled to two leads, is investigated. Various gate and bias voltage time dependences are considered. The key and new point lies in the proposed way to avoid the difficulties of the usual heavy computation when dealing with two-time Green's functions within the Keldysh formalism. The time-dependent retarded dot Green's functions are evaluated, in an efficient manner within a non-canonical Hubbard I approximation. Calculations of the time-dependent current are then presented in the wide-band limit for different parameter sets. A comparison between the method and the Hartree-Fock approximation is performed as well. It is shown that the latter cannot account reliably for dynamical aspects of transport phenomena.


Sujet(s)
Transport d'électrons , Électrons , Nanofils/composition chimique , Boîtes quantiques , Théorie quantique , Simulation numérique , Modèles chimiques , Facteurs temps
17.
Aust N Z J Obstet Gynaecol ; 54(1): 13-9, 2014 Feb.
Article de Anglais | MEDLINE | ID: mdl-24033087

RÉSUMÉ

BACKGROUND: Our randomised controlled trial (RCT) found that a hysterosalpingogram (HSG) with the oil-soluble contrast medium (OSCM) lipiodol improves pregnancy rates amongst couples with unexplained and endometriosis-related infertility. These results were supported by the findings of our observational study of the first 100 women to undergo the procedure after it was offered as an innovative treatment in New Zealand from September 2003. AIM: To further assess the safety and efficacy of lipiodol procedures and present together the complete data set of the procedures performed in our RCT and those performed as innovative procedures (n = 296) prior to it being offered as a standard fertility treatment. METHODS: Women with infertility underwent a therapeutic lipiodol procedure by HSG technique with fluoroscopy X-ray screening. Primary outcomes were clinical pregnancy within six months of the procedure and live birth. RESULTS: The overall pregnancy rate for the 296 women was 40.2%. The live birth/ongoing pregnancy rate was 31.4%. The pregnancy rates for women under the age of 40 with endometriosis and unexplained infertility were 51.1 and 31.4%, respectively. CONCLUSION: Lipiodol can now be considered a standard treatment for both unexplained and endometriosis-related infertility. The precise mechanism behind the fertility-enhancing effect of lipiodol has yet to be elucidated. This study supports a mechanism of effect on the endometrium with possible enhanced receptivity of the endometrium to embryo implantation.


Sujet(s)
Produits de contraste/usage thérapeutique , Endométriose/complications , Huile éthiodée/usage thérapeutique , Infertilité féminine/thérapie , Issue de la grossesse , Adulte , Trompes utérines , Femelle , Fécondation in vitro , Humains , Hystérosalpingographie , Infertilité féminine/étiologie , Grossesse
18.
J Child Lang ; 31(3): 537-60, 2004 Aug.
Article de Anglais | MEDLINE | ID: mdl-15612389

RÉSUMÉ

The ability to understand references to the absent enables conversation to move beyond the here-and-now to matters distant in both space and time. Such understanding requires appreciating the relation between language and communicative intent: one must recognize speakers' intentions to use language to converge on a shared conversational focus that is at least somewhat independent of the current context. Despite its centrality to language development, the emergence of absent reference understanding has received little systematic attention. The present research investigated the responses of 60 infants aged 1;0 to 2 ; 6 to a researcher talking about both present and absent caregivers. When infants aged 1 ; 3 and older heard talk about absent caregivers they displayed a complex of nonverbal communicative responses that were divergent from their responses to talk about a present person. Infants aged 2 ; 0 and older provided responses indicating understanding of absent reference. The findings suggest that by 1 ; 3 infants may have at least a tacit appreciation of language as a device for coordinating conversational focus, and hint at increased sophistication in infants' absent reference comprehension skills at 2 ; 0.


Sujet(s)
Aidants , Cognition , Communication , Formation de concepts , Langage , Enfant , Enfant d'âge préscolaire , Femelle , Gestes , Humains , Nourrisson , Mâle , Sémantique
19.
Phys Rev Lett ; 93(14): 147004, 2004 Oct 01.
Article de Anglais | MEDLINE | ID: mdl-15524832

RÉSUMÉ

We present reliable many-body calculations for the t-t(')-t('')-U Hubbard model that explain in detail the results of recent angle-resolved photoemission experiments on electron-doped high-temperature superconductors. The origin of the pseudogap is traced to two-dimensional antiferromagnetic spin fluctuations whose calculated temperature-dependent correlation length also agrees with recent neutron scattering measurements. We make specific predictions for photoemission, for neutron scattering, and for the phase diagram.

20.
J Oral Rehabil ; 31(2): 135-9, 2004 Feb.
Article de Anglais | MEDLINE | ID: mdl-15009597

RÉSUMÉ

The purpose of this study was to survey the frequency of denture-related lesions of the oral mucosa in patients treated at a Brazilian dental school and to determine if the oral lesions were related to age, sex, denture type, length of denture use and denture cleaning methods. The denture-related lesions observed in this study were chronic atrophic candidiasis, chronic hyperplastic candidiasis, denture-induced fibrous inflammatory hyperplasia (FIH), traumatic ulcer, angular cheilitis and flabby ridge. The most frequent lesion, chronic atrophic candidiasis, occurred more frequently in females, in complete maxillary denture wearers, with denture use for 16-20 years. The most common method of cleaning dentures was a toothbrush and toothpaste. These results suggest that dentures can cause a wide range of lesions of the oral mucosa, that could be prevented with follow-up to evaluate dentures and provide instructions on how to maintain oral tissues healthy.


Sujet(s)
Appareils de prothèse dentaire/effets indésirables , Muqueuse de la bouche/traumatismes , Adulte , Répartition par âge , Sujet âgé , Sujet âgé de 80 ans ou plus , Brésil/épidémiologie , Candidose buccale/épidémiologie , Candidose buccale/étiologie , Prothèse dentaire complète/effets indésirables , Femelle , Humains , Mâle , Adulte d'âge moyen , Hygiène buccodentaire/méthodes , Répartition par sexe , Facteurs temps
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