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This study reports the effects of a high-fat (HF) diet on the iron (Fe) status of growing rats over 8 weeks. Tissue Fe levels were analysed by atomic absorption spectrophotometry, and whole-body adiposity was measured by dual-energy X-ray absorptiometry. Histopathology and morphometry of adipose tissue were performed. Liver homogenates were used for measuring ferroportin (Fpn)-1 protein levels by immunoblotting, and transcript levels were used for Fe genes measured by real-time PCR. Tissue Fe pools were fit to a compartmental biokinetic model in which Fe was assessed using 14 compartments and 27 transfer constants (kj,i from tissue “i” to tissue “j”) adapted from the International Commission on Radiological Protection (ICRP) 69. Ten kj,i were calculated from the experimental data using nonlinear regression, and 17 were estimated by allometry according to the formula kj,i = a · Mb. Validation of the model was carried out by comparing predicted and analysed Fe pool sizes in red blood cells (RBCs), the liver and the spleen. Body adiposity was negatively associated with serum Fe levels and positively associated with liver Fe stores. An inferred increase in Fe transfer from bone marrow to the liver paralleled higher hepatic Fe concentrations and ferritin heavy-chain mRNA levels in the HF diet-fed animals, suggesting that liver Fe accumulation occurred at least in part due to a favoured liver RBC uptake. If this feeding condition were to be prolonged, impaired Fe decompartmentalization may occur, ultimately resulting in dysmetabolic Fe overload.
National policies target healthcare-associated infections using medical claims and National Healthcare Safety Network surveillance data. We found low concordance between the 2 data sources in rates and rankings for surgical site infection following colon surgery in 155 hospitals, underscoring the limitations in evaluating hospital quality by claims data.
Textual data are plagued by underreporting bias. For example, news sources often fail to report human rights violations. Cook et al. propose a multi-source estimator to gauge, and to account for, the underreporting of state repression events within human codings of news texts produced by the Agence France-Presse and Associated Press. We evaluate this estimator with Monte Carlo experiments, and then use it to compare the prevalence and seriousness of underreporting when comparable texts are machine coded and recorded in the World-Integrated Crisis Early Warning System dataset. We replicate Cook et al.’s investigation of human-coded state repression events with our machine-coded events, and validate both models against an external measure of human rights protections in Africa. We then use the Cook et al. estimator to gauge the seriousness and prevalence of underreporting in machine and human-coded event data on human rights violations in Colombia. We find in both applications that machine-coded data are as valid as human-coded data.
Children with single-ventricle disease experience high mortality and complex care. In other life-limiting childhood illnesses, paediatric palliative care may mitigate maternal stress. We hypothesised that early palliative care in the single-ventricle population may have the same benefit for mothers. In this pilot randomised trial of early palliative care, mothers of infants with prenatal single-ventricle diagnoses completed surveys measuring depression, anxiety, coping, and quality of life at a prenatal visit and neonatal discharge. Infants were randomised to receive early palliative care – structured evaluation, psychosocial/spiritual, and communication support before surgery – or standard care. Among 56 eligible mothers, 40 enrolled and completed baseline surveys; 38 neonates were randomised, 18 early palliative care and 20 standard care; and 34 postnatal surveys were completed. Baseline Beck Depression Inventory-II and State-Trait Anxiety Index scores exceeded normal pregnant sample scores (mean 13.76±8.46 versus 7.0±5.0 and 46.34±12.59 versus 29.8±6.35, respectively; p=0.0001); there were no significant differences between study groups. The early palliative care group had a decrease in prenatal to postnatal State-Trait Anxiety Index scores (−7.6 versus 0.3 in standard care, p=0.02), higher postnatal Brief Cope Inventory positive reframing scores (p=0.03), and a positive change in PedsQL Family Impact Module communication and family relationships scores (effect size 0.46 and 0.41, respectively). In conclusion, these data show that mothers of infants with single-ventricle disease experience significant depression and anxiety prenatally. Early palliative care resulted in decreased maternal anxiety, improved maternal positive reframing, and improved communication and family relationships.
The Maui's Dolphin Challenge was a litter reduction project that was run twice at a secondary school in Aotearoa New Zealand. The project drew on a theoretical framework encompassing four psycho-social principles: values, embodied learning, efficacy, and perceived social norms. It challenged students to reduce the litter at the school by offering to donate $200 a week for 3 weeks to help protect the endangered Maui's dolphin. However, for every piece of litter found, $1 would come off this total. The challenge was accompanied by feedback on progress, posters, assemblies, and videos. Both times it was run, litter dropped by approximately half. After the first iteration, a survey found that students (n = 275 surveys) appeared motivated not to litter primarily due to a desire to care for the Maui's dolphin. Interviews and a focus group with staff and students (n = 14) after the second iteration also found the dolphins were important, but there was a cultural norm against picking up litter. The limitations of the project, its impact on the school's sustainability culture, and implications for other whole-school environmental projects, especially those with a waste focus, are discussed.
Globally, over 800 000 people died by suicide in 2012 and there are indications that for each adult who died of suicide there were likely to be many more attempting suicide. There are many millions of people every year who are affected by suicide and suicide attempts, taking into consideration the family members, friends, work colleagues and communities, who are bereaved by suicide. In the WHO Mental Health Action Plan 2013–2020, Member States committed themselves to work towards the global target of reducing the suicide rate in countries by 10% by 2020. Hence, the first-ever WHO report on suicide prevention, Preventing suicide: a global imperative, published in September 2014, is a timely call to take action using effective evidence-based interventions. Their relevance for low- and middle-income countries is discussed in this paper, highlighting restricting access to means, responsible media reporting, introducing mental health and alcohol policies, early identification and treatment, training of health workers, and follow-up care and community support following a suicide attempt.
The aim of this study was to compare sensory processing in typically developing children (TDC), children with Autism Spectrum Disorder (ASD), and those with sensory processing dysfunction (SPD) in the absence of an ASD. Performance-based measures of auditory and tactile processing were compared between male children ages 8–12 years assigned to an ASD (N=20), SPD (N=15), or TDC group (N=19). Both the SPD and ASD groups were impaired relative to the TDC group on a performance-based measure of tactile processing (right-handed graphesthesia). In contrast, only the ASD group showed significant impairment on an auditory processing index assessing dichotic listening, temporal patterning, and auditory discrimination. Furthermore, this impaired auditory processing was associated with parent-rated communication skills for both the ASD group and the combined study sample. No significant group differences were detected on measures of left-handed graphesthesia, tactile sensitivity, or form discrimination; however, more participants in the SPD group demonstrated a higher tactile detection threshold (60%) compared to the TDC (26.7%) and ASD groups (35%). This study provides support for use of performance-based measures in the assessment of children with ASD and SPD and highlights the need to better understand how sensory processing affects the higher order cognitive abilities associated with ASD, such as verbal and non-verbal communication, regardless of diagnostic classification. (JINS, 2015, 21, 444–454)
The present study investigated the effects of fructo-oligosaccharides (FOS) on the bioavailability of Fe from ferric pyrophosphate (FP), a water-insoluble compound, in Fe-deficient anaemic rats that were subjected to a Hb repletion assay. Male Wistar rats (n 64) were fed adequate or low (8 mg/kg) Fe diets for 15 d followed by 1 or 2 weeks of Fe repletion with diets providing 35 mg Fe/kg as ferrous sulphate (FS), FP or FP that was mixed with 7·5 % FOS in the form of yacon flour or Raftilose P95 (RAF), a purified source of FOS. The effects of FOS were observed within the 1st week of the repletion period. Fe bioavailability was improved by FOS supplementation, as measured by Hb regeneration efficiency and hepatic Fe stores, which were more pronounced in the RAF group. Moreover, RAF supplementation resulted in a higher biological value relative to that of the FP group. FOS supplementation resulted in caecal enlargement, in addition to acidification and Fe species redistribution in the caecal contents relative to the control rats. These effects occurred concomitantly with decreased ferroportin (FPN)-1 expression in the caecal mucosa, which was similar in magnitude to that observed in the FS group. Caecum mucosal morphometry was influenced by FOS supplementation, whereas crypt fission and cell proliferation were highest in the caecum of the RAF group. These results reinforce the effects of FOS as Fe bioavailability enhancers in anaemic rats that are sustained by early changes in their caecal environment (decreased mucosal FPN-1 expression and increased Fe absorbability, crypt fission and cellularity).
Three cases of acardius amorphus with twin reversed arterial perfusion (TRAP) sequences are reported and the histomorphological and clinical aspects are discussed. The patho-physiology of the twin pump is briefly described. Precise prenatal assessment of the morphology of the acardius is recommended for an accurate monitoring of the perfuser in order to plan proper fetal therapy and timing for delivery.
Food storage is a crucial adaptation for hunter-gatherers who face seasonal resource shortfalls, but the extra time that hunter-gatherer s must spend accumulating food surpluses has the potential to conflict with the time they need for other activities during seasons of abundance. Since the activities that conflict with storage may be different for women and men, it is important to consider which gender is responsible for storage. We argue that when women perform most storage tasks, the tradeoff between foraging and childcare is likely to shape storage behavior, particularly the decision of which foods to store. Our analysis of storage food preferences among the prehistoric hunter-gatherers of California’s Sierra Nevada suggests that women altered their storage strategy during the late Holocene when the shift to a semi-sedentary settlement system increased the conflict they faced between foraging and providing childcare. The adoption of an acorn-based storage economy during this period allowed women to minimize the time they spent foraging away from their residential bases, so they could better accommodate their childcare needs. This study demonstrates the utility of considering issues beyond the rate of caloric return from foraging to develop more complete models of hunter-gatherer behavior and explanations of the archaeological record.
The aim of this study was to evaluate attention difficulties in a contemporary geographic cohort of adolescents born extremely preterm (EP, <28 weeks’ gestation) or extremely low birth weight (ELBW, birth weight <1000 g). The EP/ELBW group included 228 adolescents (mean age = 17.0 years) born in Victoria, Australia in 1991 and 1992. The control group were 166 adolescents (mean age = 17.4 years) born of normal birth weight (birth weight >2499 g) who were recruited in the newborn period and matched to the EP/ELBW group on date of birth, gender, language spoken and health insurance status. Participants were assessed on measures of selective, sustained, and executive (shift and divided) attention, and parents and participants completed behavioral reports. The EP/ELBW group performed more poorly across tests of selective and executive attention, had greater rates of clinically significant difficulties compared with the control group, and also had greater behavioral attention problems as reported by parents. Neonatal risk factors were weakly associated with attention outcomes. In conclusion, higher rates of attention impairments are observed in individuals born EP/ELBW well into adolescence and may have consequences for their transition to adulthood. (JINS, 2013, 19, 1–12)
Epidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.
To investigate the relationship between psychotic symptoms and non-psychotic psychopathology in community samples of adolescents in terms of prevalence, co-occurring disorders, comorbid (multiple) psychopathology and variation across early v. middle adolescence.
Data from four population studies were used: two early adolescence studies (ages 11–13 years) and two mid-adolescence studies (ages 13–16 years). Studies 1 and 2 involved school-based surveys of 2243 children aged 11–16 years for psychotic symptoms and for emotional and behavioural symptoms of psychopathology. Studies 3 and 4 involved in-depth diagnostic interview assessments of psychotic symptoms and lifetime psychiatric disorders in community samples of 423 children aged 11–15 years.
Younger adolescents had a higher prevalence (21–23%) of psychotic symptoms than older adolescents (7%). In both age groups the majority of adolescents who reported psychotic symptoms had at least one diagnosable non-psychotic psychiatric disorder, although associations with psychopathology increased with age: nearly 80% of the mid-adolescence sample who reported psychotic symptoms had at least one diagnosis, compared with 57% of the early adolescence sample. Adolescents who reported psychotic symptoms were at particularly high risk of having multiple co-occurring diagnoses.
Psychotic symptoms are important risk markers for a wide range of non-psychotic psychopathological disorders, in particular for severe psychopathology characterised by multiple co-occurring diagnoses. These symptoms should be carefully assessed in all patients.
This chapter attempts to broadly outline the current understanding of the etiology of intelligence and intelligence-related processes. First, it describes the major concepts that have primarily guided studies of the etiological bases of intellectual abilities and disabilities. Then, the chapter discusses the state of the field's understanding of cases of intellectual abilities and disabilities. A point of view on the Chinese initiative as presented in the CNN electronic publication is described. The chapter describes the major concepts that have been and are used to explore the connection between the genes and intelligence. The evidence pertaining to observations that the genome is a major source of the variations in individuals' intellectual abilities and disabilities is discussed. Studies of various indicators of information processing speed have been prominent in the field of intelligence due to the observation that these indicators reliably correlate with various aspects of intelligence, especially, with the g factor.
Biodegradable polymers with high mechanical strength, flexibility and optical transparency, optimal degradation properties and biocompatibility are critical to the success of tissue engineered devices and drug delivery systems. In this work, microfluidic devices have been fabricated from elastomeric scaffolds with tunable degradation properties for applications in tissue engineering and regenerative medicine. Most biodegradable polymers suffer from short half life resulting from rapid and poorly controlled degradation upon implantation, exceedingly high stiffness, and limited compatibility with chemical functionalization. Here we report the first microfluidic devices constructed from a recently developed class of biodegradable elastomeric poly(ester amide)s, poly(1,3-diamino-2-hydroxypropane-co-polyol sebacate)s (APS), showing a much longer and highly tunable in vivo degradation half-life comparing to many other commonly used biodegradable polymers. The device is molded in a similar approach to that reported previously for conventional biodegradable polymers, and the bonded microfluidic channels are shown to be capable of supporting physiologic levels of flow and pressure. The device has been tested for degradation rate and gas permeation properties in order to predict performance in the implantation environment. This device is high resolution and fully biodegradable; the fabrication process is fast, inexpensive, reproducible, and scalable, making it the approach ideal for both rapid prototyping and manufacturing of tissue engineering scaffolds and vasculature and tissue and organ replacements.
The growth of ZnO films deposited by Closed Space Vapor Transport (CSVT) on sapphire substrates has been investigated. Deposition on R oriented sapphire substrates gives rise to a-(11-20) oriented ZnO films. Under optimised conditions, flat surfaces can be achieved and rocking curves with full half width below 500 arcsec are observed. The electrical properties of the films were studied. Hall measurements reveal that the measured n-carrier concentration decreases linearly upon the thickness of the sample. This is interpreted as interface conduction probably related to diffusion of aluminium from the substrate. On thinnest films, the n-carrier concentration can be dramatically decreased with thermal annealing under oxygen. Furthermore, the effect of this annealing under oxygen is found to be completely reversible after a further thermal annealing under oxygen free atmosphere.
Agents of opportunity (AO) in academic medical centers (AMC) are defined as unregulated or lightly regulated substances used for medical research or patient care that can be used as “dual purpose” substances by terrorists to inflict damage upon populations. Most of these agents are used routinely throughout AMC either during research or for general clinical practice. To date, the lack of careful regulations for AOs creates uncertain security conditions and increased malicious potential. Using a consensus-based approach, we collected information and opinions from staff working in an AMC and 4 AMC-affiliated hospitals concerning identification of AO, AO attributes, and AMC risk and preparedness, focusing on AO security and dissemination mechanisms and likely hospital response. The goal was to develop a risk profile and framework for AO in the institution. Agents of opportunity in 4 classes were identified and an AO profile was developed, comprising 16 attributes denoting information critical to preparedness for AO misuse. Agents of opportunity found in AMC present a unique and vital gap in public health preparedness. Findings of this project may provide a foundation for a discussion and consensus efforts to determine a nationally accepted risk profile framework for AO. This foundation may further lead to the implementation of appropriate regulatory policies to improve public health preparedness. Agents of opportunity modeling of dissemination properties should be developed to better predict AO risk.
(Disaster Med Public Health Preparedness. 2010;4:318-325)