Search

Introduction: Acute compartment syndrome of the hand is a rare medical emergency, most often associated with trauma or fracture.Case Report: Here, we describe a rare case of isolated thenar compartment syndrome of the hand in the absence of major trauma as the presenting symptom of pancytopenia due to Evans syndrome, an uncommon autoimmune hematologic disorder.Conclusion: In cases of atraumatic compartment syndrome, it is critical to evaluate for underlying coagulopathy in patients presenting to the emergency department.

We examine the impact of product recalls on audit production. Product recalls are events that increase engagement risk associated with greater audit effort, and by extension, greater audit quality. Consistent with this conclusion, we find firm-years with a product recall have a lower likelihood of being subsequently restated and lower levels of accrual error. While a positive association generally exists between audit effort and audit fees, prior literature shows firms experiencing economic stress negotiate lower audit fees and auditors accept lower fees to earn future returns. We expect that to increase the likelihood of retaining a client, auditors will agree to lower fees when the short-term economic stress associated with a recall injects downward pressure into fee negotiations. Supporting this conclusion, we find product recalls are associated with lower audit fees – a relation attributable to differing magnitudes of temporal fee increase. We also show the effects are transitory, the higher levels of audit quality are attributable to specialist audit offices, and the lower levels of fees are attributable to engagements where the client has greater bargaining power. While a positive association typically exists between audit effort and audit fees, our paper identifies a firm-specific event that weakens this relation. [ABSTRACT FROM AUTHOR]

Primary cutaneous gamma/delta T-cell lymphoma (PCγδTCL) is a rare form of cutaneous lymphoma characterized by abnormal clonal proliferation of mature, activated gamma-delta T cells expressing the γδ heterodimer of the T-cell receptor (TCR). As an entity, PCγδTCL has recently undergone diagnostic revision since its introduction in the 2008 WHO classification of cutaneous lymphomas and confirmedin 2016. Nonetheless, diagnosis remains difficult both clinically and histologically, given its broad range of clinical manifestations and immunohistochemical phenotypes. Herein, we present a rare case of CD8+ PCγδTCL with a discussion highlighting theheterogeneity within this entity.

This article describes a Monte Carlo study of 2 methods for treating incomplete non-normal data. Skewed, kurtotic data sets conforming to a single structured model, but varying in sample size, percentage of data missing, and missing-data mechanism, were produced. An asymptotically distribution-free available-case (ADFAC) method and structured-model expectation-maximization (EM) with non-normality corrections were applied to these data sets, and the 2 methods were then compared in terms of bias in parameter estimates, bias in standard-error estimates, efficiency of parameter estimates, and model chi-squares. The results favored the non-normality corrected EM over the ADFAC method in almost all respects, the only important exception involving bias in standard-error estimates with large samples.

Although designated as a high-risk group during the 2009-2010 H1N1 pandemic, only about 40% of U.S. children received the vaccine, a relatively low percentage compared with high-risk groups in seasonal influenza, such as the elderly, whose vaccine rates typically top 70%. To better understand parental decision making and predictors of acceptance of the H1N1 vaccine, we examined data from a representative national sample of parents (n = 684), using the health belief model as a framework. The most important predictors of vaccine acceptance were "cues to action" at multiple levels, from intrapersonal to mass communication, including the influence of friends, family, the media, and modeling by the Obama family; costs and benefits and self-efficacy were also significant predictors of vaccine acceptance. Higher perceived levels of H1N1 risk were not associated with vaccine uptake. Results suggest that traditional measures of perceived risk may not account for the cost--benefit analysis inherent in vaccine decision making, and that messages designed to emphasize disease risk may be ineffective. The authors recommend emphasizing cues to action that support norming and modeling of vaccine acceptance.

Hookah tobacco smoking is increasing among US college students, including those who would not otherwise use tobacco. Part of hookah's appeal is attributed to the perception that hookah is less harmful than cigarettes. The aims of this study were to assess knowledge of harmful exposures associated with hookah smoking relative to cigarette smoking and to determine associations between this knowledge and hookah smoking outcomes. Students (N = 852) at the University of Florida were randomly sampled via e-mail to obtain information on demographics, hookah smoking behavior and knowledge of five exposures (e.g. tar and nicotine). Multivariable logistic regression models assessed independent associations between knowledge and hookah smoking outcomes. Of the five factual knowledge items asked, 475 (55.8%) of the respondents answered none correctly. In multivariable models, correct responses to any knowledge items were not associated with lower odds of hookah smoking or susceptibility to hookah smoking in the future. Although college students are largely unaware of the toxicant exposures associated with hookah smoking, there is little association between knowledge and hookah smoking behavior.

Creative teamwork in multidisciplinary teams is a topic of interest to cognitive psychologists on the one hand, and to both social and organizational psychologists on the other. However, the interconnections between cognitive and social layers have been rarely explored. Drawing on mental models and dissonance theories, the current study takes a central variable studied by cognitive psychologists--analogy--and examines its relationship to a central variable examined by social psychologists--conflict. In an observational, field study, over 11 h of audio-video data from conversations of the Mars Exploration Rover scientists were coded for different types of analogy and micro-conflicts that reveal the character of underlying psychological mechanisms. Two different types of time-lagged logistic models applied to these data revealed asymmetric patterns of associations between analogy and conflict. Within-domain analogies, but not within-discipline or outside-discipline analogies, preceded science and work process conflicts, suggesting that in multidisciplinary teams, representational gaps in very close domains will be more likely to spark conflict. But analogies also occurred in reaction to conflict: Process and negative conflicts, but not task conflicts, preceded within-discipline analogies, but not to within-domain or outside-discipline analogies. This study demonstrates ways in which cognition can be bidirectionally tied to social processes and discourse. (Contains 7 tables and 3 figures.)

Research on influenza vaccine uptake has focused largely on intrapersonal determinants (perceived risk, past vaccine acceptance, perceived vaccine safety) and on physician recommendation. The authors used a social ecological framework to examine influenza vaccine uptake during the 2009 H1N1 pandemic. Surveying an adult population (n = 2,079) in January 2010 with significant oversamples of Blacks and Hispanics, this study found that 18.4% (95% confidence interval = 15.6-21.5) had gotten the 2009 H1N1 vaccine. Variables at each level of the social ecological model were significant predictors of uptake as well as of intent to get the vaccine. The intrapersonal level explained 53%, the interpersonal explained 47%, the institutional level explained 34%, and the policy and community levels each explained 8% of the variance associated with vaccine uptake. The levels together explained 65% of the variance, suggesting that interventions targeting multiple levels of the framework would be more effective than interventions aimed at a single level. (Contains 6 tables and 1 figure.)

Objective: Segmentation of populations may facilitate development of targeted substance abuse prevention programs. The authors aimed to partition a national sample of university students according to profiles based on substance use. Participants: The authors used 2008-2009 data from the National College Health Assessment from the American College Health Association. The sample consisted of 111,245 individuals from 158 institutions. Methods: The sample was partitioned using cluster analysis according to current substance use behaviors. The association of cluster membership with individual and institutional characteristics was examined. Results: Cluster analysis yielded 6 distinct clusters. Three individual factors--gender, year in school, and fraternity/sorority membership--were the most strongly associated with cluster membership. Conclusions: In a large sample of university students, the authors were able to identify 6 distinct patterns of substance abuse. It may be valuable to target specific populations of college-aged substance users based on individual factors. However, comprehensive intervention will require a multifaceted approach. (Contains 5 tables.)

Study aims were to examine the relations between multiple forms of childhood maltreatment (CM) and adult violent victimization (AVV) and to explore other significant covariates of the relations between CM and AVV. Data were collected from women (n = 477) who participated in two longitudinal studies in the Maternal Health Practices and Child Development Project. Women with a history of CM were more than twice as likely to experience AVV as women with no history of CM. Those who experienced one or two forms of CM were significantly more likely to report any AVV compared to women with no CM. The relationship between CM and AVV remained significant after controlling for illicit drug use at baseline. Among low-income women, a history of CM exposure increased the risk of AVV. Having had any CM exposure was more important that the specific form or combination of forms, of CM exposure (e.g., sexual abuse or physical abuse). (Contains 5 tables.)

Maternal depression in low-income women is a significant problem because of its negative consequences for both mothers and their children. Economic stress increases risk for depression; however, mechanisms linking economic stress and depression are not well understood. The social support deterioration model suggests that chronic stressors can exert effects on psychological well-being directly and, also, indirectly when stressors undermine social support. The analysis presented in this article tested the relationships suggested by the social support deterioration model by examining the direct and indirect links among economic stress, social support, and depressive symptoms in a sample of 336 mothers with children in mental health care. Structural equation modeling was used to examine the hypothesized paths depicted by this model and the relevant demographic variables. Economic stress was associated with depressive symptoms and appeared to exert part of its influence by reducing social support. Future research should consider social support and economic stress as potential targets for prevention of and intervention regarding maternal depression.

Objective: Confirm the factor structure of the original 18-item Medical Outcome Study Social Support Survey (MOS-SSS) as well as two abbreviated versions in a sample of mothers with a child in mental health treatment. Method: The factor structure, internal consistency, and concurrent validity of the MOS-SSS were assessed using a convenience sample of 330 mothers. Results: A 12-item version that included subscales and a 4-item version maintained a good fit. Conclusion: 12- and 4-item versions of the MOS-SSS are psychometrically sound social support instruments and are appropriate for clinical and research uses. Given the diverse populations that social work serves, confirming instruments in various samples is important to legitimize an instrument's use and advance the evidence base for support interventions. (Contains 7 tables and 1 figure.)

The accuracy of structural model parameter estimates in latent variable mixture modeling was explored with a 3 (sample size) [times] 3 (exogenous latent mean difference) [times] 3 (endogenous latent mean difference) [times] 3 (correlation between factors) [times] 3 (mixture proportions) factorial design. In addition, the efficacy of several likelihood-based statistics (Akaike's Information Criterion [AIC], Bayesian Information Ctriterion [BIC], the sample-size adjusted BIC [ssBIC], the consistent AIC [CAIC], the Vuong-Lo-Mendell-Rubin adjusted likelihood ratio test [aVLMR]), classification-based statistics (CLC [classification likelihood information criterion], ICL-BIC [integrated classification likelihood], normalized entropy criterion [NEC], entropy), and distributional statistics (multivariate skew and kurtosis test) were examined to determine which statistics best recover the correct number of components. Results indicate that the structural parameters were recovered, but the model fit statistics were not exceedingly accurate. The ssBIC statistic was the most accurate statistic, and the CLC, ICL-BIC, and aVLMR showed limited utility. However, none of these statistics were accurate for small samples (n=500).

The relation among fit indexes, power, and sample size in structural equation modeling is examined. The noncentrality parameter is required to compute power. The 2 existing methods of computing power have estimated the noncentrality parameter by specifying an alternative hypothesis or alternative fit. These methods cannot be implemented easily and reliably. In this study, 4 fit indexes (RMSEA, CFI, McDonald's Fit Index, and Steiger's gamma) were used to compute the noncentrality parameter and sample size to achieve certain level of power. The resulting power and sample size varied as a function of (a) choice of fit index, (b) number of variables/degrees of freedom, (c) relation among the variables, and (d) value of the fit index. However, if the level of misspecification were held constant, then the resulting power and sample size would be identical.

This article describes a Monte Carlo study of 2 methods for treating incomplete nonnormal data. Skewed, kurtotic data sets conforming to a single structured model, but varying in sample size, percentage of data missing, and missing-data mechanism, were produced. An asymptotically distribution-free available-case (ADFAC) method and structured-model expectation-maximization (EM) with nonnormality corrections were applied to these data sets, and the 2 methods were then compared in terms of bias in parameter estimates, bias in standard-error estimates, efficiency of parameter estimates, and model chi-squares. The results favored the nonnormality corrected EM over the ADFAC method in almost all respects, the only important exceptions involving (a) bias in standard-error estimates with large samples and (b) mixed results with respect to the efficiency of parameter estimates.

Developed methods for testing whether or not patterns of incomplete data represent samples from a single population. Results from a simulation study show that the generalized least squares test of homogeneity of means performed close to an ideal Type I error rate for most of the conditions. The generalized least squares test of homogeneity of covariance matrices and a combined test performed quite well also. (SLD)

We explored the relationship between neighborhood socioeconomic disadvantage (NSED) and gestational weight gain and loss and if the association differed by race. A census tract level NSED index (categorized as low, mid-low, mid-high, and high) was generated from 12 measures from the 2000 US Census data. Gestational weight gain and other individual-level characteristics were derived from vital birth records for Allegheny County, PA for 2003-2010 (n = 55,608). Crude and adjusted relative risks were estimated using modified multilevel Poisson regression models to estimate the association between NSED and excessive and inadequate gestational weight gain (GWG) and weight loss (versus adequate GWG). Black women lived in neighborhoods that were more likely to be socioeconomically disadvantaged compared to white women. Almost 55% of women gained an excessive amount of weight during pregnancy, and 2% lost weight during pregnancy. Black women were more likely than white women to have inadequate weight gain or weight loss. Mid-high (aRR = 1.3, 95% CI 1.2, 1.3) and high (aRR = 1.5, 95% CI 1.5, 1.6) NSED compared to low NSED was associated with inadequate weight gain while NSED was not associated with excessive weight gain. Among black women, high versus low NSED was associated with weight loss during pregnancy (RR = 1.6, 95% CI 1.1, 2.5). Among white women, each level of NSED compared to low NSED was associated with weight loss during pregnancy. This study demonstrates how neighborhood socioeconomic characteristics can contribute to our understanding of inadequate weight gain and weight loss during pregnancy, having implications for future research and interventions designed to advance pregnancy outcomes. Keywords Gestational weight gain and loss * Neighborhood socioeconomic disadvantage * Neighborhood conditions * Racial differences, Introduction In the US, black women are more likely to gain less weight than recommended by the Institute of Medicine [1] and to lose weight during pregnancy compared to white [...]

Background: Delayed-onset carpal tunnel syndrome (DCTS) can develop weeks and months after distal radius fracture (DRFx). A better understanding of the risk factors of DCTS can guide surgeon's decision making regarding the management of DRFx and also provides another discussion point to be had with elderly patients when discussing outcomes of nonoperative management. Methods: We reviewed 216 nonoperatively managed DRFx between June 2015 and January 2019 at a single level 1 trauma center and senior author's office. We identified 26 patients who developed DCTS at a minimum of 6 weeks after DRFx, which constituted our case group. The remaining 190 patients served as the control group (non–carpal tunnel syndrome [CTS]). Differences between case and control group were evaluated through univariate and multivariate analyses. Results: The prevalence of DCTS among nonoperatively managed DRFx was 12%. In univariate analysis, volar tilt (VT) and teardrop angle (TDA) were significant independent predictors of development of DCTS. Multivariate logistic regression analysis determined that the odds of developing CTS increased by 12% and 24% for each degree of decrease in VT and TDA, respectively. No other significant risk factors were identified. Conclusions: Decreasing VT and TDA are the most significant risk factors associated with DCTS in nonoperatively managed DRFx. These are simple and reliable radiographic measurements that provide significant prognostic value. These parameters can be used to guide surgeon decision making regarding management of DRFx in the elderly while aiding patient expectations and outcomes following nonoperative management of DRFx. [ABSTRACT FROM AUTHOR]