Showing papers by "Suffolk University published in 2013"

The Digital MIQE Guidelines: Minimum Information for Publication of Quantitative Digital PCR Experiments

Abstract: There is growing interest in digital PCR (dPCR) because technological progress makes it a practical and increasingly affordable technology. dPCR allows the precise quantification of nucleic acids, facilitating the measurement of small percentage differences and quantification of rare variants. dPCR may also be more reproducible and less susceptible to inhibition than quantitative real-time PCR (qPCR). Consequently, dPCR has the potential to have a substantial impact on research as well as diagnostic applications. However, as with qPCR, the ability to perform robust meaningful experiments requires careful design and adequate controls. To assist independent evaluation of experimental data, comprehensive disclosure of all relevant experimental details is required. To facilitate this process we present the Minimum Information for Publication of Quantitative Digital PCR Experiments guidelines. This report addresses known requirements for dPCR that have already been identified during this early stage of its development and commercial implementation. Adoption of these guidelines by the scientific community will help to standardize experimental protocols, maximize efficient utilization of resources, and enhance the impact of this promising new technology.

Climate Change and Range Expansion of the Asian Tiger Mosquito (Aedes albopictus) in Northeastern USA: Implications for Public Health Practitioners

Abstract: The Asian tiger mosquito, Aedes albopictus (Skuse), is an invasive species with substantial biting activity, high disease vector potential, and a global distribution that continues to expand. New Jersey, southern New York, and Pennsylvania are currently the northernmost boundary of established Ae. albopictus populations in the eastern United States. Using positive geographic locations from these areas, we modeled the potential future range expansion of Ae. albopictus in northeastern USA under two climate change scenarios. The land area with environmental conditions suitable for Ae. albopictus populations is expected to increase from the current 5% to 16% in the next two decades and to 43%–49% by the end of the century. Presently, about one-third of the total human population of 55 million in northeastern USA reside in urban areas where Ae. albopictus is present. This number is predicted to double to about 60% by the end of the century, encompassing all major urban centers and placing over 30 million people under the threat of dense Ae. albopictus infestations. This mosquito species presents unique challenges to public health agencies and has already strained the resources available to mosquito control programs within its current range. As it continues to expand into areas with fewer resources and limited organized mosquito control, these challenges will be further exacerbated. Anticipating areas of potential establishment, while planning ahead and gathering sufficient resources will be the key for successful public health campaigns. A broad effort in community sanitation and education at all levels of government and the private sector will be required until new control techniques are developed that can be applied efficiently and effectively at reasonable cost to very large areas.

Concurrent naltrexone and prolonged exposure therapy for patients with comorbid alcohol dependence and PTSD: a randomized clinical trial.

Abstract: Importance Alcohol dependence comorbid with posttraumatic stress disorder (PTSD) has been found to be resistant to treatment. In addition, there is a concern that prolonged exposure therapy for PTSD may exacerbate alcohol use. Objective To compare the efficacy of an evidence-based treatment for alcohol dependence (naltrexone) plus an evidence-based treatment for PTSD (prolonged exposure therapy), their combination, and supportive counseling. Design, Setting, and Participants A single-blind, randomized clinical trial of 165 participants with PTSD and alcohol dependence conducted at the University of Pennsylvania and the Philadelphia Veterans Administration. Participant enrollment began on February 8, 2001, and ended on June 25, 2009. Data collection was completed on August 12, 2010. Interventions Participants were randomly assigned to (1) prolonged exposure therapy plus naltrexone (100 mg/d), (2) prolonged exposure therapy plus pill placebo, (3) supportive counseling plus naltrexone (100 mg/d), or (4) supportive counseling plus pill placebo. Prolonged exposure therapy was composed of 12 weekly 90-minute sessions followed by 6 biweekly sessions. All participants received supportive counseling. Main Outcomes and Measures The Timeline Follow-Back Interview and the PTSD Symptom Severity Interview were used to assess the percentage of days drinking alcohol and PTSD severity, respectively, and the Penn Alcohol Craving Scale was used to assess alcohol craving. Independent evaluations occurred prior to treatment (week 0), at posttreatment (week 24), and at 6 months after treatment discontinuation (week 52). Results Participants in all 4 treatment groups had large reductions in the percentage of days drinking (mean change, −63.9% [95% CI, −73.6% to −54.2%] for prolonged exposure therapy plus naltrexone; −63.9% [95% CI, −73.9% to −53.8%] for prolonged exposure therapy plus placebo; −69.9% [95% CI, −78.7% to −61.2%] for supportive counseling plus naltrexone; and −61.0% [95% CI, −68.9% to −53.0%] for supportive counseling plus placebo). However, those who received naltrexone had lower percentages of days drinking than those who received placebo (mean difference, 7.93%; P = .008). There was also a reduction in PTSD symptoms in all 4 groups, but the main effect of prolonged exposure therapy was not statistically significant. Six months after the end of treatment, participants in all 4 groups had increases in percentage of days drinking. However, those in the prolonged exposure therapy plus naltrexone group had the smallest increases. Conclusions and Relevance In this study of patients with alcohol dependence and PTSD, naltrexone treatment resulted in a decrease in the percentage of days drinking. Prolonged exposure therapy was not associated with an exacerbation of alcohol use disorder. Trial Registration clinicaltrials.gov Identifier:NCT00006489

Impacts of climate change on the complex life cycles of fish

Abstract: To anticipate the response of fish populations to climate change, we developed a framework that integrates requirements in all life stages to assess impacts across the entire life cycle. The framework was applied on plaice (Pleuronectes platessa) and Atlantic herring (Clupea harengus) in the North Sea, Atlantic cod (Gadus morhua) in the Norwegian/Barents Seas and European anchovy (Engraulis encrasicolus) in the Bay of Biscay. In each case study, we reviewed habitats required by each life stage, habitat availability, and connectivity between habitats. We then explored how these could be altered by climate change. We documented environmental processes impacting habitat availability and connectivity, providing an integrated view at the population level and in a spatial context of potential climate impacts. A key result was that climate-driven changes in larval dispersion seem to be the major unknown. Our summary suggested that species with specific habitat requirements for spawning (herring) or nursery grounds (plaice) display bottlenecks in their life cycle. Among the species examined, anchovy could cope best with environmental variability. Plaice was considered to be least resilient to climate-driven changes due to its strict connectivity between spawning and nursery grounds. For plaice in the North Sea, habitat availability was expected to reduce with climate change. For North Sea herring, Norwegian cod and Biscay anchovy, climate-driven changes were expected to have contrasting impacts depending on the life stage. Our review highlights the need to integrate physiological and behavioural processes across the life cycle to project the response of specific populations to climate change.

The Impact of Social Contagion on Non-Suicidal Self-Injury: A Review of the Literature

Abstract: In this review, we explore social contagion as an understudied risk factor for non-suicidal self-injury (NSSI) among adolescents and young adults, populations with a high prevalence of NSSI. We review empirical studies reporting data on prevalence and risk factors that, through social contagion, may influence the transmission of NSSI. Findings in this literature are consistent with social modeling/learning of NSSI increasing risk of initial engagement in NSSI among individuals with certain individual and/or psychiatric characteristics. Preliminary research suggests iatrogenic effects of social contagion of NSSI through primary prevention are not likely. Thus, social contagion factors may warrant considerable empirical attention. Intervention efforts may be enhanced, and social contagion reduced, by implementation of psychoeducation and awareness about NSSI in schools, colleges, and treatment programs.

A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder.

Abstract: Generalized anxiety disorder (GAD) is a chronic anxiety disorder associated with high comorbidity (Bruce, Machan, Dyck, & Keller, 2001), reduced quality of life (Hoffman, Dukes, & Wittchen, 2008) and significant health care utilization (Hoffman et al., 2008). Meta-analyses reveal that cognitive behavioral therapies are efficacious for GAD (Borkovec & Ruscio, 2001; Covin, Ouimet, Seeds, & Dozois, 2008). However, GAD remains one of the least successfully treated of the anxiety disorders (Waters & Craske, 2005), with most studies finding that fewer than 65% of clients meet criteria for high end-state functioning at post-treatment (e.g., Ladouceur et al., 2000; Newman et al., 2011) and few studies examining the impact of treatment on quality of life. Several researchers have aimed to refine and expand existing models of GAD in an effort to more clearly identify causal and maintaining factors to target in therapy (see Behar, DiMarco, Hekler, Mohlman, & Staples, 2009, for a review). Recent randomized controlled trials informed by these models indicate that targeting intolerance of uncertainty (Dugas et al., 2010), and the interpersonal and emotion focused aspects of GAD (Newman et al., 2011) yield effects comparable to existing CBTs for GAD. A small pilot study found that targeting meta-cognition in GAD (Wells et al., 2010) produced better outcomes than applied relaxation, however, the very low rates of response to applied relaxation, coupled with the small sample size, indicate a need for further research to confirm this finding. Roemer and Orsillo (2002) developed a model of GAD informed by research and theory highlighting the potential roles of experiential avoidance (e.g., Hayes, Wilson, Gifford, Follette & Strosahl, 1996) and ruminative, self-critical processing (e.g., Barnard & Teasdale, 1991) in the development and maintenance of psychopathology. Supported by research comparing individuals with and without GAD, this model suggests that those with GAD have a problematic relationship with their internalized experiences characterized by a narrowed attention toward threat (Bar-Haim, Lamy, Pergamin, Bakermans-Kranenburg, & van IJzendoorn, 2007), and a critical, judgmental reactivity toward their emotional responses (e.g., Lee, Orsillo, Roemer, & Allen, 2010; Llera & Newman, 2010; Mennin, Heimberg, Turk, & Fresco, 2005) and thoughts (Wells & Carter, 1999). This reaction to internal experiences motivates individuals with GAD to engage in experiential avoidance (e.g., Lee et al., 2010) using a variety of strategies including worry, the central defining feature of GAD. Although worry decreases somatic arousal and helps to distract an individual from more emotional topics (see Borkovec, Alcaine, & Behar, 2004, for a review), rigid habitual efforts at experiential avoidance can paradoxically increase distress (e.g., Hayes et al., 1996), leading to a cycle of reactivity and avoidance that in turn affects behavior. Individuals with GAD are less likely to consistently engage in behaviors that are important to them (i.e., valued actions) and as a result experience a diminished quality of life (Michelson, Lee, Orsillo, & Roemer, 2011). This model led to the development of an acceptance based behavior therapy for GAD (ABBT; Roemer & Orsillo, 2009; Roemer & Orsillo, In press), a flexible treatment adapted from traditional CBT for GAD (e.g., Borkovec et al., 2004), as well as other acceptance-based behavioral therapies including Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999), Mindfulness-based Cognitive Therapy (MBCT; Segal, Williams, & Teasdale, 2002), and Dialectical Behavior Therapy (Linehan, 1993), that explicitly target these mechanisms1. Specifically, this ABBT aims to help clients to cultivate an expanded (as opposed to narrowed, threat-focused) awareness along with a compassionate (as opposed to judgmental) and decentered (as opposed to seeing thoughts and feelings as all-encompassing indicators of truth) stance towards internal experiences. These new skills reduce rigid experiential avoidance, as does the explicit promotion of an accepting and willing stance towards internal experiences. Behavioral avoidance and constriction are targeted by encouraging clients to identify and mindfully engage in personally meaningful actions. ABBT uses empathic validation, self-monitoring, formal and informal mindfulness exercises, encouragement of acceptance through psychoeducation and experiential exercises, and writing and behavioral exercises that apply these skills to personally meaningful activities (see Roemer & Orsillo, 2009; in press, for a more detailed presentation of the treatment). Data from an open trial (Roemer & Orsillo, 2007) and waitlist RCT (Roemer, Orsillo, & Salters-Pedneault, 2008) indicate significant effects on clinician-rated and self-report symptom measures of anxiety and depression, as well as self-reported quality of life and high rates of end-state functioning. Clients receiving ABBT report significant decreases in experiential avoidance (Roemer et al., 2008), distress about emotional responses, and intolerance of uncertainty (Treanor, Erisman, Salters-Pedneault, Orsillo, & Roemer, 2011) and significant increases in values-consistent behavior (Michelson et al., 2011). Moreover, both the time spent accepting internal experiences and engaging in valued activities significantly predict outcome (Hayes, Orsillo, & Roemer, 2010) providing support for the proposed mechanisms of action. However, studies are needed that compare this treatment to a credible, efficacious alternative therapy. Other acceptance- and mindfulness-based treatments have also been tested for GAD. A recent study comparing ACT to CBT (with behavioral exposures in both conditions) showed comparable effects of the two treatments, with the 14 individuals with GAD who received ACT demonstrating medium to large effects on outcome measures (Arch et al., 2012). Similarly, in a study of older adults with GAD, the seven individuals receiving ACT demonstrated large effect sizes on outcome measures, which were comparable to the nine individuals receiving CBT in this study (Wetherell et al., 2011). A recent meta-analysis demonstrated the promise of mindfulness-based interventions in reducing anxiety generally (Hofmann, Sawyer, Witt, & Oh, 2010), and two preliminary trials of MBCT suggest an effect of treatment on self-reported GAD symptoms (Craigie, Rees, Marsh, & Nathan, 2008; Evans et al., 2008), although outcomes fell short relative to other GAD treatment trials. Unlike ACT and ABBT, MBCT did not incorporate behavioral strategies, which may partly explain the more modest effects. While findings for ABBT are promising, previous studies were limited by absence of an active control condition and modest sample sizes. To more rigorously test ABBT, this study compared ABBT to an established and efficacious treatment, Applied Relaxation (AR). AR is an empirically supported treatment for GAD (Chambless & Ollendick, 2001) and is recommended in the NICE clinical guideline 113 (National Collaborating Centre for Mental Health and the National Collaborating Centre for Primary Care, 2011). This status comes from several methodologically rigorous studies that have examined the efficacy of AR. For example, randomized controlled trials demonstrated that AR was more efficacious than a nondirective, reflective listening therapy (Borkovec & Costello, 1993) and roughly as efficacious as cognitive therapy (Arntz, 2003; Ost & Breitholtz, 2000), cognitive behavioral therapy (Borkovec & Costello, 1993; Dugas et al., 2010), and worry exposure (Hoyer et al., 2009) in treating GAD. Further supporting the efficacy of AR, a meta-analysis by Siev and Chambless (2007) found that cognitive therapy and relaxation therapy were equivalent treatments for GAD. AR is also straightforward and relatively easy to learn, which increases the probability that therapists can deliver it with good adherence and competence. In the spirit of a comparative efficacy trial, we hypothesized that both ABBT and AR would lead to statistically and clinically significant change but that ABBT would be more efficacious than AR on measures of anxiety and quality of life. Additionally, because the processes targeted in ABBT are presumed to underlie many forms of psychopathology, we hypothesized that ABBT would be associated with greater decreases in depression and comorbidity than AR. Finally, we hypothesized that the treatments would be comparably credible and acceptable to participants.

Examination of Cognitive Fatigue in Multiple Sclerosis using Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging

Abstract: The present study investigated the neural correlates of cognitive fatigue in Multiple Sclerosis (MS), looking specifically at the relationship between self-reported fatigue and objective measures of cognitive fatigue. In Experiment 1, functional magnetic resonance imaging (fMRI) was used to examine where in the brain BOLD activity covaried with “state” fatigue, assessed during performance of a task designed to induce cognitive fatigue while in the scanner. In Experiment 2, diffusion tensor imaging (DTI) was used to examine where in the brain white matter damage correlated with increased “trait” fatigue in individuals with MS, assessed by the Fatigue Severity Scale (FSS) completed outside the scanning session. During the cognitively fatiguing task, the MS group had increased brain activity associated with fatigue in the caudate as compared with HCs. DTI findings revealed that reduced fractional anisotropy in the anterior internal capsule was associated with increased self-reported fatigue on the FSS. Results are discussed in terms of identifying a “fatigue-network” in MS.

Predictors of Intimate Partner Violence Revictimization: The Relative Impact of Distinct PTSD Symptoms, Dissociation, and Coping Strategies

Abstract: Psychological distress and coping strategies following intimate partner violence (IPV) victimization may impact survivors' risk for future IPV. The current study prospectively examined the impact of distinct posttraumatic stress disorder (PTSD) symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal), dissociation, and coping strategies (engagement and disengagement coping) on IPV revictimization among recently abused women. Women (N = 69) who were seeking services for IPV and experienced their most recent episode of physical IPV between 2 weeks and 6 months prior to study enrollment completed measures of physical IPV, psychological distress, and coping strategies at baseline and at 6-month follow-up. The women averaged 36 years of age and 67% of the sample was African American. Separate Poisson regression analyses revealed that PTSD hyperarousal symptoms, dissociation, engagement coping, and disengagement coping each significantly predicted physical IPV revictimization at the 6-month follow-up (with effect sizes ranging from a 1.20-1.34 increase in the likelihood of Time 2 physical IPV with a 1 SD increase in the predictor). When these significant predictors were examined together in a single Poisson regression model, only engagement and disengagement coping were found to predict physical IPV revictimization such that disengagement coping was associated with higher revictimization risk (1.29 increase in the likelihood of Time 2 physical IPV with one SD increase in disengagement coping) and engagement coping was associated with lower revictimization risk (1.30 decrease in the likelihood of Time 2 physical IPV with one SD increase in engagement coping). The current findings suggest that coping strategies are important and potentially malleable predictors of physical IPV revictimization.

When Do Employees Speak up for Their Customers? A Model of Voice in a Customer Service Context

Abstract: We develop a conceptual model of customer-focused voice and test it in a hospital setting. Drawing from theory and research on voice, we find that customer orientation and job autonomy are positively associated with customer-focused voice. In addition, consistent with social information processing theory, these relationships are moderated by service climate, such that a high service climate compensates for the less desirable aspects of employees or their jobs. Finally, we provide evidence for a critical but untested assumption of the voice literature by linking hospital-level customer-focused voice to hospital-level service performance. Results based on data from four unique data sources, provided at varying points in time, and at different levels of analysis demonstrate support for our conceptual model.

Modelling the effects of climate change on the distribution and production of marine fishes: accounting for trophic interactions in a dynamic bioclimate envelope model.

Abstract: Climate change has already altered the distribution of marine fishes. Future predictions of fish distributions and catches based on bioclimate envelope models are available, but to date they have not considered interspecific interactions. We address this by combining the species-based Dynamic Bioclimate Envelope Model (DBEM) with a size-based trophic model. The new approach provides spatially and temporally resolved predictions of changes in species' size, abundance and catch potential that account for the effects of ecological interactions. Predicted latitudinal shifts are, on average, reduced by 20% when species interactions are incorporated, compared to DBEM predictions, with pelagic species showing the greatest reductions. Goodness-of-fit of biomass data from fish stock assessments in the North Atlantic between 1991 and 2003 is improved slightly by including species interactions. The differences between predictions from the two models may be relatively modest because, at the North Atlantic basin scale, (i) predators and competitors may respond to climate change together; (ii) existing parameterization of the DBEM might implicitly incorporate trophic interactions; and/or (iii) trophic interactions might not be the main driver of responses to climate. Future analyses using ecologically explicit models and data will improve understanding of the effects of inter-specific interactions on responses to climate change, and better inform managers about plausible ecological and fishery consequences of a changing environment.

Risk of ovarian cancer in women treated with ovarian stimulating drugs for infertility

Abstract: Background The use of assisted reproductive techniques is increasing, but the possible link between fertility drugs and ovarian cancer remains controversial. Objectives To evaluate the risk of ovarian cancer in women treated with ovulation stimulating drugs for subfertility. Search methods We searched for published and unpublished observational studies from 1990 to February 2013. The following databases were used: the Cochrane Gynaecological Cancer Collaborative Review Group's Trial Register, Cochrane Central Register of Controlled Trials (CENTRAL) 2013, Issue 1, MEDLINE (to February week 4 2013), EMBASE (to 2013 week 09) and databases of conference abstracts. We also scanned reference lists of retrieved articles. The search was not restricted by language of publication. Selection criteria We searched for randomised controlled trials (RCTs) and non-randomised studies, and case series including more than 30 participants, reporting on women with exposure to ovarian stimulating drugs for treatment of subfertility and histologically confirmed borderline or invasive ovarian cancer. Data collection and analysis At least two review authors independently conducted eligibility and 'Risk of bias' assessment, and extracted data. We grouped studies based on the fertility drug used for two outcomes: borderline ovarian tumours and invasive ovarian cancer. We expressed findings as adjusted odds ratio (OR), risk ratio (RR), hazard ratio (HR) or crude OR if adjusted values were not reported and standardised incidence ratio (SIR) where reported. We conducted no meta-analyses due to expected methodological and clinical heterogeneity. Main results We included 11 case-control studies and 14 cohort studies, which included a total of 182,972 women. Seven cohort studies showed no evidence of an increased risk of invasive ovarian cancer in subfertile women treated with any drug compared with untreated subfertile women. Seven case-control studies showed no evidence of an increased risk, compared with control women of a similar age. Two cohort studies reported an increased incidence of invasive ovarian cancer in subfertile women treated with any fertility drug compared with the general population. One of these reported a SIR of 5.0 (95% confidence interval (CI) 1.0 to 15), based on three cancer cases, and a decreased risk when cancer cases diagnosed within one year of treatment were excluded from the analysis(SIR 1.67, 95% CI 0.02 to 9.27). The other cohort study reported an OR of 2.09 (95% CI 1.39 to 3.12), based on 26 cases. For borderline ovarian tumours, exposure to any fertility drug was associated with a two to three-fold increased risk in two case-control studies. One case-control study reported an OR of 28 (95% CI 1.5 to 516), which was based on only four cases. In one cohort study, there was more than a two-fold increase in the incidence of borderline tumours compared with the general population (SIR 2.6, 95% CI 1.4 to 4.6) and in another the risk of a borderline ovarian tumour was HR 4.23 (95% CI 1.25 to 14.33) for subfertile women treated with in vitro fertilisation (IVF) compared with a non-IVF treated group with more than one year of follow-up. There was no evidence of an increased risk in women exposed to clomiphene alone or clomiphene plus gonadotrophin, compared with unexposed women. One case-control study reported an increased risk in users of human menopausal gonadotrophin (HMG)(OR 9.4, 95% CI 1.7 to 52). However, this estimate is based on only six cases with a history of HMG use. Authors' conclusions We found no convincing evidence of an increase in the risk of invasive ovarian tumours with fertility drug treatment. There may be an increased risk of borderline ovarian tumours in subfertile women treated with IVF. Studies showing an increase in the risk of ovarian cancer had a high overall risk of bias, due to retrospective study design, lack of accounting for potential confounding and estimates based on a small number of cases. More studies at low risk of bias are needed.

Detection of an outburst one year prior to the explosion of SN 2011ht

Abstract: Using imaging from the Pan-STARRS1 survey, we identify a precursor outburst at 287 and 170 days prior to the reported explosion of the purported Type IIn supernova (SN) 2011ht In the Pan-STARRS data, a source coincident with SN 2011ht is detected exclusively in the z_(P1) and y_(P1)-bands An absolute magnitude of M_z ≃ –118 suggests that this was an outburst of the progenitor star Unfiltered, archival Catalina Real Time Transient Survey images also reveal a coincident source from at least 258 to 138 days before the main event We suggest that the outburst is likely to be an intrinsically red eruption, although we cannot conclusively exclude a series of erratic outbursts which were observed only in the redder bands by chance This is only the fourth detection of an outburst prior to a claimed SN, and lends credence to the possibility that many more interacting transients have pre-explosion outbursts, which have been missed by current surveys

Carnosine: from exercise performance to health

Abstract: Carnosine was first discovered in skeletal muscle, where its concentration is higher than in any other tissue. This, along with an understanding of its role as an intracellular pH buffer has made it a dipeptide of interest for the athletic population with its potential to increase high-intensity exercise performance and capacity. The ability to increase muscle carnosine levels via β-alanine supplementation has spawned a new area of research into its use as an ergogenic aid. The current evidence base relating to the use of β-alanine as an ergogenic aid is reviewed here, alongside our current thoughts on the potential mechanism(s) to support any effect. There is also some emerging evidence for a potential therapeutic role for carnosine, with this potential being, at least theoretically, shown in ageing, neurological diseases, diabetes and cancer. The currently available evidence to support this potential therapeutic role is also reviewed here, as are the potential limitations of its use for these purposes, which mainly focusses on issues surrounding carnosine bioavailability.

The effect of platelet-rich plasma on clinical outcomes in lateral epicondylitis.

Abstract: Purpose To evaluate the evidence for application of platelet-rich plasma (PRP) in lateral epicondylitis Methods We carried out a systematic review of the current evidence on the effects of PRP in lateral epicondylitis on clinical outcomes We performed a comprehensive search of the PubMed, Medline, Cochrane, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Embase databases using various combinations of the commercial names of each PRP preparation and "lateral epicondylitis" (with its associated terms), looking specifically at human studies Data validity was assessed and collected on clinical outcome Results Nine studies met the inclusion criteria, of which 5 were randomized controlled trials Two cohort studies showed that PRP improved clinical satisfaction scores One case-control study showed that PRP yielded a significantly greater improvement in symptoms compared with bupivacaine Two randomized controlled trials compared the effect of injections of PRP and blood Only 1 of the studies noted a significant difference at the 6-week time point Three randomized controlled trials compared corticosteroids with PRP Two of the smaller trials, which had follow-up periods of 6 weeks and 3 months, showed no significant difference between treatment groups The largest randomized controlled trial found that PRP had significant benefit compared with corticosteroids with regard to pain and Disabilities of the Arm, Shoulder and Hand scores at 1- and 2-year time points Conclusions This review highlights the limited but evolving evidence for the use of PRP in lateral epicondylitis; however, further research is required to understand the concentration and preparation that facilitate the best clinical outcome Characterizing the timing of the intervention would optimize the health economics behind the decision to treat for the patient and health care provider Level of Evidence Level III, systematic review of Level I to III studies

Effectiveness of FISK, an Invasiveness Screening Tool for Non‐Native Freshwater Fishes, to Perform Risk Identification Assessments in the Iberian Peninsula

Abstract: Risk assessments are crucial for identifying and mitigating impacts from biological invasions. The Fish Invasiveness Scoring Kit (FISK) is a risk identification (screening) tool for freshwater fishes consisting of two subject areas: biogeography/history and biology/ecology. According to the outcomes, species can be classified under particular risk categories. The aim of this study was to apply FISK to the Iberian Peninsula, a Mediterranean climate region highly important for freshwater fish conservation due to a high level of endemism. In total, 89 fish species were assessed by three independent assessors. Results from receiver operating characteristic analysis showed that FISK can discriminate reliably between noninvasive and invasive fishes for Iberia, with a threshold of 20.25, similar to those obtained in several regions around the world. Based on mean scores, no species was categorized as "low risk," 50 species as "medium risk," 17 as "moderately high risk," 11 as "high risk," and 11 as "very high risk." The highest scoring species was goldfish Carassius auratus. Mean certainty in response was above the category "mostly certain," ranging from tinfoil barb Barbonymus schwanenfeldii with the lowest certainty to eastern mosquitofish Gambusia holbrooki with the highest level. Pair-wise comparison showed significant differences between one assessor and the other two on mean certainty, with these two assessors showing a high coincidence rate for the species categorization. Overall, the results suggest that FISK is a useful and viable tool for assessing risks posed by non-native fish in the Iberian Peninsula and contributes to a "watch list" in this region.

International Students in the U.S.: Social and Psychological Adjustment

Abstract: In this study, we examined the role of self-esteem, hope, optimism, coping, acculturative stress, and social support on international students’ depressive symptoms and sociocultural adjustment. Seventy international students completed a self-report online survey. The most notable finding was that the international students used adaptive and maladaptive coping techniques at similar rates. Greater use of coping techniques, higher acculturative stress and less social support were associated with more depressive symptoms and more difficulty with sociocultural adjustment. Lower self-esteem, less hope, and less optimism were associated with more depressive symptoms, but not sociocultural difficulty. Clinical implications and future directions are also discussed.

From prostate-specific antigen (PSA) to precursor PSA (proPSA) isoforms: a review of the emerging role of proPSAs in the detection and management of early prostate cancer

Abstract: Despite the popularity of PSA blood testing for prostate cancer, there are a number of important limitations of this popular serum marker including the limited ability to accurately distinguish patients with and without prostate cancer and those who harbour an aggressive form of the disease. This is especially true when the total PSA is <10 ng/mL. Thus, significant efforts have been placed to find new serum markers that can help overcome these limitations. In this review article, we discuss the emerging role of the various precursor forms of PSA (proPSAs), with a special emphasis on [-2]proPSA in the detecion and management of early prostate cancer. The clinical utility of Prostate Health Index (phi) is also discussed. Despite the overall success of prostate-specific antigen (PSA) blood test, its use as a serum marker for prostate cancer has been limited due to the lack of specificity, especially in men presenting with a total PSA (tPSA) level of <10 ng/mL. PSA testing has also resulted in an increase in the number of patients being diagnosed with low-grade, potentially clinically insignificant prostate cancer. There is therefore an urgent need for new markers that can accurately detect as well as differentiate patients with aggressive vs unaggressive prostate cancer. In this review, we discuss the emerging role of precursor forms of PSA (proPSAs) and the Prostate Health Index (phi) measurement in the detection and management of early stage prostate cancer. A literature search was conducted using PubMed® to identify key studies. Studies to date suggest that [-2]proPSA, a truncated form of proPSA is the most cancer-specific form of all, being preferentially expressed in cancerous prostatic epithelium and being significantly elevated in serum of men with prostate cancer. There is evidence to suggest that %[-2]proPSA measurement ([-2]proPSA/free PSA [fPSA] × 100) improves the specificity of both tPSA and fPSA in detecting prostate cancer. phi incorporating [-2]proPSA, fPSA and tPSA measurements has also yielded promising results and appears superior to tPSA and fPSA in predicting those patients with prostate cancer. Increased phi levels also seem to preferentially detect patients harbouring more aggressive disease. Further studies in the form of large, multicentre, prospective trials with detailed health economic analyses are required to evaluate the true clinical applicability of these novel markers.

The optimal timing for anterior cruciate ligament reconstruction with respect to the risk of postoperative stiffness.

Abstract: Purpose The aim of this meta-analysis was to compare the risk of stiffness between early and delayed anterior cruciate ligament (ACL) surgery in studies that use a modern accelerated rehabilitation protocol. Methods Medline, Embase, and the Cochrane library were searched for studies that compared outcomes for early and delayed ACL reconstruction with a modern accelerated rehabilitation protocol. Risk ratios for stiffness were pooled using random effects meta-analysis. Results A total of 8 studies were included in this review. The 3 randomized trials found no difference in the risk of postoperative stiffness at cutoff points of Conclusions If a modern surgical technique and an accelerated rehabilitation protocol are used, there is no increased risk of knee stiffness if an ACL reconstruction is performed as early as 1 week after injury. Level of Evidence Level II, meta-analysis of Level I and II studies.

Rapid Whole-Genome Sequencing for Investigation of a Suspected Tuberculosis Outbreak

Abstract: Two Southeast Asian students attending the same school in the United Kingdom presented with pulmonary tuberculosis. An epidemiological investigation failed to link the two cases, and drug resistance profiles of the Mycobacterium tuberculosis isolates were discrepant. Whole-genome sequencing of the isolates found them to be genetically identical, suggesting a missed transmission event.

Pathogenic Mitochondrial tRNA Point Mutations: Nine Novel Mutations Affirm Their Importance as a Cause of Mitochondrial Disease

Abstract: Mutations in the mitochondrial genome, and in particular the mt-tRNAs, are an important cause of human disease. Accurate classification of the pathogenicity of novel variants is vital to allow accurate genetic counseling for patients and their families. The use of weighted criteria based on functional studies—outlined in a validated pathogenicity scoring system—is therefore invaluable in determining whether novel or rare mt-tRNA variants are pathogenic. Here, we describe the identification of nine novel mt-tRNA variants in nine families, in which the probands presented with a diverse range of clinical phenotypes including mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes, isolated progressive external ophthalmoplegia, epilepsy, deafness and diabetes. Each of the variants identified (m.4289T>C, MT-TI; m.5541C>T, MT-TW; m.5690A>G, MT-TN; m.7451A>T, MT-TS1; m.7554G>A, MT-TD; m.8304G>A, MT-TK; m.12206C>T, MT-TH; m.12317T>C, MT-TL2; m.16023G>A, MT-TP) was present in a different tRNA, with evidence in support of pathogenicity, and where possible, details of mutation transmission documented. Through the application of the pathogenicity scoring system, we have classified six of these variants as “definitely pathogenic” mutations (m.5541C>T, m.5690A>G, m.7451A>T, m.12206C>T, m.12317T>C, and m.16023G>A), whereas the remaining three currently lack sufficient evidence and are therefore classed as ‘possibly pathogenic’ (m.4289T>C, m.7554G>A, and m.8304G>A).

Operative Management of Partial-Thickness Tears of the Proximal Hamstring Muscles in Athletes:

Abstract: Background:Partial tears of the hamstring muscle origin represent a challenging clinical problem to the patient and orthopaedic surgeon. Although nonoperative treatment is frequently met with limited success, there is a paucity of data on the efficacy of surgical management for partial proximal hamstring tears in the active and athletic population.Purpose:To evaluate the results of an anatomic repair for partial tears of the hamstring muscle origin in athletes.Study Design:Case series; Level of evidence, 4.Methods:The records of 17 patients with partial tears of the proximal hamstring origin were reviewed after institutional review board approval was obtained. All patients were treated with open debridement and primary tendon repair after failure of at least 6 months of nonoperative therapy. Clinical and operative records, radiographs, and magnetic resonance images were reviewed for all patients. A patient-reported outcomes survey was completed by 14 patients that included the Lower Extremity Functional S...

Physical accessibility of touchscreen smartphones

Abstract: This paper examines the use of touchscreen smartphones, focusing on physical access. Using interviews and observations, we found that participants with dexterity impairment considered a smartphone both useful and usable, but tablet devices offer several important advantages. Cost is a major barrier to adoption. We describe usability problems that are not addressed by existing accessibility options, and observe that the dexterity demands of important accessibility features made them unusable for many participants. Despite participants' enthusiasm for both smartphones and tablet devices, their potential is not yet fully realized for this population.

Revisions of the Fish Invasiveness Screening Kit (FISK) for its application in warmer climatic zones, with particular reference to peninsular Florida.

Abstract: The initial version (v1) of the Fish Invasiveness Scoring Kit (FISK) was adapted from the Weed Risk Assessment of Pheloung, Williams, and Halloy to assess the potential invasiveness of nonnative freshwater fishes in the United Kingdom. Published applications of FISK v1 have been primarily in temperate-zone countries (Belgium, Belarus, and Japan), so the specificity of this screening tool to that climatic zone was not noted until attempts were made to apply it in peninsular Florida. To remedy this shortcoming, the questions and guidance notes of FISK v1 were reviewed and revised to improve clarity and extend its applicability to broader climatic regions, resulting in changes to 36 of the 49 questions. In addition, upgrades were made to the software architecture of FISK to improve overall computational speed as well as graphical user interface flexibility and friendliness. We demonstrate the process of screening a fish species using FISK v2 in a realistic management scenario by assessing the Barcoo grunter Scortum barcoo (Terapontidae), a species whose management concerns are related to its potential use for aquaponics in Florida. The FISK v2 screening of Barcoo grunter placed the species into the lower range of medium risk (score = 5), suggesting it is a permissible species for use in Florida under current nonnative species regulations. Screening of the Barcoo grunter illustrates the usefulness of FISK v2 as a proactive tool serving to inform risk management decisions, but the low level of confidence associated with the assessment highlighted a dearth of critical information on this species.