In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients.

SNP in the vitamin D receptor (VDR) gene is associated with risk of lower respiratory infections. The influence of genetic variation in the vitamin D pathway resulting in susceptibility to upper respiratory infections (URI) has not been investigated. We evaluated the influence of thirty-three SNP in eleven vitamin D pathway genes (DBP, DHCR7, RXRA, CYP2R1, CYP27B1, CYP24A1, CYP3A4, CYP27A1, LRP2, CUBN and VDR) resulting in URI risk in 725 adults in London, UK, using an additive model with adjustment for potential confounders and correction for multiple comparisons. Significant associations in this cohort were investigated in a validation cohort of 737 children in Manchester, UK. In all, three SNP in VDR (rs4334089, rs11568820 and rs7970314) and one SNP in CYP3A4 (rs2740574) were associated with risk of URI in the discovery cohort after adjusting for potential confounders and correcting for multiple comparisons (adjusted incidence rate ratio per additional minor allele ≥1·15, Pfor trend ≤0·030). This association was replicated for rs4334089 in the validation cohort (Pfor trend=0·048) but not for rs11568820, rs7970314 or rs2740574. Carriage of the minor allele of the rs4334089 SNP in VDR was associated with increased susceptibility to URI in children and adult cohorts in the United Kingdom.

Background: The main purpose of this study was to correlate a newly developed, simple, but comprehensive screening test for dementia called the Self Test (ST) with the Mini-mental State Examination (MMSE), and establish the reliability and validity of the ST.

Methods:The ST was administered to 42 consecutive new referrals to the memory clinic at the Cole Neuroscience Center, University of Tennessee Medical Center (UTMC), Knoxville, TN, U.S.A. and 41 age-matched control subjects at regular intervals over a 12-month period.

Results:The total ST scores correlated well with cognitive severity as measured by the MMSE (r = 0.71, p<0.01). The area under the receiver-operating characteristic curve (AUROCC) in the group of patients with Alzheimer's disease (AD) with less than a high school education was 0.80, and 0.89 in those with at least a high school education. Reliability analysis showed a mean inter-item correlation of 0.31 for patients with AD, and 0.47 for normal participants. Cronbach's α was calculated to be 0.70 for the AD group. Test–retest reliability was determined using intraclass correlation coefficients (ICC = 0.93, p<0.01).

Conclusions: The ST is an internally consistent, reliable and valid screening test for cognitive impairment in persons exhibiting early symptoms of dementia. In addition, the ST requires minimal nonprofessional supervision and may be administered by an untrained person.

The 23rd season of excavation at Tell Brak took place from March 13 to May 16, 2000, with David Oates as Project Director, Geoff Emberling as Field Director, and Helen McDonald in charge of the house and recording of pottery and objects. The season was co-sponsored by the Metropolitan Museum of Art and the British School of Archaeology in Iraq and was primarily funded by the Adelaide Milton de Groot Fund, in memory of the de Groot and Hawley families, of the Metropolitan Museum of Art; we also gratefully acknowledge significant support from the National Geographic Society (grant #6738–00), the Institute of Fine Arts of New York University, the British School of Archaeology in Iraq, and the McDonald Institute for Archaeological Research at the University of Cambridge. We would like to thank the Director General of Antiquities and Museums in Syria for his encouragement and interest. We also thank Ammar Abdul Rahman from the Department of Antiquities in Damascus, who paid us a visit during the season, as well as our representative from Hassake, Hussein Yusuf. The excavation staff was a pleasure to work with: Donald Hansen, Selma al-Radi, Marta Ameri, Jean Evans, Walton Green, Melanie Hatz, Torben Larsen, Tomasz Pazdej, Laurie Tedesco, David Thomas and Tim Skuldboel were site supervisors; Jack Cheng was registrar and photographer; Henry Wright conducted a series of soundings and gathered controlled samples of material relating to fourth millennium occupation of the mound; Michael Charles and Mette Marie Hald once again ran the botanical sampling programme; Jill Weber analyzed faunal remains; Susan Rees was conservator; and David and Joan Oates supported the project through the off-season and in the field with their expertise and enthusiasm.