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Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Review of published reports shows confusion regarding the pathologic sequelae of neonatal respiratory distress. To examine this problem the authors studied histologic slides of lung from 46 patients so diagnosed listed in the autopsy files of The Johns Hopkins Hospital. Two distinct morphologic patterns emerged. In 26 patients (Group 1) there were varying sized areas of interstitial fibrosis with associated distortion of air spaces. The process was nonspecific and closely resembled the interstitial fibrosis of varying etiologies found in adults. This lesion appears to correspond to most descriptions of bronchopulmonary dysplasia. A second process predominated in 10 patients (Group 3). There were normal conducting bronchi, marked uniform enlargement of distal air spaces, and little or no interstitial fibrosis. In 10 patients (Group 2) both lesions coexisted. To gain further insight into the morphology of these disorders, the authors reconstructed serial histologic sections of lung from three infants of varying sizes with normal lungs and infants of varying ages with bronchopulmonary dysplasia. The results confirmed the observations made on routine histologic sections by showing interstitial fibrosis in the early stages of bronchopulmonary dysplasia and a reduced number of very large terminal air spaces without interstitial fibrosis in the late stages. There were no obvious differences in the clinical courses of infants with the different morphologic stages; but Group 1 patients averaged 39 days of age, Group 2 lived 142 days, and Group 3 survived 277 days. It seems probable that early bronchopulmonary dysplasia is simply the healing of alveolar wall injury of whatever cause, most commonly hyaline membrane disease of the newborn; and that in the later phases of repair, with continuing growth, there is a thinning of airway walls, but a failure of alveolar development. Recognition of these two pathologically different patterns is important for further studies of the pathogenesis of bronchopulmonary dysplasia.
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PMID:The progression of morphologic changes in bronchopulmonary dysplasia. 364 32

Under tremendous pressure to contain costs, most U.S. hospitals are radically altering the composition and skill mix of their staff, thinning their skilled registered nurse (RN) ranks, and often substituting them with minimally trained, lower paid, unlicensed assistive personnel (UAP). Twelve staff nurses were interviewed to illuminate the experience of working with UAP, who function largely in untested, expanded roles. Only two nurses viewed this experience positively; the rest were either opposed to or had strong reservations about UAP use. Confusion and emotional turmoil predominated as these nurses struggled to maintain safe, comprehensive care with the assistance of UAP who were often ambivalent and sometimes dangerously inept.
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PMID:Caught in the cross fire of change: nurses' experience with unlicensed assistive personnel. 975 9

We describe the current state of a system that recognizes printed text of various fonts and sizes for the Roman alphabet. The system combines several techniques in order to improve the overall recognition rate. Thinning and shape extraction are performed directly on a graph of the run-length encoding of a binary image. The resulting strokes and other shapes are mapped, using a shape-clustering approach, into binary features which are then fed into a statistical Bayesian classifier. Large-scale trials have shown better than 97 percent top choice correct performance on mixtures of six dissimilar fonts, and over 99 percent on most single fonts, over a range of point sizes. Certain remaining confusion classes are disambiguated through contour analysis, and characters suspected of being merged are broken and reclassified. Finally, layout and linguistic context are applied. The results are illustrated by sample pages.
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PMID:On the recognition of printed characters of any font and size. 2186 97

Many aspects of spiritual experience are similar in form and content to symptoms of psychosis. Both spiritually advanced people and patients suffering from psychopathology experience alterations in their sense of 'self.' Psychotic experiences originate from derangement of the personality, whereas spiritual experiences involve systematic thinning out of the selfish ego, allowing individual consciousness to merge into universal consciousness. Documented instances and case studies suggest possible confusion between the spiritually advanced and schizophrenia patients. Clinical practice contains no clear guidelines on how to distinguish them. Here we use a case presentation to help tabulate clinically useful points distinguishing spiritually advanced persons from schizophrenia patients. A 34-year-old unmarried male reported to our clinic with four main complaints: lack of sense of self since childhood; repeated thoughts questioning whether he existed or not; social withdrawal; and inability to continue in any occupation. Qualitative case analysis and discussions using descriptions from ancient texts and modern psychology led to the diagnosis of schizophrenia rather than spiritual advancement.
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PMID:Schizophrenia Patient or Spiritually Advanced Personality? A Qualitative Case Analysis. 2563 83

It is a common misconception that correlations between variables that share a common term are statistically invalid. Although the idea that such relationships are wholly or partially spurious was rejected decades ago by statisticians, ecologists continue mistakenly to exclude legitimate hypotheses on this basis. Besides directing attention to the statistical literature on the subject, we briefly reconsider the problem from 3 viewpoints: first, the confusion between spurious correlation and spurious inference, second, the problem of concept familiarity and definition, with particular reference to the self-thinning rule for plants, and third, a legitimate concern with measurement error of shared variable components.
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PMID:Some misconceptions about the spurious correlation problem in the ecological literature. 2831 49

Scaling relations formed in forest development processes are fairly important for understanding and predicting forest dynamics. During self-thinning of a relatively even-sized forest, tree abundance will decrease with an increase in average tree size, forming the size-abundance relation (SAR); while for a size-structured forest under the demographic equilibrium state, the frequency of trees also varies with size classes in a similar, decreasing pattern, manifesting as the size-frequency distribution (SFD). In the metabolic scaling theory (MST), the two scaling relations are considered to be consistent. However, in this paper, we proved that SFD can never be equivalent to SAR unless the growth rate of tree diameters is a constant. The reason derives from the time differences of transition between different size classes, which are influenced in SFD maintenance but not in SAR formation. Demographic equilibrium of a size structured forest requires a different resource allocation among different size classes at the same time, which contradicts the resource conservation during SAR formation in the self-thinning process. Consequently, if the rate of resource use per individual scales as a +2 power with its diameter according to MST, which led to the -2 power SAR, SFD can never be a -2 power-law distribution. The previous confusion between SFD of a size-structured forest and SAR formed during self-thinning processes may lead to many misunderstandings and unreliable predictions on forest structure and dynamics.
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PMID:Will forest size structure follow the -2 power-law distribution under ideal demographic equilibrium state? 2975 52

(1) Background: The Food Agricultural Organization/World Health Organization (FAO/WHO) International Food Standards Codex Alimentarius CXS 192e International Food Standards (hereafter, CODEX) declares additives non-toxic, but they have been associated with changes to the microbiota changes and thinning of the mucus layer of the gut. Their widespread use has occurred in parallel with increased inflammatory bowel disease (IBD) incidence. This paper reports on the development and validation of surveys to estimate additive intake. (2) Methods: Dietitians created a food-additive database, with a focus on additives that have been associated with IBD. For each additive, information on the CODEX food-category they are permitted in and the associated maximum permissible levels (mg/kg) was recorded. Based on the database, questions to assess early life (part 1) and recent (part 2) additive intake were written. Forward-backward translation from English to Chinese was undertaken. Thirty-one individuals were evaluated to assess understandability. A further fifty-seven individuals completed the tool on two occasions, a fortnight apart; agreement was assessed using Cohen's kappa coefficient or the intra-class correlation coefficient (ICC). (3) Results: The participants reported that it was difficult to remember food intake and estimate portion sizes. The participants also noted confusion around the term 'home-grown'. Instructions and definitions were added; after this, respondents judged the questionnaires as clear. The average kappa coefficient for part 1 and part 2 questions were 0.61 and 0.67, respectively. The average ICC ranged from 0.30 to 0.94; three food lists were removed due to low reliability. (4) Conclusions: Two tools have been created and validated, in two languages, that reliably assess remote and recent food additive intake.
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PMID:Development and Validation of Surveys to Estimate Food Additive Intake. 3220 74

Both thin basement membrane nephropathy (TBMN) and autosomal dominant Alport syndrome (ADAS) are types of hereditary nephritis resulting from heterozygous mutations in COL4A3 or COL4A4 genes. Although TBMN is characterized by hematuria and thinning of the glomerular basement membrane (GBM) with excellent renal prognosis, some patients develop end-stage renal disease (ESRD) later in life. In contrast, although AS is characterized by progressive nephropathy with lamellation of the GBM, there are some patients diagnosed with ADAS from a family history of ESRD but who only suffer from hematuria with GBM thinning. These findings indicate a limitation in distinction between TBMN and ADAS. Diagnosis of AS is significant because it facilitates careful follow-up and early treatment, whereas diagnosis of TBMN can underestimate the risk of ESRD. However, some experts are against using the term ADAS as the phenotypes of heterozygous variants vary from no urinary abnormality to ESRD, even between family members with the same mutations, indicating that unknown secondary factors may play a large role in the disease severity. These diagnostic difficulties result in significant confusion in clinical settings. Moreover, recent studies revealed that the number of patients with chronic kidney disease caused by these gene mutations is far higher than previously thought. The aim of this article is to review differing opinions regarding the diagnosis of heterozygous COL4A3 or COL4A4 variants, and to highlight the importance for nephrologists to recognize this disease, and the importance of the need to reclassify this disease to minimize the current confusion.
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PMID:How to resolve confusion in the clinical setting for the diagnosis of heterozygous COL4A3 or COL4A4 gene variants? Discussion and suggestions from nephrologists. 3223

The crucial point for prompt diagnostics, ideal therapeutic approach, and follow-up of hydronephrosis associated with UPJ anomalies in children is the severity of hydronephrosis. Such many hydronephrosis grading systems as AP diameter, SFU, radiology, UTD, and Onen have been developed to evaluate hydronephrosis severity in infants. Unfortunately, it is still an ongoing challenge and there is no consensus between different disciplines. AP diameter is a very dynamic parameter and is affected by many factors (hydration, bladder filling, position, respiration). More importantly, its measurement is very variable and misleading due to different renal pelvic configurations. The radiology grading system has the same grades 1, 2, and 3 as the SFU grading system with addition of the AP diameter for the first 3 grades. This grading system divides parenchymal loss into two different grades. Grade 4 represents mild parenchymal loss while grade 5 suggests severe parenchymal loss. However, it is operator dependent, is not decisive, and does not differentiate grades 4 and 5 clearly. All grades of SFU are very variable between operators and clinicians. UTD classification aims to put all significant abnormal urinary findings together including the kidney, ureter, and bladder and thus determines the risk level for infants with any urinary disease. Different renal deterioration risks occur depending on the mechanism of hydronephrosis. Therefore, SFU and UTD classification may result in significant confusion and misleading in determining the severity of hydronephrosis. SFU-4 and UTD-P3 represent a considerable range of severity of hydronephrosis. Both represent minimal thinning of the medullary parenchyma and severe thinning of the cortical parenchyma (cyst-like hydronephrotic kidneys) at the same grade. The wide definition of SFU-4 and UTD-P3 fails to indicate accurately the severity of hydronephrosis and thus significantly misleads from a prompt treatment. They do not suggest who need surgical treatment and who can safely be followed non-operatively. The anatomy and physiology of the 4 suborgans of the kidney (renal pelvis, calices, medulla, and cortex) are completely different from each other. Therefore, each part of the kidney affect and behave differently as a response to UPJ-type hydronephrosis (UPJHN) depending on the severity of hydronephrosis. The upgraded Onen hydronephrosis grading system has been developed based on this basic evidence both for prenatal and post-natal periods. The Onen grading system determines specific detailed findings of significant renal damage, which clearly show and suggest who can safely be followed conservatively from who will need surgical intervention for UPJHN. Neither AP diameter nor radiology, SFU, or UTD classification is the gold standard in determining the severity of hydronephrosis. All these grading systems are based on subjective parameters and are affected by many factors. They do not determine the exact severity of UPJHN and thus cause permanent renal damage due to a delay in surgical decision in some infants while they may cause an unnecessary surgery in others. The Onen grading system has resolved all disadvantages of other grading systems and promises a safer follow-up and a prompt treatment for UPJHN. It is an accurate and easily reproducible grading that has high sensitivity and specificity.
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PMID:Grading of Hydronephrosis: An Ongoing Challenge. 3298 98