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La place des technologies de communication grandit dans le quotidien, et l’organisation du soin en médecine. Afin d’en évaluer l’accès et l’usage, nous avons diffusé un questionnaire auprès des personnes hospitalisées au Centre Hospitalier Esquirol de Limoges, hôpital public de soin en psychiatrie à vocation régionale. Notre intérêt a porté sur le type de moyens de communication dont les personnes disposent, incluant les moyens de transport, et leur fréquence d’usage. Le questionnaire, anonyme, sans collecte de donnée médicale ou identifiante, a été diffusé auprès des patients de plus de 12 ans, accueillis en hospitalisation complète ou partielle durant la semaine du 7 au 11 avril 2014.
Les 954 questionnaires (par rapport aux 1044 théoriques) exploités correspondent à une population représentative en âge et en sexe de celle alors hospitalisées dans l’établissement. Les résultats montrent un plus faible équipement en support de communication (65 % ont un téléphone portable), et des connexions à Internet moins fréquentes qu’en population générale (54 % ne se connectent jamais). Concernant les lieux et moyens de consultation Internet, l’ordinateur personnel est le plus cité, mais pour 34 % seulement, l’usage du téléphone portable restant peu répandu. La voiture reste le moyen de transport majoritaire mais pour 60 % seulement. L’accès et l’usage des moyens de communications actuels sont plus réduits qu’en population générale [1,2], même en tenant compte de l’influence de l’âge et de la ruralité. Enfin, les moins connectés et les moins utilisateurs de technologies sont les personnes en hospitalisation partielle, âgées, accueillis en filières de soin des troubles psychotiques.
Ainsi, la possibilité d’intégrer ces techniques dans le projet individualisé de soin (rappel de rendez-vous, d’examens…) nécessite au préalable l’équipement et/ou sa mise à jour pour atteindre les populations les plus concernées.
La technique d’Eye-tracking (ET), basée sur la détection du reflet cornéen généré par une lumière infrarouge, permet l’enregistrement en temps réel des mouvements oculaires d’un individu explorant une image ou son environnement. Cette technique révélant le sens du regard en une succession de saccades et de fixations a permis d’apporter un nouvel éclairage sur la manière dont un individu explore le monde environnant et de mettre en lumière les particularités perceptives dans différentes pathologies, dont les troubles du spectre autistique. Les sujets avec trouble du spectre autistique présentent des atypies perceptives se traduisant notamment par un biais de traitement en faveur de la dimension locale (détails). La majorité des travaux en ET se sont intéressés à la cognition sociale. Certains ont notamment révélé que les stratégies d’exploration des visages au sein d’une scène sociale en milieu naturel étaient différentes chez les sujets TSA et pourraient contribuer aux troubles de cognition sociale et de reconnaissance émotionnelle . Toutefois, cette technique trouve également son intérêt dans l’étude d’autres domaines cognitifs tels que les capacités de catégorisation  ou la mémoire. Les personnes avec TSA ont un fonctionnement mnésique atypique , résultant notamment de difficultés de sélection et d’intégration d’informations perceptives complexes. Ces difficultés ont été identifiées dès les premières millisecondes d’exploration de l’information à mémoriser . Nous proposons d’illustrer l’apport de cette approche pour la caractérisation des atypies perceptives des personnes avec TSA et leurs répercussions sur le fonctionnement cognitif. Nous aborderons également les perspectives nouvelles d’évaluation neuropsychologique et de remédiation qu’offre cette technique d’ET au clinicien.
L’étude de la mémoire autobiographique dans l’autisme a été principalement réalisée chez l’adulte  et plus rarement chez l’enfant, révélant principalement des déficits en mémoire épisodique . Il n’existe qu’une étude chez l’adolescent  cherchant à caractériser les souvenirs épisodiques, incluant notamment leurs propriétés sensorielles. L’objectif de notre étude est d’évaluer les productions épisodiques d’événements à la fois passés et futurs, chez des adolescents avec trouble du spectre autistique, en utilisant un support et en explorant les détails phénoménologiques, émotionnels et les capacités de récollection.
Matériel et méthodes
Un échantillon de 16 adolescents avec un diagnostic de trouble du spectre autistique sans déficience intellectuelle (TSA-SDI), et un groupe de 16 enfants au développement typique, ont réalisé une tâche de mémoire autobiographique originale, ludique et contrôlée, comprenant à la fois une évaluation rapide et indicée de la composante sémantique et plus détaillée de la composante épisodique.
Les participants avec TSA-SDI présentent des difficultés de restitution des souvenirs épisodiques comparés aux témoins et bénéficient significativement de l’indiçage. Au niveau des propriétés perceptives, les adolescents avec TSA fournissent moins de couleurs que les témoins, alors que le nombre total de détails perceptifs ne diffère pas entre les deux groupes. Enfin, la reviviscence diffère selon la période évoquée : la reviviscence d’évènements passés est moins précise que la projection dans le futur.
Ces résultats confirment l’existence de troubles en mémoire épisodique chez les adolescents avec TSA-SDI, améliorés en présence d’un support visuel. Les propriétés sensorielles semblent être impliquées différemment dans l’organisation des souvenirs, notamment les couleurs, probablement en relation avec une perception atypique chez les personnes avec TSA-SDI . L’impact de la perception des couleurs sur la mémoire est une piste de recherche à approfondir.
Les troubles de l’usage de l’alcool représentent un problème de santé publique majeur, et sont souvent associés à des co-morbidités psychiatriques . La recherche clinique est indispensable pour mieux connaître la physiopathologie, et ses mécanismes, pour optimiser le diagnostic, et identifier des marqueurs de suivi et rechutes. Nous pensons que l’étude elle-même peut se greffer sur la pratique de routine et modifier celle-ci. Deux recherches biomédicales ont été menées concernant des sujets alcoolo-dépendants venus pour sevrage d’alcool à l’hôpital psychiatrique : un premier suivi de cohorte (2006–2009) tous les semestres pendant deux ans pour connaître le devenir et la consommation de soins, et ayant également permis de mesurer la variation de taux sériques de la neurotrophine Brain Derived Neurotrophic Factor (BDNF) [2,3] entre le sevrage et 6 mois après, et un second (2011–2014) qui a pour objet d’étudier précisément la variation des taux de BDNF et autres facteurs cliniques dans les 6 mois suivant le sevrage en fonction de l’abstinence. Le relevé des variables nécessaires à la recherche permet de mieux connaître la population demandeuse de sevrage en établissement psychiatrique, ainsi que les données associées à leur soin (traitement, suivis médicaux et psychiatriques). L’analyse de ces données montre une bonne insertion des sujets inclus aux études, avec une dépressivité importante à prendre en compte en l’intégrant dans le soin, une intermittence de l’abstinence au cours du temps témoignant de parcours non linéaires, une clinique dépendant du profil d’alcoolisation, une mauvaise concordance des indices biologiques et clinique d’abstinence, un taux de mortalité très élevé (6,4 %), un suivi médical et autre (infirmier…) peu important qu’il importe d’améliorer pour tous. La place et la nature d’indicateurs biologiques et psychométriques dans les suivis doivent être définies.
La recherche d’indices biologiques de dépendance à l’alcool est nécessaire pour le développement de nouvelles thérapeutiques et de marqueurs de suivi. Elle implique d’explorer les mécanismes physiopathologiques qui peuvent être modifiés, de préférence au niveau périphérique, afin d’en faciliter la mesure. Les phénomènes inflammatoires, la possible altération de la barrière hémato-méningée et des soutiens gliaux, et les dommages au niveau neuronal, semblent contribuer à l’expression pathologique générale. Toutefois, la façon dont les facteurs sériques qui y sont liés évoluent après sevrage reste inconnue. Nous avons mesuré, au moment du sevrage, les taux sériques des facteurs pro-inflammatoires (TNF-alpha, IFN-gamma, Il-1bêta, Il-8, Il-6, Il-10, Il-12, MCP-1) et de la satiété (leptine) (technique de Luminex) et de témoins d’altérations neuronales Neuron Specific Enolase (NSE) ou d’une activation gliale (S100-B) (Elisa) chez 115 sujets (27 femmes et 88 hommes) dépendants à l’alcool et hospitalisés. Ces mesures ont été répétées à 28 jours (j28), 2, 4 et 6 mois (m2, m4, m6). L’objectif était d’en décrire les variations, et de rechercher leur lien avec l’abstinence. Certains marqueurs pro-inflammatoires ne sont pas détectables, d’autres varient après sevrage en augmentant jusqu’à j28 avant de baisser. Les taux de NSE ne varient pas significativement après sevrage, au contraire des taux sériques de S100 bêta qui augmentent significativement à j28 puis baissent, indépendamment de l’abstinence à 6 mois. La compréhension de l’évolution de la synthèse de ces différentes protéines peut être importante pour comprendre la physiologie du sevrage ou de la dépendance, ou encore caractériser l’état neuronal des sujets dépendants à l’alcool.
Many studies have shown that metabolic efficiency of ruminants can be significantly decreased when B-vitamin supply is insufficient. Under the present state of knowledge, the amounts of B vitamins available for intestinal absorption cannot be predicted based on diet composition. Therefore, in an attempt to increase our understanding of the effects of dietary factors, on B-vitamin supply for dairy cows, the effects of increasing amounts of extruded linseed in diets based on hay (permanent grassland hay, H; Experiment 1) or corn silage (CS; Experiment 2) on apparent ruminal synthesis (ARS) of thiamin, riboflavin, niacin, vitamin B6, folates and vitamin B12 were evaluated. In each experiment, four lactating Holstein cows fitted with cannulas in the rumen and the proximal duodenum were used in a 4 × 4 Latin square design. In both experiments, the dietary treatments consisted of an increasing supply of extruded linseed representing 0%, 5%, 10% or 15% of diet DM. The forage : concentrate ratios were 50 : 50 and 60 : 40 for Experiments 1 and 2, respectively. Duodenal flow was determined using YbCl3 as a marker. The ARS of each B vitamin was calculated as duodenal flow – daily intake. In both experiments, treatments did not affect thiamin, riboflavin, niacin and vitamin B12 duodenal flow or ARS. Increasing the dietary concentration of extruded linseed decreased folate intake in Experiment 1 and vitamin B6 intake in Experiment 2 but resulted in a greater duodenal flow of vitamin B6 and folates regardless of the forage used in basal diet. Greater dietary linseed concentrations decreased vitamin B6 apparent degradation in the rumen in CS-based diet only and increased folate ARS in both H- and CS-based diets. Increasing linseed concentration of isonitrogenous and isoenergetic diets increased vitamin B6 and folate supply to dairy cows, both with H- and CS-based diets.
Repetitive transcranial magnetic stimulation (rTMS) is a neurostimulation technique used in many indications, especially in psychiatry in the treatment of mood disorders. Although its efficacy in this treatment has been demonstrated, the study of predictive response factors currently remains a major challenge.
We conducted a retrospective study from the cohort of treatment-resistant depressed patients that received rTMS treatment in Esquirol Hospital in Limoges in order to identify response predictors at three months. Of the 416 patients treated between January 2007 and November 2015, 107 subjects have been included. The clinical characteristics of responders and nonresponders at three months after treatment, but also at the end of treatment and after one month were compared. Predictors of clinical improvement objectified by the Hamilton Depression Rating Scale (HDRS) were identified using a logistic regression model.
In our cohort, the response rates were 52% at the end of treatment, 61% at 1 month and 57% at 3 months. Psychiatric family history and the recurrence of thymic episodes were found to be negative predictors of response to rTMS treatment. Similarly, high subscore of depression core symptoms in HDRS could also predict a poorer response.
Our data from a naturalistic cohort tended to prove that a number of clinical features should be taken into account in determining the profile of the treatment-resistant depressed patients that could respond to rTMS treatment.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Many people who are homeless with severe mental illnesses are high users of healthcare services and social services, without reducing widen health inequalities in this vulnerable population. This study aimed to determine whether independent housing with mental health support teams with a recovery-oriented approach (Housing First (HF) program) for people who are homeless with severe mental disorders improves hospital and emergency department use.
We did a randomised controlled trial in four French cities: Lille, Marseille, Paris and Toulouse. Participants were eligible if they were 18 years or older, being absolutely homeless or precariously housed, with a diagnosis of schizophrenia (SCZ) or bipolar disorder (BD) and were required to have a high level of needs (moderate-to-severe disability and past hospitalisations over the last 5 years or comorbid alcohol or substance use disorder). Participants were randomly assigned (1:1) to immediate access to independent housing and support from the Assertive Community Treatment team (social worker, nurse, doctor, psychiatrist and peer worker) (HF group) or treatment as usual (TAU group) namely pre-existing dedicated homeless-targeted programs and services. Participants and interviewers were unmasked to assignment. The primary outcomes were the number of emergency department (ED) visits, hospitalisation admissions and inpatient days at 24 months. Secondary outcomes were recovery (Recovery Assessment Scale), quality of life (SQOL and SF36), mental health symptoms, addiction issues, stably housed days and cost savings from a societal perspective. Intention-to-treat analysis was performed.
Eligible patients were randomly assigned to the HF group (n = 353) or TAU group (n = 350). No differences were found in the number of hospital admissions (relative risk (95% CI), 0.96 (0.76–1.21)) or ED visits (0.89 (0.66–1.21)). Significantly less inpatient days were found for HF v. TAU (0.62 (0.48–0.80)). The HF group exhibited higher housing stability (difference in slope, 116 (103–128)) and higher scores for sub-dimensions of S-QOL scale (psychological well-being and autonomy). No differences were found for physical composite score SF36, mental health symptoms and rates of alcohol or substance dependence. Mean difference in costs was €-217 per patient over 24 months in favour of the HF group. HF was associated with cost savings in healthcare costs (RR 0.62(0.48–0.78)) and residential costs (0.07 (0.05–0.11)).
An immediate access to independent housing and support from a mental health team resulted in decreased inpatient days, higher housing stability and cost savings in homeless persons with SCZ or BP disorders.
In addition to a multifactorial etiology of nutritional, social and environmental stressors, post-weaning diarrhea (PWD) in pigs is often related to infection with specific pathogens such as enterotoxigenic Escherichia coli (ETEC). In swine farming operations, the incidence of PWD is a global concern and is associated with an unbalanced gut status, resulting in poor performance and high antimicrobial consumption via prophylaxis and metaphylaxis. Increases in antimicrobial resistance are reinforcing an already-urgent need for sustainable, alternative solutions for maintaining optimal gut health in livestock. Tannin-rich plants and extracts contain bioactive compounds that could be of great interest in this respect. This review describes how the use of tannins around weaning could be beneficial for pigs, with special emphasis on the reduction of ETEC-related PWD. An overview of the broad chemical diversity of tannins is presented together with their physicochemical and biological properties, as well as how they may be metabolized in the digestive tract. The pharmacological effects exerted by tannins are summarized; more precisely, the possible mechanisms by which tannins can disrupt the different steps of the pathogenesis of ETEC-related PWD are highlighted. The factors affecting the bioactivity of tannins are also discussed, shedding light on the importance of chemical structure among different tannins.
As vitamin B12 is only synthesized by bacteria, ruminant products, especially dairy products, are excellent sources of this vitamin. This study aims to identify if diet and cow characteristics could affect vitamin B12 concentration in milk of dairy cows. Information on 1484 first, 1093 second and 1763 third and greater parity Holstein cows in 100 herds was collected during three consecutive milkings. During the first morning milking, all dietary ingredients given to cows were sampled and quantities offered were recorded throughout the day. Nutrient composition of ingredients was obtained by wet chemistry to reconstitute nutrient composition of the ration. Milk samples were taken with in-line milk meters during the evening milking of the 1st day and the morning milking of the 2nd day and were analyzed for vitamin B12 concentration. Milk yields were recorded and milk components were separately analyzed for each milking. Daily vitamin B12 concentration in milk was obtained using morning and evening vitamin B12 concentrations weighted with respective milk yield, then divided by daily yield. To decrease the number of interdependent variables to include in the multivariable model, a principal component analysis was carried out. Daily milk concentration of vitamin B12 averaged 3809±80 pg/ml, 4178±79 pg/ml and 4399±77 pg/ml for first, second and third, and greater lactation cows. Out of 11 principal components, six were significantly related to daily milk concentration of vitamin B12 when entered in the multivariable model. Results suggested that vitamin B12 concentration in milk was positively related to percentage of fiber and negatively related to starch as well as energy of the diet. Negative relationships were noted between vitamin B12 concentration in milk and milk yield as well as milk lactose concentration and positive relationships were observed between vitamin B12 concentration in milk and milk fat as well as protein concentrations. The percentages of chopped mixed silage and commercial energy supplement in the diet as well as cow BW were positively related to vitamin B12 in milk and percentages of baled mixed silage, corn and commercial protein supplement in the ration were negatively related to vitamin B12 concentration in milk. The pseudo-R2 of the model was low (52%) suggesting that diet and cow characteristics have moderate impact on vitamin B12 concentration in milk. Moreover, when entering solely the principal component related to milk production in the model, the pseudo-R2 was 46%. In conclusion, it suggests that studied diet characteristics have a marginal impact on vitamin B12 concentration in milk variation.
When assessing hepatitis B virus (HBV) status in clinical settings, it is unclear whether self-reports on vaccination history and previous HBV-test results have any diagnostic capacity. Of 3997 participants in a multi-centre HBV-screening study in Paris, France, 1090 were asked questions on their last HBV-test result and vaccination history. Discordance between self-reported history compared with infection status (determined by serology) was calculated for participants claiming ‘negative’, ‘effective vaccine’, ‘past infection’, or ‘chronic infection’ HBV-status. Serological testing revealed that 320 (29.4%) were non-immunised, 576 (52.8%) were vaccinated, 173 (15.9%) had resolved the infection and 21 (1.9%) were hepatitis B surface antigen positive. In total 208/426 (48.8%) participants with a self-reported history of ‘negative’ infection had a discordant serological result, in whom 128 (61.5%) were vaccinated and 74 (35.6%) had resolved infections. A total of 153/599 (25.5%) participants self-reporting ‘effective vaccine’ had a discordant serological result, in whom 100 (65.4%) were non-immunised and 50 (32.7%) were resolved infections. Discordance for declaring ‘past’ or ‘chronic infection’ occurred in 9/55 (16.4%) and 3/10 (30.0%) individuals, respectively. In conclusion, self-reported HBV-status based on participant history is partially inadequate for determining serological HBV-status, especially between negative/vaccinated individuals. More adapted patient education about HBV-status might be helpful for certain key populations.
Research demonstrates the importance of nutrition for early brain development. Few studies have examined the effectiveness of multiple micronutrient powders (MNP) on child development. This study examined the impacts of home fortification with MNP on motor and mental development, executive function and memory of children living in Bihar. This two-arm cluster-randomised effectiveness trial selected seventy health sub-centres to receive either MNP and nutrition counselling (intervention) or nutrition counselling alone (control) for 12 months. Front-line health workers delivered the intervention to all households in study communities with a child aged 6–18 months. Data were collected using cross-sectional surveys at baseline and endline by selecting households from intervention (baseline, n 2184; endline, n 2170) and control (baseline, n 2176; endline, n 2122) communities using a two-stage cluster-randomised sampling strategy. Children in the intervention group had a significantly larger improvement from baseline to endline compared with those in the control group on scores for motor and mental development (Cohen’s d, motor=0·12; 95 % CI 0·03, 0·22; mental=0·15; 95 % CI 0·06, 0·25). Greater impacts of MNP on motor and mental development were observed in children from households with higher stimulation scores at baseline compared with those with lower stimulation (Cohen’s d, motor=0·20 v. 0·09; mental=0·22 v. 0·14; Pinteraction<0·05). No significant treatment differences were seen for executive function or memory. Home fortification with MNP through the existing health infrastructure in Bihar was effective in improving motor and mental development and should be considered in combination with other child development interventions such as stimulation.
The next-generation radio telescopes such as LOFAR and SKA will give access to high time-resolution and high instantaneous sensitivity that can be exploited to study slow and fast transients over the whole radio window. The search for radio transients in large datasets also represents a new signal-processing challenge requiring efficient and robust signal reconstruction algorithms. Using sparse representations and the general ‘compressed sensing’ framework, we developed a 2D–1D algorithm based on the primal-dual splitting method. We have performed our sparse 2D–1D reconstruction on three-dimensional data sets containing either simulated or real radio transients, at various levels of SNR and integration times. This report presents a summary of the current level of performance of our method.
Severe longitudinally extensive transverse myelitis (LETM) can cause quadriplegia, marked sensory dysfunction, and respiratory failure. Some patients are unresponsive to conventional immune therapy. We report two cases of severe immune-mediated LETM requiring intensive care admission that failed to respond to high-dose corticosteroids, plasma exchange, intravenous immunoglobulin, and rituximab. Disease cessation and significant recovery was achieved after cyclophosphamide induction. In patients with severe acute immune-mediated LETM who fail to respond to corticosteroids and plasma exchange, cyclophosphamide induction should be considered. This agent and regimen provides a robust immunosuppressive response and can be induced rapidly. Cyclophosphamide effects and supportive evidence are discussed.
Gaia DR1 positions are used to astrometrically calibrate three epochs’ worth of Subaru SuprimeCam images in the fields of globular cluster NGC 2419 and the Sextans dwarf spheroidal galaxy. Distortion-correction “maps” are constructed from a combination of offset dithers and reference to Gaia DR1. These are used to derive absolute proper motions in the field of NGC 2419. Notably, we identify the photometrically-detected Monoceros structure in the foreground of NGC 2419 as a kinematically-cold population of stars, distinct from Galactic-field stars. This project demonstrates the feasibility of combining Gaia with deep, ground-based surveys, thus extending high-quality astrometry to magnitudes beyond the limits of Gaia.
The extensive protein degradation occurring during ensiling decreases the nutritive value of silages, but this might be counteracted by tannins. Therefore, silages from two legume species containing condensed tannins (CT) – sainfoin (SF) and birdsfoot trefoil (two cultivars: birdsfoot trefoil, cv. Bull (BTB) and birdsfoot trefoil, cv. Polom) – were compared for their in vitro ruminal fermentation characteristics. The effect of combining them with two CT-free legume silages (lucerne (LU) and red clover (RC)) was also determined. The supply of duodenally utilisable CP (uCP) in the forages was emphasised. The legumes were each harvested from three field sites. After 24 h of wilting on the field, the legumes were ensiled in laboratory silos for 86 days. Proximate constituents, silage fermentation characteristics, CT content and CP fractions were determined. Subsequently, silage samples and 1 : 1 mixtures of the CT-containing and CT-free silages were incubated for 24 h in batch cultures using ruminal fluid and buffer (1 : 2, v/v). Each treatment was replicated six times in six runs. The effects on pH, ammonia and volatile fatty acid concentrations, protozoal counts, and total gas and methane production were determined. uCP content was calculated by considering the CP in the silage and the ammonia in the incubation fluid from treatments and blanks. Statistical evaluation compared data from single plants alone and together with that from the mixtures. Among treatments, SF silage contained the least CP and the most CT. The non-protein nitrogen content was lower, favouring neutral detergent soluble and insoluble protein fractions, in the SF and RC silages. Absolute uCP content was lowest in SF and SF mixtures, although the ratio to total CP was the highest. In comparison with LU, the ammonia concentration of the incubation fluid was lower for SF, RC and BTB and for the mixture of SF with LU. The total gas and methane production was similar among the treatments, and the total volatile fatty acid production was decreased with the CT-containing legumes. Protozoal count was increased with the mixtures containing LU and either SF or BTB compared with single LU. In conclusion, compared with the other legumes, SF and RC have similar advantages as they show limited proteolysis during ensiling. In addition, SF supplies more uCP relative to total CP. The CT-containing legumes also differed in their effect on ruminal fermentation and ammonia formation, probably because of their different CT contents. Thus, SF and its mixtures appear promising for improving the protein utilisation of ruminants.
Effects of plant maturity on apparent ruminal synthesis and post-ruminal supply of B vitamins were evaluated in two feeding trials. Diets containing alfalfa (Trial 1) or orchardgrass (Trial 2) silages harvested either (1) early cut, less mature (EC) or (2) late cut, more mature (LC) as the sole forage were offered to ruminally and duodenally cannulated lactating Holstein cows in crossover design experiments. In Trial 1, conducted with 16 cows (569±43 kg of empty BW (ruminal content removed) and 43.7±8.6 kg/day of 3.5% fat-corrected milk yield; mean±SD) in two 17-day treatment periods, both diets provided ~22% forage NDF and 27% total NDF, and the forage-to-concentrate ratios were 53 : 47 and 42 : 58 for EC and LC, respectively. In Trial 2, conducted with 13 cows (588±55 kg of empty BW and 43.7±7.7 kg/day of 3.5% fat-corrected milk yield; mean±SD) in two 18-day treatment periods, both diets provided ~25% forage NDF and 31% total NDF; the forage-to-concentrate ratios were 58 : 42 and 46 : 54 for EC and LC, respectively. Thiamin, riboflavin, niacin, vitamin B6, folates and vitamin B12 were measured in feed and duodenal content. Apparent ruminal synthesis was calculated as the duodenal flow minus the intake. Diets based on EC alfalfa decreased the amounts of thiamin, niacin and folates reaching the duodenum, whereas diets based on EC orchardgrass increased riboflavin duodenal flow. Daily apparent ruminal synthesis of thiamin, riboflavin, niacin and vitamin B6 were correlated negatively with their intake, suggesting a microbial regulation of their concentration in the rumen. Vitamin B12 apparent ruminal synthesis was correlated negatively with total volatile fatty acids concentration, but positively with ruminal pH and microbial N duodenal flow.
Background: A definitive diagnosis of multiple sclerosis (MS), as distinct from a clinically isolated syndrome, requires one of two conditions: a second clinical attack or particular magnetic resonance imaging (MRI) findings as defined by the McDonald criteria. MRI is also important after a diagnosis is made as a means of monitoring subclinical disease activity. While a standardized protocol for diagnostic and follow-up MRI has been developed by the Consortium of Multiple Sclerosis Centres, acceptance and implementation in Canada have been suboptimal. Methods: To improve diagnosis, monitoring, and management of a clinically isolated syndrome and MS, a Canadian expert panel created consensus recommendations about the appropriate application of the 2010 McDonald criteria in routine practice, strategies to improve adherence to the standardized Consortium of Multiple Sclerosis Centres MRI protocol, and methods for ensuring effective communication among health care practitioners, in particular referring physicians, neurologists, and radiologists. Results: This article presents eight consensus statements developed by the expert panel, along with the rationale underlying the recommendations and commentaries on how to prioritize resource use within the Canadian healthcare system. Conclusions: The expert panel calls on neurologists and radiologists in Canada to incorporate the McDonald criteria, the Consortium of Multiple Sclerosis Centres MRI protocol, and other guidance given in this consensus presentation into their practices. By improving communication and general awareness of best practices for MRI use in MS diagnosis and monitoring, we can improve patient care across Canada by providing timely diagnosis, informed management decisions, and better continuity of care.
Physical aggression (PA) tends to have its onset in infancy and to increase rapidly in frequency. Very little is known about the genetic and environmental etiology of PA development during early childhood. We investigated the temporal pattern of genetic and environmental etiology of PA during this crucial developmental period.
Participants were 667 twin pairs, including 254 monozygotic and 413 dizygotic pairs, from the ongoing longitudinal Quebec Newborn Twin Study. Maternal reports of PA were obtained from three waves of data at 20, 32 and 50 months. These reports were analysed using a biometric Cholesky decomposition and linear latent growth curve model.
The best-fitting Cholesky model revealed developmentally dynamic effects, mostly genetic attenuation and innovation. The contribution of genetic factors at 20 months substantially decreased over time, while new genetic effects appeared later on. The linear latent growth curve model revealed a significant moderate increase in PA from 20 to 50 months. Two separate sets of uncorrelated genetic factors accounted for the variation in initial level and growth rate. Non-shared and shared environments had no effect on the stability, initial status and growth rate in PA.
Genetic factors underlie PA frequency and stability during early childhood; they are also responsible for initial status and growth rate in PA. The contribution of shared environment is modest, and perhaps limited, as it appears only at 50 months. Future research should investigate the complex nature of these dynamic genetic factors through genetic–environment correlation (rGE) and interaction (G × E) analyses.
Theories of attention deficit/hyperactivity disorder (ADHD) increasingly highlight the role of neuropsychological impairment in ADHD; however, a consistent and identifiable pattern of performance on tests is not well established. The National Institutes of Health (NIH) Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER) battery provides measures of common variance across multiple executive function tests within specific domains and was used to characterize which executive functions are most affected in children with ADHD. Thirty-two children (24 male), ages 8–15 years (M = 12.02; SD = 2.29), diagnosed with ADHD and no comorbid disorder completed the NIH EXAMINER battery. Sixty age and gender matched healthy controls were chosen from a database of participants enrolled in the NIH EXAMINER multi-site study. Children with ADHD performed worse on the working memory score compared with the controls. No differences were found on the cognitive control or fluency scores. For children with ADHD, poorer working memory performance predicted parent report of child learning problems. Cognitive control and fluency scores did not predict learning problems. In summary, working memory emerges as a primary impairment in children with ADHD who have no comorbid disorders. Furthermore, working memory weaknesses may underlie the academic problems often seen in children with ADHD. (JINS, 2013, 19, 1–11)