University of Kansas

About: University of Kansas is a education organization based out in Lawrence, Kansas, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 38183 authors who have published 81381 publications receiving 2986312 citations. The organization is also known as: KU & Univ of Kansas.

The riverine ecosystem synthesis : Biocomplexity in river networks across space and time

Abstract: We propose an integrated, heuristic model of lotic biocomplexity across spatiotemporal scales from headwaters to large rivers. This riverine ecosystem synthesis (RES) provides a framework for understanding both broad, often discontinuous patterns along longitudinal and lateral dimensions of river networks and local ecological patterns across various temporal and smaller spatial scales. Rather than posing a completely new model, we arrange a conceptual marriage of eco-geomorphology (ecological aspects of fluvial geomorphology) with a terrestrial landscape model describing hierarchical patch dynamics. We modify five components of this terrestrial model for lotic ecosystems: (1) nested, discontinuous hierarchies of patch mosaics; (2) ecosystem dynamics as a composite of intra- and inter-patch dynamics; (3) linked patterns and processes; (4) dominance of non-equilibrial and stochastic processes; and (5) formation of a quasi-equilibrial, metastable state. Our conceptual model blends our perspectives on biocomplexity with aspects of aquatic models proposed from 1980–2004. Contrasting with a common view of rivers as continuous, longitudinal gradients in physical conditions, the RES portrays rivers as downstream arrays of large hydrogeomorphic patches (e.g. constricted, braided and floodplain channel areas) formed by catchment geomorphology and climate. The longitudinal distribution of these patches, which are identifiable using standard geomorphic techniques, varies amongst rivers and is difficult to forecast above ecoregional scales. Some types of hydrogeomorphic patches may reoccur along this downstream passage. Unique ecological ‘functional process zones’ are formed by individual types of hydrogeomorphic patches because of physiochemical habitat differences which affect ecosystem structure and function. The RES currently includes 14 tenets predicting how patterns of individual species distributions, community regulation, lotic ecosystem processes, and floodplain interactions will vary over spatiotemporal scales, especially as they relate to the functional process zones formed by hydrogeomorphic differences in the river network. Copyright © 2006 John Wiley & Sons, Ltd.

Deep Brain Stimulation for Parkinson Disease: An Expert Consensus and Review of Key Issues

Abstract: Objective: To provide recommendations to patients, physicians, and other health care providers on several issues involving deep brain stimulation (DBS) for Parkinson disease (PD). Data Sources and Study Selection: An international consortium of experts organized, reviewed the literature, and attended the workshop. Topics were introduced at the workshop, followed by group discussion. Data Extraction and Synthesis: A draft of a consensus statement was presented and further edited after plenary debate. The final statements were agreed on by all members. Conclusions: (1) Patients with PD without significant active cognitive or psychiatric problems who have medically intractable motor fluctuations, intractable tremor, or intolerance of medication adverse effects are good candidates for DBS. (2) Deep brain stimulation surgery is best performed by an experienced neurosurgeon with expertise in stereotactic neurosurgery who is working as part of a interprofessional team. (3) Surgical complication rates are extremely variable, with infection being the most commonly reported complication of DBS. (4) Deep brain stimulation programming is best accomplished by a highly trained clinician and can take 3 to 6 months to obtain optimal results. (5) Deep brain stimulation improves levodopa-responsive symptoms, dyskinesia, and tremor; benefits seem to be long-lasting in many motor domains. (6) Subthalamic nuclei DBS may be complicated by increased depression, apathy, impulsivity, worsened verbal fluency, and executive dysfunction in a subset of patients. (7) Both globus pallidus pars interna and subthalamic nuclei DBS have been shown to be effective in addressing the motor symptoms of PD. (8) Ablative therapy is still an effective alternative and should be considered in a select group of appropriate patients. Arch Neurol. 2011; 68(2):165-171. Published online October 11, 2010. doi:10.1001/archneurol.2010.260

PTEN maintains haematopoietic stem cells and acts in lineage choice and leukaemia prevention

Abstract: Haematopoietic stem cells (HSCs) must achieve a balance between quiescence and activation that fulfils immediate demands for haematopoiesis without compromising long-term stem cell maintenance, yet little is known about the molecular events governing this balance. Phosphatase and tensin homologue (PTEN) functions as a negative regulator of the phosphatidylinositol-3-OH kinase (PI(3)K)-Akt pathway, which has crucial roles in cell proliferation, survival, differentiation and migration. Here we show that inactivation of PTEN in bone marrow HSCs causes their short-term expansion, but long-term decline, primarily owing to an enhanced level of HSC activation. PTEN-deficient HSCs engraft normally in recipient mice, but have an impaired ability to sustain haematopoietic reconstitution, reflecting the dysregulation of their cell cycle and decreased retention in the bone marrow niche. Mice with PTEN-mutant bone marrow also have an increased representation of myeloid and T-lymphoid lineages and develop myeloproliferative disorder (MPD). Notably, the cell populations that expand in PTEN mutants match those that become dominant in the acute myeloid/lymphoid leukaemia that develops in the later stages of MPD. Thus, PTEN has essential roles in restricting the activation of HSCs, in lineage fate determination, and in the prevention of leukaemogenesis.

The Occupational Therapy Practice Framework: the evolution of our professional language.

Abstract: 607 Mary Jane Youngstrom Over the years occupational therapy has adapted to historical, cultural, and technological change—while always staying focused on helping people to participate in their daily life occupations. As knowledge has developed and adaptations have occurred, the language that the profession’s practitioners use to describe what they do and how they do it has also evolved. The Occupational Therapy Practice Framework: Domain and Process (Framework) is an example of the natural evolution in terminology and language that occurs in a viable and dynamic profession. The Framework was adopted at the May 2002 meeting of the Representative Assembly and will replace the Uniform Terminology for Occupational Therapy—Third Edition (UT-III) (American Occupational Therapy Association [AOTA], 1994). In early 1999, the Commission on Practice (COP) began the process of reviewing UT-III and seeking feedback from practitioners, leaders, and scholars on whether it should be rescinded or revised. After review of the extensive feedback, the Commission decided that there was still a need for a document that outlined the constructs in the profession’s domain. However, many changes had occurred in the practice environment and profession’s knowledge base since UT-III’s adoption in 1994. Practice patterns in traditional health care settings were changing due to shifting reimbursement parameters. Practitioners had to rethink their practices. Occupational therapists and occupational therapy assistants were seeking support for applying occupational therapy in new practice arenas. The increased interest in the study of “occupation” was stimulating discussion about “occupation-based” practice in all areas and placing increased attention on the construct of occupation. A common theme in all of these shifts was the need to reaffirm and clarify what occupational therapy practice is all about. With these changes forming the backdrop for discussion, the Commission began to rethink what the purposes and format of a new document should be. The Commission concluded that the new document needed to be a different kind of document—one that could be helpful to practitioners adapting to these changes and assist them in clarifying the profession’s domain and process for internal and external audiences. In reviewing the feedback and discussing the profession’s current status, the Commission identified several issues that needed to be addressed in the new document: • The outline of the domain needed to be clearly tied to the idea of occupation and should reflect recent thinking and new constructs. • The document needed to explain how the construct of occupation was integrated throughout the occupational therapy process and how the domain and process were related. The process description needed to be general enough to be applicable across specialties and in newly developing arenas. At the same time, it needed to illustrate how all practice was linked by its focus on helping people engage in meaningful everyday life activities. • The language and terminology used in the new document needed to be updated to reflect current knowledge and revised to include terminology more familiar to other disciplines as well as the terminology outlined in the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) (WHO, 2001). Use of more familiar language would help external audiences to more clearly understand the profession’s interests and contributions to health care. • The new document needed to more explicitly describe occupational therapy’s outcomes and contribution to health. Occupational therapists needed to understand their role within a larger societal and health context in order to position themselves in changing traditional areas and to take advantage of opportunities in emerging arenas. Clients needed to be recognized not only as individuals but as FROM THE GUEST EDITOR The Occupational Therapy Practice Framework: The Evolution of Our Professional Language

Exemestane for Breast-Cancer Prevention in Postmenopausal Women

Abstract: Background Tamoxifen and raloxifene have limited patient acceptance for primary prevention of breast cancer. Aromatase inhibitors prevent more contralateral breast cancers and cause fewer side effects than tamoxifen in patients with early-stage breast cancer. Methods In a randomized, placebo-controlled, double-blind trial of exemestane designed to detect a 65% relative reduction in invasive breast cancer, eligible postmenopausal women 35 years of age or older had at least one of the following risk factors: 60 years of age or older; Gail 5-year risk score greater than 1.66% (chances in 100 of invasive breast cancer developing within 5 years); prior atypical ductal or lobular hyperplasia or lobular carcinoma in situ; or ductal carcinoma in situ with mastectomy. Toxic effects and health-related and menopause-specific qualities of life were measured. Results A total of 4560 women for whom the median age was 62.5 years and the median Gail risk score was 2.3% were randomly assigned to either exemestane or placebo. At a median follow-up of 35 months, 11 invasive breast cancers were detected in those given exemestane and in 32 of those given placebo, with a 65% relative reduction in the annual incidence of invasive breast cancer (0.19% vs. 0.55%; hazard ratio, 0.35; 95% confidence interval [CI], 0.18 to 0.70; P = 0.002). The annual incidence of invasive plus noninvasive (ductal carcinoma in situ) breast cancers was 0.35% on exemestane and 0.77% on placebo (hazard ratio, 0.47; 95% CI, 0.27 to 0.79; P = 0.004). Adverse events occurred in 88% of the exemestane group and 85% of the placebo group (P = 0.003), with no significant differences between the two groups in terms of skeletal fractures, cardiovascular events, other cancers, or treatmentrelated deaths. Minimal quality-of-life differences were observed. Conclusions Exemestane significantly reduced invasive breast cancers in postmenopausal women who were at moderately increased risk for breast cancer. During a median follow-up period of 3 years, exemestane was associated with no serious toxic effects and only minimal changes in health-related quality of life. (Funded by Pfizer and others; NCIC CTG MAP.3 ClinicalTrials.gov number, NCT00083174.)