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Lifespan outcomes of simultaneous versus sequential myelomeningocele repair and shunt placement or effects of repeated shunt revisions on specific domains of IQ or fine motor dexterity are largely unknown. The current study addressed these gaps in a large cohort of children and adults with spina bifida myelomeningocele (SBM).
Participants between 7 and 44 years of age with SBM and shunted hydrocephalus were recruited from international clinics at two time points. Each participant completed a standardized neuropsychological evaluation that included estimates of IQ and fine motor dexterity. Simultaneous versus sequential surgical repair and number of shunt revisions were examined in relation to long-term IQ and fine motor scores.
Simultaneous myelomeningocele repair and shunting were associated with more frequent shunt revisions, as well as to lower Full Scale and verbal IQ scores, controlling for number of shunt revisions. More shunt revisions across study time points were associated with higher nonverbal IQ (NVIQ) scores. No effects were observed on fine motor dexterity.
Findings indicate generally greater influence of surgery type over shunt revision history on outcomes in well-managed hydrocephalus. Findings supported apparent, domain-specific benefits of sequential compared to simultaneous surgery across the lifespan in SBM. Higher NVIQ scores with greater number of additional shunt revisions across surgery type supported positive outcomes with effective surgical management for hydrocephalus.
Currently no national guidelines exist for the management of scabies outbreaks in residential or nursing care homes for the elderly in the United Kingdom. In this setting, diagnosis and treatment of scabies outbreaks is often delayed and optimal drug treatment, environmental control measures and even outcome measures are unclear. We undertook a systematic review to establish the efficacy of outbreak management interventions and determine evidence-based recommendations. Four electronic databases were searched for relevant studies, which were assessed using a quality assessment tool drawing on STROBE guidelines to describe the quality of observational data. Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks. While high-quality randomised controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literature studies. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks.
Space Infrared Telescope for Cosmology and Astrophysics (SPICA), the cryogenic infrared space telescope recently pre-selected for a ‘Phase A’ concept study as one of the three remaining candidates for European Space Agency (ESA's) fifth medium class (M5) mission, is foreseen to include a far-infrared polarimetric imager [SPICA-POL, now called B-fields with BOlometers and Polarizers (B-BOP)], which would offer a unique opportunity to resolve major issues in our understanding of the nearby, cold magnetised Universe. This paper presents an overview of the main science drivers for B-BOP, including high dynamic range polarimetric imaging of the cold interstellar medium (ISM) in both our Milky Way and nearby galaxies. Thanks to a cooled telescope, B-BOP will deliver wide-field 100–350
m images of linearly polarised dust emission in Stokes Q and U with a resolution, signal-to-noise ratio, and both intensity and spatial dynamic ranges comparable to those achieved by Herschel images of the cold ISM in total intensity (Stokes I). The B-BOP 200
m images will also have a factor
30 higher resolution than Planck polarisation data. This will make B-BOP a unique tool for characterising the statistical properties of the magnetised ISM and probing the role of magnetic fields in the formation and evolution of the interstellar web of dusty molecular filaments giving birth to most stars in our Galaxy. B-BOP will also be a powerful instrument for studying the magnetism of nearby galaxies and testing Galactic dynamo models, constraining the physics of dust grain alignment, informing the problem of the interaction of cosmic rays with molecular clouds, tracing magnetic fields in the inner layers of protoplanetary disks, and monitoring accretion bursts in embedded protostars.
We examined the functions of mothers’ speech to infants during two tasks – book-sharing and bead-stringing – in low-income, ethnically diverse families. Mexican, Dominican, and African American mothers and their infants were video-recorded sharing wordless books and toy beads in the home when infants were aged 1;2 and 2;0. Mothers’ utterances were classified into seven categories (labels/descriptions, emotion/state language, attention directives, action directives, prohibitions, questions, and vocal elicitations) which were grouped into three broad language functions: referential language, regulatory language, and vocalization prompts. Mothers’ ethnicity, years of education, years living in the United States, and infant sex and age related to mothers’ language functions. Dominican and Mexican mothers were more likely to use regulatory language than were African American mothers, and African American mothers were more likely to use vocalization prompts than were Latina mothers. Vocalization prompts and referential language increased with mothers’ education and Latina mothers’ years living in the United States. Finally, mothers of boys used more regulatory language than did mothers of girls. Socio-cultural and developmental contexts shape the pragmatics of mothers’ language to infants.
Objectives: Fluency is a major problem for individuals with neurodevelopmental disorders, including fluency deficits for academic skills. The aim of this study was to determine neurocognitive predictors of academic fluency within and across domains of reading, writing, and math, in children and adults, with and without spina bifida. In addition to group differences, we expected some neurocognitive predictors (reaction time, inattention) to have similar effects for each academic fluency outcome, and others (dexterity, vocabulary, nonverbal reasoning) to have differential effects across outcomes. Methods: Neurocognitive predictors were reaction time, inattention, dexterity, vocabulary, and nonverbal reasoning; other factors included group (individuals with spina bifida, n=180; and without, n=81), age, and demographic and untimed academic content skill covariates. Univariate and multivariate regressions evaluated hypotheses. Results: Univariate regressions were significant and robust (R2=.78, .70, .73, for reading, writing, and math fluency, respectively), with consistent effects of covariates, age, reaction time, and vocabulary; group and group moderation showed small effect sizes (<2%). Multivariate contrasts showed differential prediction across academic fluency outcomes for reaction time and vocabulary. Conclusions: The novelty of the present work is determining neurocognitive predictors for an important outcome (academic fluency), within and across fluency domains, across population (spina bifida versus typical), over a large developmental span, in the context of well-known covariates. Results offer insight into similarities and differences regarding prediction of different domains of academic fluency, with implications for addressing academic weakness in spina bifida, and for evaluating similar questions in other neurodevelopmental disorders. (JINS, 2019, 25, 249–265)
The period of growth from parturition to weaning is a time of rapid fat deposition in many species. In the pig, body fat increases from about 10 g/kg at birth to 150 to 200 g/kg by 21 days of age (Wood and Groves 1965; Whittemore, Aumaitre and Williams, 1978). An adequate reserve of adipose tissue may be crucial to ensure health and survival, for example during the period of low food intake frequently observed after weaning.
It is likely that the nutrient composition of milk and the hormonal signals elicited by milk consumption play an important rôle in stimulating fat deposition. We have investigated the effects of milk ingestion on release of the gastrointestinal hormones GIP (gastric inhibitory peptide) and GLP-1 (glucagon-like peptide one). In addition, we have studied the effects of these hormones on fatty acid synthesis in vitro.
Explants (0.4 to 0.6 mg) of adipose tissue were obtained from three anatomical sites of an 18-day-old pig fasted for 12 h. The explants were pre-incubated for 90 min and then incubated in the presence of hormones and [14C] acetate (0.2μCi/ml). Triacylglycerols were extracted from the explants and following saponification, fatty acids were separated and radioactivity counted.
Over the past 50 years, research on children and adults with learning disabilities has seen significant advances. Neuropsychological research historically focused on the administration of tests sensitive to brain dysfunction to identify putative neural mechanisms underlying learning disabilities that would serve as the basis for treatment. Led by research on classifying and identifying learning disabilities, four pivotal changes in research paradigms have produced a contemporary scientific, interdisciplinary, and international understanding of these disabilities. These changes are (1) the emergence of cognitive science, (2) the development of quantitative and molecular genetics, (3) the advent of noninvasive structural and functional neuroimaging, and (4) experimental trials of interventions focused on improving academic skills and addressing comorbid conditions. Implications for practice indicate a need to move neuropsychological assessment away from a primary focus on systematic, comprehensive assessment of cognitive skills toward more targeted performance-based assessments of academic achievement, comorbid conditions, and intervention response that lead directly to evidence-based treatment plans. Future research will continue to cross disciplinary boundaries to address questions regarding the interaction of neurobiological and contextual variables, the importance of individual differences in treatment response, and an expanded research base on (a) the most severe cases, (b) older people with LDs, and (c) domains of math problem solving, reading comprehension, and written expression. (JINS, 2017, 23, 930–940)
The tri-island state of Grenada, Carriacou, and Petit Martinique's legislative and institutional compliance with the World Organisation for Animal Health's (OIE) guidelines on antimicrobial utilisation in poultry production is reviewed in this paper. This includes legislative and other institutional documents, coupled with interviews with veterinary officers, health officers and managers of the veterinary drug distribution centres were conducted to evaluate the extent of Grenada's compliance with the OIE's Terrestrial Animal Health Code in the use of antimicrobials in poultry production. Five thematic areas were evaluated: 1) legislative and institutional arrangements; 2) surveillance and reporting; 3) risks associated with the importation of poultry meat products; 4) ante- and post-mortem inspection; and 5) procurement and use of antimicrobials. The information revealed that the current legislative framework in Grenada does not adequately address poultry food safety and that there is a need to strengthen the synergies between the agricultural and health sectors to enable a more thorough monitoring of antimicrobials use in poultry production. There is a need to strengthen epidemiology of zoonotic diseases, provisioning of education and information for key stakeholders about the use of antibiotics and the development of a system to monitor antibiotic procurement, distribution and use in Grenada. These findings have implications for other small island states in the Caribbean that have similar limitations in institutional capacity and knowledge deficits in the prudent use of antibiotics.
A plausible mechanism underlying flavonoid-associated cognitive effects is increased cerebral blood flow (CBF). However, behavioural and CBF effects following flavanone-rich juice consumption have not been explored. The aim of this study was to investigate whether consumption of flavanone-rich juice is associated with acute cognitive benefits and increased regional CBF in healthy, young adults. An acute, single-blind, randomised, cross-over design was applied with two 500-ml drink conditions – high-flavanone (HF; 70·5 mg) drink and an energy-, and vitamin C- matched, zero-flavanone control. A total of twenty-four healthy young adults aged 18–30 years underwent cognitive testing at baseline and 2-h after drink consumption. A further sixteen, healthy, young adults were recruited for functional MRI assessment, whereby CBF was measured with arterial spin labelling during conscious resting state at baseline as well as 2 and 5 h after drink consumption. The HF drink was associated with significantly increased regional perfusion in the inferior and middle right frontal gyrus at 2 h relative to baseline and the control drink. In addition, the HF drink was associated with significantly improved performance on the Digit Symbol Substitution Test at 2 h relative to baseline and the control drink, but no effects were observed on any other behavioural cognitive tests. These results demonstrate that consumption of flavanone-rich citrus juice in quantities commonly consumed can acutely enhance blood flow to the brain in healthy, young adults. However, further studies are required to establish a direct causal link between increased CBF and enhanced behavioural outcomes following citrus juice ingestion.
Recent spectropolarimetric surveys of bright, hot stars have found that ~10% of OB-type stars contain strong (mostly dipolar) surface magnetic fields (~kG). The prominent paradigm describing the interaction between the stellar winds and the surface magnetic field is the magnetically confined wind shock (MCWS) model. In this model, the stellar wind plasma is forced to move along the closed field loops of the magnetic field, colliding at the magnetic equator, and creating a shock. As the shocked material cools radiatively it will emit X-rays. Therefore, X-ray spectroscopy is a key tool in detecting and characterizing the hot wind material confined by the magnetic fields of these stars. Some B-type stars are found to have very short rotational periods. The effects of the rapid rotation on the X-ray production within the magnetosphere have yet to be explored in detail. The added centrifugal force due to rapid rotation is predicted to cause faster wind outflows along the field lines, leading to higher shock temperatures and harder X-rays. However, this is not observed in all rapidly rotating magnetic B-type stars. In order to address this from a theoretical point of view, we use the X-ray Analytical Dynamical Magnetosphere (XADM) model, originally developed for slow rotators, with an implementation of new rapid rotational physics. Using X-ray spectroscopy from ESA’s XMM-Newton space telescope, we observed 5 rapidly rotating B-types stars to add to the previous list of observations. Comparing the observed X-ray luminosity and hardness ratio to that predicted by the XADM allows us to determine the role the added centrifugal force plays in the magnetospheric X-ray emission of these stars.
Ice cores and snow pits of the cryosphere contain particles that detail the history of past atmospheric air compositions. Some of these particles result from combustion processes and have undergone long-range transport to arrive in the Arctic. Recent research has focused on the separation of particulate matter from ice and snow, as well as the subsequent analysis of the separated particles for 14C with accelerator mass spectrometry (AMS) and for individual particle compositions with laser microprobe mass analysis (LAMMA). The very low particulate concentrations in Arctic samples make these measurements a challenge. The first task is to separate the particles from the ice core. Two major options exist to accomplish this separation. One option is to melt the ice and then filter the meltwater. A second option is to sublimate the ice core directly, depositing the particles onto a surface. This work demonstrates that greater control is obtained through sublimation. A suite of analytical methods has been used for the measurement of the carbon in snow and ice. Total carbon was analyzed with a carbon/nitrogen/hydrogen (CHN) analyzer. AMS was used for the determination of carbon isotopes. Since source identification of the carbonaceous particles is of primary importance here, the use of LAMMA was incorporated to link individual particle molecular-structural patterns to the same group of particles that were measured by the other techniques. Prior to this study, neither AMS nor LAMMA had been applied to particles contained in snow. This paper discusses the development and limitations of the methodology required to make these measurements.
Acceleration, propagation, and energy loss of particles energized in solar flares cannot be studied separately because their radiative signatures observed in the form of hard X-ray bremsstrahlung or radio gyrosynchrotron emission represent a convolution of all these processes. We analyze hard X-ray emission from solar flares using a kinematic model that includes free-streaming electrons (having an energy-dependent time-of-flight delay) as well as temporarily trapped electrons (which are pitch-angle scattered by Coulomb collisional scattering) to determine various physical parameters (trapping times, flux asymmetry, loss-cone angles, magnetic mirror ratios) in flare loops with asymmetric magnetic fields.
Reviewing the work of Lynton Caldwell, Robert Blank, and Andrea Bonnicksen is both a privilege and a challenge. These three scholars rank among the key figures in the development of biopolicy as a legitimate research and teaching subfield within political science. Each of them worked in academia, on significant bioethical advisory boards, and with policymaking entities, and also contributed to numerous externally funded research projects. Across long and prolific careers, Caldwell, Blank, and Bonnicksen engaged seriously with the political, social and ethical issues raised by significant advances in many bio-scientific domains. This essay analyzes several of their works across two broad themes: 1) the development of the subfields of biopolitics and biopolicy, and 2) the tension between science policy and democratic governance. While each of them wrote significant and well-received books, the focus here is on insights to be gleaned from an idiosyncratic selection of their scholarly articles across the time period, 1966 to 2007. To borrow Michel Foucault's term, this brief and necessarily selective archaeology of the published journal record nevertheless demonstrates the significance, durability and prescience of the authors' insights. (I expect that at least one, if not all three, of these authors might raise objections to the mention of Foucault, but the term “archaeology” in this instance is apt.)
We present multi-instrument observations of AR 8048, made between June 3 and June 5 1997 as part of SoHO JOP033. This active region (AR) has a sigmoid-like global shape and undergoes transient brightenings through which the stored energy is released.
Using a magneto-hydrostatic model, we compute coronal magnetic field. The large-scale magnetic lines confirm the sigmoidal characteristics of the AR. The field lines most closely matching the hotter SoHO/CDS loops extend along the quasi-separatrix-Iayers (QSLs) of the coronal field. Transition region (TR) brightenings observed with SoHO/CDS can be associated with both QSL intersections with the photosphere, and places where separatrices corresponding to bald patches (BPs, sites where field lines are tangent to the photosphere) lie at the photospheric plane. There are suggestions that the element abundances measured in the TR may depend on the type of topological structure present. TR brightenings associated with QSLs have coronal abundances, while those associated with BP separatrices have abundances closer to photospheric values.
During 1990 we surveyed the southern sky using a multi-beam receiver at frequencies of 4850 and 843 MHz. The half-power beamwidths were 4 and 25 arcmin respectively. The finished surveys cover the declination range between +10 and −90 degrees declination, essentially complete in right ascension, an area of 7.30 steradians. Preliminary analysis of the 4850 MHz data indicates that we will achieve a five sigma flux density limit of about 30 mJy. We estimate that we will find between 80 000 and 90 000 new sources above this limit. This is a revised version of the paper presented at the Regional Meeting by the first four authors; the surveys now have been completed.