This study examines the competence-related abilities of 120 psychiatrically hospitalized male juveniles age 10 to 17 years, using the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA), the Brief Psychiatric Rating Scale-Anchored (BPRS-A), the Massachusetts Youth Screening Instrument (MAYSI), the Kaufman Brief Intelligence Test (K-BIT), and discharge diagnoses derived from file review. The findings indicate significant age-related differences across adolescence with a relatively strong performance for most of the youths on the competence measure. While intellectual and psychiatric factors were found to contribute substantially to deficits in legal decisional ability, they were modulated by age and the developmental factors associated with it. These findings, replete with caveats concerning both the dimensional structure of competence as measured by the MacCAT-CA and the interplay with the mental status and developmental factors affecting it, underscore the multifarious nature of legal decisional capacity in youths of varying ages. The relevance of these findings to the structuring of restoration services and the application of legal theory to the competence standard in juvenile court are discussed.
The development of a small scintillation camera for imaging 1-125 and Tc-99m in one dimension is described. We also provide a description for the detection assembly, signal-processing procedures, and display system. Using a calibrated source, the resolution and sensitivity of the camera are reported.
Recent data suggest that inhaled corticosteroids reduce the number of clinical exacerbations in chronic obstructive pulmonary disease (COPD). It remains unknown whether a dose/response relationship exists. The present study was conducted to evaluate the long-term impact of varying doses of inhaled corticosteroids on COPD mortality. Hospital discharge data were used to identify all patients aged ≥65 yrs recently hospitalised due to COPD in Alberta, Canada (n=6,740). The relative risk (RR) for all-cause mortality was compared across different dose categories of inhaled corticosteroids (none and low, medium and high doses) following hospital discharge. Inhaled corticosteroid therapy after discharge was associated with a 25% relative reduction in risk for all-cause mortality (RR 0.75, 95% confidence interval (CI) 0.68–0.82). Patients on medium- or high-dose therapy showed lower risks for mortality than those on low doses (RR 0.77, 95% CI 0.69–0.86 for low dose; RR 0.48, 95% CI 0.37–0.63 for medium dose; and RR 0.55, 95% CI 0.44–0.69 for high dose). Use of inhaled corticosteroids following hospital discharge for chronic obstructive pulmonary disease was associated with a significant reduction in the overall mortality rate. Low- was inferior to medium- or high-dose therapy in protecting against mortality in chronic obstructive pulmonary disease.
The regulatory actions of adenosine on ion channel function are mediated by four distinct membrane receptors. The concentration of adenosine in the vicinity of these receptors is controlled, in part, by inwardly directed nucleoside transport. The purpose of this study was to characterize the effects of adenosine on ion channels in A549 cells and the role of nucleoside transporters in this regulation. Ion replacement and pharmacological studies showed that adenosine and an inhibitor of human equilibrative nucleoside transporter (hENT)-1, nitrobenzylthioinosine, activated K + channels, most likely Ca 2+ -dependent intermediate-conductance K + ( I K ) channels. A 1 but not A 2 receptor antagonists blocked the effects of adenosine. RT-PCR studies showed that A549 cells expressed mRNA for I K -1 channels as well as A 1 , A 2A , and A 2B but not A 3 receptors. Similarly, mRNA for equilibrative (hENT1 and hENT2) but not concentrative (hCNT1, hCNT2, and hCNT3) nucleoside transporters was detected, a result confirmed in functional uptake studies. These studies showed that adenosine controls the function of K + channels in A549 cells and that hENTs play a crucial role in this process.
People living with HIV (PLWHA) with adequate access to modern combination antiretroviral therapy (cART) are living longer and experiencing reduced AIDS-related morbidity and mortality. However, increases in non-AIDS related conditions, such as certain cancers, have accompanied these therapeutic advances over time. As such, our study objective was to determine the impact of HIV on all-cause and lung cancer-specific mortality amongst PLWHA with diagnoses of non-small-cell lung cancer (NSCLC) and HIV-negative individuals with NSCLC. This analysis was inclusive of PLWHA on and off cART over the age of 19 years and a 10% comparison sample from the BC population ≥19 years, over a 13-year period (2000–2013). Kaplan-Meier estimates, Cox PH models, and competing risk analysis for all-cause and cause-specific mortality (respectively) compared PLWHA to HIV-negative individuals, controlling for age, gender, cancer stage, co-morbidities; and nadir CD4 count, viral load, and injection drug use for a HIV-positive specific analysis. We identified 71 PLWHA and 2463 HIV-negative individuals diagnosed with NSCLC between 2000 and 2013. PLWHA with NSCLC were diagnosed at a significantly younger age than HIV-negative individuals (median age 57 vs 71 years, p < 0.01). We found no significant difference in lung cancer-specific mortality. However, in multivariate analysis, HIV was associated with greater all-cause mortality (adjusted hazard ratio [aHR]:1.44; 95% confidence interval [CI]: 1.08–1.90), with median survival of 4 months for PLWHA, and 10 months for HIV-negative. Higher nadir CD4 count was protective against mortality (aHR: 0.33, 95% CI: 0.17–0.64) amongst PLWHA in multivariate analysis. Our analysis suggests that PLWHA in the modern cART era experience similar lung cancer survival outcomes compared to the general BC population with NSCLC. However, we also observed significantly higher all-cause mortality among PLWHA with NSCLC, which may warrant further inquiry into the role of HIV in exacerbating mortality among PLWHA with comorbidities and cancer.
