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Search Results: 1 - 10 of 4214 matches for " Max Marshall "
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A systematic review and meta-analysis of neurological soft signs in relatives of people with schizophrenia
Kishen Neelam, Deepak Garg, Max Marshall
BMC Psychiatry , 2011, DOI: 10.1186/1471-244x-11-139
Abstract: A systematic search identified potentially eligible studies in the EMBASE (1980-2011), OVID - MEDLINE (1950-2011) and PsycINFO (1806-2011) databases. Studies were included if they carried out a three-way comparison of levels of soft signs between people with schizophrenia, their first-degree relatives, and normal controls. Data were extracted independently by two reviewers and cross-checked by double entry.After screening 8678 abstracts, seven studies with 1553 participants were identified. Neurological soft signs were significantly more common in first-degree relatives of people with schizophrenia than in controls (pooled standardised mean difference (SMD) 1.24, 95% confidence interval (c.i) 0.59-1.89). Neurological soft signs were also significantly more common in people with schizophrenia than in their first-degree relatives (SMD 0.92, 95% c.i 0.64-1.20). Sensitivity analyses examining the effects of age and group blinding did not significantly alter the main findings.Both hypotheses were confirmed, suggesting that the distribution of neurological soft signs in people with schizophrenia and their first-degree relatives is consistent with the endophenotype criterion of familial association.Neurological soft signs are subtle but observable impairments in motor and sensory functions that are not localized to a specific area of the brain nor characteristic of any specific neurological condition [1]. Typically they are classified into signs relating to: motor co-ordination, sequencing of complex motor tasks, sensori-motor integration, and disinhibition [2]. Neurological soft signs are known to correlate with a range of neuro-cognitive and neuro-anatomical abnormalities, and it has been proposed that they represent an underlying defect in neural integration [3]. Until recently neurological soft signs have been considered of little practical clinical significance, but the prospect that they could be an endophenotype of schizophrenia has led to a resurgence of interest [
Supermassive galactic centre with repulsive gravity
Trevor W. Marshall,Max K. Wallis
Physics , 2013,
Abstract: Repulsive gravity has its origin in the 1939 article of Oppenheimer and Snyder which describes a collapsar, that is an idealized star of non-interacting material (dust) collapsing under its own gravity. The stellar material has a final state resembling a football, that is a significant part of it is concentrated in a thin surface shell. An interior pressure is exerted by the strong gravitational field, equivalent to a negative mass. However, the OS solution has been misunderstood, the shell's position being incorrectly identified with the "event horizon" in black-hole theory. While half the material is concentrated in a shell occupying a small fraction of the radius, some material is spread throughout the interior, unlike the concentration in a black hole's singularity. We deal with the singularity in density at the shell surface, by including Fermi pressure of degenerate electrons for a shell density comparable to a solar mass-sized white dwarf. Because the high-density region is concentrated in a shell, instead of at the centre as in a black hole, our conclusion is that repulsive gravity enables the existence of supermassive white dwarfs.
Essential elements of an early intervention service for psychosis: the opinions of expert clinicians
Max Marshall, Austin Lockwood, Sh?n Lewis, Matthew Fiander
BMC Psychiatry , 2004, DOI: 10.1186/1471-244x-4-17
Abstract: A 'Delphi' exercise was carried out to identify how far there was consensus on the essential elements of early intervention teams in a group of 21 UK expert clinicians. Using published guidelines, an initial list was constructed containing 151 elements from ten categories of team structure and function.Overall there was expert consensus on the importance of 136 (90%) of these elements. Of the items on which there was consensus, 106 (70.2%) were rated essential, meaning that in their absence the functioning of the team would be severely impaired.This degree of consensus over essential elements suggests that it is reasonable to define a model for UK early intervention teams, from which a measure of fidelity could be derived.Early intervention attempts to improve outcome in schizophrenia through earlier detection of untreated psychosis and provision of effective, phase-specific treatments [1]. Early intervention is usually delivered by a team of clinicians who work exclusively with people who have recently experienced a first episode of psychosis or have presented with prodromal symptoms of psychosis [2]. Over the past decade early intervention teams have been established in the USA, Canada, Australia and several European countries [3]. The UK Department of Health has announced its intention to set up 50 Early Intervention Teams to provide care to all young people with a first episode of psychosis in England [4].Early intervention teams are specialised multi-disciplinary entities that seek to provide a range of sophisticated interventions to several distinct target populations. Experience with other specialised psychiatric teams shows that teams with similar labels and philosophies often exhibit profound differences in structure and function [5,6]. To avoid confusion in research and clinical practice, it is essential to be clear about what are the essential elements of an early intervention team, and to develop a standardised way of assessing the degree to which these
Lipoperoxidation and Protein Oxidative Damage Exhibit Different Kinetics During Septic Shock
Max Andresen,Tomas Regueira,Alejandro Bruhn,Druso Perez,Pablo Strobel,Alberto Dougnac,Guillermo Marshall,Federico Leighton
Mediators of Inflammation , 2008, DOI: 10.1155/2008/168652
Abstract: Septic shock (SS)-related multiorgan dysfunction has been associated with oxidative damage, but little is known about the temporal damage profile and its relationship to severity. The present work investigated prospectively 21 SS patients. Blood samples were obtained at diagnosis, 24, 72 hours, day 7, and at 3 months. At admission, thiobarbituric acid reactive substances (TBARSs), plasma protein carbonyls, plasma protein methionine sulfoxide (MS), ferric/reducing antioxidant power (FRAP), total red blood cell glutathione (RBCG), uric acid (UA), and bilirrubin levels were increased (<.05). Total radical—trapping antioxidant potential (TRAP) and vitamin-E were similar to controls, and vitamin-C was decreased (<.05). During evolution, TBARS and RBCG increased (<.001), vitamin-E levels remained stable, whereas plasma protein carbonyls and MS, TRAP, vitamin-C, reduced glutathione, and UA levels decreased (<.006). After 3 months, plasma protein carbonyls and MS persisted elevated. More severe patients exhibited higher TBARS, TRAP, FRAP, vitamin-C, UA, and bilirrubin levels. Our results suggest early and persistent oxidative stress during septic shock and a correlation between increasing levels of lipoperoxidation and sepsis severity.
The Effect of Helium Sedimentation on Galaxy Cluster Masses and Scaling Relations
G. Esra Bulbul,Nicole Hasler,Max Bonamente,Marshall Joy,Daniel Marrone,Amber Miller,Tony Mroczkowski
Physics , 2011, DOI: 10.1051/0004-6361/201016407
Abstract: Recent theoretical studies predict that the inner regions of galaxy clusters may have an enhanced helium abundance due to sedimentation over the cluster lifetime. If sedimentation is not suppressed (e.g., by tangled magnetic fields), this may significantly affect the cluster mass estimates. We use Chandra X-ray observations of eight relaxed galaxy clusters to investigate the upper limits to the effect of helium sedimentation on the measurement of cluster masses and the best-fit slopes of the Y_X - M_500 and Y_X - M_2500 scaling relations. We calculated gas mass and total mass in two limiting cases: a uniform, un-enhanced abundance distribution and a radial distribution from numerical simulations of helium sedimentation on a timescale of 11 Gyrs. The assumed helium sedimentation model, on average, produces a negligible increase in the gas mass inferred within large radii (r < r500) (1.3 +/- 1.2 per cent) and a (10.2 +/- 5.5) per cent mean decrease in the total mass inferred within r < r500. Significantly stronger effects in the gas mass (10.5 +/- 0.8 per cent) and total mass (25.1 +/- 1.1 per cent) are seen at small radii owing to a larger variance in helium abundance in the inner region, r < 0.1 r500. We find that the slope of the Y_X -M_500 scaling relation is not significantly affected by helium sedimentation.
The Modernisation of Manipulative Therapy  [PDF]
Max Zusman
International Journal of Clinical Medicine (IJCM) , 2011, DOI: 10.4236/ijcm.2011.25110
Abstract: Research indicates that, despite physiotherapists’ comprehensive training in the basic sciences, manipulative (currently “musculoskeletal”) therapy is still dominated in the clinical setting by its original, now obsolete, structure-based “biomedical” model. This is further inexplicable in the light of evidence that not only the underlying “philosophy” but also several of the fundamental requirements of the clinical process itself which has the structural-mechanical model as its basis, have been shown to be flawed or at least irrelevant. The apparent inability of the profession to fully abandon outmoded “concepts” (and embrace the acknowledged science-based “best practice” biopsychosocial model) may have potentially undesirable consequences for both patients and therapists engaged in the management of (chronic) musculoskeletal pain and disability.
On the Existence of Subharmonic Screech in Choked Circular Jets from a Sharp-Edged Orifice  [PDF]
Max Kandula
Open Journal of Acoustics (OJA) , 2014, DOI: 10.4236/oja.2014.41003
Abstract: Experiments are performed in choked circular hot and cold nitrogen jets issuing from a 2.44 cm diameter sharp-edged orifice at a fully expanded jet Mach number of 1.85 in an effort to investigate the character of screech phenomenon. The stagnation temperature of the cold and the hot jets are 299 K and 319 K respectively. The axial distribution of the centerline Mach number was obtained with a pitot tube, while the screech data (frequency and amplitude) at different axial and radial stations were measured with the aid of microphones. The fundamental screech frequency of the hot jet is slightly increased relative to that of the cold jet. It is concluded that temperature effects on the screech amplitude are manifested with regard to the fundamental and the subharmonic even at relatively small temperature range considered.
CRIMSON [CRisis plan IMpact: Subjective and Objective coercion and eNgagement] Protocol: A randomised controlled trial of joint crisis plans to reduce compulsory treatment of people with psychosis
Graham Thornicroft, Simone Farrelly, Max Birchwood, Max Marshall, George Szmukler, Waquas Waheed, Sarah Byford, Graham Dunn, Claire Henderson, Helen Lester, Morven Leese, Diana Rose, Kim Sutherby
Trials , 2010, DOI: 10.1186/1745-6215-11-102
Abstract: This is a 3 centre, individual-level, single-blind, randomised controlled trial of the JCP compared with treatment as usual for people with a history of relapsing psychotic illness in Birmingham, London and Lancashire/Manchester. 540 service users will be recruited across the three sites. Eligible service users will be adults with a diagnosis of a psychotic disorder (including bipolar disorder), treated in the community under the Care Programme Approach with at least one admission to a psychiatric inpatient ward in the previous two years. Current inpatients and those subject to a community treatment order will be excluded to avoid any potential perceived pressure to participate. Research assessments will be conducted at baseline and 18 months. Following the baseline assessment, eligible service users will be randomly allocated to either develop a Joint Crisis Plan or continue with treatment as usual. Outcome will be assessed at 18 months with assessors blind to treatment allocation. The primary outcome is the proportion of service users treated or otherwise detained under an order of the Mental Health Act (MHA) during the follow-up period, compared across randomisation groups. Secondary outcomes include overall costs, service user engagement, perceived coercion and therapeutic relationships. Sub-analyses will explore the effectiveness of the JCP in reducing use of the MHA specifically for Black Caribbean and Black African service users (combined). Qualitative investigations with staff and service users will explore the acceptability of the JCPs.JCPs offer a potential solution to the rise of compulsory treatment for individuals with psychotic disorders and, if shown to be effective in this trial, they are likely to be of interest to mental health service providers worldwide.Current Controlled Trials ISRCTN11501328Two of the key guiding principles of mental health policy in England are that service users should: (i) exercise choice and control over their treatment [1]
The Sign Test with Ties Included  [PDF]
Jennings B. Marshall
Applied Mathematics (AM) , 2014, DOI: 10.4236/am.2014.510152

The sign rank test is taught in virtually all introductory Statistics classes. When teaching the sign rank test the students are told to ignore the ties. Ignoring ties that support the null hypothesis is not logical. Why should valid data that support the null hypothesis be ignored? The approach taken here demonstrates a method for testing with ties included. A typical problem presentation in a text book would indicate that if you had ten ties in a sample of size fifty the tie scores would be excluded. However, the ten tie scores are a very valuable piece of statistical information which should not be ignored. The method demonstrated here shows that a different conclusion is reached in some cases when the ties are not excluded. Further many sign tests often will have ties because in some cases the data are not a cardinal number, but an ordinal number chosen from a set often results in ties. The alternative approach uses a one-tailed distribution and considers both +’s and -'s separated. A two-tailed test for equal variances is done with a one-tail of an F distribution. This alternate approach to the sign test allows the use of important statistical information which has been ignored with the traditional sign rank test.

Estudio de la cinética de citoquinas en sepsis grave y su relación con mortalidad y score de disfunción orgánica
Dougnac L,Alberto; Riquelme P,Arnoldo; Calvo A,Mario; Andresen H,Max; Magedzo N,Amiram; Eugenin,Eliseo; Marshall R,Guillermo; Gutiérrez T,Miguel;
Revista médica de Chile , 2001, DOI: 10.4067/S0034-98872001000400002
Abstract: background: the infectious systemic inflammatory response syndrome and multiple organic dysfunction have common physiopathological mechanisms. multiple organic dysfunction can be assessed using severity scores. aim: to relate cytokine kinetics with a multiple organic dysfunction score during sepsis. material and methods: tumor necrosis factor a (tnfa) and interleukin 6 (il6) kinetics were studied in 25 patients with severe sepsis with less than 48 h of evolution and interleukin 1? (il?) kinetics was studied in 13 patients. measurements were made at 0, 12, 24 and 48 hours after admission to the study, using an elisa technique. these parameters were correlated with the marshall multiple organic dysfunction score and survival. results: mean age of study subjects was 70 years, the apache ii score was 16.9±6 and the marshall score was 6.8±3.6. sepsis was of pulmonary origin in 56% of patients and intra abdominal in 32%. mortality was 36%. tnfa increased during the study period (24.1 pg/ml initially and 37.8 pg/ml at 24 hours, with a slight posterior reduction, p<0.02). these levels had no association with mortality or organic dysfunction. il6 remained elevated during the first hours and had a tendency to decrease thereafter. deceased patients had higher values than survivors (306 pg/ml and 55.4 pg/ml respectively, p=0.011). its values were tightly correlated with marshall score, with the number of failing organs, with the presence of shock and with probability of dying during hospitalization. il1? remained low and was not associated with clinical parameters. conclusions: there is a tight correlation between the elevation of il6 and the severity of the systemic inflammatory response and mortality in these patients with sepsis. (rev méd chile 2001; 129: 347-58)
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