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High and low states represent a large variety of features in the optical activity of some types of cataclysmic variables. Here, we examine them in the intermediate polar V1223 Sgr. We use the photographic observations from the Bamberg Observatory and from Garnavich and Szkody, and the CCD ASAS-3 and NSVS data. One plate or CCD image was usually obtained per night. These data span 78 years. We use the histograms of brightness to set the separation between the high and low states in V1223 Sgr at the level of 13.9 mag(B). The profile of this statistical distribution is dominated by a broad bump with the peak-to-peak amplitude of more than 1 mag(B). This is the result of co-adding various episodes of the high states, sometimes with the brightness varying on a timescale of months even during a single episode. The high state is not any uniquely defined level of brightness. Groups of the low states represent tails from such bumps rather than forming specific levels of brightness. The fuzzy boundaries of the bright side of the statistical distributions of brightness show that the system cannot find equilibrium of the mass transfer even in the high state. We show that V1223 Sgr underwent a large change of its high/low state activity; we ascribe it to the changes of the stellar activity of the donor. The episodes of the low states with mutually similar depth and profile were observed to recur with a cycle of 1092 days in the data mapping the years from 1999 to 2009; this behavior was discordant with the typical recurrence times present before. In our scenario, this cycle is driven by the changing aspect of some structure (e.g. a sequence of star spots migrating across the L1 point) on the donor. Because of the differential rotation of the donor, this configuration cyclically influences the mass flow to the accretion disk.

Background: A recording of ≥30 s is required for diagnosis of paroxysmal atrial fibrillation (AF) when using ambulatory electrocardiography (ECG) monitoring. It is unclear if shorter runs of atrial arrhythmia are relevant with regard to stroke risk. Aim: To assess current management of patients with atrial arrhythmia of

Leading questions are generally defined as those that raise details not provided by the witness. Leading questions can raise content details (eg, actions, objects, persons) or can refer to the time when details occurred. The latter questions are referred to as temporally leading. Study 1 compared the incidence of content and temporally leading questions in field interviews conducted by police officers when eliciting accounts from children about repeated, or a single episode of, abuse. Study 2 extended the analysis to use standardised mock rather than field interviews, where there was a precise record of what events occurred. In both studies, temporally leading questions were more frequent than content-leading questions, but only in situations in which multiple occurrences of the event were being discussed. The implications of these results are discussed.

A 75-year-old man presented with significant weight loss, persistent cough, single episode of frontotemporal pulsatile headache, and leg weakness. A paraneoplastic syndrome was suspected, and F-FDG PET/CT was performed. Diffuse, moderate-to-intense tracer symmetrical uptake of many large and medium arteries was unexpectedly noted. The peculiarity of this case is the extensive involvement of both large and medium head and neck and extremity vessels, whereas the aorta was relatively spared.

A 46-year-old male patient presented with high-grade fever with chills of 3 days duration. Patient had severe dysuria and bothersome lower urinary tract symptoms like frequency, urgency and intermittency for the past 4 months. On further evaluation, patient had single episode of frank haematuria

Background: Febrile seizures are commonly seen in children and about one-third of the children develop a recurrence of febrile seizures. Objectives: The main objective is to study the risk factors associated with recurrence of febrile seizures in Indian children. Methods: This prospective, longitudinal study was carried out in the Department of Pediatrics, GSVM Medical College, Kanpur. All children, 6 months to 5 years of age, attending the department from February 2015 to January 2016 presenting with first febrile seizures were included in the study and followed up for recurrence. Results: Of 528 children, 174 (32.9%) had recurrence and 354 (67.1%) had a single episode of febrile seizures. Recurrence was more in children

Aim Cholangitis is a well-known complication that contributes to morbidity, mortality, as well as health-care utilisation in children with biliary atresia who have undergone the Kasai portoenterostomy. The aim of the study was to determine the common causative organisms for cholangitis and characterise its burden, health-care resource and service utilisation and cost. Methods This was a retrospective chart review of children who underwent Kasai portoenterostomy in our institution from 1988 to 2011. The causative organisms were identified based on culture reports. The burden of the disease was estimated based on the number of patients experiencing one or more episodes of cholangitis. Health-care resource and service utilisation were based on different categories, and cost was computed based on the charges at the institution. Results Twenty-seven (64.3%) out of 42 children included in the analysis experienced at least one episode of cholangitis. There were a total of 97 episodes of cholangitis, with an average of 3.6 (1–15) episodes per patient. The average length of stay per episode of cholangitis was 14.8 (2–64) days. Common organisms isolated during blood cultures were Klebsiella pneumoniae, Enterococcus, Escherichia coli and Pseudomonas aeruginosa. The estimated cost per in-patient admission of 15 days (rounded off) for a single episode of cholangitis was $SG 8986.61 ($US 7369.02). Conclusion The knowledge about the incidence and cost of cholangitis will allow physicians to counsel parents of children newly diagnosed with biliary atresia and to better prepare them both emotionally and financially for what to expect.

“I never ate Kellogg’s Frosted Sugar Stars (cereal mascot character: Hillbilly Goat), and I never saw a single episode of The Beverly Hillbillies or Hee Haw , because the nearby ridges kept our flimsy rooftop T V antenna from pulling in CBS shows.”

Introduction: The aim of this work is to study the density of the renal papillae in stone-forming patients and to determine its usefulness. Materials and Methods: This study included a total of 79 patients diagnosed with renal stones and on whom a computed tomography without contrast was performed from June 2014 to May 2015. The patients were divided into two groups: Group 1 (single episode) included 43 patients, and Group 2 (recurrent episodes) included 36 patients. The density of six renal papillae (3 per kidney) was measured, and the means obtained were compared between Groups 1 and 2. Statistical analysis was performed using SPSS 20.0. Results: The mean papillary density in Group 1 was 32.26 (SD 4.07) HU compared to 42.36 (SD 8.03) HU in Group 2 (P=00001). A ROC curve was constructed, obtaining an optimal cut-off point of 36.8HU [area under the curve, 0.881 (95% CI; 0.804-0.958); P=0001], with a sensitivity of 80% and a specificity of 90%. The relative risk was estimated at 40.3 (95% CI; 10.8-151.1), meaning that a patient with a mean papillary density greater than 36.8HU would have a 40 times greater risk of having recurrent renal stones. The positive predictive value (PPV) was 81% and the negative predictive value (NPV) was 90%. Conclusion: The measurement of renal papillary density could be useful in predicting recurrent stone-formers. These results need to be confirmed in future studies with a greater number of patients and a longer follow-up.

Two studies were conducted to develop and validate a six-item scale for measuring context-specific attributions regarding the extent to which people either blame or exonerate partners during couples' conflicts. Context-specific attributions pertain to appraisals made during a single episode of relationship conflict, and the scale was expected to be distinct from existing attribution scales measuring people's schemas regarding the types of attributions they typically make. Study 1 included 2,452 people in marriage or cohabitating relationships; Study 2 included 172 people in dating relationships, and participants in both studies completed Internet questionnaires. Item response theory was used to create an attribution scale using the fewest number of items to discriminate reliably across the full range of attribution levels. The resulting scale produced an expected pattern of convergent and divergent correlations with other context-specific measures, including two types of underlying concerns and three types of emotion. The context-specific attribution scale explained variance in these criterion variables that could not be explained by other existing scales that assess attributions at the schematic level.

CHRONIC wasting disease (CWD) is a prion disease affecting many species of deer, which was, until recently, confined to North America. However, confirmed diagnoses in Norway in both reindeer ( Rangifer tarandus ) and European elk/moose ( Alces alces ) in two geographically widely separated regions (Defra 2016a) is particularly disturbing. The origin of CWD in Norway is obscure. It is possible that introduction from North America in contaminated deer material occurred as a single episode and the infection has spread or there have been two independent introductions. Alternatively, abnormal prions may have been generated anew in a Norwegian deer with subsequent dissemination. Establishing the most probable route will facilitate the implementation of appropriate control strategies to limit further incursion of CWD into Europe. However, if the North American experience is anything to go by, this incursion will have far-reaching implications throughout Europe and Asia since it has severely damaged deer farming and hunting industries in affected regions of Canada and the USA. Like all prion diseases, such as scrapie and bovine spongiform encephalopathy (BSE), CWD is a member of the transmissible spongiform encephalopathies (TSE) identified by the typical histological lesions found in the brain. As such, it is an invariably fatal neurodegenerative disease with pathological changes associated with the conversion of the normal host-encoded membrane-associated prion protein (PrPC) to abnormal disease-associated isoforms (PrPd) which accumulate, principally in nervous tissue, due to their resistance to enzymatic breakdown; it is also referred to as PrPres (Collinge 2001). In CWD, PrPd also accumulates peripherally in lymphoid tissue, similar to scrapie in sheep, and detection of PrPd is the current method of definitive diagnosis (Gavier-Widen and others 2005).⇓ FIG 1: North American elk ( Cervus canadensis ) in the clinical stage …

We investigated the characteristics of multiple episodes of mechanical restraint versus a single episode in a psychiatric ward of a public general hospital. The following characteristics were associated with multiple restraints: young age, length of hospital stay, not being readmitted within 30 days from previous discharge, and admission in the previous year before the implementation of an intervention program to reduce mechanical restraint. The study suggests that both organizational factors and patients' disturbed behaviour are associated with the risk of being mechanically restrained several times.

Up to now, there is no adequate definition of the alcohol hangover. The purpose of the current study was to develop a useful definition, and consensus among those who will use it in scientific publications. A survey was conducted among N=1099 social drinkers who recently had a hangover. They were asked to provide their definition of the alcohol hangover. Text mining and content analysis revealed 3 potential definitions. These were submitted to members of the Alcohol Hangover Research Group, who were asked to give their expert opinion on the proposed definitions. Taking into account their comments and suggestions, the following definition for the alcohol hangover was formulated: “The alcohol hangover refers to the combination of mental and physical symptoms, experienced the day after a single episode of heavy drinking, starting when blood alcohol concentration approaches zero.”

Several recent reports pointed out how the practice of using a “second screen” while following a television program is becoming an increasingly widespread phenomenon. When the secondary device is used to read or to comment about a watched program, most of the discussion takes place on popular social media such as Facebook and Twitter. Previous research has shown that the analysis of these contents could lead to a better understanding of the behavior of networked publics and of the structure of the show itself. Nevertheless most of the existing research is focused on the content only and focused on a single episode analysis or on big media events. Leveraging this background, this article presents instead a study focused on the relationships between content and users across an entire airing season of a TV program. Through a quantitative network analysis of the tweets produced during 25 episodes of the Italian political talks show Servizio Pubblico, we identified a small loyal group of viewers. Despite the d...

Background: Most cases of neuroretinitis (NR) are idiopathic or due to cat scratch disease and occur as a single episode but a subgroup of patients experience recurrent attacks with cumulative visual loss. We reviewed our cases of NR to better characterize the clinical features of these subgroups in an effort to predict the risk of recurrence.Methods: Retrospective study of NR patients from a single institution. Sixty-seven patients were divided into three groups: 22 cases due to cat scratch disease (CSD-NR), 24 with idiopathic neuroretinitis (I-NR) and 21 (23 eyes) with recurrent neuroretinitis (R-NR).Results: Preceding systemic symptoms, predominantly central visual field (VF) loss and the combination of poor acuity with small relative afferent pupillary defect at presentation were common features of CSD-NR. There were no cases of recurrent CSD-NR. In the first attack of R-NR, the magnitude of VF loss at presentation was greater compared to the other two groups. While 39% of R-NR had a pattern of VF los...

Recent research and policy making concerning homelessness has focused on the particular challenges associated with ending chronic homelessness. It is generally assumed that individuals who have been homeless for longer durations have a greater impact on the public system of care and are in need of the most assistance. The aim of this study was to examine key sample characteristics by duration of homelessness (total lifetime duration and longest single episode) using bivariate and multivariable regression analysis. Participants (n = 425) were adults recruited in Vancouver, BC on the basis of absolute homelessness or precarious housing and a current mental disorder. Interviewer-administered questionnaires elicited details concerning demographics, mental illness, substance use, service use, and duration of homelessness. In multivariable models, “persistent” homelessness (lifetime duration of three or more years) was independently predicted by male gender, older age, younger age when first homeless, incomplet...

Candidaemia is associated with high patient mortality. Among those who survive an initial episode of candidaemia, the incidence of recurrent episodes has been incompletely defined. All patients in Iceland with candidaemia in 1980–2008 were identified, and clinical information was reviewed. Episodes of candidaemia in the same patient were considered to be separate if they occurred ≥1 month apart or were caused by different Candida species. The isolates were genotyped by using PCR fingerprinting, and antifungal susceptibility was determined. During the 29-year period, candidaemia was diagnosed in 307 patients in Iceland, 298 of whom (97.1%) had a single episode. Overall, 206 patients survived >1 month from the first episode and were therefore at risk of recurrence, yielding 1062 patient-years of observation in the survivors. Of those, nine (4.4%) later developed recurrent candidaemia. The median time between recurrences was 6 months (range

Drug-eluting stents (DES) have significantly improved the rate of in-stent restenosis (ISR) following percutaneous coronary intervention (PCI). However, ISR remains a therapeutic challenge, often leading to recurrent ISR. The aim of this study was to compare patients with a single DES ISR event to

As practicing rheumatologists we have probably never given thought to how common an ailment, back pain is. Two thirds to almost three fourths of the population would have suffered at least a single episode of back pain in their lifespan. Usually the first episode of back pain occurs in the third or the fourth decade of life and increases with advancing age. Most clinicians approach back pain with an algorithm to classify whether back pain is inflammatory or non inflammatory. Amongst Non inflammatory back pain, we first proceed to rule out a prolapsed disc and then sinister causes such as malignancy and infection. Once the above have been ruled out all the leftover complaints are collectively given the label of “Mechanical back pain”. It is precisely this kind of back pain which is more likely to be chronic, unresolved and unrelenting and it is this “Mechanical back pain” that we would like to focus on rather than the whole list of differential diagnosis.

Background Alcohol addiction develops through a series of stages, and mechanistic studies are needed to understand the transition from initial drug use to sustained controlled alcohol consumption followed by abuse and physical dependence. The focus of this study was to examine the effects of voluntary alcohol consumption on brain gene expression profiles using a mouse model of binge drinking. The main goal was to identify alcohol-responsive genes and functional categories after a single episode of drinking to intoxication.

A 45 year old immunocompetent female presented to us with fever, dry cough, vomitingand headache. There was a single episode of convulsion after hospital admission. ChestXray was normal. After through clinical examination and relevant investigations we came toknow that it was a case of concurrent multiple brain tuberculomas with miliary tuberculosis.Patient was managed with antitubercular drugs and other supportive therapy promptly and sheresponed well. Occurence of tuberculoma in the brain in a patient with miliary tuberculosisis a rare phenomenon.DOI: http://dx.doi.org/10.3126/ajms.v6i2.10279Asian Journal of Medical Sciences Vol.6(2) 2015 118-120

ObjectivesTo determine the frequency, severity and natural history of neutropaenia in early rheumatoid arthritis (RA), explore its associations with clinical features and assess its impact on clinical management.MethodsThe Scottish Early Rheumatoid Arthritis inception cohort prospectively recruited patients with newly diagnosed RA and followed them up every 6 months. Patients with RA who developed at least one episode of neutropaenia (grade 1: Results77 neutropaenia episodes were recorded in 58 of 771 (7.5%) patients with RA, who were followed up for a median (range) of 18 (6–48) months. Neutropaenia occurred at a median (range) of 12 (0–120) months after RA diagnosis. The majority had mild neutropaenia (grade 1: n=42; grade 2: n=14; grade 3: n=1; grade 4: n=1). Neutropaenia was transient (single episode) in the majority (44; 75.8%) of cases but led to treatment discontinuation in 14 (24.1%) patients. Patients who developed neutropaenia were more likely to be female (p=0.01) and non-smokers (p=0.007) and had lower baseline neutrophil levels (pConclusionNeutropaenia was a common finding in this cohort. It was usually mild, transient and not associated with increased infection rates. Neutropaenia occurrence was associated with non-smoking, female gender and lower baseline neutrophil levels.

Supraventricular tachycardia (SVT), being atrioventricular reentry the underlying mechanism, is the most frequently tachyarrhythmia requiring a medical treatment in infants with no cardiac disease. The acute treatment of a single episode of SVT has generally an excellent prognosis. An antiarrhythmic prophylaxis of SVT recurrences is usually recommended during the first year of life. Although many efficient drugs are available for the SVT treatment, a careful risk-benefit analysis of each single case should suggest the correct drug choice.

Summary An 11-year-old Italian Saddlebred showjumper mare was referred for investigation of recurrent colic. The mare had undergone surgery for left dorsal displacement of the ascending colon 5 years previously and had subsequently experienced several episodes of colic that had responded to medical treatment. Due to deterioration of the mare’s clinical condition in the last episode, characterised by unrelenting pain and worsening of the cardiovascular parameters, the mare underwent repeat surgery for suspected colonic displacement. Exploratory laparotomy revealed a complete rupture of the mesocolon of the ascending colon. The mesocolon was repaired and the mare recovered uneventfully. She returned to training and competition and only a single episode of mild transient colic was recorded in the follow-up.

Urolithiasis is increasing in prevalence and causes substantial morbidity and economic burden. Aside from “acute” stone episodes, urolithiasis should be regarded as a systemic disorder and investigated fully. Practical guidance is given for the medical investigation, diagnosis and treatment of urolithiasis. A single episode of urolithiasis should prompt a review of potential risk factors for recurrent disease and appropriate baseline investigations should be performed. Further biochemical tests may then be directed appropriately and allow individualised advice and treatment to be given to the patient with urolithiasis.

OBJECTIVES: Research and theory provide initial support for the potential utility in distinguishing between recurrent and single episode MDD smokers for cessation treatment. However, no study to date has examined differences in clinical presentation at the outset of treatment among these two groups and whether these clinical profiles are indicative of early cessation failure (smoking on quit day). METHODS: In a secondary analysis of a sample of 179 smokers entering cessation treatment, we examined baseline differences in dysfunctional attitudes, maladaptive coping, self-efficacy to manage negative affect, depressive symptoms, depressed mood, and experienced pleasure from life events between smokers with a history of recurrent major depression (MDD-R; 54.7%) and single episode major depression (MDD-S). RESULTS: Results showed that MDD-R smokers reported lower self-efficacy to cope with negative affect, greater depressive symptoms, and greater depressed mood than MDD-S smokers, although no differences were found on dysfunctional attitudes, avoidance coping, and level of experienced pleasure from daily life events. A greater number of MDD-R compared to MDD-S smokers were not abstinent on their quit day, however a history of recurrent MDD did not increase risk for early cessation failure. CONCLUSIONS: The findings indicate that although depressed mood, negative affect-regulation ability, and depression severity distinguish recurrent and single episode MDD smokers at the start of cessation treatment, these differences do not necessarily portend greater risk for cessation failure in the early stages of treatment.

Objective:The death of a person is a stressful event. Such stress affects the physical and psychological well-being of the bereaved. As an associated mental disorder, major depressive disorder (MDD) is common. Some dream of the deceased, and these dreams are called bereavement dreams. Some MDD patients also experience dreams. These two types of dreams are sometimes difficult to differentiate. The dream of the bereaved might be only a bereavement-related dream, yet it might be a symptom of MDD. Herein, we report one patient who had distressing dreams after the death of her mother.Methods:A 63-year-old woman was referred for psychiatric consultation because of generalized fatigue and insomnia. Questioning her about recent events, she said that her mother had died of colonic carcinoma 5 months previously. Two months after the death, she suddenly started dreaming of her mother, getting angry with her almost every night. Generalized fatigue, insomnia, and distressing dreams appeared simultaneously. The dream caused much distress, making her afraid to fall asleep.Results:Her psychiatric features fulfilled the DSM-IV-TR criteria for MDD, single episode. The death of her mother was considered to be one of the causes of MDD. She was administered 25 mg/day of sertraline hydrochloride. After that, her symptoms gradually disappeared, and the frequency of distressing dreams was reduced. Five months later, physical and psychiatric symptoms of MDD were completely resolved. Subsequently, she has not suffered from any distressing dreams of her mother.Significance of results:This case indicates that dreams experienced after the death of a loved one should not be regarded simply as bereavement dreams. Some of the dreams may be symptoms of MDD. If the dreams are the symptoms of MDD, antidepressant treatment as well as psychotherapy may be useful. Therefore, we should avoid regarding symptoms of MDD as reactions to bereavement.

Despite increasing concern with the effects of archaeological data recovery methods on the types and quantity of objects extracted from the material record, archaeologists rarely discuss recovery biases attributable to the most basic excavation procedures. In this study I examine how several factors, including variable artifact identification skills, can affect artifact recovery rates in the field. Data from household-level investigations at the Stó:lō (Coast Salish) village of Welqámex (DiRi 15) are presented to show how interobserver variation can compromise interpretations of past behavior when opportunities for artifact recovery are limited to observations at the excavation unit and single-episode (field-only) sieving. Laboratory sorting of screen residue retained in 3.2-mm (one-eighth-inch) mesh sieves is shown to account for the recovery of as much as 87.5 percent of lithic artifacts and nearly 90 percent of archaeofaunal remains. Rates of artifact recovery in the field are highly variable among excavation crews working at Welqámex, and I argue that the application of correction factors is inappropriate unless the magnitude of recovery bias can be measured for specific excavation teams and particular depositional contexts. The results of this study further highlight the importance of documenting and mitigating the unintended effects of methodological decisions on archaeological assemblages.

Summary Background: Previous studies have shown that a Mini Mental State Examination (MMSE) score of

A 51-year-old man presented with a single episode of generalized tonic-clonic seizure after returning to Canada from a trip to Mexico. A farmer, he was originally from Mexico and had lived in Canada for several years. He reported no weight loss or other symptoms of concern before the seizure. He had

Human primary immunodeficiencies (PIDs) are often thought to be confined to a few rare, familial, monogenic, recessive traits impairing the development or function of one or several leucocyte subsets and resulting in multiple, recurrent, opportunistic and fatal infections in infancy. We highlight here the rapidly growing number of exceptions to each of these conventional qualifications. Indeed, bona fide PIDs include common and sporadic illnesses and may present as dominant, or even polygenic traits; their pathogenesis may involve non haematopoietic cells, and they may result in single episode of illness, with a single or multiple morbid phenotypes, some of which may involve infection, in otherwise healthy adults. We need to increase awareness of the multitude of clinical presentations of human PIDs considerably and rapidly in the medical community. Human PIDs should be considered in a wide range of clinical situations.

The etiology of LCPD still is not clear. Thrombosis has been accused in the pathogenesis of LCPD but it is not proven until now. The aim of this study is to evaluate the results of single episode of obstruction of blood supply to the femoral heads of dogs.Blood supply femoral heads of 45 dogs was interrupted with embolisation with gel foam. The radiologic appearances, macroscopic and microscopic specimes of the hips were evaluated and compared with the human specimens of 15 LCPD patients obtained at the time of femoral osteotomies.After one infarct, we demonstrated changes in femoral heads of puppies showing close resemblance to the findings of LCPD in human.Obstruction of the femoral head caused by single artificial emboli caused changes in the femoral head similar to LCPD. The cause of the obstruction is obscure, intravascular and/or extravascular pathologies need specific attention, further studies focusing especially on the coagulation system are needed.

Spontaneous bacterial peritonitis (SBP) is the infection of ascitic fluid in the absence of any intra-abdominal, surgically treatable source of infection. Despite timely diagnosis and treatment its reported incidence in ascitic patients varies between 7–30%. Ascitic paracentesis remains the chief diagnostic procedure. Automated cell counters have the same diagnostic accuracy as the manual measurement of white cells. Lately, the use of leucocyte reagent strips (dipsticks) has emerged as a useful alternative. Examination of the fluid is not complete unless the sample is inoculated in blood culture bottles. Treatment is currently with third-generation cephalosporins or oral quinolones. Following a single episode of SBP patients should have long term antibiotic prophylaxis.

Objective—To evaluate changes in serum cartilage oligomeric matrix protein (COMP) concentrations in response to exercise in horses. Animals—15 horses in experiment 1 and 27 horses in experiment 2. Procedures—In experiment 1, 15 Thoroughbreds free of orthopedic disease underwent a standardized exercise protocol. Running velocity and heart rate (HR) were recorded, and blood samples were collected immediately before (baseline) and 1, 5, and 24 hours after a single episode of exercise. In experiment 2, 27 horses underwent 9 stages of a training program in which each stage consisted of 4 to 8 consecutive daily workouts followed by a rest day. Blood samples were collected immediately before the first and final daily workouts in each stage. Serum COMP concentrations were measured via inhibition ELISA with a monoclonal antibody (14G4) against equine COMP. Results—In experiment 1, mean serum COMP concentration was significantly higher than baseline 1 and 5 hours after exercise and returned to baseline concentrations 24 hours after exercise. Mean serum baseline COMP concentration increased as the velocity of running at maximum HR and at an HR of 200 beats/min increased, being significantly higher during the third and fourth exercise tests than during the first. In experiment 2, mean baseline COMP concentration at the final workout of each stage was significantly higher than that at the first workout, beginning with stage 3. Conclusions and Clinical Relevance—Serum COMP concentrations changed significantly in response to exercise. Exercise may enhance movement of COMP into the circulation as well as change the basal turnover rate of COMP.

Aim: The present study sought to document client attendance norms at a multi‐site outpatient alcohol and other drug (AOD) treatment service located in Auckland, New Zealand.Method: Service attendance data were retrospectively analysed for two client cohorts: consecutive admissions over the period 1 January 2001 to 31 March 2001 (n = 501) and a sub‐sample of admissions who were entering the treatment service for the first time over the same period (n = 325). Data from the former cohort were analysed over a single episode of care. Data from the latter sample were analysed over a period of five calendar years (1 January 2001 to 31 March 2005).Results: Across a single episode of care, 73% of the respective client cohort exited treatment having attended four or fewer appointments. Furthermore, 61% of these clients exited treatment against clinical advice or prior to completing a scheduled treatment appointment. Only 15% of the ‘new to treatment’ sub‐sample initiated a second episode of care during the next fiv...

Two episodes of attentional selection cannot occur very close in time. This is the traditional account of the attentional blink, whereby observers fail to report the second of two temporally proximal targets. Recent analyses have challenged this simple account, suggesting that attentional selection during the attentional blink is not only (a) suppressed, but also (b) temporally advanced then delayed, and (c) temporally diffused. Here, we reanalyzed six data sets using mixture modeling of report errors, and revealed much simpler dynamics. Exposing a problem inherent in previous analyses, we found evidence of a second attentional episode only when the second target (T2) follows the first (T1) by more than 100 to 250 ms. When a second episode occurs, suppression and delay reduce steadily as lag increases and temporal precision is stable. At shorter lags, both targets are reported from a single episode, which explains why T2 can escape the attentional blink when it immediately follows T1 (Lag-1 sparing).

Objectives: We describe the process of identifying and defining nocturnal sleep-related variables (for example, movement/non-movement indicators of sleep efficiency, waking episodes, midpoint and so on) using the unique 24-h waist-worn free-living accelerometer data collected in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE).Methods: Seven consecutive days of 24-h waist-worn accelerometer (GT3X+, ActiGraph LLC) data were collected from over 500 children at each site. An expert subgroup of the research team with accelerometry expertize, frontline data collectors and data managers met on several occasions to categorize and operationally define nocturnal accelerometer signal data patterns. The iterative process was informed by the raw data drawn from a sub set of the US data, and culminated in a refined and replicable delineated definition for each identified nocturnal sleep-related variable. Ultimately based on 6318 participants from all 12 ISCOLE sites with valid total sleep episode time (TSET), we report average clock times for nocturnal sleep onset, offset and midpoint in addition to sleep period time, TSET and restful sleep efficiency (among other derived variables). Results: Nocturnal sleep onset occurred at 2218 hours and nocturnal sleep offset at 0707 hours. The mean midpoint was 0243 hours. The sleep period time of 529.6 min (8.8 h) was typically accumulated in a single episode, making the average TSET very similar in duration (529.0 min). The mean restful sleep efficiency ranged from 86.8% (based on absolute non-movement of 0 counts per minute) to 96.0% (based on relative non-movement of

Background Single-episode anesthetic exposure is the most prevalent surgery-related incidence among young children in the United States. Although numerous studies have used animals to model the effects of neonatal anesthetics on behavioral changes later on in life, our understanding of the functional consequences to the developing brain in a comprehensive and clinically relevant manner is unclear. Methods The volatile anesthetic, sevoflurane (sevo) was administered to C57BL6 postnatal day 7 (P7) mice in a 40% oxygen and 60% nitrogen gas mixture. In order to examine the effects of sevo alone on the developing brain in a clinically relevant manner, mice were exposed to an average of 2.38 ± 0.11% sevo for 2 h. No sevo (control) mice were treated in an identical manner without sevo exposure. Mice were examined for cognition and neuropsychiatric-like behavioral changes at 1–5 months of age. Results Using the active place avoidance (APA) test and the novel object recognition (NOR) test, we demonstrated that P7 sevo-treated mice showed a deficit in learning and memory both during periadolescence and adulthood. We then employed a battery of neuropsychiatric-like behavioral tests to examine social interaction, communication, and repetitive behavior. Interestingly, compared to the no-sevo–treated group, sevo-treated mice showed significant reductions in the time interacting with a novel mouse (push–crawl and following), time and interaction in a chamber with a novel mouse, and time sniffing a novel social odor. Conclusions Our study established that single-episode, 2-h sevo treatment during early life impairs cognition later on in life. With this approach, we also observed neuropsychiatric-like behavior changes such as social interaction deficits in the sevo-treated mice. This study elucidated the effects of a clinically relevant single-episode sevo application, given during the neonatal period, on neurodevelopmental behavioral changes later on in life.

EXERCISE-INDUCED pulmonary haemorrhage (EIPH) is an important respiratory disease reported to impact racing performance in horses (Hinchcliff and others 2015). Various methods have been described for diagnosing EIPH, including endoscopic detection of tracheal blood after exercise, or cytological evaluation of bronchoalveolar lavage (BAL) fluid. The former is the most frequently used diagnostic method, whereas the latter is reported to be more sensitive (Sullivan and Hinchcliff 2015). Indeed, BAL allows detection of microscopic bleeding and identification of haemosiderophages, that is, alveolar macrophages containing haemosiderin (an iron-storage complex produced by digestion of erythrocytes). In humans, haemosiderophages are detected 50–72 hours after natural or experimentally induced haemorrhage (Sherman and others 1984), and might persist for up to one month in the airways following a single episode (Gosselin and others 1989). In contrast, erythrocytes are no longer detectable within the airways after 7–10 days post exercise (Meyer and others 1998, Doucet and Viel 2002). Two cytological staining methods, namely May-Grunwald-Giemsa (MGG) and Perls' Prussian Blue (PPB), have been described for identification of haemosiderophages in BAL fluid. MGG is a conventional method used for the morphological assessment of cell populations in blood and fluids, and commonly recommended for BAL fluid evaluation (Richard and others 2010). PPB is specifically used to detect cellular iron contents. Proportions of haemosiderophages among alveolar macrophages (H/M) and …

Background/Aims: There is no nationwide population-based study for the long-term mortality after single episode of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. Our study showed the short-term and long-term mortalities, and identified the mortality risk of SBP. Materials and Methods: The National Health Insurance Database, derived from the Taiwan National Health Insurance program, was used to collect data from 16,992 cirrhotic patients. These cirrhotic patients were classified into three groups: SBP group (n=451, 2.7%), ascites without SBP group (n=2,564, 15.1%), and non-ascites (n=13,977, 82.3%) group. Each patient was followed up to 3 years after the initial hospitalization. Results: The 30-day mortalities in SBP, ascites without SBP, and non-ascites groups were 24.2%, 14.1%, and 8.1%, respectively. The 3-year mortalities in SBP, ascites without SBP, and non-ascites groups were 66.5%, 61.1%, and 41.5%. After Cox’s regression analysis adjusted by the patients’ age, gender, and underlying medical disorders, the SBP patients (hazard ratio=2.52) and ascites without SBP patients (hazard ratio=1.91) have higher risk for 3-year mortality than those without ascites. Conclusion: Cirrhotic patients with SBP have a 2.5-fold increase of 3-year mortality, compared to those without ascites.

A clinically isolated syndrome is the result of a single episode of demyelination in one area of the central nervous system (a monofocal episode) or several areas of the central nervous system (a multifocal episode) which lasts for at least 24 hours. Of those who are eventually diagnosed with MS, 85% experience an initial onset of symptoms or a first attack that is referred to as a clinically isolated syndrome (CIS). Here we describe a 10-yr-old-boy with ataxia and ophthalmoplegia, whose MRI showed demyelination only in bilateral fronto- parietal subcortical areas. Patient improved on pulse methyl-prednisolone therapy with tapering dose of steroids and never had recurrence on further follow up till date.

A 60-year-old man presented to the emergency department for evaluation of rectal bleeding, syncope, and pain in the right leg. Five days earlier, diffuse abdominal pain that worsened with movement had developed in association with nausea, anorexia, and malaise. Shortly before admission, the patient had a single episode of gross hematochezia and hematuria followed by syncope, as well as intense pain in the right leg.

Background Down syndrome patients are not always suited for peritoneal dialysis, mainly due to their lack of compliance with the procedure. We report a case of a 42-year-old male Down syndrome patient successfully treated with peritoneal dialysis. Methods The patient suffered from end-stage renal disease caused by chronic pyelonephritis due to a dysplastic urinary tract. Comorbid conditions included hypothyroidism, hypertension, hyperlipidemia, malnutrition with obesity, left ventricle dysfunction, multiple corneal erosions, and glaucoma. Because, in this case, the patient's mother would be required to sit full time at his bedside during a hemodialysis procedure, a peritoneal dialysis program was preferred. The treatment was complicated by peritoneal catheter dysfunction leading to the prolongation of the draining out time and the need to change the position of the body during drainage in the 29th month of treatment. Results Three months later, when the patient became overhydrated and a dry ultrafiltration procedure in the hemodialysis unit became necessary, the peritoneal catheter was replaced, which solved this problem. Conclusion Although the peritoneal dialysis procedure in mentally retarded patients is prone to failure mainly because of an increased risk of peritonitis and a burn-out syndrome among their parents, this patient's mother has been successfully treating him by for more than 4 years without a single episode of peritonitis.

245-49), the moment of theFall tends to eclipse other significant themes in the epic, such as obedi-ence, restoration, and grace. Accepting Raleigh’s claim that the epicaction centers on the single episode of the Fall,A. J.A.Waldock arguesthat this episode ultimately fails (25-64). His devastating critique of theentire poem prompted substantial defection from Raleigh’s theory. In“The Crisis of

When people monitor a visual stream of rapidly presented stimuli for two targets (T1 and T2), they often miss T2 if it falls into a time window of about half a second after T1 onset—the attentional blink. However, if T2 immediately follows T1, performance is often reported being as good as that at long lags—the so-called Lag-1 sparing effect. Two experiments investigated the mechanisms underlying this effect. Experiment 1 showed that, at Lag 1, requiring subjects to correctly report both identity and temporal order of targets produces relatively good performance on T2 but relatively bad performance on T1. Experiment 2 confirmed that subjects often confuse target order at short lags, especially if the two targets are equally easy to discriminate. Results suggest that, if two targets appear in close succession, they compete for attentional resources. If the two competitors are of unequal strength the stronger one is more likely to win and be reported at the expense of the other. If the two are equally strong, however, they will often be integrated into the same attentional episode and thus get both access to attentional resources. But this comes with a cost, as it eliminates information about the targets’ temporal order.

A retrospective study was designed to determine whether socio-demographic and clinical factors at onset, previously shown to relate to outcome, differentiated those with a single episode with no persistent symptoms of schizophrenia from other outcome groups. In a geographically determined sample of 436 people with schizophrenia spectrum disorder and a minimum followup period of at least 6 years, 68 people (15.6%) had a single episode with complete remission. The single episode group differed significantly from the rest of the sample at onset on nine variables. On a logistic regression, employment status independently predicted single episodes. Although those with single episodes differed from the rest of the sample on a number of variables, they did not differ significantly at onset from the other better outcome group (repeated episodes without persistent symptoms) on any variables with the exception of insight. Two possibilities are considered: (1) the two better outcome groups differed very little at onset but subsequent treatment or experiences accounted for the differences in outcome; or (2) important differences, not routinely assessed at onset, influenced outcome. The implications of these findings for research into the prevention of relapse in psychosis are considered.

OBJECTIVES AND METHODS Aim of the study was to identify and estimate psychiatric axis I disorders as risk factors for suicide in different age groups using a psychological autopsy study with case-control design. 163 suicides and 396 population-based control persons were assessed with a standardized semi-structured interview including SCID-I (for DSM-IV). RESULTS Logistic regression analyses revealed significantly elevated odds ratios for alcohol-related disorders in men aged 31 to 45, 46 to 60, and 61 to 75 years (OR = 9.0, OR = 7.5, and OR = 10.7, respectively) and for Major Depression, single episode, in men and women aged 61 to 75 years (OR = 42.7 and OR = 15.9). In males aged 31 to 45 years polysubstance-related disorders (OR = 9.5) and in females aged 61 to 75 years cognitive and mental disorders due to a general medical condition (OR = 12.2) were significantly and independently associated with suicide. CONCLUSIONS Alcohol-related disorders and Major Depression differently contribute to male and female suicide risk in special age groups. These findings imply differentiated prevention strategies.