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PubMed1994

Autologous bone marrow transplantation in acute lymphoblastic leukaemia.

The purpose of this review is to assess the current status of autografting in acute lymphoblastic leukaemia. In the first part of the review, the prognostic factors are discussed. Only the studies that contained adequate response and survival data were selected for analysis, including peer-reviewed articles, book chapter and proceedings of international meetings. The most current and complete references were used for series reported more than once. In the second part, some areas of discussion and controversy, such as the timing of autografting and the role of marrow purging are argued. In the last part of this review we have discussed our recent experience with blood progenitor cells collected during early haemopoietic function restoration after intensive conventional treatment for patients with cytogenetic abnormalities. The first preliminary results seem highly interesting and confirm our results achieved with the same procedure in Ph-positive chronic myelogenous leukaemia.

Adolescent↗
PubMed2006

Comparative analysis of environmental sequences: potential and challenges.

Environmental sequencing, also dubbed metagenomics, is increasingly being used to obtain insights into organismal communities in diverse habitats, and has a variety of potential applications foreseeable in biotechnology and medicine. The first public large-scale data provide already a wealth of information hidden in vast amounts of fragmented pieces of DNA from unknown species residing in these environments. Comparative sequence analysis is essential for the interpretation of such data. However, different layers of complexity that are intrinsic to each sample require the establishment of some baselines for comparison: how to normalize for the differences in phylogenetic and functional diversity, how to avoid biases from incomplete data, and how to deal with differences in species dominance or genome sizes? Here we discuss a few of these items and delineate some simple discriminative sequence properties for four distinct habitats.

Biodiversity↗
PubMed2005

Sleep architecture in children with idiopathic generalized epilepsy.

PURPOSE: Children with epilepsy experience sleep disturbances, behavioral and attentional problems at higher rates than their peers. However, the relation between sleep disturbances and the observed behavioral and attentional abnormalities is poorly defined. METHODS: Children with primary generalized epilepsy who were seizure free and between the ages of 5 and 18 years were matched with age- and gender-matched healthy controls and underwent two consecutive nights of nocturnal polysomnography with extended electroencephalography. Connor's Continuous Performance Test (CPT) was administered to assess daytime attentional function. Parents completed the Child Behavior Checklist (CBCL) to assess their emotional-behavioral status. Two sample t tests were used to examine group differences. Spearman correlations were used to examine the relation between sleep variables and behavior and attention variables. Multiple regression analysis was used to identify independent predictors of abnormal behavior and attention among patients. RESULTS: Eleven children with primary generalized epilepsy and eight age- and sex-matched controls participated in the study. Children with epilepsy had longer stage 1 sleep percentage (7.19 +/- 3.2 vs. 4.8 +/- 3.5; p = 0.05) and latency to rapid-eye-movement (REM) sleep (123.5 +/- 40.1 vs. 101.75 +/- 24.3; p = 0.018) compared with controls. Children with epilepsy had worse attention (CPT index, 10.94 +/- 6.55 vs. 3.42 +/- 4.04; p = 0.004) and exhibited significantly higher CBCL Total Behavior and Internalizing Behavior Problem scales. Whereas regression analysis showed no independent predictors of abnormal behavior and attention, a tendency toward association between CBCL total behavior scale and REM percentage (r= 0.55; p = 0.07), and between CPT overall index and stage 1 sleep percentage (r= 0.40; p = 0.10) was noted. CONCLUSIONS: Sleep architecture is abnormal in children with primary generalized epilepsy. Further studies are needed to determine whether abnormalities in sleep architecture contribute to poor daytime behavior and attention.

Adolescent↗
PubMed1994

Physical conditioning in children with arthritis: Assessment and guidelines for exercise prescription.

OBJECTIVE: To review the literature in the area of physical fitness and conditioning programs for individuals with chronic illnesses, and increase the awareness of the need to include fitness testing and conditioning programs in the therapeutic management of children and adolescents with chronic arthritis. METHODS: This article provides a review of original research reports, information from principal texts, and review articles related to physical fitness testing and training in children. RESULTS: Several factors limit the exercise capacity of children with chronic arthritis, and studies report that these children have lower aerobic endurance and muscle performance than their peers. Preliminary studies suggest that fitness testing is safe for most children with arthritis, and physical conditioning programs, which appear to benefit adults with arthritis and children with other chronic illnesses, may also benefit children with arthritis. Easily administered, inexpensive field tests of fitness are available. Guidelines for prescribing physical conditioning programs are provided. The risks and benefits of increased exercise are discussed. CONCLUSIONS: Assessment of exercise capacity and muscle function and individualized prescription of physical conditioning programs are indicated for children with chronic arthritis, soon after diagnosis.

Arthritis, Juvenile↗
PubMed2006

Social effectiveness therapy for children: five years later.

Social Effectiveness Therapy for Children (SET-C) is a comprehensive behavioral treatment combining social skills training, peer generalization experiences, and individualized in vivo exposure for the treatment of social phobia in youth. SET-C results in positive treatment outcome and its effects are maintained at least 3 years later. In this investigation, maintenance of treatment gains 3, 4, and 5 years later was examined using a multidimensional assessment strategy consisting of self-report, parental report, clinician ratings, and direct behavioral assessment. Furthermore, the overall functioning of adolescents treated with SET-C 5 years earlier was compared with that of a group of adolescents who never suffered from psychological disorders. All posttreatment gains were maintained 5 years later, and the general functioning of SET-C treatment responders was not significantly different from those who never had a disorder. The data indicate that SET-C results in long-term positive effects for youth suffering from social phobia.

Adolescent↗
PubMed2002

Establishing a standardized clinical assessment tool of pathologic and prosthetic hand function: normative data, reliability, and validity.

OBJECTIVE: To develop a new assessment procedure, the Southampton Hand Assessment Procedure (SHAP), that allows contextual results of hand function to be obtained readily in a clinical environment. DESIGN: Reliability (test-retest, interrater) and validity (criterion, content) of new assessment procedure against standard medical outcome measure techniques. SETTING: Normative data collected in a university laboratory. PARTICIPANTS: Twenty-four volunteers selected on the basis of optimum hand function using these criteria: age (range, 18-25 y), and no adverse hand trauma, neurologic condition, or disabling effects of the upper limb. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The normative control group was assessed for variability, and the procedure measured in terms of interrater and test-retest reliability. The absence of a direct comparison prevents a criterion standard from being established; however, content validity was shown by expert peer review. RESULTS: The control group data were shown to be multivariate gaussian; test-retest and interrater reliability were demonstrated at the 95% confidence level. The content validity was demonstrated by peer panel approval. CONCLUSIONS: Results of the control group established the statistical integrity of SHAP. Clinical trials are underway, although more extensive use of the procedure is advocated in primary care and rehabilitation centers where physiotherapy and occupational therapy are actively used in hand rehabilitation.

Activities of Daily Living↗
PubMed1996

Geriatric oral health and its impact on eating.

OBJECTIVE: Adequate food and fluid intake and nutritional health are requisites for sustaining life. The oral-pharyngeal region has evolved multiple, highly regulated processes to ensure that the intake, chewing, and swallowing of foods and beverages is maintained. The objective of this paper is to identify the independent and collective roles of oral health on eating in older people. DESIGN: Research reports from peer-reviewed scientific journals. Hypothesis-driven research that objectively examined taste, smell, dental and oral mucosal health, dental prostheses, chewing, and swallowing in the context of aging. DATA EXTRACTION AND SYNTHESIS: Data results were extracted independently by multiple observers. A qualitative synthesis of data results from independent studies was made in order to form conclusions regarding the role of oral health on eating in older people. CONCLUSIONS: Many oral functions remain intact in healthy older adults. However, significant alterations arise from oral and systemic diseases and their treatments, and these may have a profound effect on eating, drinking, and the nutritional status of older individuals. The care of older persons with smell, taste, dental/alveolar, oral mucosal, chewing, and swallowing problems requires a multidisciplinary team of health care providers. Recognition of the interrelationship between oral, pharyngeal, and systemic physiological processes will help practitioners identify the etiology of these disorders and implement appropriate therapy.

Aged↗
PubMed1996

Metamemorial functioning of children with moderate learning difficulties.

This study investigates whether children with moderate learning difficulties (MLDs) have a knowledge of which mnemonic strategies are available and applicable across a range of hypothetical memory tasks. The study compared the strategic awareness of 20 MLD and 20 typical children. Recall tasks were varied to include both discrete, abstract or context free items (described as 'non-authentic') and meaningful items (described as 'authentic'). The results suggest that, when required to make strategic judgments relating to the recall of non-authentic items, MLD children are significantly less efficient than their typical peers. Under these task conditions, the modal strategy mentioned was of the 'look/think/say' variety. By way of contrast, when required to make strategic judgments relating to the recall of authentic items the MLD children demonstrated mnemonic awareness that was equal to that of their typical peers. The implications of this for the design of strategy training programmes are discussed, with particular reference to the need to utilise the mnemonic awareness already at the disposal of MLD children.

Child↗
PubMed2005

Octogenarians undergoing cardiac surgery outlive their peers: a case for early referral.

OBJECTIVE: To examine short and long term outcomes of octogenarians having heart operations and to analyse the interaction between patient and treatment factors. METHODS: Multivariate analysis of prospectively collected data and a survival comparison with an age and sex matched national population. The outcomes were base in-hospital mortality, risk stratified by logistic EuroSCORE (European system for cardiac operative risk evaluation), and long term survival. RESULTS: 12,461 consecutive patients (706 over 80 years) operated on between 1996 and 2003 in a regional UK unit were studied. Octogenarians more often had impaired ventricular function, pulmonary hypertension, and valve operations. They also included a higher proportion of women, had a higher serum creatinine concentration, and had a trend towards more unstable angina. Younger patients had a higher prevalence of previous cardiac operation, previous myocardial infarction, and diabetes. The in-hospital mortality rate was 3.9% for all patients (EuroSCORE predicted 6.1%, p < 0.001) and 9.8% for octogenarians (predicted 14.1%, p = 0.002). Long bypass time and non-elective surgery increased the risk of death above EuroSCORE prediction in both groups. A greater proportion of octogenarians stayed in intensive care more than 24 hours (37% v 23%, p < 0.001). Long term survival was significantly better in the study patients than in a general population with the same age-sex distribution (survival rate at five years 82.1% v 55.9%, p < 0.001). CONCLUSIONS: Cardiac surgery in a UK population of octogenarians produced excellent results. Elective referrals should be encouraged in all age groups.

Age Factors↗
PubMed2000

Cardiopulmonary exercise performance in prematurely born children.

Prematurely born children have reduced peak VO2 compared with their peers, inferentially attributed to ventilatory limitation. The primary purpose of this study was to compare exercise ventilation and cardiac output in a sample of childhood survivors of lung disease of prematurity with those of a control group to elucidate reasons for lower peak VO2. A secondary aim was to describe and compare the ventilatory response to incremental exercise. Thirty-two children, aged 8-9 y, were recalled for lung function and progressive exercise tests. Fifteen of them also performed submaximal exercise with measurement of cardiac output (indirect [CO2] Fick) and physiologic dead space. Results were compared with those of term-born, age- and sex-matched, control children. Pulmonary function tests showed mild airflow limitation. Peak VO2 was lower in prematurely born children compared with control children, and was correlated with lean body mass. Their heart rate-VO2 relationship and stroke volume were similar to that of term-born control children. Children with a history of bronchopulmonary dysplasia and hyaline membrane disease as infants exhibited greater exercise hyperpnea than did healthy control children, because of higher breathing frequency, and maintained lower end-tidal PCO2 during submaximal exercise. Physiologic dead space normalized for body weight was similar in preterm and term-born children. Lower peak VO2 in this population is not caused by cardiopulmonary factors, but is best predicted by lean body mass. Ventilation did not limit exercise performance, although it appears that breathing during exercise is regulated differently in prematurely born children than in term-born children.

Birth Weight↗
PubMed2000

Beyond IQ: broad-based measurement of individual success potential or "emotional intelligence".

Individual-difference correlates of life success were studied using 302 participants aged 17-46 years (107 men, 195 women) and 31 individual-difference measures. Factor 1 (Relaxed Temperament) included Trait Pleasure-Displeasure (+), Anxiety (-), Depression (-), Optimism (+), Self-Esteem (+), Covert Index of Employee Reliability (+), and Functional Flexibility (-). Positively loading scales on Factor 2 (Arousable Temperament) were Trait Arousability, Emotional Empathy, Emotional Thinking, and Affiliative Tendency. Factor 3 (Disciplined Goal Orientation) included Delay of Gratification (+), Impulsivity (-), Procrastination (-), Patience (+), Integrity (+), Adaptive Coping (+), and Intelligence (+). Positively loading scales on Factor 4 (Dominant Temperament) were Trait Dominance-Submissiveness, Social Competence, Achieving Tendency, and Self-Actualization. Factors 1, 3, 4, and intelligence exhibited positive relations with all peer-rated criterion measures of life success. Trait Arousability, representing Factor 2, correlated negatively with relationship, physical, work, and overall success. Physical attractiveness correlated positively with all success measures except emotional success. When success measures were regressed against intelligence and personality scales or factors, intelligence did not account for variance beyond that explained by personality.

Adolescent↗
PubMed1997

What should biomedical sciences education in dental schools achieve?

Education for the first professional degree in dentistry is intended to produce graduates capable of offering a wide range of high quality dental services to the general public. More than that, it is expected that graduates will be firmly grounded in the scientific basis for their professional practices and be equipped to evaluate critically and integrate selectively new scientific findings that emerge during their professional lifetimes. In addition, they are expected to be able to work effectively with diverse patient populations and to conduct their practices with a high level of sensitivity to the ethical and psychosocial dimensions of patient care. Indiana University School of Dentistry has undergone a process of curriculum reform that has yielded a new first professional degree program. Its hallmarks are large, multidisciplinary courses (seven courses in the first two years) that are taught using a variety of strategies including problem-based learning in small groups as well as lectures. The biomedical sciences curriculum is concept-based. Students will demonstrate their understanding of science concepts and methods by applying them to the solution of research and health care problems. Biomedical sciences will be taught at a level that will provide a comprehensive understanding of the functioning of the human body in health and disease, allow students to assimilate the coming revolution in molecular medicine, and selectively use new diagnostics, preventives, and therapeutics that evolve as molecular biological technologies yield solutions to current medical and dental problems. Using the biomedical sciences curriculum as a vehicle, we will also achieve the goal of training dentists as critical thinkers, problem solvers, lifelong learners, and ethical practitioners, skillful in peer and self-evaluation, and cognizant of the psychosocial as well as biomedical perspective of health and disease.

Biological Science Disciplines↗
PubMed2003

Low-cost on-the-job peer training of nurses improved immunization coverage in Indonesia.

In Indonesia responsibility for immunizations is placed on local government health centres and on the nurses who provide the immunizations at each centre. An on-the-job peer training programme for these nurses, which was designed to improve the immunization performance of poorly performing health centres in terms of coverage and practice in Maluku province, was evaluated. Experienced immunization nurses were sent to health centres where nurses were inexperienced or performing poorly; the experienced nurses spent 1-2 weeks providing on-the-job training for the less experienced ones. An evaluation of the 13 centres that participated in the programme and the 95 that did not found that the programme increased both immunization coverage and the quality of practice. Coverage of diphtheria/pertussis/tetanus (DPT), polio, and measles vaccinations rose by about 39% in all 13 participating centres when compared with non-participating centres, and by about 54% in the 11 centres that had a functioning transportation system during the year after training. These results reflect increases in the actual number of doses given and improvements in the accuracy of reports. Potential threats to the study's validity were examined and found not to be significant. The out-of-pocket cost of the training programme was about US$ 53 per trainee or about US$ 0.05 per additional vaccine reported to have been given. The marginal cost per additional fully immunized child was estimated to be US$ 0.50.

Cost-Benefit Analysis↗
PubMed2007

A cross-cultural study of gambling behaviour among adolescents.

This study investigated whether the prevalence of weekly and problem gambling among youth varied according to cultural affiliation. A convenience sample of 1,265 Quebec high school students aged 12-18 was divided into three linguistic groupings: Anglophone (English), Francophone (French), and Allophone (other). Results revealed that the Allophone grouping contained the highest proportion of youth who gambled on a weekly basis and who reported gambling problems, followed by the Anglophone, and finally the Francophone groupings. Acculturation difficulties were associated with problem gambling. Few meaningful between-group differences were found with respect to factors related to problem gambling (i.e., comorbidity with other risk factors, coping, family functioning and resiliency). The results are discussed with respect to the influence of cultural background on gambling behavior.

Adolescent↗
PubMed2006

Gene functional annotation by statistical analysis of biomedical articles.

BACKGROUND: Functional annotation of genes is an important task in biology since it facilitates the characterization of genes relationships and the understanding of biochemical pathways. The various gene functions can be described by standardized and structured vocabularies, called bio-ontologies. The assignment of bio-ontology terms to genes is carried out by means of applying certain methods to datasets extracted from biomedical articles. These methods originate from data mining and machine learning and include maximum entropy or support vector machines (SVM). PURPOSE: The aim of this paper is to propose an alternative to the existing methods for functionally annotating genes. The methodology involves building of classification models, validation and graphical representations of the results and reduction of the dimensions of the dataset. METHODS: Classification models are constructed by Linear discriminant analysis (LDA). The validation of the models is based on statistical analysis and interpretation of the results involving techniques like hold-out samples, test datasets and metrics like confusion matrix, accuracy, recall, precision and F-measure. Graphical representations, such as boxplots, Andrew's curves and scatterplots of the variables resulting from the classification models are also used for validating and interpreting the results. RESULTS: The proposed methodology was applied to a dataset extracted from biomedical articles for 12 Gene Ontology terms. The validation of the LDA models and the comparison with the SVM show that LDA (mean F-measure 75.4%) outperforms the SVM (mean F-measure 68.7%) for the specific data. CONCLUSION: The application of certain statistical methods can be beneficial for functional gene annotation from biomedical articles. Apart from the good performance the results can be interpreted and give insight of the bio-text data structure.

Abstracting and Indexing↗
PubMed1991

Social and psychological consequences, at 10 years old, of an earlier onset of self-reported delinquency.

In this paper we will answer the following question: what are the consequences of an earlier onset of delinquency on competence several years after onset? Rather than studying the social and psychological predictors of an early onset, we will be interested in the impact of the age of onset of self-reported delinquency on the social and personal adaptation of boys at age 10, social and personal adaptation referring to the broad concepts of competence--"having the requisite or adequate capacity or qualities to function or develop in a particular way" or "sufficiency of means for the necessities and conveniences of life."

Achievement↗
PubMed2004

Gene expression profiling of the rat superior olivary complex using serial analysis of gene expression.

The superior olivary complex (SOC) is an auditory brainstem region that represents a favourable system to study rapid neurotransmission and the maturation of neuronal circuits. Here we performed serial analysis of gene expression (SAGE) on the SOC in 60-day-old Sprague-Dawley rats to identify genes specifically important for its function and to create a transcriptome reference for the subsequent identification of age-related or disease-related changes. Sequencing of 31 035 tags identified 10 473 different transcripts. Fifty-seven per cent of the unique tags with a count greater than four were statistically more highly represented in the SOC than in the hippocampus. Among them were genes encoding proteins involved in energy supply, the glutamate/glutamine shuttle, and myelination. Approximately 80 plasma membrane transporters, receptors, channels, and vesicular transporters were identified, and 25% of them displayed a significantly higher expression level in the SOC than in the hippocampus. Some of the plasma membrane proteins were not previously characterized in the SOC, e.g. the purinergic receptor subunit P2X(6) and the metabotropic GABA receptor Gpr51. Differential gene expression between SOC and hippocampus was confirmed using RNA in situ hybridization or immunohistochemistry. The extensive gene inventory presented here will alleviate the dissection of the molecular mechanisms underlying specific SOC functions and the comparison with other SAGE libraries from brain will ease the identification of promoters to generate region-specific transgenic animals. The analysis will be part of the publicly available database ID-GRAB.

Animals↗
PubMed2002

Relationship between premorbid functioning and symptom severity as assessed at first episode of psychosis.

OBJECTIVE: Investigating the relationship between premorbid and prodromal status and the clinical manifestations of the first psychotic episode is relevant for understanding the pathophysiology of psychosis and for improving management of the disease. This study examined patterns of premorbid functioning of persons interviewed during their first episode of psychotic illness and examined the relationship of premorbid characteristics with symptom severity and cognitive functioning during the first illness episode. METHOD: The data were derived from the baseline assessments of a multicenter international drug trial that enrolled 535 patients in their first episode of psychosis. Subjects' scores on the Premorbid Adjustment Scale were used to assign them to groups according to whether their premorbid functioning was stable-good, stable-poor, or deteriorating. The three groups' scores on the Positive and Negative Syndrome Scale, Clinical Global Impression (CGI) severity scale, and a cognitive battery were compared. RESULTS: Almost half of the patients (47.5%) had stable-good premorbid functioning, 37.3% had stable-poor premorbid functioning, and 15.1% had initially good, but later deteriorating, premorbid functioning. Compared to the stable-poor and deteriorating groups, the stable-good group had lower (better) negative syndrome and general psychopathology scores on the Positive and Negative Syndrome Scale and a lower CGI severity scale score. Differences between the stable-poor and stable-good groups were also found on some cognitive measures and on the positive syndrome subscale of the Positive and Negative Syndrome Scale. CONCLUSIONS: More than half of the subjects, who were interviewed during their first episode of psychotic disorder, had evident premorbid behavioral disturbances. Poor premorbid functioning before onset of psychosis was associated with more severe symptoms and more severe cognitive manifestations of illness during the first illness episode.

Achievement↗

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