663 research outputs found

    Validity of histology for the diagnosis of paediatric coeliac disease: a Swedish multicentre study.

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    Objective Histological evaluation of intestinal biopsies for the diagnosis of coeliac disease can be challenging and compatible with risk of misdiagnosis. The aim was to evaluate the agreement of pathological diagnosis for coeliac disease in children investigated at four major paediatric university hospitals in Sweden. Materials and methods Intestinal duodenal biopsies were collected from 402 children at median 9.7 years (1.4-18.3 years). A pathologist at each hospital performed the primary evaluation. A designated pathologist, blinded to the primary evaluation, performed a second Marsh classification of biopsies (M0 to M3c) taken from the bulb and duodenum separately. Kappa (Îș) scores between first and second evaluation determined the agreement. Plasma samples were collected at the day of intestinal biopsy and analysed for tissue transglutaminase autoantibodies (tTGA) using radioligand-binding assays. Results Marsh scores were concordant in 229/356 biopsies (64%, Îș = 0.52, p < 0.0001). Among discordant results, 15/127 (12%) showed M0 in distal duodenum but ≄ M2 in the bulb, whereas the opposite was true for 8/127 (6%) of the biopsies. There were fewer collected duodenal biopsies, more missing bulb biopsies and missing CD3 staining among discordant evaluations. The second evaluation revealed a Marsh score compliant with coeliac disease in 22 children of whom seven children were tTGA positive. Conclusions The variation between university hospitals on the pathological evaluation of biopsies may lead to misdiagnosis of coeliac disease in paediatric patients. Access to clinical and endoscopic information as well as tTGA levels may be useful for the pathologist to complement the evaluation in dubious cases

    The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come

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    The Lancet Countdown: tracking progress on health and climate change was established to provide an independent, global monitoring system dedicated to tracking the health dimensions of the impacts of, and the response to, climate change. The Lancet Countdown tracks 41 indicators across five domains: climate change impacts, exposures, and vulnerability; adaptation, planning, and resilience for health; mitigation actions and health co-benefits; finance and economics; and public and political engagement. This report is the product of a collaboration of 27 leading academic institutions, the UN, and intergovernmental agencies from every continent. The report draws on world-class expertise from climate scientists, ecologists, mathematicians, geographers, engineers, energy, food, livestock, and transport experts, economists, social and political scientists, public health professionals, and doctors. The Lancet Countdown's work builds on decades of research in this field, and was first proposed in the 2015 Lancet Commission on health and climate change,1 which documented the human impacts of climate change and provided ten global recommendations to respond to this public health emergency and secure the public health benefits available (panel 1)

    The absence of an auditory-visual attentional blink is not due to echoic memory.

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    Als binnen een halve seconde twee visuele items in een serieel aangeboden stroom moeten worden geselecteerd, is de prestatie voor het tweede item vaak relatief slecht (er treedt een “attentional blink” op); wanneer het eerste echter item auditief wordt aangeboden, verdwijnt de blink meestal. We hebben aangetoond dat dit laatste niet wordt veroorzaakt doordat proefpersonen hun echoïsch geheugen gebruiken om de verwerking van het auditieve item uit te stellen tot na het einde van de visuele stroom

    Telephone conversation impairs sustained visual attention via a central bottleneck

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    Recent research has shown that holding telephone conversations disrupts one's driving ability. We asked whether this effect could be attributed to a visual attention impairment. In Experiment 1, participants conversed on a telephone or listened to a narrative while engaged in multiple object tracking (MOT), a task requiring sustained visual attention. We found that MOT was disrupted in the telephone conversation condition, relative to single-task MOT performance, but that listening to a narrative had no effect. In Experiment 2, we asked which component of conversation might be interfering with MOT performance. We replicated the conversation and single-task conditions of Experiment 1 and added two conditions in which participants heard a sequence of words over a telephone. In the shadowing condition, participants simply repeated each word in the sequence. In the generation condition, participants were asked to generate a new word based on each word in the sequence. Word generation interfered with MOT performance, but shadowing did not. The data indicate that telephone conversation disrupts attention at a central stage, the act of generating verbal stimuli, rather than at a peripheral stage, such as listening or speaking

    Integrated cross-domain object storage in working memory: Evidence from a verbal-spatial memory task

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    Working-memory theories often include domain-specific verbal and visual stores (e.g., the phonological and visuospatial buffers of Baddeley, 1986), and some also posit more general stores thought to be capable of holding verbal or visuospatial materials (Baddeley, 2000; Cowan, 2005). However, it is currently unclear which type of store is primarily responsible for maintaining objects that include components from multiple domains. In these studies, a spatial array of letters was followed by a single probe identical to an item in the array or differing systematically in spatial location, letter identity, or their combination. Concurrent verbal rehearsal suppression impaired memory in each of these trial types in a task that required participants to remember verbal-spatial binding, but did not impair memory for spatial locations if the task did not require verbal-spatial binding for a correct response. Thus, spatial information might be stored differently when it must be bound to verbal information. This suggests that a cross-domain store such as the episodic buffer of Baddeley (2000) or the focus of attention of Cowan (2001) might be used for integrated object storage, rather than the maintenance of associations between features stored in separate domain-specific buffers

    Participatory analysis for adaptation to climate change in Mediterranean agricultural systems: possible choices in process design (versĂŁo Pre Print)

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    There is an increasing call for local measures to adapt to climate change, based on foresight analyses in collaboration with actors. However, such analyses involve many challenges, particularly because the actors concerned may not consider climate change to be an urgent concern. This paper examines the methodological choices made by three research teams in the design and implementation of participatory foresight analyses to explore agricultural and water management options for adaptation to climate change. Case studies were conducted in coastal areas of France, Morocco, and Portugal where the groundwater is intensively used for irrigation, the aquifers are at risk or are currently overexploited, and a serious agricultural crisis is underway. When designing the participatory processes, the researchers had to address four main issues: whether to avoid or prepare dialogue between actors whose relations may be limited or tense; how to select participants and get them involved; how to facilitate discussion of issues that the actors may not initially consider to be of great concern; and finally, how to design and use scenarios. In each case, most of the invited actors responded and met to discuss and evaluate a series of scenarios. Strategies were discussed at different levels, from farming practices to aquifer management. It was shown that such participatory analyses can be implemented in situations which may initially appear to be unfavourable. This was made possible by the flexibility in the methodological choices, in particular the possibility of framing the climate change issue in a broader agenda for discussion with the actors
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