The Sleep Condition Indicator: a clinical screening tool to evaluate insomnia disorder

Objective: Describe the development and psychometric validation of a brief scale (the Sleep Condition Indicator (SCI)) to evaluate insomnia disorder in everyday clinical practice.<p></p> Design: The SCI was evaluated across five study samples. Content validity, internal consistency and concurrent validity were investigated.<p></p> Participants: 30 941 individuals (71% female) completed the SCI along with other descriptive demographic and clinical information.<p></p> Setting: Data acquired on dedicated websites.<p></p> Results: The eight-item SCI (concerns about getting to sleep, remaining asleep, sleep quality, daytime personal functioning, daytime performance, duration of sleep problem, nights per week having a sleep problem and extent troubled by poor sleep) had robust internal consistency (α≥0.86) and showed convergent validity with the Pittsburgh Sleep Quality Index and Insomnia Severity Index. A two-item short-form (SCI-02: nights per week having a sleep problem, extent troubled by poor sleep), derived using linear regression modelling, correlated strongly with the SCI total score (r=0.90).<p></p> Conclusions: The SCI has potential as a clinical screening tool for appraising insomnia symptoms against Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria.<p></p&gt

The Sleep Condition Indicator: a clinical screening tool to evaluate insomnia disorder

Objective: Describe the development and psychometric validation of a brief scale (the Sleep Condition Indicator (SCI)) to evaluate insomnia disorder in everyday clinical practice.<p></p> Design: The SCI was evaluated across five study samples. Content validity, internal consistency and concurrent validity were investigated.<p></p> Participants: 30 941 individuals (71% female) completed the SCI along with other descriptive demographic and clinical information.<p></p> Setting: Data acquired on dedicated websites.<p></p> Results: The eight-item SCI (concerns about getting to sleep, remaining asleep, sleep quality, daytime personal functioning, daytime performance, duration of sleep problem, nights per week having a sleep problem and extent troubled by poor sleep) had robust internal consistency (α≥0.86) and showed convergent validity with the Pittsburgh Sleep Quality Index and Insomnia Severity Index. A two-item short-form (SCI-02: nights per week having a sleep problem, extent troubled by poor sleep), derived using linear regression modelling, correlated strongly with the SCI total score (r=0.90).<p></p> Conclusions: The SCI has potential as a clinical screening tool for appraising insomnia symptoms against Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria.<p></p&gt

Non-histopathological parameters associated with upgrade of breast tumours yielding a core biopsy report of histological grade 2 ductal no special type to grade 3 on excision

Purpose: The aim of the study was to identify clinical, radiological and immuno-histochemical factors that may help predict upgrade of invasive ductal cancers of no special type (IDC-NST) with a core biopsy grade of 2 to grade 3 on final histology.Methods: A prospectively maintained database of ultrasound visible solid masses was used to identify lesions yielding a core biopsy result of IDC-NST grade 2 who underwent immediate surgery yielding a grade 2 or grade 3 tumour. Associations were sought between the source of patient (screening/symptomatic), core biopsy receptor status and imaging findings and the grade of the excision specimen tumour. Statistical analysis, which included the chi-squared test, ROC curves and Cox regression analysis, was used to compare upgrade vs no upgrade for each factor.Results: 463 IDC-NST breast cancers of core biopsy grade 2 gave 344 grade 2 and 119 grade 3 tumours at excision. Factors significantly associated with upgrade were large ultrasound (US) size, hyperechogencity, stiffness at shearwave elastography (SWE), calcification on mammography and oestrogen receptor (ER) and progesterone receptor (PR) negativity. Patient source, Human epidermal growth factor receptor 2 (HER-2) status, ultrasound (US) distal effect and mammographic spiculation were not significantly associated with chance of upgrade. On multivariate analysis, only US size maintained statistical significance.Conclusion: Oncologists and surgeons should be aware that lesions with a core biopsy diagnosis of grade 2 IDC-NST measuring over 15 mm on US have a 37% chance of being grade 3 on excision and this should be considered when deciding pre-operative management.</p

Clebsch-Gordan Construction of Lattice Interpolating Fields for Excited Baryons

Large sets of baryon interpolating field operators are developed for use in lattice QCD studies of baryons with zero momentum. Operators are classified according to the double-valued irreducible representations of the octahedral group. At first, three-quark smeared, local operators are constructed for each isospin and strangeness and they are classified according to their symmetry with respect to exchange of Dirac indices. Nonlocal baryon operators are formulated in a second step as direct products of the spinor structures of smeared, local operators together with gauge-covariant lattice displacements of one or more of the smeared quark fields. Linear combinations of direct products of spinorial and spatial irreducible representations are then formed with appropriate Clebsch-Gordan coefficients of the octahedral group. The construction attempts to maintain maximal overlap with the continuum SU(2) group in order to provide a physically interpretable basis. Nonlocal operators provide direct couplings to states that have nonzero orbital angular momentum.Comment: This manuscript provides an anlytical construction of operators and is related to hep-lat/0506029, which provides a computational construction. This e-print version contains a full set of Clebsch-Gordan coefficients for the octahedral grou

Narrowband ultraviolet B treatment for psoriasis is highly economical and causes significant savings in cost for topical treatments

Background: Narrowband ultraviolet B (NB-UVB) treatment for psoriasis is considered expensive. However, existing data are based on estimates and do not consider indirect cost savings. Objectives: To define the actual costs of NB-UVB incurred by the service provider, as well as treatment-associated cost savings. Methods: We performed data linkage of (i) comprehensive treatment records and (ii) prescribing data for all NB-UVB treatment episodes spanning 6 years in a population of 420 000. We minimized data fluctuation by compiling data from four independent treatment sites, and using drug prescriptions unrelated to psoriasis as a negative control. Results: National Health Service Tayside spent an average of £257 per NB-UVB treatment course (mean 257 ± 63, range 150–286, across four independent treatment sites), contrasting sharply with the estimate of £1882 used by the U.K. National Institute for Health and Care Excellence. The cost of topical treatments averaged £128 per patient in the 12 months prior to NB-UVB, accounting for 42% of the overall drug costs incurred by these patients. This was reduced by 40% to £53 per patient over the 12-month period following NB-UVB treatment, while psoriasis-unrelated drug prescription remained unchanged, suggesting disease-specific effects of NB-UVB. The data were not due to site-specific factors, as confirmed by highly similar results observed between treatment sites operated by distinct staff. Finally, we detail all staff hours directly and indirectly involved in treatment, allowing direct translation of cost into other healthcare systems. Conclusions: NB-UVB is a low-cost treatment; cost figures currently used in health technology appraisals are an overestimate based on the data presented here. Creating or extending access to NB-UVB is likely to offer additional savings by delaying or avoiding costly third-line treatments for many patients.PostprintPeer reviewe

Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study

OBJECTIVES: Few studies have quantified the incidence and prevalence of celiac disease (CD) and dermatitis herpetiformis (DH) nationally and regionally by time and age groups. Understanding this epidemiology is crucial for hypothesizing about causes and quantifying the burden of disease. METHODS: Patients with CD or DH were identified in the Clinical Practice Research Datalink between 1990 and 2011. Incidence rates and prevalence were calculated by age, sex, year, and region of residence. Incidence rate ratios (IRR) adjusted for age, sex, and region were calculated with Poisson regression. RESULTS: A total of 9,087 incident cases of CD and 809 incident cases of DH were identified. Between 1990 and 2011, the incidence rate of CD increased from 5.2 per 100,000 (95% confidence interval (CI), 3.8-6.8) to 19.1 per 100,000 person-years (95% CI, 17.8-20.5; IRR, 3.6; 95% CI, 2.7-4.8). The incidence of DH decreased over the same time period from 1.8 per 100,000 to 0.8 per 100,000 person-years (average annual IRR, 0.96; 95% CI, 0.94-0.97). The absolute incidence of CD per 100,000 person-years ranged from 22.3 in Northern Ireland to 10 in London. There were large regional variations in prevalence for CD but not DH. CONCLUSIONS: We found a fourfold increase in the incidence of CD in the United Kingdom over 22 years, with large regional variations in prevalence. This contrasted with a 4% annual decrease in the incidence of DH, with minimal regional variations in prevalence. These contrasts could reflect differences in diagnosis between CD (serological diagnosis and case finding) and DH (symptomatic presentation) or the possibility that diagnosing and treating CD prevents the development of DH

The Academical Dress of the University of Stirling, 1967–2006

The University of Stirling, one of four universities established in Scotland in the 1960s, was the only new foundation; the other three were raised to university status from pre-existing institutions. Unlike the other three—Dundee, Heriot-Watt and Strathclyde—Stirling had no established programmes of study around which to develop a system of academical dress. This helps to explain why Stirling was unique among the Scottish 1960s foundations in not adopting a faculty colour scheme. Rather, the system of academical dress was allowed to evolve with the University itself. This has led to a few anomalies but no more than those at other, more venerable, institutions. When designing its own academical dress, the University drew on a number of themes and traditions in Scottish universities’ academical dress: the use of Edinburgh shaped hoods for most graduates; the design of the gown for the honorary degree of Doctor of the University is based on a Glasgow gown; and the use of a masters’-style gown for all graduates,other than for Doctors of the University. Unlike all the other Scottish universities established in the 1960s as well as the ancient foundations, Stirling does not require the use of head gear (except by the Chancellor and Principal and Vice-Chancellor). In one area it has broken with tradition: it uses fur on its masters’ hoods, but this departure is not as significant as it might seem at first

The presence of PHOSPHO1 in matrix vesicles and its developmental expression prior to skeletal mineralization

PHOSPHO1 is a phosphoethanolamine/phosphocholine phosphatase that has previously been implicated in generating inorganic phosphate (Pi) for matrix mineralization. In this study, we have investigated PHOSPHO1 mRNA expression during embryonic development in the chick. Whole-mount in situ hybridization indicated that PHOSPHO1 expression occurred prior to E6.5 and was initially restricted to the bone collar within the mid-shaft of the diaphysis of long bones but by E11.5 expression was observed over the entire length of the diaphysis. Alcian blue/alizarin red staining revealed that PHOSPHO1 expression seen in the primary regions of ossification preceded the deposition of mineral, suggesting that it is involved in the initial events of mineral formation. We isolated MVs from growth plate chondrocytes and confirmed the presence of high levels of PHOSPHO1 by immunoblotting. Expression of PHOSPHO1, like TNAP activity, was found to be up-regulated in MVs isolated from chondrocytes induced to differentiate by the addition of ascorbic acid. This suggests that both enzymes may be regulated by similar mechanisms. These studies provide for the first time direct evidence that PHOSPHO1 is present in MVs, and its developmental expression pattern is consistent with a role in the early stages of matrix mineralization

Hadronic Resonances from Lattice QCD

The determination of the pattern of hadronic resonances as predicted by Quantum Chromodynamics requires the use of non-perturbative techniques. Lattice QCD has emerged as the dominant tool for such calculations, and has produced many QCD predictions which can be directly compared to experiment. The concepts underlying lattice QCD are outlined, methods for calculating excited states are discussed, and results from an exploratory Nucleon and Delta baryon spectrum study are presented.Comment: 8 pages, VII Latin American Symposium on Nuclear Physics and Application