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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.
Human Stampedes (HS) occur at religious mass gatherings. Religious events have a higher rate of morbidity and mortality than other events that experience HS. This study is a subset analysis of religious event HS data regarding the physics principles involved in HS, and the associated event morbidity and mortality.
To analyze reports of religious HS to determine the initiating physics principles and associated morbidity and mortality.
Thirty-four reports of religious HS were analyzed to find shared variables. Thirty-three (97.1%) were written media reports with photographic, drawn, or video documentation. 29 (85.3%) cited footage/photographs and 1 (2.9%) was not associated with visual evidence. Descriptive phrases associated with physics principles contributing to the onset of HS and morbidity data were extracted and analyzed to evaluate frequency before, during, and after events.
34 (39.1%) reports of HS found in the literature review were associated with religious HS. Of these, 83% were found to take place in an open space, and 82.3% were associated with population density changes. 82.3% of events were associated with architectural nozzles (small streets, alleys, etc). 100% were found to have loss of XY-axis motion and 89% reached an average velocity of zero. 100% had loss of proxemics and 91% had associated Z-axis displacement (falls). Minimum reported attendance for a religious HS was 3000. 100% of religious HS had reported mortality at the event and 56% with further associated morbidity.
HS are deadly events at religious mass gatherings. Religious events are often recurring, planned gatherings in specific geographic locations. They are frequently associated with an increase in population density, loss of proxemics and velocity, followed by Z-axis displacements, leading to injury and death. This is frequently due to architectural nozzles, which those organizing religious mass gatherings can predict and utilize to mitigate future events.
Giardiasis is one of the most important non-viral causes of human diarrhoea. Yet, little is known about the epidemiology of giardiasis in the context of developed countries such as Australia and there is a limited information about local sources of exposure to inform prevention strategies in New South Wales. This study aimed to (1) describe the epidemiology of giardiasis and (2) identify potential modifiable risk factors associated with giardiasis that are unique to south-western Sydney, Australia. A 1:2 matched case-control study of 190 confirmed giardiasis cases notified to the South-Western Local Health District Public Health Unit from January to December 2016 was employed to investigate the risk factors for giardiasis. Two groups of controls were selected to increase response rate; Pertussis cases and neighbourhood (NBH) controls. A matched analysis was carried out for both control groups separately. Variables with a significant odds ratio (OR) in the univariate analysis were placed into a multivariable regression for each matched group, respectively. In the regression model with the NBH controls, age and sex were controlled as potential confounders. Identified risk factors included being under 5 years of age (aOR = 7.08; 95% confidence intervals (CI) 1.02–49.36), having a household member diagnosed with a gastrointestinal illness (aOR = 15.89; 95% CI 1.53–164.60) and having contact with farm animals, domestic animals or wildlife (aOR = 3.03; 95% CI 1.08–8.54). Cases that travelled overseas were at increased risk of infection (aOR = 19.89; 95% CI 2.00–197.37) when compared with Pertussis cases. This study provides an update on the epidemiology and associated risk factors of a neglected tropical disease, which can inform enhanced surveillance and prevention strategies in the developed metropolitan areas.
Postoperative cognitive impairment is among the most common medical complications associated with surgical interventions – particularly in elderly patients. In our aging society, it is an urgent medical need to determine preoperative individual risk prediction to allow more accurate cost–benefit decisions prior to elective surgeries. So far, risk prediction is mainly based on clinical parameters. However, these parameters only give a rough estimate of the individual risk. At present, there are no molecular or neuroimaging biomarkers available to improve risk prediction and little is known about the etiology and pathophysiology of this clinical condition. In this short review, we summarize the current state of knowledge and briefly present the recently started BioCog project (Biomarker Development for Postoperative Cognitive Impairment in the Elderly), which is funded by the European Union. It is the goal of this research and development (R&D) project, which involves academic and industry partners throughout Europe, to deliver a multivariate algorithm based on clinical assessments as well as molecular and neuroimaging biomarkers to overcome the currently unsatisfying situation.
In the southeastern United States, Amaranthus, or pigweed species, have become troublesome weeds in agricultural systems. To implement management strategies for the control of these species, agriculturalists need information on areas affected by pigweeds. Geographic information systems (GIS) afford users the ability to evaluate agricultural issues at local, county, state, national, and global levels. Also, they allow users to combine different layers of geographic information to help them develop strategic plans to solve problems. Furthermore, there is a growing interest in testing free and open-source GIS software for weed surveys. In this study, the free and open-source software QGIS was used to develop a geographic information database showing the distribution of pigweeds at the county level in the southeastern United States. The maps focused on the following pigweeds: Palmer amaranth, redroot pigweed, and tall waterhemp. Cultivated areas and glyphosate-resistant (GR) pigweed data were added to the GIS database. Database queries were used to demonstrate applications of the GIS for precision agriculture applications at the county level, such as tallying the number of counties affected by the pigweeds, identifying counties reporting GR pigweed, and identifying cultivated areas located in counties with GR pigweeds. This research demonstrated that free and open-source software such as QGIS has strong potential as a decision support tool, with implications for precision weed management at the county scale.
Precision weed management, an application of precision agriculture, accounts for within-field variability of weed infestation and herbicide damage. Unmanned aerial vehicles (UAVs) provide a unique platform for remote sensing of field crops. They are more efficient and flexible than manned agricultural airplanes in acquiring high-resolution images at low altitudes and low speeds. UAVs are more universal than agricultural aircraft, because the latter are used only in specific regions. We have developed and used UAV systems for red–green–blue digital and color–infrared imaging over crop fields to identify weed species, determine crop injury from dicamba at different doses, and detect naturally grown glyphosate-resistant weeds. This article presents remote sensing technologies for weed management and focuses on development and application of UAV-based low-altitude remote sensing technology for precision weed management. In particular, this article futher discusses the potential application of UAV-based plant-sensing systems for mapping the distributions of glyphosate-resistant and glyphosate-susceptible weeds in crop fields.
The Crab pulsar was first detected soon after the discovery of pulsars, and has long been studied for its unique traits. One of these traits, giant pulses that can be upwards of 1000 times brighter than the average pulse, was key to the Crab’s initial detection. Giant pulses are only seen in a few pulsars, and their energy distributions distinguish them from normal pulsed emission. There have been many studies over a period of decades to measure the power-law slope of these energy distributions, which provide insight into the possible emission mechanism of these giant pulses.
The 42-foot telescope at Jodrell Bank Observatory monitors the Crab pulsar on a daily basis. We have single-pulse data dating back to 2012, containing roughly 1,000,000 giant pulses, the largest sample of Crab giant pulses to date. This large set of giant pulses allows us to do a range of science, including pulse-width studies and in-depth studies of giant-pulse energy distributions. The latter are particularly interesting, as close inspection of the high-energy tail of the energy distribution allows us to investigate the detectability of extragalactic giant-pulsing pulsars. Also, by calculating rates from these energy distributions, we may be able to shed light on a possible link between Fast Radio Bursts and giant pulses.
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.
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.
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.
After more than half a century of community support related to the science of “solar activity”, IAU's Commission 10 was formally discontinued in 2015, to be succeeded by C.E2 with the same area of responsibility. On this occasion, we look back at the growth of the scientific disciplines involved around the world over almost a full century. Solar activity and fields of research looking into the related physics of the heliosphere continue to be vibrant and growing, with currently over 2,000 refereed publications appearing per year from over 4,000 unique authors, publishing in dozens of distinct journals and meeting in dozens of workshops and conferences each year. The size of the rapidly growing community and of the observational and computational data volumes, along with the multitude of connections into other branches of astrophysics, pose significant challenges; aspects of these challenges are beginning to be addressed through, among others, the development of new systems of literature reviews, machine-searchable archives for data and publications, and virtual observatories. As customary in these reports, we highlight some of the research topics that have seen particular interest over the most recent triennium, specifically active-region magnetic fields, coronal thermal structure, coronal seismology, flares and eruptions, and the variability of solar activity on long time scales. We close with a collection of developments, discoveries, and surprises that illustrate the range and dynamics of the discipline.
The main purpose of this study was to investigate the psychological and functional impact attributed to acoustic neuroma symptoms.
Materials and methods:
A sample of 207 acoustic neuroma patients completed a study-specific questionnaire about the severity, frequency, and psychological and functional impact of 9 acoustic neuroma symptoms.
The survey response rate was 56.4 per cent. All symptoms had some degree of psychological impact for the majority of participants; hearing loss was the symptom most often reported to have a severe psychological impact. The majority of respondents reported functional impact attributed to hearing loss, balance disturbance, dizziness, eye problems, headache and fatigue; balance disturbance was the symptom most often reported to have a severe functional impact. For most symptoms, psychological and functional impact were related to severity and frequency.
Of the acoustic neuroma symptoms investigated, hearing loss and balance disturbance were the most likely to have a severe psychological and functional impact, respectively.
Many hemipteroids are major pests and vectors of microbial pathogens, infecting crops. Saliva of the hemipteroids is critical in enabling them to be voracious feeders on plants, including the economically important ones. A plethora of hemipteroid salivary enzymes is known to inflict stress in plants, either by degrading the plant tissue or by affecting their normal metabolism. Hemipteroids utilize one of the following three strategies of feeding behaviour: salivary sheath feeding, osmotic-pump feeding and cell-rupture feeding. The last strategy also includes several different tactics such as lacerate-and-flush, lacerate-and-sip and macerate-and-flush. Understanding hemipteroid feeding mechanisms is critical, since feeding behaviour directs salivary composition. Saliva of the Heteroptera that are specialized as fruit and seed feeders, includes cell-degrading enzymes, auchenorrhynchan salivary composition also predominantly consists of cell-degrading enzymes such as amylase and protease, whereas that of the Sternorhyncha includes a variety of allelochemical-detoxifying enzymes. Little is known about the salivary composition of the Thysanoptera. Cell-degrading proteins such as amylase, pectinase, cellulase and pectinesterase enable stylet entry into the plant tissue. In contrast, enzymes such as glutathione peroxidase, laccase and trehalase detoxify plant chemicals, enabling the circumvention of plant-defence mechanisms. Salivary enzymes such as M1-zinc metalloprotease and CLIP-domain serine protease as in Acyrthosiphon pisum (Aphididae), and non-enzymatic proteins such as apolipophorin, ficolin-3-like protein and ‘lava-lamp’ protein as in Diuraphis noxia (Aphididae) have the capacity to alter host-plant-defence mechanisms. A majority of the hemipteroids feed on phloem, hence Ca++-binding proteins such as C002 protein, calreticulin-like isoform 1 and calmodulin (critical for preventing sieve-plate occlusion) are increasingly being recognized in hemipteroid–plant interactions. Determination of a staggering variety of proteins shows the complexity of hemipteroid saliva: effector proteins localized in hemipteran saliva suggest a similarity to the physiology of pathogen–plant interactions.