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To determine whether optic disc hemorrhages (ODH) and cotton wool spots (CWS) at presentation are associated with worse visual outcomes in pediatric patients with idiopathic intracranial hypertension (IIH).
Retrospective institutional review of 100 eyes of 50 consecutive pediatric IIH patients (aged 16 years or less) who had baseline optic disc photographs before or within 30 days of their diagnostic lumbar puncture and initiation of medical treatment. Optic disc photographs were independently graded by three ophthalmologists in a standardized manner. Visual function was assessed using visual acuity (VA) and visual field grade (VFG).
At least one ODH was found in 41% of eyes, at least one CWS was found in 27% of eyes, and 20% of eyes had both ODH and CWS. At presentation, Frisén grade was associated with the presence of CWS (p = 0.013) and showed no association with ODH (p = 0.060). When controlling for Frisén grade, ODH and CWS were not associated with worse VA or VFG at final follow-up. Severe ODH were associated with worse VA and VFG at presentation (p < 0.03), but not at final follow-up. Severe CWS at presentation was strongly associated with a worse Humphrey mean deviation of 5.0 dB (95% confidence interval 1.6–8.3) at final follow-up (p = 0.002).
When controlling for the severity of papilledema, ODH do not provide any additional prognostic value in pediatric IIH patients. Frisén grade and severe CWS at presentation were independently associated with worse visual outcomes at the final follow-up.
Antineuronal antibodies are associated with psychosis, although their clinical significance in first episode of psychosis (FEP) is undetermined.
To examine all patients admitted for treatment of FEP for antineuronal antibodies and describe clinical presentations and treatment outcomes in those who were antibody positive.
Individuals admitted for FEP to six mental health units in Queensland, Australia, were prospectively tested for serum antineuronal antibodies. Antibody-positive patients were referred for neurological and immunological assessment and therapy.
Of 113 consenting participants, six had antineuronal antibodies (anti-N-methyl-D-aspartate receptor antibodies [n = 4], voltage-gated potassium channel antibodies [n = 1] and antibodies against uncharacterised antigen [n = 1]). Five received immunotherapy, which prompted resolution of psychosis in four.
A small subgroup of patients admitted to hospital with FEP have antineuronal antibodies detectable in serum and are responsive to immunotherapy. Early diagnosis and treatment is critical to optimise recovery.
After the Portuguese discovered the Cape Verde Islands in AD 1456 they divided its main island, Santiago, into two governing captaincies. The founding settlement in the south-west, Cidade Velha, soon became the Islands’ capital and a thriving trade centre; in contrast, that in the east, Alcatrazes, only lasted as an official seat from 1484–1516 and is held to have ‘failed’ (see Richter 2015).
Objectives: Following pediatric moderate-to-severe traumatic brain injury (msTBI), few predictors have been identified that can reliably identify which individuals are at risk for long-term cognitive difficulties. This study sought to determine the relative contribution of detailed descriptors of injury severity as well as demographic and psychosocial factors to long-term cognitive outcomes after pediatric msTBI. Methods: Participants included 8- to 19-year-olds, 46 with msTBI and 53 uninjured healthy controls (HC). Assessments were conducted in the post-acute and chronic stages of recovery. Medical record review provided details regarding acute injury severity. Parents also completed a measure of premorbid functioning and behavioral problems. The outcome of interest was four neurocognitive measures sensitive to msTBI combined to create an index of cognitive performance. Results: Results indicated that none of the detailed descriptors of acute injury severity predicted cognitive performance. Only the occurrence of injury, parental education, and premorbid academic competence predicted post-acute cognitive functioning. Long-term cognitive outcomes were best predicted by post-acute cognitive functioning. Discussion: The findings suggest that premorbid factors influence cognitive outcomes nearly as much as the occurrence of a msTBI. Furthermore, of youth with msTBI who initially recover to a level of moderate disability or better, a brief cognitive battery administered within several months after injury can best predict which individuals will experience poor long-term cognitive outcomes and require additional services. (JINS, 2016, 22, 1–8)
In Africa the spectrum of neurological disease is in many ways similar to other parts of the world, but significant differences are obvious. Relative to industrialized countries, stroke and epilepsy are very common, but dementia or Parkinson's disease are much less so, at least at present. Which of the particular geographical, climatic, social and ethnic factors of the continent govern the pattern of disease? Why is multiple sclerosis almost unknown in tropical Africa, whereas defined local factors account for tropical ataxic neuropathy? While the epidemic of HIV infection is bringing its own range of neurological complications, there are few local data about Parkinson's disease, or even stroke. A comment made about tropical neurology by Spillane in 1973, is still true of Africa, ‘ . . . the repeated assertion that many diseases of the nervous system are uncommon or actually rare in certain tropical zones is a premature generalization . . . We are nowhere near a position to make any broad and confident generalization about the distribution of diseases of the nervous system in the tropics’.
Epidemiological work in Africa is demanding, but some careful studies have provided valuable data, as the early example from Ethiopia demonstrates (Table 73.1). Researchers are actively building a more comprehensive picture, but the lack of neurological resource is a constant obstruction to development, and to basic assessment and treatment of neurological problems (WHO, 2004).
This paper is the second part of a two part sequence on multiphysics algorithms and software. The first  focused on the algorithms; this part treats the multiphysics software framework and applications based on it. Tight coupling is typically designed into the analysis application at inception, as such an application is strongly tied to a composite nonlinear solver that arrives at the final solution by treating all equations simultaneously. The application must also take care to minimize both time and space error between the physics, particularly if more than one mesh representation is needed in the solution process. This paper presents an application framework that was specifically designed to support tightly coupled multiphysics analysis. The Multiphysics Object Oriented Simulation Environment (MOOSE) is based on the Jacobian-free Newton-Krylov (JFNK) method combined with physics-based preconditioning to provide the underlying mathematical structure for applications. The report concludes with the presentation of a host of nuclear, energy and environmental applications that demonstrate the efficacy of the approach and the utility of a well-designed multiphysics framework.
There is a growing trend within energy and environmental simulation to consider tightly coupled solutions to multiphysics problems. This can be seen in nuclear reactor analysis where analysts are interested in coupled flow, heat transfer and neutronics, and in nuclear fuel performance simulation where analysts are interested in thermomechanics with contact coupled to species transport and chemistry. In energy and environmental applications, energy extraction involves geomechanics, flow through porous media and fractured formations, adding heat transport for enhanced oil recovery and geothermal applications, and adding reactive transport in the case of applications modeling the underground flow of contaminants. These more ambitious simulations usually motivate some level of parallel computing. Many of the physics coupling efforts to date utilize simple code coupling or first-order operator splitting, often referred to as loose coupling. While these approaches can produce answers, they usually leave questions of accuracy and stability unanswered. Additionally the different physics often reside on distinct meshes and data are coupled via simple interpolation, again leaving open questions of stability and accuracy.
Commercial excavators often find that their way back to the past runs through relatively recent structures. What should we do with them? Intellectually sensitive modern excavators, like our authors, are beginning to convince us that these recent constructions not only matter in themselves, but may have interesting links to what lies beneath. Here they introduce us to the foundations of an early telescope, a monument that takes its context both from the much-investigated lands of West Cambridge, and the more abstract landscape of early science. Forcing archaeology to ask fresh questions and make ambitious connections is only proper in a place heavy with the aroma of investigative scholarship.
This paper reports on the excavation of a small, but high-status, later seventh-century Anglo-Saxon cemetery in Ely. Of fifteen graves, two were particularly well furnished, one of which was buried with a gold and silver necklace that included a cross pendant, as well as two complete glass palm cups and a composite comb, placed within a wooden padlocked casket. The paper reports on the skeletal and artefactual material (including isotopic analysis of the burials), and seeks to set the site in its wider social and historical context, arguing that this cemetery may well have been associated with the first monastery in Ely, founded by Etheldreda in ad 673.
Glazes found on ancient Nubian quartzite sculpture were characterized in a previous study by scanning electron microscopy/energy-dispersive X-ray spectrometry (SEM/EDS). Now in the collection of the Museum of Fine Arts, Boston, these objects were excavated in the early 20th century by the joint Harvard University-Boston Museum of Fine Arts Expedition, in ancient Kerma, the capital of ancient Kush. The project presented here attempts to recreate the ancient technology used to glaze quartzite with compositions determined in the previous study. Raw and fritted experimental glazes were prepared, as well as an alkali paste mixed with a copper colorant. All of the samples were fired in modern kilns. After firing, samples of the glazes and their quartzite substrates were examined with SEM/EDS.
The use of boron as a sintering aid reduces the sintering temperature, enhances the sintering density, and improves the microwave properties of Ba(Cd1/3Ta2/3)O3 ceramic dielectrics. Observations by transmission electron microscopy indicate that the liquid sintering mechanism contributes to the improvement in sintering density for boron concentrations exceeding 0.5 wt%. The introduction of as small as 0.01% boron also results in the production of high-density samples (∼95%), presumably indicating that a point defect mechanism may also play an important role in the sintering process. X-ray diffraction data combined with high-resolution transmission electron microscopy images show that boron-doped Ba(Cd1/3Ta2/3)O3 ceramic material has a well-ordered hexagonal structure. Annealing treatment is found to improve the microwave properties. The best sample has a dielectric constant of 32, a temperature coefficient of resonant frequency of 80 ± 15 ppm/°C, and a quality factor of >25,000 at 2 GHz.
Scanning electron microscopy/energy-dispersive X-ray spectrometry (SEM/EDS) was used to characterize the composition of glazes found on a collection of blue glazed, white quartzite sculptures, excavated from 1913–1916 by the Harvard University–Boston Museum of Fine Arts Expedition at the site of Kerma, the capital of ancient Kush, in today's Sudan. The scientific analysis of these artifacts shows the experimental nature of this extremely rare manufacture which appears to have developed out of faience technology.
In March 1999, a large community outbreak of Escherichia coli O157 infection occurred in North Cumbria. A total of 114 individuals were reported to the Outbreak Control Team (OCT); 88 had laboratory confirmed E. coli O157. Twenty-eight (32%) of the confirmed cases were admitted to hospital, including three children (3·4%) with haemolytic uraemic syndrome. There were no deaths. A case-control study found that illness was strongly associated with drinking pasteurized milk from a local farm (P=<0·0001) on single variable analysis. Microbiological investigations at the farm revealed E. coli O157 phage type (PT) 21/28 VT 2 which was indistinguishable from the human isolates by pulsed field gel electrophoresis. At the time of occurrence this was the largest E. coli O157 outbreak in England and Wales and the first E. coli O157 PT 21/28 VT 2 outbreak associated with pasteurized milk. This outbreak highlights lessons to be learnt regarding on-farm pasteurization.
Qero cups, made from wood, ceramics and precious metals, have been used for millennia in the Andean region for ritual consumption of maize beer. From the cusp of the Inka-Colonial period, painted decoration became more common on qero cups. Most of the painted decoration actually consists of thin layers of a pigmented rubbery material that was cut and inlaid into shallow carved cavities in the wood substrate. For this project, 312 paint samples from 53 qerocups in collections of the Brooklyn Museum of Art, National Museum of the American Indian/Smithsonian Institution, Metropolitan Museum of Art, and American Museum of Natural History were analyzed. The study of paints is part of larger study of the technology of over 150 qero cups from these four collections. Samples from seven qeros in Peruvian collections have also been analyzed. Nearly two dozen pigments have been identified, including mineral, synthetic inorganic compounds, and natural dyestuffs. The binder consisted of an unusual natural resin (commonly called ‘mopa mopa’) usually mixed with a nondrying or semidrying oil. This resin, which was used at least locally during the pre-Inka period and continued to be used through the Colonial period and later, came from a tree that grows in the montana of southwest Colombia, a region that was part of the northernmost extension of the Inka empire.
The original authors of Billman et al. (2000) are joined by three other analysts from the Cowboy Wash research team to respond to the critique of this article by Dongoske et al. (2000). Dongoske and his coauthors state that Billman et al. (2000) failed to test alternative hypotheses or to consider alternative explanations for the findings at 5MT10010 and similar sites. The original authors point out that alternative hypotheses were examined and rejected, leaving a violent episode of cannibalism as the most plausible explanation for the remains found at 5MT10010. Dongoske et al. also question many aspects of the osteological, archaeological, coprolite, and biochemical analyses that were presented in the 5MT10010 study. Our response addresses issues of data collection, procedure, and interpretation, and attempts to clarify some points that were not fully developed in the original text due to length restrictions.
Si-Ge monocrystals up to 50 mm diameter and up to 17 at% germanium were grown using a modified Czochralski technique. Pre-grown large diameter silicon seeds with various crystallographic orientations were used as templates for the alloy solidification to reduce cap crystallization time and insure monocrystallinity at desired diameters. Discussed are the influences that seed preparation, crystal growing parameters, and post-growth processing have on the material that was produced using this new technique.