University of Nebraska Omaha

About: University of Nebraska Omaha is a education organization based out in Omaha, Nebraska, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 4526 authors who have published 8905 publications receiving 213914 citations. The organization is also known as: UNO & University of Omaha.

Remission of rheumatoid arthritis in clinical practice: application of the American College of Rheumatology/European League Against Rheumatism 2011 remission criteria.

Abstract: Objective To describe use of the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) rheumatoid arthritis (RA) remission criteria in clinical practice Methods Remission was examined using data on 1,341 patients with RA (91% men) from the US Department of Veterans Affairs RA (VARA) registry (total of 9,700 visits) and 1,153 patients with RA (258% men) in a community rheumatology practice (Arthritis and Rheumatology Clinics of Kansas [ARCK]) (total of 6,362 visits) Cross-sectional and cumulative probabilities were studied, and agreement between the various remission criteria was assessed Aspects of reliability of the criteria were determined using Boolean-based definitions, as well as the Clinical Disease Activity Index (CDAI) and Simplified Disease Activity Index (SDAI) scoring methods proposed by the ACR/EULAR joint committee Results When the 3-variable ACR/EULAR definition of remission recommended for use in community practice (swollen and tender joint counts ≤1, and visual analog scale score for patient's global assessment of disease activity ≤1) was applied, cross-sectional remission was 75% (95% confidence interval [95% CI] 64, 87%) for ARCK and 89% (95% CI 79, 99%) for VARA, and cumulative remission (remission at any observation) was 180% (for ARCK) and 244% (for VARA), over a mean followup of ∼22 years Addition of the erythrocyte sedimentation rate or C-reactive protein level to the criteria set reduced remission to 50–62%, and use of the CDAI/SDAI increased the proportions to 69–101% Moreover, 18–46% of the patients met remission criteria at ≥2 visits Agreement between criteria definitions was good, as assessed by kappa statistics and Jaccard coefficients Among patients in remission, the probability of a remission lasting 2 years was 60–141% Among all patients, the probability of a remission lasting 2 years was <3% Remission status and examination results for each patient varied substantially among physicians, as determined by multilevel analyses Conclusion Cross-sectional remission occurred in 50–101% of the patients in these cohorts, with cumulative remission being 2–3 times greater; however, long-term remission was rare Problems with reliability and agreement limit the usefulness of these criteria in the individual patient However, the criteria can be an effective method for measuring clinical status and treatment effect in groups of patients in the community

Precambrian zircons from the Florida basement: A Gondwanan connection

Abstract: A Gondwanan origin for the pre-Cretaceous basement of Florida is suggested by U- Pb ages of 515 to 2860 Ma for single zircons separated from subsurface samples of lower Paleozoic sandstone of the Suwannee basin (Alachua County, Florida) and Neoproterozoic Osceola granite (Osceola County, Florida). Forty individual grains analyzed by SHRIMP ion microprobe yielded ages from 515 to 2860 Ma; ages >1000 Ma were predominantly concordant. Two principal populations are evident: (1) 515 to 637 Ma (avg. = 574 Ma; 206 Pb/ 238 U ages) and (2) 1967 to 2282 Ma (avg. = 2130 Ma; 207 Pb/ 206 Pb ages). Only six zircons were recovered from the granite; four are Pan-African and two are Archean. For the sandstone, the similarity between the Sm-Nd model age (1245 Ma) and the average of the single zircon ages (1326 Ma) suggests that these zircons are chronologically representative of the aggregate provenance of the sandstone. The two dominant zircon age groupings correspond chronologically to the Pan-African and Birimian or Eburnian (Africa) and to the Brasiliano and Trans-Amazonian (South America) orogenic cycles. The presence of detritus from rocks of these two orogenic cycles clearly places the basement of Florida in Gondwanaland proximal to the West African and/or Trans-Amazonian-San Luis cratons in the early Paleozoic, a location it probably shared with other circum-Atlantic exotic terranes (Avalonian, Cadomian, and/or Carolina).

Feasibility of a Sleep Intervention During Adjuvant Breast Cancer Chemotherapy

Abstract: Purpose/objectives To evaluate the feasibility of an intervention designed to promote sleep and modify fatigue during four cycles of adjuvant breast cancer chemotherapy. Design Prospective, repeated measures, quasi-experimental feasibility study. Setting Midwestern urban oncology clinics. Sample 25 women between the ages of 40-65 (mean = 54.3) with stage I-II breast cancer receiving doxorubicin-based chemotherapy. Methods Each woman developed, reinforced, and revised an individualized sleep promotion plan (ISPP) with four components: sleep hygiene, relaxation therapy, stimulus control, and sleep restriction techniques. A daily diary, the Pittsburgh Sleep Quality Index, a wrist actigraph, and the Piper Fatigue Scale were used to collect data two days before and seven days after each treatment. Main research variables Adherence, sleep and wake outcomes, and fatigue. Findings Adherence rates with the components of the ISPP varied during treatments one through four: sleep hygiene (68%-78%), relaxation therapy (57%-67%), stimulus control (46%-67%), and sleep restriction (76%-80%). Mean sleep and wake outcomes at baseline, peak, and rebound times were that (a) sleep latency remained brief (less than 30 minutes per night), (b) time awake after sleep onset exceeded the desired less than 30 minutes per night, (c) sleep efficiency scores remained stable at 85%-90%, (d) total rest time remained stable at 8-10 hours per night, (e) subjective ratings of feelings on arising were stable, and (f) nighttime awakenings were 8-10 per night. Fatigue outcomes were that fatigue was stable two days after each treatment and mean daily fatigue intensity was lower at treatment three than at treatment one but rebounded at treatment four. Conclusions The intervention was feasible, adherence rates improved over time, and most sleep and wake patterns were consistent with normal values. Revisions will focus on decreasing nighttime awakenings. Implications for nursing Adopting behaviors to promote sleep may assist in maintaining sleep and managing fatigue during chemotherapy.

Gait Variability is Altered in Older Adults When Listening to Auditory Stimuli with Differing Temporal Structures

Abstract: Gait variability in the context of a deterministic dynamical system may be quantified using nonlinear time series analyses that characterize the complexity of the system. Pathological gait exhibits altered gait variability. It can be either too periodic and predictable, or too random and disordered, as is the case with aging. While gait therapies often focus on restoration of linear measures such as gait speed or stride length, we propose that the goal of gait therapy should be to restore optimal gait variability, which exhibits chaotic fluctuations and is the balance between predictability and complexity. In this context, our purpose was to investigate how listening to different auditory stimuli affects gait variability. Twenty-seven young and 27 elderly subjects walked on a treadmill for 5 min while listening to white noise, a chaotic rhythm, a metronome, and with no auditory stimulus. Stride length, step width, and stride intervals were calculated for all conditions. Detrended Fluctuation Analysis was then performed on these time series. A quadratic trend analysis determined that an idealized inverted-U shape described the relationship between gait variability and the structure of the auditory stimuli for the elderly group, but not for the young group. This proof-of-concept study shows that the gait of older adults may be manipulated using auditory stimuli. Future work will investigate which structures of auditory stimuli lead to improvements in functional status in older adults.

Event-related potential amplitude/intensity slopes predict response to antidepressants.

Abstract: We measured event-related potential (ERP) component amplitudes to four intensities of randomly presented tones. Patients diagnosed with major depressive disorder were tested prior to and following a clinical trial of antidepressant medication. Slope of P2 amplitude as a function of stimulus intensity was calculated for each subject and condition. Subjects were divided into two groups (responders and nonresponders) based on their Hamilton Rating Scale for depression scores following treatment. Responders had significantly larger P2 slopes prior to treatment than did nonresponders. P2 slopes did not differ significantly between responders and nonresponders following antidepressant treatment. These data support the conclusion that P2 amplitude/intensity slope may be a predictor of response to treatment with antidepressant medication.