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PubMed2006

Delta V as a predictor of significant injury for children involved in frontal motor vehicle crashes.

OBJECTIVE: The objective of this study was to examine the association between delta V and risk of injury to children involved in frontal motor vehicle crashes. BACKGROUND: Previous studies, primarily focused on adult occupants, have demonstrated the relationship between crash severity, as measured by delta V and injury severity. As children have unique safety needs, these results cannot be directly applied to the pediatric population. METHODS: Case series crash investigation data and clinical injury information were reviewed from a child-focused crash surveillance system. Analyses were performed examining the relationship between the estimated delta V and any AIS > or = 2 or any AIS > or = 3 injury. RESULTS: Detailed crash investigation and clinical data were available on 407 children involved in 235 frontal crashes. The average delta V for all crashes was 29 +/- 16.9 kph [18 +/- 10.5 mph (range, 5-123 kph)]. Delta V was strongly and positively associated with the odds of both an AIS > or = 2 and AIS > or = 3 injury (P < 0.0001). The adjusted odds of at least one AIS > or = 2 injury increased on average by 56% (95% confidence interval [CI], 33%-85%) for each 10 kph increase in delta V. Similarly, the adjusted odds of at least one AIS > or = 3 injury increased on average by 67% (95% CI, 40%-102%) for each 10 kph increase in delta V. The delta V at which 50% of child occupants would be expected to sustain any AIS > or = 2 injury was 37 kph [23.0 mph (95% CI, 32-45 kph)], and any AIS > or = 3 injury was 63 kph [39.1 mph (95% CI, 51-infinity kph)]. CONCLUSION: Delta V is strongly predictive of injury risk for child occupants. As many newer generation cars are now fitted with event data recorders, this information is increasingly available and may become useful as a clinical predictor.

Abbreviated Injury Scale↗

PubMed2004

Aromatase inhibitors: possible future applications.

In premenopausal women ovaries are the major sites of estrogen production, while in postmenopausal women estrogen is produced by aromatization of ovarian and adrenal androgens in extragonadal sites, mostly in adipose tissue. Aromatase is a cytochrome P450 hemoprotein-containing enzyme complex that catalyzes the rate-limiting step in the conversion of androstenedione and testosterone to estrone and estradiol (E2). Aromatase inhibitors (AIs) have been developed primarily for use in either natural or surgical postmenopausal patients. In premenopausal women, the ovary can overcome the estrogen blockade by reflex increments of luteinizing hormone (LH) and follicle stimulating hormone (FSH), so AIs must be combined with a gonadotropin releasing hormone (GnRH) agonist to prevent the reflex LH and FSH increments. In advanced hormone-dependent breast cancer treatment, AIs have been shown to be superior to tamoxifen. Preliminary evidence also suggests superiority in the adjuvant, neoadjuvant settings and also for breast cancer prevention. AIs have been used in infertility and can increase ovulation rate. Reducing FSH dose, estrogen levels, improving response to FSH, implantation rates, and developing multiple follicles that can be used in in vitro maturation procedures are potential areas that AIs might be used in in assisted reproductive technologies (ART), besides simple ovulation induction. AIs are reported to be successful in treatment of endometriosis, an estrogen-dependent process. The use of AIs in gynecomastia, puberte precox, leiomyoma uteri, some estrogen-dependent cancers (ovarian), endometrial cancer and male infertility are reported; some of the results are promising but more clinical trials are needed. AIs are predicted to become the gold standard in the treatment of estrogen-dependent diseases in reproductive medicine in the near future.

Aromatase Inhibitors↗

PubMed1996

Effect of heavy alcohol intake on long-term results after curative resection of hepatitis C virus-related hepatocellular carcinoma.

We studied the effect of heavy alcohol intake (ethanol intake > or = 80 g/day for > or = 5 yr) on long-term results in 53 patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) who had undergone curative hepatic resection. Cell proliferative activity in the tumor and non-tumorous liver was also assessed by counting argyrophilic nucleolar organizer region-associated proteins (Ag-NOR) in the resected specimens. Twenty patients (20 males, 0 females) were positive for heavy alcohol intake [AI(+)] and 33 (28 males, 5 females) were not [AI(-)]. All patients were positive for HCV antibody and negative for hepatitis B surface antigen. Carcinoma recurred within 3 to 51 postoperative months in 42 (79.2%) of the 53 patients. The median disease-free survival time was 12.6 mo in the AI(+) group and 25.4 mo in the AI(-) group (P < 0.01). The AI(+) group also had significantly poorer survival than the AI(-) group (P < 0.05, 3-year survival rate: 66.7% vs. 93.5%). HCC tumor in the AI(+) group showed significantly increased proliferative activity compared with that in the AI(-) group (P < 0.05, Ag-NOR number: 2.3 +/- 0.8 vs. 1.9 +/- 0.4). However, there was no significant difference between the numbers of Ag-NORs in non-tumorous liver from these two groups (1.5 +/- 0.2 vs. 1.5 +/- 0.2). Patients with heavy alcohol intake should be followed particularly closely, even if they have received curative surgery, since heavy alcohol intake is closely related to a poor postoperative prognosis.

Carcinoma, Hepatocellular↗

PubMed1996

Clinical features of adrenal insufficiency in patients with acquired immunodeficiency syndrome.

OBJECTIVE: Adrenal insufficiency (AI) is a well known complication of AIDS. However, the clinical and biochemical features of AI in HIV infected patients have not been extensively studied. DESIGN: A retrospective clinical study. PATIENTS: We reviewed clinical records of 74 AIDS patients with clinical and/or biochemical indications of AI who underwent Synacthen testing in order to determine adrenocortical function during a 5-year period. MEASUREMENTS: AI was diagnosed when cortisol levels failed to rise above 496 nmol/l at any time during the test. Cortisol was measured by RIA. RESULTS: Sixteen patients (22%) were diagnosed with AI. Most were young males and all of them had a known risk factor, principally i.v. drug users. The main complaint was fatigue. Hyponatraemia or hyperkalaemia were uncommon. All of them were severely immunosuppressed, with AIDS-defining conditions from at least 6 months before the diagnosis of AI, and had been diagnosed with at least one disease that has been reported to produce AI in AIDS patients. Survival was poor. Thirteen of these patients (81%) died within 6 months. Basal cortisol levels were lower than 275 nmol/l in 75% of patients with AI but in only 2% of the group of 58 patients who had normal adrenal responses to Synacthen. CONCLUSIONS: Adrenal insufficiency features in AIDS patients with advanced disease, without specific findings and with a history of previous opportunistic diseases. Basal cortisol values at 0830 h lower than 275 nmol/l are highly suggestive of adrenal insufficiency in patients with AIDS.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Autoinducer 2: a concentration-dependent signal for mutualistic bacterial biofilm growth.

4,5-Dihydroxy-2,3-pentanedione (DPD), a product of the LuxS enzyme in the catabolism of S-ribosylhomocysteine, spontaneously cyclizes to form autoinducer 2 (AI-2). AI-2 is proposed to be a universal signal molecule mediating interspecies communication among bacteria. We show that mutualistic and abundant biofilm growth in flowing saliva of two human oral commensal bacteria, Actinomyces naeslundii T14V and Streptococcus oralis 34, is dependent upon production of AI-2 by S. oralis 34. A luxS mutant of S. oralis 34 was constructed which did not produce AI-2. Unlike wild-type dual-species biofilms, A. naeslundii T14V and an S. oralis 34 luxS mutant did not exhibit mutualism and generated only sparse biofilms which contained a 10-fold lower biomass of each species. Restoration of AI-2 levels by genetic or chemical (synthetic AI-2 in the form of DPD) complementation re-established the mutualistic growth and high biomass characteristic for the wild-type dual-species biofilm. Furthermore, an optimal concentration of DPD was determined, above and below which biofilm formation was suppressed. The optimal concentration was 100-fold lower than the detection limit of the currently accepted AI-2 assay. Thus, AI-2 acts as an interspecies signal and its concentration is critical for mutualism between two species of oral bacteria grown under conditions that are representative of the human oral cavity.

Actinomyces↗

PubMed1996

Increased in vitro cysteinyl leukotriene release from blood leukocytes in patients with asthma, nasal polyps, and aspirin intolerance.

In vitro cysteinyl leukotriene (cLT) release from blood leukocytes was measured in eight normal individuals (NI), nine patients with nasal polyps (NP) without aspirin intolerance, and eight patients with NP, asthma, and aspirin intolerance (AI). Blood leukocytes were prestimulated with interleukin-3 (IL-3) and incubated with acetylsalicylic acid (ASA) (10 and 100 micrograms/ml) together with C5a (10(-8) mol/l) for 18 h. cLT release (LTC4, LTD4 and LTE4) from blood leukocytes was measured with a competitive enzyme-linked immunoassay. Background cLT release was 259 +/- 66 pg/ml (mean +/- SEM) in the NI group, 185 +/- 33 pg/ml in the NP group, and 578 +/- 136 pg/ml in the AI group (P = 0.1). After incubation with 10 micrograms/ml ASA, cLT concentration was lower in normal subjects (346 +/- 72 pg/ml) and in patients with NP (209 +/- 53) than in patients with AI (686 +/- 75 pg/ml, P = 0.002). After incubation with 100 micrograms/ml ASA, cLT concentrations were 285 +/- 72 pg/ml in the NI group, 313 +/- 77 pg/ml in the NP group, and 654 +/- 121 pg/ml in the AI group (P = 0.04), respectively. Simultaneous incubation with ASA 10 micrograms/ml and C5a (10(-8)mol/l) resulted in a cLT concentration of 751 +/- 171 pg/ml in the NI group, 343 +/- 102 pg/ml in the NP group, and 2196 +/- 480 pg/ml in patients with AI (P = 0.0006), whereas simultaneous incubation with ASA 100 g/ml and C5a (10(-8)mol/l) resulted in 268 +/- 51 pg/ml in the NI group, 412 +/- 97 pg/ml in the NP group, and 1701 +/- 368 pg/ml in the AI group (P = 0.005). In patients with AI, cLT release from blood leukocytes is altered when compared with normals and patients with NP. The presented cLT-release assay could be of potential use in the in vitro diagnosis of AI.

Adult↗

PubMed1982

Posttransfusion viability of rabbit erythrocytes preserved in a medium containing inosine, adenine, and isoosmotic sucrose.

A sucrose medium containing relatively great amounts of adenine and inosine (AIS-CPD) was more effective for maintaining adenosine triphosphate (ATP) and 2,3-diphosphoglyceric acid (DPG) levels of human erythrocytes for more than 35 days at 4 degrees C than control ACD-packed cells, sucrose medium (S-CPD), and sucrose medium containing a small amount of adenine. Then rabbit erythrocytes were used prior to in vivo test of human cells. (1) After storage for 5 weeks the ATP level (mumol/g Hb) was 3.25 in AIS-CPD, 2.65 in AISNa-CPD (AIS-CPD containing NACl plus sucrose instead of sucrose), 0.77 in S-CPD, and 0.42 in CPD (fresh: 5.39; n = 4-10). (2) The DPG level (mumol/g Hb) was AIS-CPD not equal to fresh greater than AISNa-CPD greater than S-CPD not equal to CPD. (3) The mean corpuscular volume decreased gradually in AIS-CPD. (4) The fragility of red cells decreased in AIS-CPD. (5) The posttransfusion viability measured by the 51Cr method after storage of erythrocytes for 5 weeks was 84.5% in AIS-CPD, 70.6% in AISNa-CPD, 59.5% in S-CPD, and 28.5% in CPD, 24 h after transfusion 14.9 in AIS-CPD, 9.9 in AISNa-CPD, 12.8 in S-CPD, and 8.4 in CPD (fresh: 14.0; n = 7-8).

Adenine↗

PubMed2005

Effect of insemination volume on uterine contractions and inflammatory response and on elimination of semen in the mare uterus-scintigraphic and ultrasonographic studies.

The effect of artificial insemination (AI) volume on uterine contractility and inflammation and on elimination of semen in the reproductive tract of mares was examined for 4 h after AI using two methods, scintigraphy and ultrasonography. The same doses were used in both methods: 2 and 100 ml of skim milk-extended frozen semen. In the scintigraphic study, the number of reproductively normal mares was four per group and in the ultrasonographic study five per group. For scintigraphy, the semen was radiolabelled with technetium-99m. The static scintigrams were acquired immediately before and 30, 60, 120, 180 and 240 min after AI. The activities in the vagina and uterus were calculated and the values for sperm that had been discharged from the mare were obtained by subtracting the counts for the uterus and vagina from the total radioactivity. The dynamic scintigrams were taken continuously for the first 30 min after AI and in 5-min periods immediately after having acquired the static scintigrams. The uterine contractions were counted. In the ultrasonographic study, the mares were scanned before AI and at 5, 10, 15, 20, 25, 30, 60, 120, 150, 180, and 240 min after AI, for at least 1 min each time. The examinations were videotaped and contractions counted per minute. More contractions were observed with the ultrasonographic method than with the scintigraphic method. No difference was present in the number of contractions between the groups, except in the ultrasonographic study at 4 h, when the mares inseminated with 100 ml showed more contractions than did the mares inseminated with 2 ml. The intraluminal fluid was sampled with a tampon and by uterine lavage 4 h after AI in the ultrasonographic study. The numbers of polymorphonuclear leukocytes and spermatozoa were counted, but the differences between the groups were not significant. Under our experimental conditions and with the number of mares examined, the volume of the AI dose had an insignificant effect on contractility - with the exception at 4 h - and inflammatory reaction and on semen elimination in the uterus.

Animals↗

PubMed2006

Incidence of unilateral fertilizations after low dose deep intrauterine insemination in spontaneously ovulating sows under field conditions.

A new procedure for non-surgical deep intrauterine insemination (DUI) in unrestrained sows hormonally induced to ovulate, has been reported. In comparison with standard artificial insemination (AI), with this procedure, the sperm numbers inseminated can be reduced 20-fold without reducing the reproductive performance of these hormonally treated sows. The present study evaluated, using two experiments, the reproductive performance applying 20-fold different sperm numbers per AI dose using DUI or standard AI in spontaneously ovulating sows, under field conditions. In experiment 1, AI was applied to crossbred sows at 12, 24 and 36 h after onset of spontaneous oestrus using one of the following two regimes: (i) DUI (treatment) with 0.15 x 10(9) fresh boar spermatozoa in 5 ml of Beltsville thawing solution (BTS) extender (n = 95), and (ii) standard cervical AI (control) with 2.85 x 10(9) fresh spermatozoa in 95 ml of BTS extender (n = 95). The farrowing rates of the two groups of sows were statistically similar (NS). However, a decrease (p < 0.002) in litter size and the total number of pigs born alive was observed in sows inseminated with the DUI procedure. In experiment 2, 42 post-weaned oestrus sows were inseminated following the same design described for experiment 1 during spontaneous oestrus. On day 6 after onset of oestrus, the proximal segment of the uterine horns of the sows were flushed under surgery to retrieve eventual embryos and evaluate the success of fertilization per cornua (e.g. occurrence of effective uni- vs bilateral sperm transport rendering uni- or bilateral, complete or partial fertilization). Retrieved embryos were assessed for cleavage and number of accessory spermatozoa. Although identical overall pregnancy rates were achieved in both insemination groups, the percentage of sows with partial bilateral fertilization and unilateral fertilization was markedly higher (p < 0.05) in the DUI group (35%) compared with the control (standard AI) group (5%), with a consequent lower (p < 0.001) percentage of viable early embryos after DUI. The number of accessory spermatozoa in the zona pellucida of the embryos was highly variable, but higher (p < 0.001) in control animals than in DUI-AI. No accessory spermatozoa were found in oocytes retrieved from sows depicting unilateral fertilization. In conclusion, DUI in spontaneously ovulating sows with 0.15 x 10(9) spermatozoa renders similar farrowing rates but a lower litter size compared with use of standard AI with a 20-fold higher sperm dose. The lower litter size ought to be related to a decreased distribution of spermatozoa after DUI leading to a higher incidence of partial bilateral and unilateral fertilization.

Animals↗

PubMed2005

Is laser conization adequate for therapeutic excision of adenocarcinoma in situ of the uterine cervix?

AIMS: To determine the safety of uterine-preserving operations for adenocarcinoma in situ of the cervix. METHODS: Fifteen cases of adenocarcinoma in situ (AIS) were diagnosed using neodymium:yttrium aluminum garnet (Nd:YAG) laser conization. The accuracy of preconization histology or cytology was evaluated in 15 AIS cases. In these AIS cases, we investigated how far the tumor was located from the squamocolumnar junction (SCJ) and the endocervix. Fourteen cases of the 15 AIS-affected patients were treated using laser conization alone. These patients were closely followed up. RESULTS: Precise agreement between preconization diagnosis and conization histology was seen in 46.7% (7/15) of the AIS cases. In 14 of the 15 cases of AIS (93.3%), the tumor was adjacent to the transitional zone, within 3 mm of the SCJ, and in the other case (6.7%), the tumor was between 0 and 5 mm away from the SCJ. In all subjects, cone height was 8-18 mm (mean 13.1 mm). None of the 15 patients showed any recurrence of AIS during follow up ranging from 15 to 75 months (43.1 months on average). CONCLUSIONS: Women with AIS who want to preserve their fecundity might be treated with laser conization alone.

Adenocarcinoma↗

PubMed2004

Predictors of androgen independence in metastatic prostate cancer.

OBJECTIVE: To assess the factors that influence the onset of androgen independence (AI, which heralds a dismal outcome) in patients with metastatic prostate carcinoma. PATIENTS AND METHODS: The records of 361 consecutive patients with prostate carcinoma diagnosed and treated in the authors' institution from 1 January 1996 to 31 December 1999 were reviewed retrospectively; 92 with metastatic prostate carcinoma were assessed (median age 71.0 years, range 42-93). Patients were included if they developed metastatic disease from prostate cancer at the time of diagnosis. The nadir for prostate specific antigen (PSA) level was defined as the date of the lowest PSA level after hormonal therapy, and AI was defined as the date of the third consecutive PSA increase above the nadir value by any threshold. RESULTS: The median Gleason sum was 8 and the modal Gleason score 4 + 5. The median (range) pretreatment PSA level was 274.0 (1.3-2179) ng/mL. Of the 92 men, 57 (62%) attained a nadir PSA, including 23 with a nadir of < 2 ng/mL; 32 (35%) progressed to AI within 2 years and 27% reached a nadir PSA but did not develop AI. The mean (sd) time from diagnosis to the nadir PSA was 13.7 (11.8) months, while the mean time from diagnosis to progression to AI was 30.3 (15.6) months. Univariate analysis showed that a nadir PSA level after treatment of >/= 1 ng/mL (P = 0.0128) was an early predictor of progression to AI; a nadir PSA level of >/= 2 ng/mL (P = 0.0216) was a predictor of poor overall survival. CONCLUSION: Failure to attain a nadir PSA of < 1 ng/mL after treatment predicts progression to AI and a nadir PSA of > 2 ng/mL predicts poorer overall survival. The development of skeletal events predicts the onset of AI but occurs late in the disease and is unsuitable as an early prognostic marker.

Adult↗

PubMed1993

Inhibitory effect of endothelin on renin release in dog kidneys.

To investigate the effect of endothelin on renin release, experiments were performed in barbiturate-anaesthetized dogs with denervated kidneys. Intrarenal infusion of endothelin (1 ng min-1 kg-1 body wt) reduced renal blood flow (RBF) from 145 +/- 10 ml min-1 to 98 +/- 9 ml min-1 without altering renin release (1 +/- 1 microgram angiotensin I (AI) min-1). Renin release was then increased either by renal arterial constriction or ureteral occlusion. When renal arterial pressure was reduced to 50 mmHg, renin release averaged 79 +/- 20 micrograms AI min-1 in six dogs and fell significantly to 24 +/- 6 micrograms AI min-1 during endothelin infusion. During ureteral occlusion the inhibitory effect of endothelin on renin release either during inhibition of beta-adrenergic activity with propranolol or after inhibiting prostaglandin synthesis by indomethacin during intrarenal infusion of isoproterenol was examined. After propranolol administration ureteral occlusion increased renin release from 5 +/- 2 micrograms AI min-1 to 38 +/- 12 micrograms AI min-1 in six dogs. Subsequent intrarenal endothelin infusion (1 ng min-1 kg-1 body wt) during maintained ureteral occlusion reduced renin release to 10 +/- 3 micrograms AI min-1. In six other dogs prostaglandin synthesis was inhibited by indomethacin. Subsequent infusion of isoproterenol (0.2 microgram min-1 kg-1 body wt) to stimulate beta-adrenoceptor activity increased renin release from 13 +/- 4 micrograms AI min-1 to 68 +/- 8 micrograms AI min-1 during ureteral occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗

PubMed2026

The Role of Artificial Intelligence for Intimate Partner Violence Prevention: A Systematic Review.

INTRODUCTION: Intimate partner violence (IPV), encompassing physical, sexual, emotional and economic abuse, remains a pervasive global health concern. Traditional prevention efforts face obstacles such as underreporting, delayed detection and limited personalised support. Emerging artificial intelligence (AI) approaches offer new opportunities to enhance IPV prevention. AIM: This systematic review maps and synthesises evidence on AI-driven tools in IPV prevention based on studies published between 2004 and 2024. METHODS: Following PRISMA 2020 guidelines and PROSPERO registration, we searched PubMed, Embase, CINAHL, PsycINFO, IEEE Xplore and Web of Science. Eligible studies explicitly evaluated AI technologies targeting IPV prediction, screening, intervention or support delivery. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Of 1304 records initially identified, 41 studies met eligibility criteria. AI applications ranged from machine learning (ML) for risk prediction and natural language processing (NLP) for IPV detection in clinical and social media data, to image analysis for forensic evaluation and chatbot-based support. Predictive modelling demonstrated strong discriminative performance, while NLP-based screening detected IPV with notable sensitivity. Chatbots showed feasibility and user acceptability, but evidence of their direct impact on reducing IPV incidence was limited, with one randomised controlled trial showing a modest reduction. Key challenges identified included algorithmic bias, data privacy risks and barriers to integration across health and social care systems. DISCUSSION: AI-informed interventions show promise for improving IPV detection, risk assessment, and scalable support, but questions remain about long-term effectiveness, ethical fairness, transparency and equitable implementation. Future interdisciplinary research should address these concerns to responsibly deploy AI in IPV prevention. RELEVANCE TO CLINICAL PRACTICE: The findings highlight the importance of trauma-informed, culturally responsive care and provider training in AI applications. Nurse-led innovation and policy advocacy will be crucial for safe, equitable integration of AI in IPV prevention.

Artificial Intelligence↗

PubMed2026

The Impact of Baseline Negative Emotions on Postoperative Quality of Life in Adolescent Idiopathic Scoliosis Patients: A 2-Year Follow-Up Study.

OBJECTIVE: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that develops during puberty without a clear etiology. Beyond physical manifestations, AIS severely impacts adolescents' psychological and social well-being, leading to anxiety, depression, and low self-esteem. While advancements in surgical techniques have enhanced objective outcomes, existing studies on AIS have primarily focused on objective indices, with limited attention to the long-term impact of preoperative negative emotions on patient-reported subjective quality of life. METHODS: This was a retrospective cohort study. A total of 112 eligible AIS patients who underwent posterior spinal correction surgery between April and August 2023 were enrolled. Inclusion criteria included confirmed AIS, completion of 2-year follow-up, and informed consent; exclusion criteria included missing imaging/questionnaire data, comorbid psychiatric/neurological diseases, or prior spinal surgery. Patients were grouped using the Hospital Anxiety and Depression Scale (HADS) administered on admission. Quality of life was assessed preoperatively and 2 years postoperatively using the Scoliosis Research Society-22 (SRS-22, evaluating self-image, mental health, pain, function, treatment satisfaction) and Short Form 36 Health Survey (SF-36, assessing 8 physical and mental health dimensions). Statistical analysis was performed via SPSS, using independent t-tests, paired t-tests, Mann-Whitney U test, and chi-square test. p < 0.05 was considered significant. RESULTS: There were no significant differences in baseline characteristics (age, gender, BMI, surgical parameters, scoliosis type, preoperative/postoperative Cobb angles) between the two groups (all p > 0.05). Preoperatively, SRS-22 and SF-36 scores showed no inter-group differences (all p > 0.05). Postoperatively, the Negative Emotion Group had significantly lower scores in SRS-22 mental health (3.9 ± 0.3 vs. 4.5 ± 0.2) and treatment satisfaction (4.0 ± 0.3 vs. 4.6 ± 0.7), as well as SF-36 general health (68.6 ± 6.4 vs. 79.7 ± 13.3), role-emotional (61.3 ± 9.3 vs. 70.8 ± 9.7), and mental health (61.8 ± 14.3 vs. 68.9 ± 10.7) (all p < 0.05); no inter-group differences were observed in physical function-related dimensions. Both groups showed significant improvements in physical function-related dimensions postoperatively. The Non-Negative Emotion Group also exhibited significant improvements in SRS-22 self-image/pain and SF-36 bodily pain (all p < 0.05), while the Negative Emotion Group showed no significant improvements in these dimensions. CONCLUSIONS: Preoperative anxiety and depression do not affect the recovery of physical function in AIS patients after spinal correction surgery but significantly impede improvements in subjective quality of life dimensions, including mental health and treatment satisfaction. These findings highlight the need to integrate psychological assessment and targeted interventions into the perioperative management of AIS. Such a patient-centered approach will help optimize both physical and psychological outcomes, ultimately achieving comprehensive rehabilitation for AIS adolescents.

Humans↗

PubMed2005

Consonant recognition and the articulation index.

The purpose of this paper is to provide insight into how speech is processed by the auditory system, by quantifying the nature of nonsense speech sound confusions. (1) The Miller and Nicely [J. Acoust. Soc. Am. 27(2), 338-352 (1955)] confusion matrix (CM) data are analyzed by plotting the CM elements Si,j(SNR) as a function of the signal-to-noise ratio (SNR). This allows for the robust clustering of perceptual feature (event) groups, not robustly defined by a single CM table, where clusters depend on the sound order. (2) The SNR is then re-expressed as an articulation index (AI), and used as the independent variable. The normalized log scores log(1-Si,i(AI)) and log(Si,j(AI)), j not equal to i, then become linear functions of AI, on log-error versus AI plots. This linear dependence may be interpreted as an extension of the band-independence model of Fletcher. (3) The model formula for the average score for the finite-alphabet case Pc(AI,H)= sigma(N)i=1Si,i/N is then modified to include the effect of entropy H. Due to the grouping of sounds with increased SNR (and AI), the sound-group entropy Hg plays a key role in this performance measure. (4) A parametric model for the confusions Si,j(AI,Hg) is then described, which characterizes the confusions between competing sounds within a group.

Female↗

PubMed2001

Intra- and interspecies regulation of gene expression by Actinobacillus actinomycetemcomitans LuxS.

The cell density-dependent control of gene expression is employed by many bacteria for regulating a variety of physiological functions, including the generation of bioluminescence, sporulation, formation of biofilms, and the expression of virulence factors. Although periodontal organisms do not appear to secrete acyl-homoserine lactone signals, several species, e.g., Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum, have recently been shown to secrete a signal related to the autoinducer II (AI-2) of the signal system 2 pathway in Vibrio harveyi. Here, we report that the periodontal pathogen Actinobacillus actinomycetemcomitans expresses a homolog of V. harveyi luxS and secretes an AI-2-like signal. Cell-free conditioned medium from A. actinomycetemcomitans or from a recombinant Escherichia coli strain (E. coli AIS) expressing A. actinomycetemcomitans luxS induced luminescence in V. harveyi BB170 >200-fold over controls. AI-2 levels peaked in mid-exponential-phase cultures of A. actinomycetemcomitans and were significantly reduced in late-log- and stationary-phase cultures. Incubation of early-log-phase A. actinomycetemcomitans cells with conditioned medium from A. actinomycetemcomitans or from E. coli AIS resulted in a threefold induction of leukotoxic activity and a concomitant increase in leukotoxin polypeptide. In contrast, no increase in leukotoxin expression occurred when cells were exposed to sterile medium or to conditioned broth from E. coli AIS(-), a recombinant strain in which luxS was insertionally inactivated. A. actinomycetemcomitans AI-2 also induced expression of afuA, encoding a periplasmic iron transport protein, approximately eightfold, suggesting that LuxS-dependent signaling may play a role in the regulation of iron acquisition by A. actinomycetemcomitans. Finally, A. actinomycetemcomitans AI-2 added in trans complemented a luxS knockout mutation in P. gingivalis by modulating the expression of the luxS-regulated genes uvrB and hasF in this organism. Together, these results suggest that LuxS-dependent signaling may modulate aspects of virulence and the uptake of iron by A. actinomycetemcomitans and induce responses in other periodontal organisms in mixed-species oral biofilm.

Aggregatibacter actinomycetemcomitans↗

PubMed2002

Precision and accuracy of a procedure for detecting recent human immunodeficiency virus infections by calculating the antibody avidity index by an automated immunoassay-based method.

We evaluated the precision and accuracy of a procedure for detecting recent human immunodeficiency virus (HIV) infections, specifically, the avidity index (AI) calculated using a method based on an automated AxSYM HIV 1/2gO assay (Abbott). To evaluate precision, we performed multiple replicates on eight HIV-positive serum samples. To evaluate the accuracy in identifying recent infections (i.e., within 6 months of seroconversion), we used 216 serum samples from 47 persons whose dates of seroconversion were known. To evaluate the sensitivity and specificity of the procedure for different AI cutoff values, we performed receiver operating characteristic (ROC) analysis. To determine the effects of antiretroviral treatment, advanced stage of the disease (i.e., low CD4-cell count), and low HIV viral load on the AI, we analyzed 15 serum samples from 15 persons whose dates of seroconversion were unknown. The precision study showed that the procedure was robust (i.e., the total variance of the AI was lower than 10%). Regarding accuracy, the mean AI was significantly lower for samples collected within 6 months of seroconversion, compared to those collected afterwards (0.68 +/- 0.16 versus 0.99 +/- 0.10; P < 0.0001), with no overlap of the 95% confidence intervals. The ROC analysis revealed that an AI lower than 0.6 had a sensitivity of 33.3% and a specificity of 98.4%, compared to 87.9 and 86.3%, respectively, for an AI lower than 0.9. Antiretroviral treatment, low CD4-cell count, and low viral load had no apparent effect on the AI. In conclusion, this procedure is reproducible and accurate in identifying recent infections; it is automated, inexpensive, and easy to perform, and it provides a quantitative result with different levels of sensitivity and specificity depending on the selected cutoff.

AIDS Serodiagnosis↗

PubMed1999

Natural history and surgical outcomes for isolated discrete subaortic stenosis in children.

OBJECTIVE: To document the natural history and surgical outcomes for discrete subaortic stenosis in children. DESIGN: Retrospective review. SETTING: Tertiary care paediatric cardiology centres. PATIENTS: 92 children diagnosed between 1985 and 1998. MAIN OUTCOME MEASURES: Echocardiographic left ventricular outflow gradient (echograd), and aortic insufficiency (AI). RESULTS: The mean (SEM) age at diagnosis was 5.3 (0.4) years; the mean echograd was 30 (2) mm Hg, with AI in 22% (19/87) of patients. The echograd and incidence of AI increased to 35 (3) mm Hg and 53% (36/68) (p < 0.05) 3.6 (0.3) years later. The echograd at diagnosis predicted echograd progression and appearance of AI. 42 patients underwent surgery 2.2 (0.4) years after diagnosis. Preoperatively echograd and AI incidence increased to 58 (6) mm Hg and 76% (19/25) (p < 0.05). The echograd was 26 (4) mm Hg 3.7 (0.4) years postoperatively, with AI in 82% (31/38) of patients. Surgical morbidities included complete heart block, need for prosthetic valves, and iatrogenic ventricular septal defects. Eight patients underwent reoperation for recurrent subaortic stenosis. The age at diagnosis of 44 patients followed medically and 42 patients operated on did not differ (5.5 (0.6) v 5. 0 (0.6) years, p < 0.05). However, the echograd at diagnosis in the former was less (21 (2) v 40 (5) mm Hg, p < 0.05) and did not increase (23 (2) mm Hg) despite longer follow up (4.1 (0.4) v 2.2 (0. 4) years, p < 0.05). The incidence of AI at diagnosis and at last medical follow up was also less (14% (6/44) v 34% (13/38); 40% (17/43) v 76% (19/25), p < 0.05). CONCLUSIONS: Many children with mild subaortic stenosis exhibit little progression of obstruction or AI and need not undergo immediate surgery. Others with more severe subaortic stenosis may progress precipitously and will benefit from early resection despite risks of surgical morbidity and recurrence.

Aortic Valve Insufficiency↗