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Children's observed effortful control (EC) at 30, 42, and 54 months (n = 145) was predicted from the interaction between mothers' observed parenting with their 30-month-olds and three variants of the solute carrier family C6, member 3 (SLC6A3) dopamine transporter gene (single nucleotide polymorphisms in intron8 and intron13, and a 40 base pair variable number tandem repeat [VNTR] in the 3′-untranslated region [UTR]), as well as haplotypes of these variants. Significant moderating effects were found. Children without the intron8-A/intron13-G, intron8-A/3′-UTR VNTR-10, or intron13-G/3′-UTR VNTR-10 haplotypes (i.e., haplotypes associated with the reduced SLC6A3 gene expression and thus lower dopamine functioning) appeared to demonstrate altered levels of EC as a function of maternal parenting quality, whereas children with these haplotypes demonstrated a similar EC level regardless of the parenting quality. Children with these haplotypes demonstrated a trade-off, such that they showed higher EC, relative to their counterparts without these haplotypes, when exposed to less supportive maternal parenting. The findings revealed a diathesis–stress pattern and suggested that different SLC6A3 haplotypes, but not single variants, might represent different levels of young children's sensitivity/responsivity to early parenting.
We used sex, observed parenting quality at 18 months, and three variants of the catechol-O-methyltransferase gene (Val158Met [rs4680], intron1 [rs737865], and 3′-untranslated region [rs165599]) to predict mothers' reports of inhibitory and attentional control (assessed at 42, 54, 72, and 84 months) and internalizing symptoms (assessed at 24, 30, 42, 48, and 54 months) in a sample of 146 children (79 male). Although the pattern for all three variants was very similar, Val158Met explained more variance in both outcomes than did intron1, the 3′-untranslated region, or a haplotype that combined all three catechol-O-methyltransferase variants. In separate models, there were significant three-way interactions among each of the variants, parenting, and sex, predicting the intercepts of inhibitory control and internalizing symptoms. Results suggested that Val158Met indexes plasticity, although this effect was moderated by sex. Parenting was positively associated with inhibitory control for methionine–methionine boys and for valine–valine/valine–methionine girls, and was negatively associated with internalizing symptoms for methionine–methionine boys. Using the “regions of significance” technique, genetic differences in inhibitory control were found for children exposed to high-quality parenting, whereas genetic differences in internalizing were found for children exposed to low-quality parenting. These findings provide evidence in support of testing for differential susceptibility across multiple outcomes.
Computerized interpretation of the prehospital electrocardiogram (ECG) is increasingly being used in the basic life support (BLS) ambulance setting to reduce delays to treatment for patients suspected of ST segment elevation myocardial infarction (STEMI).
To estimate 1) predictive values of computerized prehospital 12-lead ECG interpretation for STEMI and 2) additional on-scene time for 12-lead ECG acquisition.
Over a 2-year period, 1,247 ECGs acquired by primary care paramedics for suspected STEMI were collected. ECGs were interpreted in real time by the GEMarquette 12SL ECG analysis program. Predictive values were estimated with a bayesian latent class model incorporating the computerized ECG interpretations, consensus ECG interpretations by study cardiologists, and hospital diagnosis. On-scene time was compared for ambulance-transported patients with (n 5 985) and without (n 5 5,056) prehospital ECGs who received prehospital aspirin and/or nitroglycerin.
The computer's positive and negative predictive values for STEMI were 74.0% (95% credible interval [CrI] 69.6–75.6) and 98.1% (95% CrI 97.8–98.4), respectively. The sensitivity and specificity were 69.2% (95% CrI 59.0–78.5) and 98.9% (95% CrI 98.1–99.4), respectively. Prehospital ECGs were associated with a mean increase in on-scene time of 5.9 minutes (95% confidence interval 5.5–6.3).
The predictive values of the computerized prehospital ECG interpretation appear to be adequate for diversion programs that direct patients with a positive result to hospitals with angioplasty facilities. The estimated 26.0% chance that a positive interpretation is false is likely too high for activation of a catheterization laboratory from the field. Acquiring prehospital ECGs does not substantially increase on-scene time in the BLS setting.
Norovirus is a common cause of gastroenteritis in all ages. Typical infections cause viral shedding periods of days to weeks, but some individuals can shed for months or years. Most norovirus risk models do not include these long-shedding individuals, and may therefore underestimate risk. We reviewed the literature for norovirus-shedding duration data and stratified these data into two distributions: regular shedding (mean 14–16 days) and long shedding (mean 105–136 days). These distributions were used to inform a norovirus transmission model that predicts the impact of long shedders. Our transmission model predicts that this subpopulation increases the outbreak potential (measured by the reproductive number) by 50–80%, the probability of an outbreak by 33%, the severity of transmission (measured by the attack rate) by 20%, and transmission duration by 100%. Characterizing and understanding shedding duration heterogeneity can provide insights into community transmission that can be useful in mitigating norovirus risk.
Causal mechanisms of norovirus outbreaks are often not revealed. Understanding the transmission route (e.g. foodborne, waterborne, or environmental) and vehicle (e.g. shellfish or recreational water) of a norovirus outbreak, however, is of great public health importance; this information can facilitate interventions for an ongoing outbreak and regulatory action to limit future outbreaks. Towards this goal, we conducted a systematic review to examine whether published outbreak information was associated with the implicated transmission route or vehicle. Genogroup distribution was associated with transmission route and food vehicle, but attack rate and the presence of GII.4 strain were not associated with transmission route, food vehicle, or water vehicle. Attack rate, genogroup distribution, and GII.4 strain distribution also varied by other outbreak characteristics (e.g. setting, season, hemisphere). These relationships suggest that different genogroups exploit different environmental conditions and thereby can be used to predict the likelihood of various transmission routes or vehicles.
The Muslim-dominated ‘Swahili coast’ has always served as a conceptual as well as physical periphery for post-colonial Kenya. This article takes Kenyan youth music under the influence of global hip-hop as an ethnographic entry into the dynamics of identity and citizenship in this region. Kenyan youth music borrows from global hip-hop culture the idea that an artist must ‘represent the real’. The ways in which these regional artists construct their public personae thus provide rich data on ‘cultural citizenship’, in Aihwa Ong's (1996) sense of citizenship as subjectification. I focus here on youth music production in the Kenyan coastal city of Mombasa between 2004 and 2007. During this time, some local artists adopted a representational strategy that subtly reinscribed the symbolic violence to which members of the coast's Muslim-Swahili society have long been subjected. I examine the representational strategies that were adopted during this period by Mombasan artists who happened to be members of the Muslim-Swahili society (‘subjects of the Swahili coast’, as I name them), with an ethnographic eye and ear trained on what they say about the ways in which young subjects of the Swahili coast are objectified and subjectified as ‘Kenyan youth’ in the twenty-first century.
The purpose of this study was to examine global epidemiological trends in human norovirus (NoV) outbreaks by transmission route and setting, and describe relationships between these characteristics, viral attack rates, and the occurrence of genogroup I (GI) or genogroup II (GII) strains in outbreaks. We analysed data from 902 reverse transcriptase–polymerase chain reaction-confirmed, human NoV outbreaks abstracted from a systematic review of articles published from 1993 to 2011 and indexed under the terms ‘norovirus’ and ‘outbreak’. Multivariate regression analyses demonstrated that foodservice and winter outbreaks were significantly associated with higher attack rates. Foodborne and waterborne outbreaks were associated with multiple strains (GI+GII). Waterborne outbreaks were significantly associated with GI strains, while healthcare-related and winter outbreaks were associated with GII strains. These results identify important trends for epidemic NoV detection, prevention, and control.
Intermediate structures were trapped during the mesophase transition from lamellae to higher curvature structures in a sol-gel matrix. The target structures included normal hexagonally arranged cylinders and/or normal spheres in a cubic array distributed in a hydrophilic matrix. The present system is believed to be the first to trap these intermediates. Through solvent evaporation-induced self-assembly (EISA), mesostructured silica/diblock films with large characteristic length scales were prepared. The structure-directing agents were polystyrene-block-poly(ethylene oxide) (PS-b-PEO) diblock copolymers with high molecular weight, which are water insoluble and alcohol insoluble. We believe that no micellization took place in the present system; a disorder-to-order transition occurred due to the cooperative self- assembly of the diblock and silicates as the solvent preferentially evaporated from a film cast from a dilute homogeneous solution. During further preferential evaporation, the morphogenic effect of the increase of species concentration facilitates the mesophase development in the direction of a normal cubic to hexagonal to lamellar pathway. However, the morphogenic effects of both the decrease of the PS coil dimension and the siloxane condensation drive the mesophase development in opposite directions. The decrease of the PS coil dimension plays an important role in the present self-assembly process. Trapping of the intermediates and coexisting multiple mesophases are related to the facts that PS has high Tg and high hydrophobicity in particular, as well as to the fact that polymers have relatively low mobility in general.
We are building a biosensor based on ion channels inserted into lipid bilayers that are suspended across an aperture in silicon. The process flow only involves conventional optical lithography and deep Si reactive ion etching to create micromachined apertures in a silicon wafer. In order to provide surface properties for lipid bilayer attachment that are similar to those of the fluorocarbon films that are currently used, we coated the silicon surface with a fluoropolymer using plasma-assisted chemical vapor deposition. When compared with the surface treatment methods using self-assembled monolayers of fluorocarbon chemicals, this novel approach towards modifying the wettability of a silicon dioxide surface provides an easy and fast method for subsequent lipid bilayer formation. Current-Voltage measurements on OmpF ion channels incorporated into these membranes show the voltage dependent gating action expected from a working porin ion channel.
The use of hot water immersion to aid in the drying of wafers subsequent to liquid chemical processing has recently been increasing. Both the TREBOR HydrodryTM and the Isopropyl Alcohol (IPA) dry used by CFM Technologies Inc. use water rinses at elevated temperature. These treatments are of particular concern when they follow HF immersions where surface oxides are removed and bare silicon surfaces are exposed to the hot water. Studies by Watanabe et al.1 show that Si(l 11) facets can be produced by hot water immersion. This, in turn, implies that hot water etches silicon with an anisotropic etch rate. In this work, the etching of oxide patterned Si(100) wafers by immersion in hot water is studied. Etching is clearly observed in images produced by Transmission Electron Microscopy (TEM) with a concomitant increase in surface roughness. The rate of etching varies dramatically with the dissolved oxygen concentration of the water used. Possible mechanisms to explain the etching will be discussed.
Oppositional defiant disorder (ODD) is frequently co-occurring with attention deficit hyperactivity disorder (ADHD) in children and adolescents. Because ODD is a precursor of later conduct disorder (CD) and affective disorders, early diagnostic identification is warranted. Furthermore, the predictability of three recently confirmed ODD dimensions (ODD-irritable, ODD-headstrong and ODD-hurtful) may assist clinical decision making.
Receiver-operating characteristic (ROC) analysis was used in order to test the diagnostic accuracy of the Conners' Parent Rating Scale revised (CPRS-R) and the parent version of the Strength and Difficulties Questionnaire (PSDQ) in the prediction of ODD in a transnational sample of 1093 subjects aged 5–17 years from the International Multicentre ADHD Genetics study. In a second step, the prediction of three ODD dimensions by the same parent rating scales was assessed by backward linear regression analyses.
ROC analyses showed adequate diagnostic accuracy of the CPRS-R and the PSDQ in predicting ODD in this ADHD sample. Furthermore, the three-dimensional structure of ODD was confirmed by confirmatory factor analysis and the CPRS-R emotional lability scale significantly predicted the ODD irritable dimension.
The PSDQ and the CPRS-R are both suitable screening instruments in the identification of ODD. The emotional lability scale of the CPRS-R is an adequate predictor of irritability in youth referred for ADHD.