Brain volumes predict neurodevelopment in adolescents after surgery for congenital heart disease

Patients with complex congenital heart disease are at risk for neurodevelopmental impairments. Evidence suggests that brain maturation can be delayed and pre- and postoperative brain injury may occur, and there is limited information on the long-term effect of congenital heart disease on brain development and function in adolescent patients. At a mean age of 13.8 years, 39 adolescent survivors of childhood cardiopulmonary bypass surgery with no structural brain lesions evident through conventional cerebral magnetic resonance imaging and 32 healthy control subjects underwent extensive neurodevelopmental assessment and cerebral magnetic resonance imaging. Cerebral scans were analysed quantitatively using surface-based and voxel-based morphometry. Compared with control subjects, patients had lower total brain (P = 0.003), white matter (P = 0.004) and cortical grey matter (P = 0.005) volumes, whereas cerebrospinal fluid volumes were not different. Regional brain volume reduction ranged from 5.3% (cortical grey matter) to 11% (corpus callosum). Adolescents with cyanotic heart disease showed more brain volume loss than those with acyanotic heart disease, particularly in the white matter, thalami, hippocampi and corpus callosum (all P-values < 0.05). Brain volume reduction correlated significantly with cognitive, motor and executive functions (grey matter: P < 0.05, white matter: P < 0.01). Our findings suggest that there are long-lasting cerebral changes in adolescent survivors of cardiopulmonary bypass surgery for congenital heart disease and that these changes are associated with functional outcom

Controlled reattachment in separated flows: a variational approach to recirculation length reduction

A variational technique is used to derive analytical expressions for the sensitivity of recirculation length to steady forcing in separated flows. Linear sensitivity analysis is applied to the two-dimensional steady flow past a circular cylinder for Reynolds numbers $40 \leq Re \leq 120$, both in the subcritical and supercritical regimes. Regions which are the most sensitive to volume forcing and wall blowing/suction are identified. Control configurations which reduce the recirculation length are designed based on the sensitivity information, in particular small cylinders used as control devices in the wake of the main cylinder, and fluid suction at the cylinder wall. Validation against full non-linear Navier-Stokes calculations shows excellent agreement for small-amplitude control. The linear stability properties of the controlled flow are systematically investigated. At moderate Reynolds numbers, we observe that regions where control reduces the recirculation length correspond to regions where it has a stabilising effect on the most unstable global mode associated to vortex shedding, while this property does not hold any more at larger Reynolds numbers.Comment: 17 pages, 11 figure

Effect of a Computer-Based Decision Support Intervention on Autism Spectrum Disorder Screening in Pediatric Primary Care Clinics: A Cluster Randomized Clinical Trial

Importance: Universal early screening for autism spectrum disorder (ASD) is recommended but not routinely performed. Objective: To determine whether computer-automated screening and clinical decision support can improve ASD screening rates in pediatric primary care practices. Design, Setting, and Participants: This cluster randomized clinical trial, conducted between November 16, 2010, and November 21, 2012, compared ASD screening rates among a random sample of 274 children aged 18 to 24 months in urban pediatric clinics of an inner-city county hospital system with or without an ASD screening module built into an existing decision support software system. Statistical analyses were conducted from February 6, 2017, to June 1, 2018. Interventions: Four clinics were matched in pairs based on patient volume and race/ethnicity, then randomized within pairs. Decision support with the Child Health Improvement Through Computer Automation system (CHICA) was integrated with workflow and with the electronic health record in intervention clinics. Main Outcomes and Measures: The main outcome was screening rates among children aged 18 to 24 months. Because the intervention was discontinued among children aged 18 months at the request of the participating clinics, only results for those aged 24 months were collected and analyzed. Rates of positive screening results, clinicians' response rates to screening results in the computer system, and new cases of ASD identified were also measured. Main results were controlled for race/ethnicity and intracluster correlation. Results: Two clinics were randomized to receive the intervention, and 2 served as controls. Records from 274 children (101 girls, 162 boys, and 11 missing information on sex; age range, 23-30 months) were reviewed (138 in the intervention clinics and 136 in the control clinics). Of 263 children, 242 (92.0%) were enrolled in Medicaid, 138 (52.5%) were African American, and 96 (36.5%) were Hispanic. Screening rates in the intervention clinics increased from 0% (95% CI, 0%-5.5%) at baseline to 68.4% (13 of 19) (95% CI, 43.4%-87.4%) in 6 months and to 100% (18 of 18) (95% CI, 81.5%-100%) in 24 months. Control clinics had no significant increase in screening rates (baseline, 7 of 64 children [10.9%]; 6-24 months after the intervention, 11 of 72 children [15.3%]; P = .46). Screening results were positive for 265 of 980 children (27.0%) screened by CHICA during the study period. Among the 265 patients with positive screening results, physicians indicated any response in CHICA in 151 (57.0%). Two children in the intervention group received a new diagnosis of ASD within the time frame of the study. Conclusions and Relevance: The findings suggest that computer automation, when integrated with clinical workflow and the electronic health record, increases screening of children for ASD, but follow-up by physicians is still flawed. Automation of the subsequent workup is still needed

Psychological adjustment to breast cancer: Congruence of locus of control and information and decision-making participation.

Forty-two breast cancer patients were interviewed to examine the relationship between psychological adjustment to breast cancer, current locus of control orientation, and treatment approach (i.e., amount of medical information received and degree of treatment participation). Specifically, the present study tested Reid\u27s (1984) congruence hypothesis which suggests that a treatment approach congruent with locus of control orientation is associated with better psychological adjustment than a mismatched approach. Psychological adjustment was assessed with the profile of Mood States (McNair, Lorr, & Droppleman, 1971, 1992) and three subscales--emotional adjustment, sexual adjustment, and appearance satisfaction--of the Mastectomy Attitude Scale (Heyl, 1977). Locus of control, measured with the Cancer Health Locus of Control Scale (Dickson, Dodd, Carrieri, & Levenson, 1985), tapped internal, powerful other, and chance control expectancies. Treatment approach was evaluated by a series of questionnaire items. In addition, quantity, helpfulness, and reciprocity of social support networks were assessed with the Social Relationships Scale (McFarlane, Neale, Norman, Roy, & Streiner, 1981) to test for an interaction of locus of control and social support on adjustment. The congruence hypothesis was not supported. Strong chance beliefs were related to poorer adjustment, regardless of treatment approach. However, powerful other beliefs and treatment approach interacted, with increased information and participation associated with enhanced adjustment for women with stronger powerful other control beliefs. Powerful other beliefs also interacted with helpfulness of social support; increased helpfulness was associated with less mood disturbance for those with weaker powerful other beliefs. The implications of these findings for cancer patients and physicians were discussed.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis1995 .K57. Source: Dissertation Abstracts International, Volume: 56-11, Section: B, page: 6395. Adviser: Shelagh Towson. Thesis (Ph.D.)--University of Windsor (Canada), 1995

Foreword: Control and Conservation of Lampreys Beyond 2020 – Proceedings from the 3rd Sea Lamprey International Symposium (SLIS III)

This special issue summarizes outcomes from the 3rd Sea Lamprey International Symposium (SLIS III; Fig. 1) held 28 July – 2 August 2019 at Wayne State University in Detroit, Michigan, U.S.A. The first two symposia (SLIS I and SLIS II) were held 30 July – 8 August 1979 at Northern Michigan University in Marquette, Michigan and 14–18 August 2000 at Lake Superior State University in Sault Ste. Marie, Michigan, respectively. The published volumes from these symposia in 1980 (Canadian Journal of Fisheries and Aquatic Sciences, Volume 37, Issue 11) and 2003 (Journal of Great Lakes Research Volume 29, Supplement 1) have been invaluable references for the broader scientific community and for management agencies around the Laurentian Great Lakes; cited over 4800 and 3300 times, respectively. SLIS III was attended by over 150 scientists, biologists, resource managers, graduate students, and Commission advisors, including participants from Australia, Canada, China, Japan, New Zealand, Portugal, Spain, the United Kingdom, and the United States (Fig. 2). Similar to SLIS I and SLIS II, the goals of SLIS III were to provide a forum to (i) update and publish information on sea lamprey control and research on lampreys since SLIS II, (ii) exchange knowledge and ideas to bring practitioners to a common plateau of understanding, and (iii) develop innovative initiatives and stimulate new vigor in efforts to control sea lamprey in the Great Lakes and to conserve lampreys in their native ranges. The emphasis on conservation of lampreys is unique to SLIS III and reflects a heightened international recognition that scientific and management advances supporting sea lamprey control in the Great Lakes can benefit the global effort to conserve native lampreys and vice versa

Dopaminergic Nigrostriatal Connectivity in Early Parkinson Disease:In Vivo Neuroimaging Study of C-11-DTBZ PET Combined with Correlational Tractography

Previous histopathologic and animal studies have shown axonal impairment and loss of connectivity of the nigrostriatal pathway in Parkinson disease (PD). However, there are conflicting reports from in vivo human studies. C-11-dihydrotetrabenazine (C-11-DTBZ) is a vesicular monoamine type 2 transporter PET ligand that allows assessment of nigrostriatal presynaptic dopaminergic terminal integrity. Correlational tractography based on diffusion MRI can incorporate ligand-specific information provided by C-11-DTBZ PET into the fiber-tracking process. The purpose of this study was to assess the in vivo association between the integrity of the nigrostriatal tract (defined by correlational tractography) and the degree of striatal dopaminergic denervation based on C-11-DTBZ PET. Methods: The study involved 30 subjects with mild to moderate PD (23 men and 7 women; mean age, 66 +/- 6.2 y; disease duration, 6.4 +/- 4.0 y; Hoehn and Yahr stage, 2.1 +/- 0.6; Movement Disorder Society [MDS]-revised Unified Parkinson Disease Rating Scale [UPDRS] [I-III] total score, 43.4 +/- 17.8) and 30 control subjects (18 men and 12 women; mean age, 62 +/- 10.3 y). C-11-DTBZ PET was performed using standard synthesis and acquisition protocols. Correlational tractography was performed to assess quantitative anisotropy (QA; a measure of tract integrity) of white matter fibers correlating with information derived from striatal C-11-DTBZ data using the DS! Studio toolbox. Scans were realigned according to least and most clinically affected cerebral hemispheres. Results: Nigrostriatal tracts were identified in both hemispheres of PD patients. Higher mean QA values along the identified tracts were significantly associated with higher striatal C-11-DTBZ distribution volume ratios (least affected: r = 0.57, P = 0.001; most affected: r = 0.44, P = 0.02). Lower mean QA values of the identified tract in the LA hemisphere associated with increased severity of bradykinesia sub-score derived from MDS-UPDRS part III (r = 0.42; P = 0.02). Cross-validation revealed the generalizability of these results. Conclusion: These findings suggest that impaired integrity of dopaminergic nigrostriatal nerve terminals is associated with nigrostriatal axonal dysfunction in mild to moderate PD. Assessment of nigrostriatal tract integrity may be suitable as a biomarker of earlyor even prodromal-stage PD

An Overview about the Current Situation on C&D Waste Management in Italy: Achievements and Challenges

[EN] The disposal volume of material for Construction and Demolition in Europe is increasing each year, that the European Union has decided to take control of the matter unifying practices and goals to achieve. This article analyses how waste management works in Italy adjusting its system to the European Union, regarding Construction and Demolition, taking into consideration the disposal of material coming from C&D (Construction and Demolition) production. In Italy, the disposition may differ according to the regions in which it is divided, and this must be taken into consideration when analysing information that reflects the different logistical aspect linked to the territory. It is also necessary to consider how the volume of waste can vary according to the size of the region considered and the type of industrial development to which it belongs. The analysis of the Italian situation shows their achievements regarding reaching a good level of recycling waste volume; indeed, their amount of C&D recycled waste after 2010 was always up to the 70% value established by the European Union, though barriers are still present in the field of waste management. Through data collecting, it has been seen the different volume that is generated in construction-related activities in the country, along with the recovered waste volume. Thus, the goal of this paper is to deepen the general knowledge on waste produced by Construction and Demolition in Italy and waste management practices adopted according to the European Union.This work was carried out at the Universitat Politècnica de València in the framework of CONDEREFF project (Ref. PGI05560-CONDEREFF).Cárcel-Carrasco, J.; Peñalvo-López, E.; Pascual Guillamón, M.; Salas Vicente, F. (2021). An Overview about the Current Situation on C&D Waste Management in Italy: Achievements and Challenges. Buildings. 11(7):1-12. https://doi.org/10.3390/buildings11070284S11211

Economic policy uncertainty and the information content of earnings announcements: Empirical evidence from the US in 1985-2018

This thesis studies the impact of economic policy uncertainty on the information content of earnings announcements. There is a large body of literature regarding both economic policy uncertainty and the information content of earnings announcements, but the relationship between the two phenomena has not yet been studied. This study gives an overview of the topic with empirical evidence, paving the road for future research. Economic policy uncertainty (EPU) index by Baker et al. (2013) has been used as a measure of economic policy uncertainty. This recent measure has been found to capture many aspects of economic policy uncertainty, and therefore it has been widely used by academics in many fields. It has been found to have an adverse impact on many areas of economic, including but not limited to decreased GDP growth, M&A activity and capital investments, and increased stock price volatility and equity risk premium. This thesis continues the research on EPU index by investigating its impact on the information content of earnings announcement in US stock listed companies between 19852018. This is done by observing the trading volume of stocks in the earnings announcement window, that includes the daily firm/trading volume observations that are within 16 days of the closest earnings announcement. With this dataset of 17,015,045 observations, two analyses are done. Firstly, a visual illustration is provided by replicating Beaver (1968) methodology but incorporating high/low EPU groups to show the difference. In addition, OSL regressions are run for the whole period and sub-periods of approximately 11 years, to explain the trading volume by the release of the earnings announcement, a proxy for economic policy uncertainty, and the interaction term of the two. It is found that economic policy uncertainty decreases trading volume during the earnings announcement window. In addition, the magnitude of this effect increases during the release day of an earnings announcement, and one day after that. This shows that the information shock caused by earnings announcement decreases during high economic policy uncertainty, implying a decrease in the information content of earnings announcements. The results regarding the changes in this phenomenon across time are conflicting, and no clear conclusions can be drawn from those. This thesis provides a starting point for research on the area but is also prone to limitations. The most important one being the lack of control variables, that are suggested to be incorporated as a part of future research. In addition, a qualitative approach could be taken to explain why the information content decreases during the times of high economic policy uncertainty

High Intensity Interval Training (HIIT) Improves Cardiorespiratory Fitness (CRF) in Healthy, Overweight and Obese Adolescents: A Systematic Review and Meta-Analysis of Controlled Studies

Background: High Intensity Interval Training (HIIT) is a sustainable and effective method for improving Cardiorespiratory Fitness (CRF) in adolescents. HIIT is proven to produce equal or greater improvements in CRF when compared to moderate intensity continuous exercise (MICE) in adolescents. Methods: The studies included were considered eligible if: (1) Participants were adolescents (11–18 years old); (2) Examined changes in CRF measured either directly or indirectly; (3) Included a non-exercising control group or MICE comparison group; (4) Participants were matched at enrolment; (5) Reported HIIT protocol information; (6) Provided HIIT intensity. A meta-analysis was conducted to determine the effect of HIIT on CRF. Meta-regression and moderator analyses were performed out to quantitatively examine moderators of protocol design on CRF improvements. Results: HIIT displays a moderate effect to improve CRF (g = 0.86, 95% CI 0.518–1.106, p 0.05). Conclusions: HIIT is an effective method to improve CRF in adolescents, irrespective of body composition. Notably, meta regression analysis identified that prolonged high volume HIIT programs are similarly effective to short term low volume HIIT programs. This becomes of particular interest for those involved in school curricula, where short HIIT exercise may provide a pragmatic adjunct to the health benefits of Physical Education (PE) lessons. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Direct replacement of oral sodium benzoate with glycerol phenylbutyrate in children with urea cycle disorders

Long-term management of urea cycle disorders (UCDs) often involves unlicensed oral sodium benzoate (NaBz) which has a high volume and unpleasant taste. A more palatable treatment is licenced and available (glycerol phenylbutyrate [GPB], Ravicti) but guidance on how to transition patients from NaBz is lacking. A retrospective analysis of clinical and biochemical data was performed for eight children who transitioned from treatment with a single ammonia scavenger, NaBz, to GPB at a single metabolic centre; UCDs included arginosuccinic aciduria (ASA) (n = 5), citrullinaemia type 1 (n = 2) and carbamoyl phosphate synthetase I deficiency (CPS1) (n = 1). Patients transitioned either by gradual transition over 1–2 weeks (n = 3) or direct replacement of NaBz with GPB (n = 5). Median initial dose of GPB was 8.5 mL/m2/day based on published product information; doses were revisited subsequently in clinic and titrated individually (range 4.5–11 mL/m2/day). Pre-transition and post-transition mean ammonia levels were 37 μmol/L (SD 28 μmol/L) and 29 μmol/L (SD 22 μmol/L), respectively (p = 0.09), and mean glutamine levels were 664 μmol/L (SD 225 μmol/L) and 598 μmol/L (SD 185 μmol/L), respectively (p = 0.24). There were no reductions in levels of branched chain amino acids. No related adverse drug reactions were reported. Patients preferred GPB because of its lower volume and greater palatability. Direct replacement of NaBz with GPB maintained metabolic control and was simple for the health service and patients to manage. A more cautious approach with additional monitoring would be warranted in brittle patients and patients whose ammonia levels are difficult to control