Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
30
result(s) for
"Marciano, Paul L"
Sort by:
Advanced Theory of Mind in High-Functioning Adults with Autism
Twenty-four high-functioning adults with autism (16 men) who passed a first-order theory-of-mind task and 24 nonautistic adults (10 men) attributed mental states to recordings of various verbal intonations and to photos of people's eyes to assess advanced theory of mind. Participants with autism performed significantly worse than nonautistic participants on both tasks. Thus, the previously described inattention to others' eyes exhibited by adults with autism is not solely responsible for their inability to attribute mental states from eyes, as they also did not correctly attribute mental states from voices. These findings support the view that a core deficit for people with autism lies in their theory of mind, that is, their inability to attribute mental states to others.
Journal Article
Genetic Risk for Inflammatory Bowel Disease Is a Determinant of Crohn's Disease Development in Chronic Granulomatous Disease
Approximately, one-third to one-half of children with chronic granulomatous disease (CGD) develop gastrointestinal inflammation characteristic of idiopathic inflammatory bowel disease (IBD), usually Crohn's disease. We hypothesized that the overall IBD genetic risk, determined by IBD genetic risk score (GRS), might in part determine IBD development in CGD.MethodsWe reviewed medical records to establish IBD diagnoses in CGD subjects seen at NIAID. IBD risk single nucleotide polymorphism genotypes were determined using the Immunochip, and GRS were estimated by Mangrove.ResultsAmong 157 white patients with CGD, 55 were confirmed, 78 excluded, and 24 were uncertain for IBD. Two hundred one established, independent European IBD risk single nucleotide polymorphisms passed quality control. After sample quality control and removing non-IBD CGD patients with perianal disease, mean GRS for 40 unrelated patients with CGD-IBD was higher than 53 CGD non-IBD patients (in log2-scale 0.08 ± 1.62 versus −0.67 ± 1.64, P = 0.026) but lower than 239 IBD Genetics Consortium (IBDGC) young-onset Crohn's disease cases (0.76 ± 1.60, P = 0.025). GRS for non-IBD CGD was similar to 609 IBDGC controls (−0.69 ± 1.60, P = 0.95). Seven established IBD single nucleotide polymorphisms were nominally significant among CGD-IBD versus CGD non-IBD, including those near LACC1 (P = 0.005), CXCL14 (P = 0.007), and TNFSF15 (P = 0.016).ConclusionsThe weight of the common IBD risk alleles are significant determinants of IBD in CGD. However, IBD risk gene burden among CGD children with IBD is significantly lower than that in nonsyndromic pediatric Crohn's disease, congruent with the concept that defective superoxide production in CGD is also a major IBD risk factor. Individual IBD genes might interact with the CGD defect to cause IBD in CGD.
Journal Article
أب للمرة الأولى : بدء رحلة الحياة من عمر الثالثة /
رزقت بطفل ؟ يأتي خبر الطفل الجديد على المرأة متزامنا مع بداية حياة أخرى بداخلها. ولكن التجربة تختلف تماما بالنسبة للأب المستقبلي وعادة ما تجتر تساؤلات مثل : متى يبدأ شعوري بالأبوة ؟ وكيف أرتبط بطفلي أثناء فترة الحمل ؟ وكيف أصبح والدا مسؤول بمجرد أن يولد الطفل ؟ يتناول هذا الكتاب تفاصيل مراحل الحمل والولادة وصول إلى قدوم المولود الجديد إلى البيت من منظور الأب الجديد. إنه كتاب لا غنى عنه لأي رجل يخطو بقدمه للمرة الأولى في عالم الأبوة إذ تضم صفحاته نصائح ومشورات ورؤى ثاقبة يقدمها له ذوو الخبرة والاختصاص.
Book
Do robot-related complications influence 1 year reoperations and other clinical outcomes after robot-assisted lumbar arthrodesis? A multicenter assessment of 320 patients
Background
Robot-assisted platforms in spine surgery have rapidly developed into an attractive technology for both the surgeon and patient. Although current literature is promising, more clinical data is needed. The purpose of this paper is to determine the effect of robot-related complications on clinical outcomes
Methods
This multicenter study included adult (≥18 years old) patients who underwent robot-assisted lumbar fusion surgery from 2012-2019. The minimum follow-up was 1 year after surgery. Both bivariate and multivariate analyses were performed to determine if robot-related factors were associated with reoperation within 1 year after primary surgery.
Results
A total of 320 patients were included in this study. The mean (standard deviation) Charlson Comorbidity Index was 1.2 (1.2) and 52.5% of patients were female. Intraoperative robot complications occurred in 3.4% of patients and included intraoperative exchange of screw (0.9%), robot abandonment (2.5%), and return to the operating room for screw exchange (1.3%). The 1-year reoperation rate was 4.4%. Robot factors, including robot time per screw, open vs. percutaneous, and robot system, were not statistically different between those who required revision surgery and those who did not (
P
>0.05). Patients with robot complications were more likely to have prolonged length of hospital stay and blood transfusion, but were not at higher risk for 1-year reoperations. The most common reasons for reoperation were wound complications (2.2%) and persistent symptoms due to inadequate decompression (1.5%). In the multivariate analysis, robot related factors and complications were not independent risk factors for 1-year reoperations.
Conclusion
This is the largest multicenter study to focus on robot-assisted lumbar fusion outcomes. Our findings demonstrate that 1-year reoperation rates are low and do not appear to be influenced by robot-related factors and complications; however, robot-related complications may increase the risk for greater blood loss requiring a blood transfusion and longer length of stay.
Journal Article
Is There a Difference in Screw Accuracy, Robot Time Per Screw, Robot Abandonment, and Radiation Exposure Between the Mazor X and the Renaissance? A Propensity-Matched Analysis of 1179 Robot-Assisted Screws
Study Design:
Prospective single-cohort analysis.
Objectives:
To compare the outcomes/complications of 2 robotic systems for spine surgery.
Methods:
Adult patients (≥18-years-old) who underwent robot-assisted spine surgery from 2016-2019 were assessed. A propensity score matching (PSM) algorithm was used to match Mazor X to Renaissance cases. Preoperative CT scan for planning and an intraoperative O-arm for screw evaluation were preformed. Outcomes included screw accuracy, robot time/screw, robot abandonment, and radiation. Screw accuracy was measured using Vitrea Core software by 2 orthopedic surgeons. Screw breach was measured according to the Gertzbein/Robbins classification.
Results:
After PSA, a total of 65 patients (Renaissance: 22 vs. X: 43) were included. Patient/operative factors were similar between robot systems (P > .05). The pedicle screw accuracy was similar between robots (Renaissance: 1.1%% vs. X: 1.3%, P = .786); however, the S2AI screw breach rate was significantly lower for the X (Renaissance: 9.5% vs. X: 1.2%, P = .025). Robot time per screw was not statistically different (Renaissance: 4.6 minutes vs. X: 3.9 minutes, P = .246). The X was more reliable with an abandonment rate of 2.3% vs. Renaissance:22.7%, P = .007. Radiation exposure were not different between robot systems. Non-robot related complications including dural tear, loss of motor/sensory function, and blood transfusion were similar between robot systems.
Conclusion:
This is the first comparative analyses of screw accuracy, robot time/screw, robot abandonment, and radiation exposure between the Mazor X and Renaissance systems. There are substantial improvements in the X robot, particularly in the perioperative planning processes, which likely contribute to the X’s superiority in S2AI screw accuracy by nearly 8-fold and robot reliability by nearly 10-fold.
Journal Article
Thoracic Surgery in Chronic Granulomatous Disease: a 25-Year Single-Institution Experience
Introduction
Chronic granulomatous disease (CGD) is a genetic disorder in which phagocyte dysfunction leads to recurrent infection. Persistent pulmonary infections sometimes require thoracic surgical intervention. We reviewed our 25-year experience to identify outcomes and prognostic factors associated with thoracic surgery in these patients.
Methods
A retrospective single-institution review of all patients with CGD from 1990 through 2015 was performed. Univariate analysis identified prognostic variables to include in a Cox model. Overall survival was estimated by the Kaplan-Meier method.
Results
We identified 258 patients who had 2221 admissions (both scheduled and emergent). During the period examined, 51 thoracic operations were performed in 13.6 % (35/258) of patients and 2.3 % (35/2221) of overall admissions. Patients undergoing surgery did not have statistically significant differences in disease genotype compared to those that did not require surgery. Pathogens were identified from 67 % (34/51) of specimens. Complications occurred in 27 % (14/51), including 10 % (5/51) with wound and 12 % (6/51) with pulmonary infections. Mortality at 30 and 90 days was 0 and 6 % (3/51), respectively. Overall survival probabilities were 75 and 62 % at 5- and 10-year follow-up (median potential follow-up: 16.5 years), respectively. Undergoing thoracic surgery was associated with an increased hazard ratio for death of 3.71 (
p
< 0.0001). Both chest wall resection and EBL > 500 mL were negative prognostic factors (
p
< 0.05).
Conclusions
A minority of CGD patients required thoracic surgery for infections refractory to antibiotic or antifungal therapy. Patients who had these operations had significant morbidity and relatively poor long-term survival, particularly in the cases of chest wall resection or significant blood loss.
Journal Article
Modulation of type I interferon responses potently inhibits SARS-CoV-2 replication and inflammation in rhesus macaques
Type-I interferons (IFN-I) are critical mediators of innate control of viral infections, but also drive recruitment of inflammatory cells to sites of infection, a key feature of severe COVID-19. Here, and for the first time, IFN-I signaling was modulated in rhesus macaques (RMs) prior to and during acute SARS-CoV-2 infection using a mutated IFNα2 (IFN-modulator; IFNmod), which has previously been shown to reduce the binding and signaling of endogenous IFN-I. In SARS-CoV-2-infected RMs, IFNmod reduced both antiviral and inflammatory ISGs. Notably, IFNmod treatment resulted in a potent reduction in (i) SARS-CoV-2 viral load in Bronchoalveolar lavage (BAL), upper airways, lung, and hilar lymph nodes; (ii) inflammatory cytokines, chemokines, and CD163+MRC1-inflammatory macrophages in BAL; and (iii) expression of Siglec-1, which enhances SARS-CoV-2 infection and predicts disease severity, on circulating monocytes. In the lung, IFNmod also reduced pathogenesis and attenuated pathways of inflammasome activation and stress response during acute SARS-CoV-2 infection. This study, using an intervention targeting both IFN-α and IFN-β pathways, shows that excessive inflammation driven by type 1 IFN critically contributes to SARS-CoV-2 pathogenesis in RMs, and demonstrates the potential of IFNmod to limit viral replication, SARS-CoV-2 induced inflammation, and COVID-19 severity.
Journal Article
Soil carbon and nitrogen stocks following forest clearing for pasture in the Southwestern Brazilian Amazon
Tropical soils contain large stocks of carbon and nitrogen that can be altered by clearing for agriculture. In the Brazilian Amazon, cattle pasture is the predominant use for cleared forest lands. We examined changes to soil bulk density and C and N stocks in seven chronosequences, each consisting of an intact forest and pastures of different ages created directly from cleared forest (7 forests, 18 pastures), along a 700-km transect in Rondonia in the southwestern Amazon Basin. The transect included sites with a similar climate but a range of soil types. We used soil δ13C distributions to determine the origin of soil C and to infer changes to soil C cycling patterns after forest clearing. Soil bulk density increased under pasture; these increases were significant in 6 of 18 pastures examined. Changes in C stocks to a depth of 30 cm under pasture ranged from a loss of 0.72 kg/m2to an increase of 1.77 kg/m2. Soil C stocks increased in 14 of 18 pastures, but these increases were significant in only 4 pastures. Changes in soil N stocks to a depth of 30 cm ranged from a loss of 0.25 kg/m2to a gain of 0.23 kg/m2and showed a similar pattern to C, except in one site where we measured significant N loss. Five of 18 pastures accumulated significant amounts of N, and one pasture lost a significant amount of N. Soil δ13C values were greater in pastures than in the original forests, and δ13C values increased with a longer time under C4pasture vegetation. Bulk density increases were greater on soils with higher clay contents. Carbon accumulation increased with pasture age but was independent of soil texture. Soil C increases to a depth of 30 cm of up to 1.77 kg/m2amounted to an increase of >50% of the original soil C stock and represented up to 12% of the C in the biomass of forest vegetation. In contrast, changes to soil N stocks in the range of 0.25 kg/m2approximately equaled the N stock in the original forest vegetation. Our results indicated that when site history was controlled by considering only pastures formed directly from cleared forest, C and N accumulation was the dominant trend in pasture soils. Absence of a correlation between C and N accumulation and soil texture suggested that site history and management may be more important than soil type as determinants of the direction and magnitude of changes in soil C and N stocks.
Journal Article