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BMRetriever

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biomed_retrieval_dataset

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BMRetriever 3

[ "Reflection from a flat Mirror. mirror. equal to the angle of reflection. When rays of light strike a flat mirror they are reflected and the exiting ray of light is reflected at the same angle as the angle of incidence. The angles of incidence and reflection are measured from a normal to the plane of the mirror as shown in Figure 1." ]

[ "Fig. 3 is the reflection of Fig. 1 about the y-axis. Every point that was to the right of the origin gets reflected to the left. And every point that was on the left gets reflected to the right. Every x becomes − x. Only the y-intercept is invariant. The equation of the reflection of f (x) about the y-axis is y = f(−x) .", "In fact, any light rays emanating from the top of the object will pass through the image point. Thus, merely construct a ray diagram to determine the image location; use the two rules of reflection. Then draw the reflected rays for the two given incident rays through the same image point." ]

[ "Visit Portal Nou to see the modern part of town." ]

[ "It is not a gateway through the great wall" ]

[ "Relapse is the leading cause of mortality in children with acute lymphoblastic leukemia (ALL). Among chemotherapeutics, thiopurines are key drugs in ALL combination therapy. Using whole-exome sequencing, we identified relapse-specific mutations in the phosphoribosyl pyrophosphate synthetase 1 gene (PRPS1), which encodes a rate-limiting purine biosynthesis enzyme, in 24/358 (6.7%) relapsed childhood B cell ALL (B-ALL) cases. All individuals who harbored PRPS1 mutations relapsed early during treatment, and mutated ALL clones expanded exponentially before clinical relapse. Our functional analyses of PRPS1 mutants uncovered a new chemotherapy-resistance mechanism involving reduced feedback inhibition of de novo purine biosynthesis and competitive inhibition of thiopurine activation. Notably, the de novo purine synthesis inhibitor lometrexol effectively abrogated PRPS1 mutant-driven drug resistance. These results highlight the importance of constitutive activation of the de novo purine synthesis pathway in thiopurine resistance, and they offer therapeutic strategies for the treatment of relapsed and thiopurine-resistant ALL." ]

[ "BACKGROUND AND AIM: Interindividual variation seen in the thiopurine metabolism is attributed to the genetic variant in thiopurine methyltransferase (TPMT) gene leading to myelosuppression. In Asians, the thiopurine-induced toxicity is not completely explained by TPMT variants. Literature indicates that a newer genetic variant in nucleoside diphosphate-linked moiety X-type motif 15 (NUDT15) gene is associated with thiopurine intolerance. We aimed to determine the risk allele frequency of NUDT15 genetic variant and its association with thiopurine-induced toxicity in Indian patients.METHODS: In this pilot study, 69 patients on thiopurine therapy were analyzed. The frequencies of thiopurine-induced leukopenia were recorded. NUDT15 (C415T) and TPMT (*2, *3A, *3B, and *3C) genotyping was performed using amplification refractory mutation system-polymerase chain reaction and restriction fragment length polymorphism technique. Results were validated by DNA sequencing.RESULTS: The NUDT15 CC, CT, and TT genotypes were found to be 86.9%, 11.5%, and 1.5%, respectively, whereas TPMT genetic variants were absent. Of 60 patients without NUDT15 variant, none developed leukopenia, whereas of nine patients with NUDT15 variant, six developed leukopenia (P-value < 0.0001). The mean thiopurine dose of 1.01 and 0.73 mg/kg/day for patients with wild and mutant NUDT15 alleles, respectively, was statistically significant (P < 0.01). The sensitivity and specificity for NUDT15 variant were 100% and 95.2%, respectively.CONCLUSIONS: The NUDT15 risk allele frequency was 7.2%. There are 6/69 (8.7%) patients who developed leukopenia and harbored NUDT15 variant, thus showing a strong association for thiopurine-induced toxicity. Hence, NUDT15 genotyping may be considered before thiopurine therapy in Indian patients.", "BACKGROUND & AIMS: More than 20% of patients with inflammatory bowel disease (IBD) discontinue thiopurine therapy because of severe adverse drug reactions (ADRs); leukopenia is one of the most serious ADRs. Variants in the gene encoding thiopurine S-methyltransferase (TPMT) alter its enzymatic activity, resulting in higher levels of thiopurine metabolites, which can cause leukopenia. We performed a prospective study to determine whether genotype analysis of TPMT before thiopurine treatment, and dose selection based on the results, affects the outcomes of patients with IBD.METHODS: In a study performed at 30 Dutch hospitals, patients were assigned randomly to groups that received standard treatment (control) or pretreatment screening (intervention) for 3 common variants of TPMT (TPMT*2, TPMT*3A, and TPMT*3C). Patients in the intervention group found to be heterozygous carriers of a variant received 50% ofthe standard dose of thiopurine (azathioprine or 6-mercaptopurine), and patients homozygous for a variant received 0%-10% of the standard dose. We compared, in an intention-to-treat analysis, outcomes of the intervention (n=405) and control groups (n= 378) after 20 weeks of treatment. Primary outcomes were the occurrence of hematologic ADRs (leukocyte count < 3.0*10(9)/L or reduced platelet count <100*10(9)/L) and disease activity (based on the Harvey-Bradshaw Index for Crohn's disease [n= 356] or the partial Mayo score for ulcerative colitis [n= 253]).RESULTS: Similar proportions of patients in the intervention and control groups developed a hematologic ADR (7.4% vs 7.9%; relative risk, 0.93; 95% confidence interval, 0.57-1.52) in the 20 weeks of follow-up evaluation; the groups also had similar mean levels of disease activity (P= .18 for Crohn's disease and P= .14 for ulcerative colitis). However, a significantly smaller proportion of carriers of the TPMT variants in the intervention group (2.6%) developed hematologic ADRs compared with patients in the control group (22.9%) (relative risk, 0.11; 95% confidence interval, 0.01-0.85).CONCLUSIONS: Screening for variants in TPMT did not reduce the proportions of patients with hematologic ADRs during thiopurine treatment for IBD. However, there was a 10-fold reduction in hematologic ADRs among variant carriers who were identified and received a dose reduction, compared with variant carriers who did not, without differences in treatment efficacy. ClinicalTrials.gov number: NCT00521950." ]

[ " Jason Sudeikis Daniel Jason Sudeikis ( -LSB- sʊˈdeɪkɪs -RSB- ; born September 18 , 1975 ) is an American actor , comedian , screenwriter , and producer . He began his career in improvisational comedy and was a member of The Second City . In 2003 , he was hired as a sketch writer for Saturday Night Live and was a cast member from 2005 to 2013 . He has appeared on the television shows 30 Rock , The Cleveland Show , Eastbound & Down , The Last Man on Earth , Son of Zorn , and other shows . He is best known for his film roles in Hall Pass ( 2011 ) , A Good Old Fashioned Orgy ( 2011 ) , Horrible Bosses ( 2011 ) , We 're the Millers ( 2013 ) , Horrible Bosses 2 ( 2014 ) , Sleeping with Other People ( 2015 ) , The Angry Birds Movie ( 2016 ) , and Colossal ( 2017 ) ." ]

[ " Something Wicked This Way Comes (film) Something Wicked This Way Comes is a 1983 American horror fantasy film directed by Jack Clayton and produced by Walt Disney Productions from a screenplay written by Ray Bradbury , based on his novel of the same name . The novel 's title was taken directly from a line in Act IV of William Shakespeare 's Macbeth : `` By the pricking of my thumbs / Something wicked this way comes . '' The film stars Jason Robards , Jonathan Pryce , Diane Ladd , and Pam Grier . It was shot in Vermont and at the Walt Disney Studios in Burbank , California . The film had a troubled production -- Clayton fell out with Bradbury over an uncredited script rewrite , and after test screenings of the director 's cut failed to meet the studio 's expectations , Disney sidelined Clayton , fired the original editor , and scrapped the original score , spending some $ 5 million and many months re-shooting , re-editing and re-scoring the film , before its eventual release .", " Screenwriting Screenwriting , also called scriptwriting , is the art and craft of writing scripts for mass media such as feature films , television productions or video games . It is frequently a freelance profession . Screenwriters are responsible for researching the story , developing the narrative , writing the screenplay , and delivering it , in the required format , to development executives . Screenwriters therefore have great influence over the creative direction and emotional impact of the screenplay and , arguably , of the finished film . They either pitch original ideas to producers in the hope that they will be optioned or sold , or screenwriters are commissioned by a producer to create a screenplay from a concept , true story , existing screen work or literary work , such as a novel , poem , play , comic book or short story ." ]

[ "The Spanish term grima refers to the aversive emotional experience typically evoked when one hears, for example, a scratch upon a chalkboard. Whereas Spanish speakers can distinguish between the concepts of grima and disgust, English and German speakers lack a specific word for this experience and typically label grima as disgust. In the present research, we tested the degree of differentiation between the two aversive experiences in Spanish speakers. Study 1 addressed whether Spanish speakers apply spontaneously the term grima rather than disgust to grima-eliciting experiences. Study 2 systematically addressed the constitutive features of both grima and disgust by mapping their internal structures. Results showed that the noise of a chulk on a blackboard and scraping fingernails on a blackboard, along with the physical manifestation of goose bumps, were the most typical features of the category. Whereas both grima and disgust were characterized as unpleasant sensations, t(193) = 1.21, ns, they differed with respect to their physiological signatures (e.g., producing shivers was characteristic of grima, as compared to disgust, t(194) = 12.02, p = .001, d = 1.72) and elicitors (e.g., a fractured bone was a characteristic elicitor of grima; t(193) = 5.78, p = .001, d = .83, whereas pederasts and pedophiles were the most characteristic elicitor of disgust, t(193) = 8.46, p = .001, d = 1.21). Thus, both grima and disgust are conceptually different experiences, whose shared features hold different degrees of typicality. The present research suggests that grima and disgust are two distinct emotion concepts." ]

[ "Children may be prepared to associate adult disgust reactions with adult disgust elicitors. To test this, three-year olds (and adults) were presented with two images and an emotive vocalization. The images and vocalizations included stimuli adults found disgusting, fear-provoking, and sad. On one set of trials, the main dependent variable (DV) was time spent looking at each image and on a second set of repeat trials the DV was knowledge of image-sound matches. Fear and disgust vocalizations were both more effective at orienting a child's attention to adult fear and disgust images, than sad vocalizations. Parental disgust sensitivity was associated with this effect, moderated by explicit matching knowledge. Matching knowledge was poor in children and good in adults. These data suggest that in children, fear and disgust vocalizations may both promote attention to stimuli that adults find disgusting and/or fear-provoking, suggesting that \"preparedness\" may not be wholly emotion-specific.", "Research consistently finds that homosexuality elicits strong feelings of disgust, but the reasons remain unclear. In the current research, we investigate responses to gay men who violate social norms governing the expression of gender and sexuality. Two hundred forty-three college undergraduates read a vignette about a gay male college student whose personality traits (masculine, feminine, or neutral) and sexual behavior (active vs. passive) varied and reported their affective responses to and cognitive appraisals of the target. The gay target who displayed a feminine personality elicited more disgust and was perceived as lower in gender role conformity than a gay man who displayed a masculine personality. Similarly, the gay target who assumed a passive sex role elicited more disgust and was perceived as lower in gender role conformity than a gay man who assumed an active sex role. The sexual behavior/disgust relationship was mediated by perceived gender role conformity." ]

[ "BACKGROUND: Bisphenol A (BPA) is a synthetic industrial chemical commonly used in consumer products. Results from the Canadian Heath Measures Survey (CHMS) indicate that more than 90% of children and youth aged 6 to 19 have detectable levels of urinary BPA. Childhood concentration levels of BPA have been linked with negative behavioural outcomes.DATA AND METHODS: The data are from the first two cycles (2007 to 2009 and 2009 to 2011) of the CHMS, which collected biomonitoring indicators via spot blood and urine samples. Behavioural outcomes--hyperactivity/inattention, emotional symptoms, conduct problems, peer problems, and prosocial behavior--were assessed with Goodman's Strengths and Difficulties Questionnaire. Geometric mean urinary BPA concentration was examined overall and by demographic and socioeconomic correlates. Six multiple logistic regression analyses were conducted to investigate associations between childhood BPA concentrations and risk status for each outcome.RESULTS: Children aged 6 to 8 had higher BPA concentrations than did older children and youth. Concentrations were significantly higher among children and youth exposed to second-hand smoke every day or almost every day and those in low or lower-middle income households. Higher BPA concentrations were associated with increased odds of hyperactivity among girls and lower prosocial behaviour among boys.INTERPRETATION: These findings suggest an association between urinary BPA concentration and children's behavioural outcomes." ]

[ "Bisphenol A (BPA), triclosan (TCS) and perfluorooctanoic acid (PFOA) are endocrine disruptors linked with negative health effects such as developmental, reproductive and cardiovascular toxicity. The aim of this study was to determine simultaneously the concentration of BPA, TCS and PFOA in hair from children and adults and examine possible associations between biomonitoring data and age, gender, dietary habits and body mass index. Methanolic extraction was applied and the compounds were determined by liquid chromatography-mass spectrometry. Low levels of exposure to PFOA were detected for children and adults at concentrations below limit of quantification. The mean concentration of BPA in children and adults was 20.6 and 16.6pgmg-1 , while for TCS 275.2 and 687.0pgmg-1 , respectively. Children were highly exposed to BPA relative to adults (P=.011) although adults had greater exposure to TCS (P=.003). Hair from girls had a greater burden of BPA (P=.06) compared to boys. Moreover, higher TCS levels were depicted for females in both examined groups (children P=.200 and adults P=.213) compared to males, but no statistical differences were observed. Significant differences were also observed between age groups (P=.0007) for TCS. No correlations were found between BPA or TCS levels and body mass index or dietary habits for both children and adults. Children have a greater exposure to BPA compared to adults, whereas exposure of adults to TCS seems to be higher than that in children and elderly people. Exposure to BPA occurs mainly via ingestion whereas exposure to TCS mainly via dermal absorption.", "Bisphenol A (BPA) is used in a wide variety of products and objects for consumers use (digital media such as CD's and DVD's, sport equipment, food and beverage containers, medical equipment). Here, we demonstrate the ubiquitous presence of this contaminant in foods with a background level of contamination of less than 5 g/kg in 85% of the 1498 analysed samples. High levels of contamination (up to 400 g/kg) were found in some foods of animal origin. We used a probabilistic approach to calculate dietary exposure from French individual consumption data for infants under 36 months, children and adolescents from 3 to 17 years, adults over 18 years and pregnant women. The estimated average dietary exposure ranged from 0.12 to 0.14 g/kg body weight per day (bw/d) for infants, from 0.05 to 0.06 g/kg bw/d for children and adolescents, from 0.038 to 0.040 g/kg bw/d for adults and from 0.05 to 0.06 g/kg bw/d for pregnant women. The main sources of exposure were canned foods (50% of the total exposure), products of animal origin (20%) and 30% as a background level. Based on the toxicological values set by the French Agency for Food, Environmental and Occupational Health & Safety (ANSES) for pregnant women, the risk was non negligible. Thus, we simulated scenarios to study the influence of cans and/or food of animal origin on the BPA-related risk for this specific population." ]

[ "At an online discussion forum, you see the phrase in regards to the OP, I think that health care is going to be pivotal in this coming election. What does this OP expression mean? The original poster is the person who started a discussion thread, and OP is used to refer back to that person as the responses grow." ]

[ "OP said he was going to follow up with more details, but hasn't said anything since he made this post. See more words with the same meaning: Internet, texting, SMS, email, chat acronyms (list of). Last edited on Apr 07 2015. Submitted by Walter Rader (Editor) from Sacramento, CA, USA on Aug 11 2009. operator..", "Op art works were first produced in black-and-white, later in vibrant colour. Historically, the Op-Art style may be said to have originated in the work of the kinetic artist Victor Vasarely (1908-97), and also from Abstract Expressionism. Another major Op artist is the British painter Bridget Riley (b.1931)." ]

[ "Overactive bladder (OAB) is a symptom complex which is present in approximately 17% of the European population. It is observed in the presence or absence of incontinence (wet or dry) and is associated with a high degree of psychological stress as well as high costs for the healthcare system. Myogenic, urothelial and neurogenic factors lead to frequently unknown changes of muscular, neural and connective tissue. The diagnosis of OAB is empirical and can be used as a basis for initial treatment, while lower urinary tract symptoms have to be evaluated up front. As there are no established biomarkers for OAB, a definitive diagnosis is problematic. It is important to carry out routine diagnostics including a detailed medical history and if needed urodynamic evaluation of the patient. Therapy of OAB will be the topic of a further continuing medical education (CME) article entitled \"Therapy of overactive bladder (OAB)\"." ]

[ "OBJECTIVE: To evaluate the costs and outcomes associated with different sequences of oral anti-muscarinic agents and the selective (3)-adrenoceptor agonist, mirabegron, for the treatment of overactive bladder (OAB).METHODS: A Markov model with monthly cycle length and time horizon up to 3 years was designed to compare two different sequences of up to three lines of oral therapy for OAB. Patients who discontinued one oral medication could switch to another oral medication or could discontinue treatment. Patients whose symptoms were not controlled were considered for botulinum toxin or sacral nerve stimulation. Outcomes were measured by (a) number of patients with controlled symptoms (no incontinence episodes and <8 micturitions per 24 h); (b) patients with no incontinence episodes per 24 hours; and (c) patients with <8 micturitions per 24 h.RESULTS: Including a third-line oral medication before considering other treatment options improved all patient outcomes, irrespective of the specific drugs used. A three-line sequence including two generic (oxybutynin first line and tolterodine extended-release second line) and one branded drug (solifenacin 5 mg third line) resulted in inferior patient outcomes at costs similar to a sequence of branded drugs (mirabegron first line, solifenacin 5 mg second line, solifenacin 10 mg third line): controlled patients (generic 29.6/1000 vs branded 38.7/1000); patients with no incontinence episodes (103.6/1000 vs 123.7/1000); patients with <8 micturitions (228.7/1000 vs 262.1/1000). Annual treatment costs per patient were similar (generic 1299 vs branded 1385).CONCLUSIONS: In the treatment of OAB, low-cost generic treatments are not necessarily more cost-effective than branded drugs, primarily because a better efficacy and tolerability balance improves both symptom control and persistence.", "The oomycetes are a class of microscopic, filamentous eukaryotes within the stramenopiles-alveolates-rhizaria eukaryotic supergroup. They include some of the most destructive pathogens of animals and plants, such as Phytophthora infestans, the causative agent of late potato blight. Despite the threat they pose to worldwide food security and natural ecosystems, there is a lack of tools and databases available to study oomycete genetics and evolution. To this end, we have developed the Oomycete Gene Order Browser (OGOB), a curated database that facilitates comparative genomic and syntenic analyses of oomycete species. OGOB incorporates genomic data for 20 oomycete species including functional annotations and a number of bioinformatics tools. OGOB hosts a robust set of orthologous oomycete genes for evolutionary analyses. Here, we present the structure and function of OGOB as well as a number of comparative genomic analyses we have performed to better understand oomycete genome evolution. We analyze the extent of oomycete gene duplication and identify tandem gene duplication as a driving force of the expansion of secreted oomycete genes. We identify core genes that are present and microsyntenically conserved (termed syntenologs) in oomycete lineages and identify the degree of microsynteny between each pair of the 20 species housed in OGOB. Consistent with previous comparative synteny analyses between a small number of oomycete species, our results reveal an extensive degree of microsyntenic conservation amongst genes with housekeeping functions within the oomycetes. OGOB is available at https://ogob.ie." ]

[ "Long non-coding RNAs (lncRNAs) are novel transcripts that may play important roles in cancer. Our study aimed to resolve the lncRNA profile of larynx squamous cell carcinoma (LSCC) and to determine its clinical significance. The global lncRNA expression profile in LSCC tissues was measured by lncRNA microarray. Distinctly expressed lncRNAs were identified and levels of AC026166.2-001 and RP11-169D4.1-001 lncRNAs in 87 LSCC samples and paired adjacent normal tissue were analyzed by real-time quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). The clinical significance of these lncRNAs in laryngeal cancer was analyzed and survival data were estimated by the Kaplan-Meier method and the log-rank test. A receiver operating characteristic (ROC) curve was constructed to check the diagnostic value. In the lncRNA expression profile of tumor samples, 684 lncRNAs were upregulated and 747 lncRNAs were downregulated (fold-change >2.0). Of these, AC026166.2-001 and RP11-169D4.1-001 were distinctly dysregulated, with AC026166.2-001 exhibiting lower expression in cancer tissues and RP11-169D4.1-001 higher expression. We verified that both AC026166.2-001 and RP11-169D4.1-001 were expressed at a lower level in cervical lymph nodes compared with paired laryngeal cancer tissues and paired normal tissues. RP11-169D4.1-001 levels were positively correlated with lymph node metastasis (P = 0.007). From the survival analysis, decreased levels of AC026166.2-001 and RP11-169D4.1-001 were associated with poorer prognosis. The area under the ROC curve was up to 0.65 and 0.67, respectively, and the cut-off point of Ct was 11.23 and 10.53, respectively. AC026166.2-001 and RP11-169D4.1-001 may act as novel biomarkers in LSCC and may be potential therapeutic targets for LSCC patients. Both AC026166.2-001 and RP11-169D4.1-001 could be independent prognostic factors for survival in LSCC." ]

[ "BACKGROUND: Laryngeal squamous cell carcinoma (LSCC) is the most common group among head and neck cancers. LSCC is characterized by a high incidence in Europe. With the aim of better understanding its genetic background we performed global miRNA expression profiling of LSCC cell lines and primary specimens. By this approach we identified a cohort of 33 upregulated and 9 downregulated miRNA genes in LSCC as compared to epithelial no tumor controls.RESULTS: Within this group we identified overexpression of the novel miR-1290 gene not reported in the context of LSCC before. Using a combined bioinformatical approach in connection with functional analysis we delineated two putative target genes of miR-1290 namely ITPR2 and MAF which are significantly downregulated in LSCC. They are interesting candidates for tumor suppressor genes as they are implicated in apoptosis and other processes deregulated in cancer.CONCLUSION: Taken together, we propose miR-1290 as the new oncomiR involved in LSCC pathogenesis. Additionally, we suggest that the oncogenic potential of miR-1290 might be expressed by the involvement in downregulation of its target genes MAF and ITPR2.", "In recent years, increasing number of lncRNAs have been studied in lung adenocarcinoma (LAD). LncRNA HOXA10-AS was found to be upregulated in LAD tissues. Based on the data of TCGA database, HOXA10-AS was a prognostic factor for lung adenocarcinoma. This study aims to reveal the biological function of HOXA10-AS in LAD. qRT-PCR was applied to test expression levels of HOXA10-AS in both LAD tissues and cell lines. Next, transcription factor ELK1 was demonstrated to upregulate HOXA10-AS in LAD cells through performing bioinformatics analysis and dual luciferase activity. Loss of function assays were performed in two different LAD cell lines. Silenced HOXA10-AS was proved to inhibit LAD progression by affecting cell proliferation, cell apoptosis and cell metastasis and EMT progress. Western blot analysis revealed that HOXA10-AS increased Wnt/-catenin signaling in LAD cell lines. Finally, rescue assays were carried out to identify the biological function of HOXA10-AS-Wnt/-catenin signaling in LAD progression. In conclusion, ELK1-induced upregulation of HOXA10-AS improved LAD progression through increasing Wnt/-catenin signaling." ]

[ "One of the key technical guidelines outlined by psychodynamic theorists and clinicians is for therapists to interpret a patient's most prominent defenses (Greenson, 1967; Langs, 1973). However, a debate exists about what constitutes a patient's most prominent defense and which defenses therapists actually choose to interpret in-session. This study aimed to shed light on this debate by examining 35 psychotherapy sessions (18 high alliance and 17 low alliance dyads) of individuals in therapy at a university counselling center. The analysis focused on comparing the patients' most prominent defenses and the range of defenses they utilized, and the therapists' most prominent interpretation level as well as the range of interpretation level. Paired sample t-tests showed no significant mean difference between sessions with low and high alliance scores in patient defense levels (e.g., frequency and range) and therapist interpretation levels (e.g., frequency and range). Significant differences were found between the range of patient defense levels and the range of therapist interpretation levels. Correlational analyses showed no significant relationship between patient defense levels and therapist interpretation levels on both the frequency and range levels. Clinical implications of these results, and directions for future research are discussed." ]

[ "INTRODUCTION: Patient interpretation of advice from hand therapists may be related to nonadaptive pain thoughts (automatic, overprotective, unduly pessimistic statements triggered by nociception and exacerbated by psychological distress).PURPOSE OF THE STUDY: This study aimed to determine whether there were correlations between participants' hand therapy goals, interpretation of advice from hand therapists, nonadaptive pain thoughts, and upper extremity-specific disability.METHODS: One hundred and five participants completed questionnaires assessing nonadaptive pain thoughts, upper extremity-specific disability, lessons from hand therapists, and hand therapy goals.RESULTS: Nonadaptive pain thoughts correlated with disability and were bi-directionally related to participant goals and interpretation of advice from hand therapists.DISCUSSION: Patients' nonadapative pain thoughts and the words/concepts used by hand therapists are both important in recovery from upper extremity illness.CONCLUSIONS: Hand therapists should be mindful that nonadaptive pain thoughts are an important determinant of disability and that such thoughts can affect and be affected by their recommendations.LEVEL OF EVIDENCE: n/a.", "OBJECTIVES: To dissociate injury-related factors from psychological contributions to impaired awareness of deficits following traumatic brain injury (TBI); impaired awareness is theorized to partly reflect psychological factors (e.g., denial), but empirical evidence for this theory is scarce.DESIGN: We examined how different factors predict awareness in patients undergoing rehabilitation (N=43). Factors included (1) neurological (injury severity), (2) neuropsychological loss, (3) psychological (denial, projection, identification), and (4) personality (narcissism).METHODS/MAIN MEASURES: The Patient Competency Rating Scale, comparing patient with clinician reports on different functional domains; the Thematic Apperception Test, an injury-independent measure of the propensity to mobilize specific defence mechanisms; and the Narcissism Personality Inventory.RESULTS: Impaired awareness was not predicted by injury-related and neuropsychological scores but was significantly predicted by use of primitive defence mechanisms (denial and projection). Patients who underestimate their abilities also demonstrated high denial levels, but contrary to underestimators, this was positively related to depression and negatively to awareness.CONCLUSIONS: Primitive defence mechanism use significantly contributes to impaired awareness independent of injury-related factors, particularly in domains associated with self-identity. Well-validated tests of defence mechanism mobilization are needed to support clinical interpretation of and intervention with impaired awareness. More research is needed to understand the psychology of hypersensitivity to deficits.PRACTITIONER POINTS: This study provides an empirical demonstration of dissociable contributions of neurological and psychological factors to awareness of deficits in TBI. Trait proclivity to mobilize defence mechanisms in response to anxiety-provoking situations can be measured, and strongly predicts impaired awareness. Importantly, measures of psychological reactions were independent of responses to the neurological deficits themselves, discriminating between psychological and neurological contributions to impaired awareness. The importance of identifying psychological reactions to impaired awareness and hindering rehabilitation success is highlighted, and vital for clinicians to consider during the rehabilitation process. Psychological reactions to TBI can be identified using well-validated, quantitative measures of the use of psychological defences (e.g., Cramer's Thematic Apperception Test scoring system), and the authors suggest this is a critical step to properly characterize and manage awareness in patients during treatment. Although only TBI patients were examined, the results may inform impaired awareness that occur as a result of other disorders and illnesses. The patients in this study were in the chronic stages of the injury, and therefore, the results may not generalize to patients in more acute stages." ]