949 resultados para Significant Discrepancies


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Neuroimaging studies in bipolar disorder report gray matter volume (GMV) abnormalities in neural regions implicated in emotion regulation. This includes a reduction in ventral/orbital medial prefrontal cortex (OMPFC) GMV and, inconsistently, increases in amygdala GMV. We aimed to examine OMPFC and amygdala GMV in bipolar disorder type 1 patients (BPI) versus healthy control participants (HC), and the potential confounding effects of gender, clinical and illness history variables and psychotropic medication upon any group differences that were demonstrated in OMPFC and amygdala GMV. Images were acquired from 27 BPI (17 euthymic, 10 depressed) and 28 age- and gender-matched HC in a 3T Siemens scanner. Data were analyzed with SPM5 using voxel-based morphometry (VBM) to assess main effects of diagnostic group and gender upon whole brain (WB) GMV. Post-hoc analyses were subsequently performed using SPSS to examine the extent to which clinical and illness history variables and psychotropic medication contributed to GMV abnormalities in BPI in a priori and non-a priori regions has demonstrated by the above VBM analyses. BPI showed reduced GMV in bilateral posteromedial rectal gyrus (PMRG), but no abnormalities in amygdala GMV. BPI also showed reduced GMV in two non-a priori regions: left parahippocampal gyrus and left putamen. For left PMRG GMV, there was a significant group by gender by trait anxiety interaction. GMV was significantly reduced in male low-trait anxiety BPI versus male low-trait anxiety HC, and in high- versus low-trait anxiety male BPI. Our results show that in BPI there were significant effects of gender and trait-anxiety, with male BPI and those high in trait-anxiety showing reduced left PMRG GMV. PMRG is part of medial prefrontal network implicated in visceromotor and emotion regulation.

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We show a new method for term extraction from a domain relevant corpus using natural language processing for the purposes of semi-automatic ontology learning. Literature shows that topical words occur in bursts. We find that the ranking of extracted terms is insensitive to the choice of population model, but calculating frequencies relative to the burst size rather than the document length in words yields significantly different results.

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Background: Medication discrepancies are common when patients cross organisational boundaries. However, little is known about the frequency of discrepancies within mental health and the efficacy of interventions to reduce discrepancies. Objective: To evaluate the impact of a pharmacy-led reconciliation service on medication discrepancies on admissions to a secondary care mental health trust. Setting: In-patient mental health services. Methods: Prospective evaluation of pharmacy technician led medication reconciliation for admissions to a UK Mental Health NHS Trust. From March to June 2012 information on any unintentional discrepancies (dose, frequency and name of medication); patient demographics; and type and cause of the discrepancy was collected. The potential for harm was assessed based on two scenarios; the discrepancy was continued into primary care, and the discrepancy was corrected during admission. Logistic regression identified factors associated with discrepancies. Main outcome measure: Mean number of discrepancies per admission corrected by the pharmacy technician. Results Unintentional medication discrepancies occurred in 212 of 377 admissions (56.2 %). Discrepancies involving 569 medicines (mean 1.5 medicines per admission) were corrected. The most common discrepancy was omission (n = 464). Severity was assessed for 114 discrepancies. If the discrepancy was corrected within 16 days the potential harm was minor in 71 (62.3 %) cases and moderate in 43 (37.7 %) cases whereas if the discrepancy was not corrected the potential harm was minor in 27 (23.7 %) cases and moderate in 87 (76.3 %) cases. Discrepancies were associated with both age and number of medications; the stronger association was age. Conclusions: Medication discrepancies are common within mental health services with potentially significant consequences for patients. Trained pharmacy technicians are able to reduce the frequency of discrepancies, improving safety. © 2013 Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie.

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A significant change of scene in a gradually changing scene is detected with the aid of a least one camera means for capturing digital images of the scene. A current image of the scene is formed together with a present weighted reference image which is formed from a plurality of previous images of the scene. Cell data is established based on the current image and the present weighted reference image. The cell data is statistically analysed so as to be able to identify at least one difference corresponding to a significant change of scene. When identified, an indication of such significant change of scene is provided.

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Objective: Previous studies have suggested that somatoform disorders (SFD) might be associated with changes in the function of the central and autonomic nervous systems. The aim of this study was to examine the possible immunological differences between SFD and healthy controls. Methods: Twenty-four patients with SFD and 13 healthy individuals completed the psychological questionnaires to assess symptom reporting [Symptom Checklist-90 Revised (SCL-90-R)] and to diagnose for SFD [Screening for Somatoform Symptoms scale (SOMS-scale)]. Participants also provided a blood sample taken in the morning, which was analysed with an automated cell counter to determine the number of leucocytes per μl and with flow cytometry to determine lymphocyte subsets. Results: With the exception of a higher T4/T8 ratio in the patient group, which was mainly because of lower CD8 counts, there were no significant differences in the absolute number of lymphocytes (subsets) between patients with SFD and healthy subjects. A positive correlation between B-lymphocyte subsets (CD19+CD22+, CD19+CD5+, CD19+CD3-) to all scales of the SCL-90-R, except somatisation, were found in SFD. Additionally, a positive correlation was found in SFD between CD14+CD16+ monocytes and somatisation (0.573) on the SCL-90-R scale. Conclusion: These data indicate that patients with SFD have an enhanced humoral immunity as shown by increased B-cell numbers and furthermore an elevated T4/T8 ratio because of lower CD8 suppressor cells. Further studies will be required to determine whether these alterations in lymphocyte subsets are directly involved in the pathophysiology of SFD. © 2007 Blackwell Munksgaard.

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This study evaluates the antidiabetic potential of an enzyme-resistant analog, (Val8)GLP-1. The effects of daily administration of a novel dipeptidyl peptidase IV-resistant glucagon-like peptide-1 (GLP-1) analog, (Val8)GLP-1, on glucose tolerance and pancreatic β-cell function were examined in obese-diabetic (ob/ob) mice. Acute intraperitoneal administration of (Val8)GLP-1 (6.25-25 nmol/kg) with glucose increased the insulin response and reduced the glycemic excursion in a dose-dependent manner. The effects of (Val8)GLP-1 were greater and longer lasting than native GLP-1. Once-daily subcutaneous administration of (Val8)GLP-1 (25 nmol/kg) for 21 days reduced plasma glucose concentrations, increased plasma insulin, and reduced body weight more than native GLP-1 without a significant change in daily food intake. Furthermore, (Val8)GLP-1 improved glucose tolerance, reduced the glycemic excursion after feeding, increased the plasma insulin response to glucose and feeding, and improved insulin sensitivity. These effects were consistently greater with (Val8)GLP-1 than with native GLP-1, and both peptides retained or increased their acute efficacy compared with initial administration. (Val8)GLP-1 treatment increased average islet area 1.2-fold without changing the number of islets, resulting in an increased number of larger islets. These data demonstrate that (Val8)GLP-1 is more effective and longer acting than native GLP-1 in obese-diabetic ob/ob mice.

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We demonstrate a great variability of single-pulse (with only one pulse/wave-packet traveling along the cavity) generation regimes in fiber lasers passively mode-locked by non-linear polarization evolution (NPE) effect. Combining extensive numerical modeling and experimental studies, we identify multiple very distinct lasing regimes with a rich variety of dynamic behavior and a remarkably broad spread of key parameters (by an order of magnitude and more) of the generated pulses. Such a broad range of variability of possible lasing regimes necessitates developing techniques for control/adjustment of such key pulse parameters as duration, radiation spectrum, and the shape of the auto-correlation function. From a practical view point, availability of pulses/wave-packets with such different characteristics from the same laser makes it imperative to develop variability-aware designs with control techniques and methods to select appropriate application-oriented regimes. © 2014 The Authors.

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Discrepancies of materials, tools, and factory environments, as well as human intervention, make variation an integral part of the manufacturing process of any component. In particular, the assembly of large volume, aerospace parts is an area where significant levels of form and dimensional variation are encountered. Corrective actions can usually be taken to reduce the defects, when the sources and levels of variation are known. For the unknown dimensional and form variations, a tolerancing strategy is typically put in place in order to minimize the effects of production inconsistencies related to geometric dimensions. This generates a challenging problem for the automation of the corresponding manufacturing and assembly processes. Metrology is becoming a major contributor to being able to predict, in real time, the automated assembly problems related to the dimensional variation of parts and assemblies. This is done by continuously measuring dimensions and coordinate points, focusing on the product's key characteristics. In this paper, a number of metrology focused activities for large-volume aerospace products, including their implementation and application in the automation of manufacturing and assembly processes, are reviewed. This is done by using a case study approach within the assembly of large-volume aircraft wing structures.

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Medication reconciliation is an important process in reducing medication errors in many countries. Canada, the USA, and UK have incorporated medication reconciliation as a priority area for national patient safety initiatives and goals. The UK national guidance excludes the pediatric population. The aim of this review was to explore the occurrence of medication discrepancies in the pediatric population. The primary objective was to identify studies reporting the rate and clinical significance of the discrepancies and the secondary objective was to ascertain whether any specific interventions have been used for medication reconciliation in pediatric settings. The following electronic bibliographic databases were used to identify studies: PubMed, OVID EMBASE (1980 to 2012 week 1), ISI Web of Science, ISI Biosis, Cumulative Index to Nursing and Allied Health Literature, and OVID International Pharmaceutical Abstracts (1970 to January 2012). Primary studies were identified that observed medication discrepancies in children under 18 years of age upon hospital admission, transfer and discharge, or had reported medication reconciliation interventions. Two independent reviewers screened titles and abstracts for relevant articles and extracted data using pre-defined data fields, including risk of bias assessment. Ten studies were identified with variances in reportage of stage and rate of discrepancies. Studies were heterogeneous in definitions, methods, and patient populations. Most studies related to admissions and reported consistently high rates of discrepancies ranging from 22 to 72.3 % of patients (sample size ranging from 23 to 272). Seven of the studies were low-quality observational studies and three studies were 'grey literature' non-peer reviewed conference abstracts. Studies involving small numbers of patients have shown that medication discrepancies occur at all transitions of care in children. Further research is required to investigate and demonstrate how implementing medication reconciliation can reduce discrepancies and potential patient harm. © 2013 Springer International Publishing Switzerland.

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Dissociation of molecular hydrogen is an important step in a wide variety of chemical, biological, and physical processes. Due to the light mass of hydrogen, it is recognized that quantum effects are often important to its reactivity. However, understanding how quantum effects impact the reactivity of hydrogen is still in its infancy. Here, we examine this issue using a well-defined Pd/Cu(111) alloy that allows the activation of hydrogen and deuterium molecules to be examined at individual Pd atom surface sites over a wide range of temperatures. Experiments comparing the uptake of hydrogen and deuterium as a function of temperature reveal completely different behavior of the two species. The rate of hydrogen activation increases at lower sample temperature, whereas deuterium activation slows as the temperature is lowered. Density functional theory simulations in which quantum nuclear effects are accounted for reveal that tunneling through the dissociation barrier is prevalent for H2 up to ∼190 K and for D2 up to ∼140 K. Kinetic Monte Carlo simulations indicate that the effective barrier to H2 dissociation is so low that hydrogen uptake on the surface is limited merely by thermodynamics, whereas the D2 dissociation process is controlled by kinetics. These data illustrate the complexity and inherent quantum nature of this ubiquitous and seemingly simple chemical process. Examining these effects in other systems with a similar range of approaches may uncover temperature regimes where quantum effects can be harnessed, yielding greater control of bond-breaking processes at surfaces and uncovering useful chemistries such as selective bond activation or isotope separation.

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The E01-011 experiment at Jefferson Laboratory (JLab) studied light-to-medium mass Λ hypernuclei via the AZ + e → [special characters omitted] + e' + K+ electroproduction reaction. Precise measurement of hypernuclear ground state masses and excitation energies provides information about the nature of hyperon-nucleon interactions. Until recently, hypernuclei were studied at accelerator facilities with intense π+ and K- meson beams. The poor quality of these beams limited the resolution of the hypernuclear excitation energy spectra to about 1.5 MeV (FWHM). This resolution is not sufficient for resolving the rich structure observed in the excitation spectra. By using a high quality electron beam and employing a new high resolution spectrometer system, this study aims to improve the resolution to a few hundred keV with an absolute precision of about 100 keV for excitation energies. In this work the high-resolution excitation spectra of [special characters omitted], and [special characters omitted] hypernuclei are presented. In an attempt to emphasize the presence of the core-excited states we introduced a novel likelihood approach to particle identification (PID) to serve as an alternative to the commonly used standard hard-cut PID. The new method resulted in almost identical missing mass spectra as obtained by the standard approach. An energy resolution of approximately 400–500 keV (FWHM) has been achieved, an unprecedented value in hypernuclear reaction spectroscopy. For [special characters omitted] the core-excited configuration has been clearly observed with significant statistics. The embedded Λ hyperon increases the excitation energies of the 11B nuclear core by 0.5–1 MeV. The [special characters omitted] spectrum has been observed with significant statistics for the first time. The ground state is bound deeper by roughly 400 keV than currently predicted by theory. Indication for the core-excited doublet, which is unbound in the core itself, is observed. The measurement of [special characters omitted] provides the first study of a d-shell hypernucleus with sub-MeV resolution. Discrepancies of up to 2 MeV between measured and theoretically predicted binding energies are found. Similar disagreement exists when comparing to the [special characters omitted] mirror hypernucleus. Also the core-excited structure observed between the major s-, p- and d-shell Λ orbits is not consistent with the available theoretical calculations. In conclusion, the discrepancies found in this study will provide valuable input for the further development of theoretical models.

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The protection of organic carbon stored in forests is considered as an important method for mitigating climate change. Like terrestrial ecosystems, coastal ecosystems store large amounts of carbon, and there are initiatives to protect these ‘blue carbon’ stores. Organic carbon stocks in tidal salt marshes and mangroves have been estimated, but uncertainties in the stores of seagrass meadows—some of the most productive ecosystems on Earth—hinder the application of marine carbon conservation schemes. Here, we compile published and unpublished measurements of the organic carbon content of living seagrass biomass and underlying soils in 946 distinct seagrass meadows across the globe. Using only data from sites for which full inventories exist, we estimate that, globally, seagrass ecosystems could store as much as 19.9 Pg organic carbon; according to a more conservative approach, in which we incorporate more data from surface soils and depth-dependent declines in soil carbon stocks, we estimate that the seagrass carbon pool lies between 4.2 and 8.4 Pg carbon. We estimate that present rates of seagrass loss could result in the release of up to 299 Tg carbon per year, assuming that all of the organic carbon in seagrass biomass and the top metre of soils is remineralized.

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Raising academic standards is a driving force behind public school initiatives. True educational reform requires a data-driven approach to choosing valid options for student improvement. We discuss current and continuing research that provides evidence that class size reduction, with related variables, is a significant option for improving student learning.

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Changes in the demographic structure of American families have highlighted the need to reevaluate fatherhood. Research illustrates that paternal involvement positively affects child development, but father absence has increased due to rising rates of divorce, cohabitation, and non-marital childbirth. There is evidence that other male figures can function as effective father surrogates. However, information is limited, particularly with respect to female development. ^ This study examined differences in well-being, achievement, and paternal support among girls in four father categories: (a) Biological Father, (b) Step-Father, (c) Surrogate Father, and (d) No Father. Maternal support, economic hardship, and life stressors were included as potential covariates. Interviews were conducted with an ethnically and economically diverse sample of 694 sixth and eighth grade children. The sample included boys to assess the extent to which the findings were unique to girls. Measures included quantitative and qualitative support from father figures and indices of self-esteem, loneliness, and depression. Standardized test scores and classroom grades were also obtained from school records. ^ Girls with biological fathers had higher achievement test scores than girls in the other father categories, but there were no other differences related to the presence or absence of a father-figure. Biological fathers also provided greater quantitative and qualitative support than step- and surrogate fathers. Surrogate fathers provided a greater amount but lower quality of support than step-fathers. ^ Girls who received lower levels of support from biological fathers reported lower self-esteem and greater loneliness, compared to fatherless girls and those receiving low support from other father figures, suggesting that low support from biological fathers may be especially distressing. On the other hand, girls with low biological father support had higher achievement scores compared to fatherless girls and those who received low support from step- and surrogate fathers. Thus, the mere presence of the biological father appears to facilitate achievement, regardless of the level of support he provides. ^ This study highlights the supportive characteristics of different father figures and their influence on well-being and achievement in females. Future research should focus on the dynamics of surrogate father relationships and the specific characteristics that differentially affect developmental outcomes. ^

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Low-rise buildings are often subjected to high wind loads during hurricanes that lead to severe damage and cause water intrusion. It is therefore important to estimate accurate wind pressures for design purposes to reduce losses. Wind loads on low-rise buildings can differ significantly depending upon the laboratory in which they were measured. The differences are due in large part to inadequate simulations of the low-frequency content of atmospheric velocity fluctuations in the laboratory and to the small scale of the models used for the measurements. A new partial turbulence simulation methodology was developed for simulating the effect of low-frequency flow fluctuations on low-rise buildings more effectively from the point of view of testing accuracy and repeatability than is currently the case. The methodology was validated by comparing aerodynamic pressure data for building models obtained in the open-jet 12-Fan Wall of Wind (WOW) facility against their counterparts in a boundary-layer wind tunnel. Field measurements of pressures on Texas Tech University building and Silsoe building were also used for validation purposes. The tests in partial simulation are freed of integral length scale constraints, meaning that model length scales in such testing are only limited by blockage considerations. Thus the partial simulation methodology can be used to produce aerodynamic data for low-rise buildings by using large-scale models in wind tunnels and WOW-like facilities. This is a major advantage, because large-scale models allow for accurate modeling of architectural details, testing at higher Reynolds number, using greater spatial resolution of the pressure taps in high pressure zones, and assessing the performance of aerodynamic devices to reduce wind effects. The technique eliminates a major cause of discrepancies among measurements conducted in different laboratories and can help to standardize flow simulations for testing residential homes as well as significantly improving testing accuracy and repeatability. Partial turbulence simulation was used in the WOW to determine the performance of discontinuous perforated parapets in mitigating roof pressures. The comparisons of pressures with and without parapets showed significant reductions in pressure coefficients in the zones with high suctions. This demonstrated the potential of such aerodynamic add-on devices to reduce uplift forces.