20 results
Seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies among healthcare personnel in the Midwestern United States, September 2020–April 2021
- Rachel E. Bosserman, Christopher W. Farnsworth, Caroline A. O’Neil, Candice Cass, Daniel Park, Claire Ballman, Meghan A. Wallace, Emily Struttmann, Henry Stewart, Olivia Arter, Kate Peacock, Victoria J. Fraser, Philip J. Budge, Margaret A. Olsen, Carey-Ann D. Burnham, Hilary M. Babcock, Jennie H. Kwon, for the CDC Prevention Epicenters
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 04 August 2023, e133
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Objective:
To determine the prevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) IgG nucleocapsid (N) antibodies among healthcare personnel (HCP) with no prior history of COVID-19 and to identify factors associated with seropositivity.
Design:Prospective cohort study.
Setting:An academic, tertiary-care hospital in St. Louis, Missouri.
Participants:The study included 400 HCP aged ≥18 years who potentially worked with coronavirus disease 2019 (COVID-19) patients and had no known history of COVID-19; 309 of these HCP also completed a follow-up visit 70–160 days after enrollment. Enrollment visits took place between September and December 2020. Follow-up visits took place between December 2020 and April 2021.
Methods:At each study visit, participants underwent SARS-CoV-2 IgG N-antibody testing using the Abbott SARS-CoV-2 IgG assay and completed a survey providing information about demographics, job characteristics, comorbidities, symptoms, and potential SARS-CoV-2 exposures.
Results:Participants were predominately women (64%) and white (79%), with median age of 34.5 years (interquartile range [IQR], 30–45). Among the 400 HCP, 18 (4.5%) were seropositive for IgG N-antibodies at enrollment. Also, 34 (11.0%) of 309 were seropositive at follow-up. HCP who reported having a household contact with COVID-19 had greater likelihood of seropositivity at both enrollment and at follow-up.
Conclusions:In this cohort of HCP during the first wave of the COVID-19 pandemic, ∼1 in 20 had serological evidence of prior, undocumented SARS-CoV-2 infection at enrollment. Having a household contact with COVID-19 was associated with seropositivity.
361 WDR5 represents a therapeutically exploitable target for cancer stem cells in glioblastoma
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- Christopher Hubert, Kelly Mitchell, Samuel Sprowls, Sajina Shakya, Sonali Arora, Daniel J. Silver, Christopher M. Goins, Lisa Wallace, Gustavo Roversi, Rachel Schafer, Kristen Kay, Tyler E. Miller, Adam Lauko, John Bassett, Anjali Kashyap, J. D’Amato Kass, Erin E. Mulkearns-Hubert, Sadie Johnson, Joseph Alvarado, Jeremy N. Rich, Patrick J. Paddison, Anoop P. Patel, Shaun R. Stauffer, Christopher G. Hubert, Justin D. Lathia
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- Journal:
- Journal of Clinical and Translational Science / Volume 7 / Issue s1 / April 2023
- Published online by Cambridge University Press:
- 24 April 2023, p. 107
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OBJECTIVES/GOALS: Glioblastomas (GBMs) are heterogeneous, treatment-resistant tumors that are driven by populations of cancer stem cells (CSCs). In this study, we perform an epigenetic-focused functional genomics screen in GBM organoids and identify WDR5 as an essential epigenetic regulator in the SOX2-enriched, therapy resistant cancer stem cell niche. METHODS/STUDY POPULATION: Despite their importance for tumor growth, few molecular mechanisms critical for CSC population maintenance have been exploited for therapeutic development. We developed a spatially resolved loss-of-function screen in GBM patient-derived organoids to identify essential epigenetic regulators in the SOX2-enriched, therapy resistant niche. Our niche-specific screens identified WDR5, an H3K4 histone methyltransferase responsible for activating specific gene expression, as indispensable for GBM CSC growth and survival. RESULTS/ANTICIPATED RESULTS: In GBM CSC models, WDR5 inhibitors blocked WRAD complex assembly and reduced H3K4 trimethylation and expression of genes involved in CSC-relevant oncogenic pathways. H3K4me3 peaks lost with WDR5 inhibitor treatment occurred disproportionally on POU transcription factor motifs, required for stem cell maintenance and including the POU5F1(OCT4)::SOX2 motif. We incorporated a SOX2/OCT4 motif driven GFP reporter system into our CSC cell models and found that WDR5 inhibitor treatment resulted in dose-dependent silencing of stem cell reporter activity. Further, WDR5 inhibitor treatment altered the stem cell state, disrupting CSC in vitro growth and self-renewal as well as in vivo tumor growth. DISCUSSION/SIGNIFICANCE: Our results unveiled the role of WDR5 in maintaining the CSC state in GBM and provide a rationale for therapeutic development of WDR5 inhibitors for GBM and other advanced cancers. This conceptual and experimental framework can be applied to many cancers, and can unmask unique microenvironmental biology and rationally designed combination therapies.
469 Electroencephalographic Correlate of Sensory Over-Responsivity in Adults with Chronic Tic Disorders
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- David A. Isaacs, Alexander C. Conley, Alexandra P. Key, Carissa J. Cascio, Harrison C. Walker, Mark T. Wallace, Daniel O. Claassen
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- Journal:
- Journal of Clinical and Translational Science / Volume 7 / Issue s1 / April 2023
- Published online by Cambridge University Press:
- 24 April 2023, p. 137
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OBJECTIVES/GOALS: To identify an electroencephalographic (EEG) signature of SOR in adults with TS METHODS/STUDY POPULATION: We will recruit 60 adults with CTD and 60 sex- and age-matched healthy controls to complete scales assessing severity of SOR (Sensory Gating Inventory, SGI), tics, and psychiatric symptoms. Subjects will then be monitored on dense-array scalp EEG during sequential auditory and tactile sensory gating paradigms, as such paradigms have been shown to correlate with self-report measures of SOR in other populations. Single-trial EEG data will be segmented into 100-ms epochs and spectrally deconvoluted into standard frequency bands (delta, theta, alpha, beta, gamma) for pre-defined regions of interest. We will conduct between-group contrasts (Wilcoxon rank-sum) of band-specific sensory gating indices and within-group correlations (Spearman rank correlations) between sensory gating indices and SGI scores. RESULTS/ANTICIPATED RESULTS: We hypothesize that, relative to controls, adults with CTD exhibit impaired sensory gating and that extent of impairment correlates with severity of SOR. 14 adults with CTD (9 men, 5 women) and 16 controls (10 men, 6 women) have completed the protocol to date. Within this sample, adults with CTD showed significantly reduced sensory gating compared to controls in frontal (CTD median 0.12 dB (interquartile range -0.15–0.70 dB); control -0.37 dB (-0.80–-0.13 dB); p = 0.01) and parietal (CTD 0.17 dB (-0.08–0.50 dB); control -0.20 dB (-0.43–0.10 dB); p = 0.01) gamma band during the 100-200 ms epoch in the tactile paradigm. No significant between-group differences were evident for the auditory paradigm. Among adults with CTD, multiple sensory gating indices significantly correlated with SGI scores. Enrollment continues. DISCUSSION/SIGNIFICANCE: Results aim to clarify the extent of sensory gating impairment in TS and identify a clinical correlate of neurophysiologic dysfunction in the disorder. Such knowledge has direct implications for identification of candidate neurophysiologic biomarkers, an express goal of the National Institutes of Health.
Antibodies in healthcare personnel following severe acute respiratory syndrome coronavirus virus 2 (SARS-CoV-2) infection
- Rachel E. Bosserman, Christopher W. Farnsworth, Caroline A. O’Neil, Candice Cass, Daniel Park, Claire Ballman, Meghan A. Wallace, Emily Struttmann, Henry Stewart, Olivia Arter, Kate Peacock, Victoria J. Fraser, Philip J. Budge, Margaret A. Olsen, Carey-Ann D. Burnham, Hilary M. Babcock, Jennie H. Kwon, for the CDC Prevention Epicenters
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 2 / Issue 1 / 2022
- Published online by Cambridge University Press:
- 15 June 2022, e93
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In a prospective cohort of healthcare personnel (HCP), we measured severe acute respiratory syndrome coronavirus virus 2 (SARS-CoV-2) nucleocapsid IgG antibodies after SARS-CoV-2 infection. Among 79 HCP, 68 (86%) were seropositive 14–28 days after their positive PCR test, and 54 (77%) of 70 were seropositive at the 70–180-day follow-up. Many seropositive HCP (95%) experienced an antibody decline by the second visit.
292 Fibromyalgianess and Glucocorticoid Persistence Among Patients with Rheumatoid Arthritis
- Beth Wallace, Meriah N. Moore, Andrew C. Heisler, Lutfiyya N. Muhammad, Jing Song, Daniel J. Clauw, Clifton O. Bingham III, Marcy B. Bolster, Wendy Marder, Tuhina Neogi, Alyssa Wohlfahrt, Dorothy D. Dunlop, Yvonne C. Lee
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- Journal:
- Journal of Clinical and Translational Science / Volume 6 / Issue s1 / April 2022
- Published online by Cambridge University Press:
- 19 April 2022, p. 51
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OBJECTIVES/GOALS: Over 30% of patients with rheumatoid arthritis (RA) exhibit fibromyalgianess, a symptom cluster associated with increased pain sensitivity. Up to half of RA patients use oral glucocorticoids (GCs) long-term despite their known, dose-dependent toxicity. We examined the association between fibromyalgianess and oral GC persistence in RA patients. METHODS/STUDY POPULATION: We used data from the Central Pain in Rheumatoid Arthritis (CPIRA) cohort to follow participants with active RA on oral prednisone who initiated a new disease-modifying anti-rheumatic drug. We measured fibromyalgianess using the Fibromyalgia Survey Questionnaire (FSQ), previously shown to correlate with key fibromyalgia features often superimposed upon RA. We stratified fibromyalgianess severity as follows: FSQ<8 low, 8-10 moderate, >10 high/very high. We defined GC persistence as GC use at 3 month followup visit. We assessed the association between baseline fibromyalgianess (exposure) and GC persistence at followup (outcome) using multiple logistic regression, adjusted for demographics, RA duration, serostatus, and inflammatory activity measured by swollen joint count and C reactive protein. RESULTS/ANTICIPATED RESULTS: Of 97 participants on prednisone at baseline, 65% were taking prednisone at follow-up. Fifty-seven percent of participants with low baseline fibromyalgianess had persistent GC use, compared to 84% with high or very high fibromyalgianess. After adjustment as outlined above, participants with high/very high baseline fibromyalgianess remained more likely to be on prednisone at follow-up, relative to those with low fibromyalgianess (OR 4.99 [95% CI 1.20 – 20.73]). DISCUSSION/SIGNIFICANCE: In this cohort of patients with active RA, high fibromyalgianess is associated with persistent GC use, independent of inflammatory activity. This finding suggests non-inflammatory pain related to fibromyalgianess may be misclassified as inflammatory pain related to RA disease activity.
Cultural variation in running techniques among non-industrial societies
- Ian J. Wallace, Thomas S. Kraft, Vivek V. Venkataraman, Helen E. Davis, Nicholas B. Holowka, Alexandra R. Harris, Daniel E. Lieberman, Michael Gurven
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- Journal:
- Evolutionary Human Sciences / Volume 4 / 2022
- Published online by Cambridge University Press:
- 11 April 2022, e14
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Research among non-industrial societies suggests that body kinematics adopted during running vary between groups according to the cultural importance of running. Among groups in which running is common and an important part of cultural identity, runners tend to adopt what exercise scientists and coaches consider to be good technique for avoiding injury and maximising performance. In contrast, among groups in which running is not particularly culturally important, people tend to adopt suboptimal technique. This paper begins by describing key elements of good running technique, including landing with a forefoot or midfoot strike pattern and leg oriented roughly vertically. Next, we review evidence from non-industrial societies that cultural attitudes about running associate with variation in running techniques. Then, we present new data from Tsimane forager–horticulturalists in Bolivia. Our findings suggest that running is neither a common activity among the Tsimane nor is it considered an important part of cultural identity. We also demonstrate that when Tsimane do run, they tend to use suboptimal technique, specifically landing with a rearfoot strike pattern and leg protracted ahead of the knee (called overstriding). Finally, we discuss processes by which culture might influence variation in running techniques among non-industrial societies, including self-optimisation and social learning.
42956 Patterns and impact of long-term glucocorticoid use on RA patients at risk for major adverse cardiac events
- Beth I. Wallace, Yuqing Gao, Punyasha Roul, Shirley Cohen-Mekelberg, Bryant England, Ted Mikuls, Daniel J. Clauw, Rodney Hayward, Akbar K. Waljee
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- Journal:
- Journal of Clinical and Translational Science / Volume 5 / Issue s1 / March 2021
- Published online by Cambridge University Press:
- 30 March 2021, p. 141
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ABSTRACT IMPACT: Glucocorticoid steroids are commonly used despite known dose-dependent cardiovascular toxicity, yet little is known about a) how patients with other cardiovascular risk factors use glucocorticoids, and b) how risks of glucocorticoid treatment might vary depending on a patient’s baseline cardiovascular risk. OBJECTIVES/GOALS: Up to one-third of RA patients use long-term glucocorticoids (GCs) despite a known, dose-dependent association with increased risk of major adverse cardiovascular events (MACE). We aim to evaluate patterns of GC use among RA patients with other MACE risk factors (i.e. diabetes, smoking), and examine how GC use may potentiate these risk factors. METHODS/STUDY POPULATION: We used claims data from Veterans Health Administration to identify 6,090 RA patients with ≥1 rheumatology clinic visit during 2013-2017. We used logistic regression to evaluate associations between incident MACE between 2013-2018, recent long-term GC use, and 5 MACE risk factors: hypertension, diabetes, hyperlipidemia, smoking, and prior MACE. We included two-way interaction terms between GC use and each risk factor. We used a claims-based algorithm to define MACE as any of acute MI, ischemic stroke, TIA, sudden death, or coronary revascularization, between index date and 12/31/2018. We defined index date as first rheumatology visit after meeting RA diagnostic criteria, and recent long-term GC use as ≥90 days’ supply dispensed over 2 years prior to index date. RESULTS/ANTICIPATED RESULTS: Among 2,884 eligible patients,1,553 (54%) had MACE risk factors, and 97 (3%) had prior MACE (Table 1). Overall, 16% of patients recently used long-term GC, compared to 17% of patients with MACE risk factors, and 22% of patients with prior MACE. Incident MACE occurred in 308 (11%) patients, 24% of whom had recent long-term GC use. Recent long-term GC use was independently associated with increased incident MACE (Table 2). While no interaction term was statistically significant overall, differences in odds of incident MACE were seen across levels of recent GC use for several risk factors, particularly diabetes (OR 2.10, 95% CI [0.93-4.77]), tobacco use (OR 2.88, 95% CI [1.16-7.14]) and prior MACE (OR 2.41, 95% CI [0.73-7.95]). DISCUSSION/SIGNIFICANCE OF FINDINGS: Long-term GC use is common among RA patients with MACE risk factors. In this cohort, 25% of patients with incident MACE had recently used long-term GC. Long-term GC use may potentiate effects of comorbidities like diabetes and smoking, disproportionately increasing MACE risk in certain patients.
Experimentally imposed circadian misalignment alters the neural response to monetary rewards and response inhibition in healthy adolescents
- Brant P. Hasler, Adriane M. Soehner, Meredith L. Wallace, Ryan W. Logan, Wambui Ngari, Erika E. Forbes, Daniel J. Buysse, Duncan B. Clark
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- Psychological Medicine / Volume 52 / Issue 16 / December 2022
- Published online by Cambridge University Press:
- 17 March 2021, pp. 3939-3947
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Background
Sleep and circadian timing shifts later during adolescence, conflicting with early school start times, and resulting in circadian misalignment. Although circadian misalignment has been linked to depression, substance use, and altered reward function, a paucity of experimental studies precludes the determination of causality. Here we tested, for the first time, whether experimentally-imposed circadian misalignment alters the neural response to monetary reward and/or response inhibition.
MethodsHealthy adolescents (n = 25, ages 13–17) completed two in-lab sleep schedules in counterbalanced order: An ‘aligned’ condition based on typical summer sleep-wake times (0000–0930) and a ‘misaligned’ condition mimicking earlier school year sleep-wake times (2000–0530). Participants completed morning and afternoon functional magnetic resonance imaging scans during each condition, including monetary reward (morning only) and response inhibition (morning and afternoon) tasks. Total sleep time and circadian phase were assessed via actigraphy and salivary melatonin, respectively.
ResultsBilateral ventral striatal (VS) activation during reward outcome was lower during the Misaligned condition after accounting for the prior night's total sleep time. Bilateral VS activation during reward anticipation was lower during the Misaligned condition, including after accounting for covariates, but did not survive correction for multiple comparisons. Right inferior frontal gyrus activation during response inhibition was lower during the Misaligned condition, before and after accounting for total sleep time and vigilant attention, but only during the morning scan.
ConclusionsOur findings provide novel experimental evidence that circadian misalignment analogous to that resulting from school schedules may have measurable impacts on healthy adolescents' reward processing and inhibition of prepotent responses.
Schizophrenia polygenic risk scores in youth mental health: preliminary associations with diagnosis, clinical stage and functioning
- Jacob J. Crouse, Joanne S. Carpenter, Frank Iorfino, Tian Lin, Nicholas Ho, Enda M. Byrne, Anjali K. Henders, Leanne Wallace, Daniel F. Hermens, Elizabeth M. Scott, Naomi R. Wray, Ian B. Hickie
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- Journal:
- BJPsych Open / Volume 7 / Issue 2 / March 2021
- Published online by Cambridge University Press:
- 22 February 2021, e58
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Background
The schizophrenia polygenic risk score (SCZ-PRS) is an emerging tool in psychiatry.
AimsWe aimed to evaluate the utility of SCZ-PRS in a young, transdiagnostic, clinical cohort.
MethodSCZ-PRSs were calculated for young people who presented to early-intervention youth mental health clinics, including 158 patients of European ancestry, 113 of whom had longitudinal outcome data. We examined associations between SCZ-PRS and diagnosis, clinical stage and functioning at initial assessment, and new-onset psychotic disorder, clinical stage transition and functional course over time in contact with services.
ResultsCompared with a control group, patients had elevated PRSs for schizophrenia, bipolar disorder and depression, but not for any non-psychiatric phenotype (for example cardiovascular disease). Higher SCZ-PRSs were elevated in participants with psychotic, bipolar, depressive, anxiety and other disorders. At initial assessment, overall SCZ-PRSs were associated with psychotic disorder (odds ratio (OR) per s.d. increase in SCZ-PRS was 1.68, 95% CI 1.08–2.59, P = 0.020), but not assignment as clinical stage 2+ (i.e. discrete, persistent or recurrent disorder) (OR = 0.90, 95% CI 0.64–1.26, P = 0.53) or functioning (R = 0.03, P = 0.76). Longitudinally, overall SCZ-PRSs were not significantly associated with new-onset psychotic disorder (OR = 0.84, 95% CI 0.34–2.03, P = 0.69), clinical stage transition (OR = 1.02, 95% CI 0.70–1.48, P = 0.92) or persistent functional impairment (OR = 0.84, 95% CI 0.52–1.38, P = 0.50).
ConclusionsIn this preliminary study, SCZ-PRSs were associated with psychotic disorder at initial assessment in a young, transdiagnostic, clinical cohort accessing early-intervention services. Larger clinical studies are needed to further evaluate the clinical utility of SCZ-PRSs, especially among individuals with high SCZ-PRS burden.
Last Interglacial Climates
- George J. Kukla, Michael L. Bender, Jacques-Louis de Beaulieu, Gerard Bond, Wallace S. Broecker, Piet Cleveringa, Joyce E. Gavin, Timothy D. Herbert, John Imbrie, Jean Jouzel, Lloyd D. Keigwin, Karen-Luise Knudsen, Jerry F. McManus, Josef Merkt, Daniel R. Muhs, Helmut Müller, Richard Z. Poore, Stephen C. Porter, Guy Seret, Nicholas J. Shackleton, Charles Turner, Polychronis C. Tzedakis, Isaac J. Winograd
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- Quaternary Research / Volume 58 / Issue 1 / July 2002
- Published online by Cambridge University Press:
- 20 January 2017, pp. 2-13
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The last interglacial, commonly understood as an interval with climate as warm or warmer than today, is represented by marine isotope stage (MIS) 5e, which is a proxy record of low global ice volume and high sea level. It is arbitrarily dated to begin at approximately 130,000 yr B.P. and end at 116,000 yr B.P. with the onset of the early glacial unit MIS 5d. The age of the stage is determined by correlation to uranium–thorium dates of raised coral reefs. The most detailed proxy record of interglacial climate is found in the Vostok ice core where the temperature reached current levels 132,000 yr ago and continued rising for another two millennia. Approximately 127,000 yr ago the Eemian mixed forests were established in Europe. They developed through a characteristic succession of tree species, probably surviving well into the early glacial stage in southern parts of Europe. After ca. 115,000 yr ago, open vegetation replaced forests in northwestern Europe and the proportion of conifers increased significantly farther south. Air temperature at Vostok dropped sharply. Pulses of cold water affected the northern North Atlantic already in late MIS 5e, but the central North Atlantic remained warm throughout most of MIS 5d. Model results show that the sea surface in the eastern tropical Pacific warmed when the ice grew and sea level dropped. The essentially interglacial conditions in southwestern Europe remained unaffected by ice buildup until late MIS 5d when the forests disappeared abruptly and cold water invaded the central North Atlantic ca. 107,000 yr ago.
Incidence of Surgical Site Infection Following Mastectomy With and Without Immediate Reconstruction Using Private Insurer Claims Data
- Margaret A. Olsen, Katelin B. Nickel, Ida K. Fox, Julie A. Margenthaler, Kelly E. Ball, Daniel Mines, Anna E. Wallace, Victoria J. Fraser
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 36 / Issue 8 / August 2015
- Published online by Cambridge University Press:
- 03 June 2015, pp. 907-914
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- August 2015
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OBJECTIVE
The National Healthcare Safety Network classifies breast operations as clean procedures with an expected 1%–2% surgical site infection (SSI) incidence. We assessed differences in SSI incidence following mastectomy with and without immediate reconstruction in a large, geographically diverse population.
DESIGNRetrospective cohort study
PATIENTSCommercially insured women aged 18–64 years with ICD-9-CM procedure or CPT-4 codes for mastectomy from January 1, 2004 through December 31, 2011
METHODSIncident SSIs within 180 days after surgery were identified by ICD-9-CM diagnosis codes. The incidences of SSI after mastectomy with and without immediate reconstruction were compared using the χ2 test.
RESULTSFrom 2004 to 2011, 18,696 mastectomy procedures among 18,085 women were identified, with immediate reconstruction in 10,836 procedures (58%). The incidence of SSI within 180 days following mastectomy with or without reconstruction was 8.1% (1,520 of 18,696). In total, 49% of SSIs were identified within 30 days post-mastectomy, 24.5% were identified 31–60 days post-mastectomy, 10.5% were identified 61–90 days post-mastectomy, and 15.7% were identified 91–180 days post-mastectomy. The incidences of SSI were 5.0% (395 of 7,860) after mastectomy only, 10.3% (848 of 8,217) after mastectomy plus implant, 10.7% (207 of 1,942) after mastectomy plus flap, and 10.3% (70 of 677) after mastectomy plus flap and implant (P<.001). The SSI risk was higher after bilateral compared with unilateral mastectomy with immediate reconstruction (11.4% vs 9.4%, P=.001) than without (6.1% vs 4.7%, P=.021) immediate reconstruction.
CONCLUSIONSSSI incidence was twice that after mastectomy with immediate reconstruction than after mastectomy alone. Only 49% of SSIs were coded within 30 days after operation. Our results suggest that stratification by procedure type facilitates comparison of SSI rates after breast operations between facilities.
Infect Control Hosp Epidemiol 2015;36(8):907–914
Stratification of Surgical Site Infection by Operative Factors and Comparison of Infection Rates after Hernia Repair
- Margaret A. Olsen, Katelin B. Nickel, Anna E. Wallace, Daniel Mines, Victoria J. Fraser, David K. Warren
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 36 / Issue 3 / March 2015
- Published online by Cambridge University Press:
- 22 December 2014, pp. 329-335
- Print publication:
- March 2015
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Objective
To investigate whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair.
DesignRetrospective cohort study.
PatientsCommercially insured enrollees aged 6 months-64 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure or Current Procedural Terminology, fourth edition, codes for inguinal/femoral, umbilical, and incisional/ventral hernia repair procedures from January 1, 2004, through December 31, 2010.
MethodsSSIs within 90 days after hernia repair were identified by diagnosis codes. The χ2 and Fisher exact tests were used to compare SSI incidence by operative factors.
ResultsA total of 119,973 hernia repair procedures were analyzed. The incidence of SSI differed significantly by anatomic site, with rates of 0.45% (352/77,666) for inguinal/femoral, 1.16% (288/24,917) for umbilical, and 4.11% (715/17,390) for incisional/ventral hernia repair. Within anatomic sites, the incidence of SSI was significantly higher for open versus laparoscopic inguinal/femoral (0.48% [295/61,142] vs 0.34% [57/16,524], P=.020) and incisional/ventral (4.20% [701/16,699] vs 2.03% [14/691], P=.005) hernia repairs. The rate of SSI was higher following procedures with bowel obstruction/necrosis than procedures without obstruction/necrosis for open inguinal/femoral (0.89% [48/5,422] vs 0.44% [247/55,720], P<.001) and umbilical (1.57% [131/8,355] vs 0.95% [157/16,562], P<.001), but not incisional/ventral hernia repair (4.01% [224/5,585] vs 4.16% [491/11,805], P=.645).
ConclusionsThe incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction/necrosis. Stratification of hernia repair SSI rates by some operative factors may facilitate accurate comparison of SSI rates between facilities.
Infect Control Hosp Epidemiol 2014;00(0): 1–7
Can Additional Information Be Obtained from Claims Data to Support Surgical Site Infection Diagnosis Codes?
- David K. Warren, Katelin B. Nickel, Anna E. Wallace, Daniel Mines, Victoria J. Fraser, Margaret A. Olsen
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 35 / Issue S3 / October 2014
- Published online by Cambridge University Press:
- 10 May 2016, pp. S124-S132
- Print publication:
- October 2014
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Objective.
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes are increasingly used to identify healthcare-associated infections, often with insufficient evidence demonstrating validity of the codes used. Absent medical record verification, we sought to confirm a claims algorithm to identify surgical site infections (SSIs) by examining the presence of clinically expected SSI treatment.
Methods.We performed a retrospective cohort study, using private insurer claims data from persons less than 65 years old with ICD-9-CM procedure or Current Procedure Terminology (CPT-4) codes for anterior cruciate ligament (ACL) reconstruction from January 2004 through December 2010. SSIs occurring within 90 days after ACL reconstruction were identified by ICD-9-CM diagnosis codes. Antibiotic utilization, surgical treatment, and microbiology culture claims within 14 days of SSI codes were used as evidence to support the SSI diagnosis.
Results.Of 40,702 procedures, 401 (1.0%) were complicated by SSI, 172 (0.4%) of which were specifically identified as septic arthritis. Most SSIs were associated with an inpatient admission (232/401 [58%]), and/or surgical procedure(s) for treatment (250/401 [62%]). Temporally associated antibiotics, surgical treatment procedures, and cultures were present for 84% (338/401), 61% (246/401), and 59% (238/401), respectively. Only 5.7% (23/401) of procedures coded for SSI after the procedure had no antibiotics, surgical treatments, or cultures within 14 days of the SSI claims.
Conclusions.More than 94% of patients identified by our claims algorithm as having an SSI received clinically expected treatment for infection, including antibiotics, surgical treatment, and culture, suggesting that this algorithm has very good positive predictive value. This method may facilitate retrospective SSI surveillance and comparison of SSI rates across facilities and providers.
Trauma Exposure and Posttraumatic Stress Disorder Among Employees of New York City Companies Affected by the September 11, 2001 Attacks on the World Trade Center
- Carol S. North, David E. Pollio, Rebecca P. Smith, Richard V. King, Anand Pandya, Alina M. Surís, Barry A. Hong, Denis J. Dean, Nancy E. Wallace, Daniel B. Herman, Sarah Conover, Ezra Susser, Betty Pfefferbaum
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- Disaster Medicine and Public Health Preparedness / Volume 5 / Issue S2 / September 2011
- Published online by Cambridge University Press:
- 08 April 2013, pp. S205-S213
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Objective: Several studies have provided prevalence estimates of posttraumatic stress disorder (PTSD) related to the September 11, 2001 (9/11) attacks in broadly affected populations, although without sufficiently addressing qualifying exposures required for assessing PTSD and estimating its prevalence. A premise that people throughout the New York City area were exposed to the attacks on the World Trade Center (WTC) towers and are thus at risk for developing PTSD has important implications for both prevalence estimates and service provision. This premise has not, however, been tested with respect to DSM-IV-TR criteria for PTSD. This study examined associations between geographic distance from the 9/11 attacks on the WTC and reported 9/11 trauma exposures, and the role of specific trauma exposures in the development of PTSD.
Methods: Approximately 3 years after the attacks, 379 surviving employees (102 with direct exposures, including 65 in the towers, and 277 with varied exposures) recruited from 8 affected organizations were interviewed using the Diagnostic Interview Schedule/Disaster Supplement and reassessed at 6 years. The estimated closest geographic distance from the WTC towers during the attacks and specific disaster exposures were compared with the development of 9/11–related PTSD as defined by the Diagnostic and Statistical Manual, Fourth Edition, Text Revision.
Results: The direct exposure zone was largely concentrated within a radius of 0.1 mi and completely contained within 0.75 mi of the towers. PTSD symptom criteria at any time after the disaster were met by 35% of people directly exposed to danger, 20% of those exposed only through witnessed experiences, and 35% of those exposed only through a close associate’s direct exposure. Outside these exposure groups, few possible sources of exposure were evident among the few who were symptomatic, most of whom had preexisting psychiatric illness.
Conclusions: Exposures deserve careful consideration among widely affected populations after large terrorist attacks when conducting clinical assessments, estimating the magnitude of population PTSD burdens, and projecting needs for specific mental health interventions.
(Disaster Med Public Health Preparedness. 2011;5:S205-S213)
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- By Ashok Agarwal, Linda D. Applegarth, Nelson E. Bennett, Nancy L. Brackett, Melissa B. Brisman, Mark F. H. Brougham, Cara B. Cimmino, Owen K. Davis, Rian J. Dickstein, Michael L. Eisenberg, Mikkel Fode, Gretchen A. Gignac, Bruce R. Gilbert, Ellen R. Goldmark, Marc Goldstein, Wayne J. G. Hellstrom, Wayland Hsiao, Jack Huang, Kathleen Hwang, Ann A. Jakubowski, Keith Jarvi, Loren Jones, Hey-Joo Kang, Joanne Frankel Kelvin, Mohit Khera, Thomas F. Kolon, Kate H. Kraft, Andrew C. Kramer, Dolores J. Lamb, Andrew B. Lassman, Helen R. Levey, Larry I. Lipshultz, Charles M. Lynne, Akanksha Mehta, Marvin L. Meistrich, Gregory C. Mitchell, Mark A. Moyad, John P. Mulhall, Lauren Murray, Craig Niederberger, Ariella Noy, Robert D. Oates, Dana A. Ohl, Kutluk Oktay, Ndidiamaka Onwubalili, Fabio Firmbach Pasqualatto, Elena Pentsova, Susanne A. Quallich, Gwendolyn P. Quinn, Alex Ridgeway, Matthew T. Roberts, Kenny A. Rodriguez-Wallberg, Allison B. Rosen, Lisa Rosenzweig, Edmund S. Sabanegh, Hossein Sadeghi-Nejad, Mary K. Samplaski, Jay I. Sandlow, Peter N. Schlegel, Gunapala Shetty, Mark Sigman, Jens Sønksen, Peter J. Stahl, Eytan Stein, Doron S. Stember, Raanan Tal, Susan T. Vadaparampil, W. Hamish, B. Wallace, Leonard H. Wexler, Daniel H. Williams
- Edited by John P. Mulhall, Memorial Sloan-Kettering Cancer Center, New York
- Edited in association with Linda D. Applegarth, Robert D. Oates, Peter N. Schlegel
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- Fertility Preservation in Male Cancer Patients
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- By Gregory A. Aarons, Nick Axford, Frances Wallace Bailey, Judith Bennett, Karen A. Blase, James Boyle, Tracey Bywater, Linda L. Caldwell, Jeanne Century, Anne Michelle Daniels, Thomas J. Dishion, Celene E. Domitrovich, Morgaen Donaldson, Glen Dunlap, Carl J. Dunst, Melissa Van Dyke, Dean L. Fixsen, Tamsin Ford, Lise Fox, Cassie Freeman, Robyn M. Gillies, Amy E. Green, Mark T. Greenberg, Violet H. Harada, Tim Hobbs, Cindy Huang, Robert J. Illback, Barbara Kelly, Kathryn Margolis, Elizabeth Miller, Dana T. Mitra, Jeremy J. Monsen, Julia E. Moore, Louise Morpeth, Barbara Neufeld, Colleen K. Reutebuch, Mollie Rudnick, Robert Savage, Robert E. Slavin, Elizabeth A. Stormshack, Phillip Strain, Keith J. Topping, Carol M. Trivette, Sharon Vaughn, Janet A. Welsh, Lisa Marks Woolfson, Joyce Yukawa
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- Handbook of Implementation Science for Psychology in Education
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- 05 November 2012
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- 20 August 2012, pp xi-xiv
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. 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Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. 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Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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15 - Sleep and fibromyalgia in the elderly
- from Part 3 - Sleepdisorders in the elderly
- Edited by S. R. Pandi-Perumal, Jaime M. Monti, Universidad de la República, Uruguay, Andrew A. Monjan, National Institute on Aging, Bethesda, Maryland
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- Principles and Practice of Geriatric Sleep Medicine
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Summary
The central research topic of this chapter is embedded within three major fields of research, that is, sleep, memory, and cognitive aging research. Sleep is further characterized by changes in cerebral activity across the sleep-wake cycle. At a global level, brain activity decreases from waking to non-REM (NREM) sleep and returns back to waking levels during rapid eye movement (REM) sleep. Like sleep, memory is not a unitary system. In fact, there are several different classification schemes for human memory. In the context of sleep-dependent memory consolidation, an important distinction is usually drawn between declarative and non-declarative memory systems. Age-related cognitive decline is characterized by healthy and pathological processes in adult brain development. In this context, an important distinction is drawn between normal aging, mild cognitive impairment (MCI), and Alzheimer's disease (AD). Several psychiatric disorders such as Alzheimer's disease and depression are associated with disturbances of both sleep and memory.
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- By Sonia Ancoli-Israel, Ragnar Asplund, Michel Billiard, Theresa M. Buckley, Rohit Budhiraja, Robert N. Butler, Daniel J. Buysse, Scott S. Campbell, Daniel P. Cardinali, Julie Carrier, Cynthia L. Comella, Jana R. Cooke, Pietro Cortelli, Agnès Demazieres, Glenna A. Dowling, Luigi Ferini-Strambi, Philip R. Gehrman, Nalaka Sudheera Gooneratne, David S. Hallegua, Patrick J. Hanly, David G. Harper, Orla P. Hornung, Magdolna Hornyak, Michal Karasek, Milton Kramer, Andrew D. Krystal, Malcolm H. Lader, Rachel Leproult, Kenneth L. Lichstein, Andrea H.S. Loewen, Rémy Luthringer, Laurin J. Mack, Evelyn Mai, Atul Malhotra, Jennifer L. Martin, Judy Mastick, Monique A.J. Mets, Andrew A. Monjan, Timothy H. Monk, Daniel Monti, Jaime M. Monti, Patricia J. Murphy, C. Ineke Neutel, Eric A. Nofzinger, Seithikurippu R. Pandi-Perumal, Scott B. Patton, Donald B. Penzien, Max H. Pittler, Giora Pillar, Marc J. Poulin, Louis J. Ptácek, Stuart F. Quan, Jeanetta C. Rains, Megan E. Ruiter, Bruce D. Rybarczyk, Colin M. Shapiro, Vijay Kumar Sharma, D. Warren Spence, Kai Spiegelhalder, Luc Staner, Stephanie A. Studenski, Nikola N. Trajanovic, Eve Van Cauter, Gregory S. Vander Wal, Joris C. Verster, Aleksandar Videnovic, Matthew P. Walker, Daniel J. Wallace, David K. Welsh, David P. White, Barbara Wider, Theresa B. Young, Stefano Zanigni
- Edited by S. R. Pandi-Perumal, Jaime M. Monti, Universidad de la República, Uruguay, Andrew A. Monjan, National Institute on Aging, Bethesda, Maryland
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- Principles and Practice of Geriatric Sleep Medicine
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- 04 August 2010
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- By Ralph Adolphs, Bernard J. Baars, John A. Bargh, Jesse M. Bering, David F. Bjorklund, Joseph E. Bogen, Rebekah Bradley, Wallace Chafe, Michael C. Corballis, Diego Cosmelli, Jean-Marie Danion, Richard J. Davidson, Steven W. Day, Georges Dreyfus, John D. Dunne, Stan Franklin, Helena Hong Gao, Lisa Geraci, Deborah E. Hannula, J. Allan Hobson, Caroline Huron, John F. Kihlstrom, Asher Koriat, Uriah Kriegel, Jean-Philippe Lachaux, Charles D. Laughlin, Antoine Lutz, Drew McDermott, Katharine McGovern, Keith Oately, Suparna Rajaram, Henry L. Roediger III, Edmund T. Rolls, Daniel L. Schachter, William Seager, Daniel J. Simons, Scott D. Slotnick, Henry Stapp, Petra Stoerig, Ron Sun, Evan Thompson, C. Jason Throop, Rebecca Todd, Carlo Umiltà, David E. Warren, Joel Weinberger, Drew Westen, Dan Zahavi, Philip David Zelazo
- Edited by Philip David Zelazo, University of Toronto, Morris Moscovitch, University of Toronto, Evan Thompson, University of York
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- The Cambridge Handbook of Consciousness
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- 05 June 2012
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- 14 May 2007, pp -
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