Evaluation of the infant at risk for neurodevelopmental disability

Background. Infants with neurodevelopmental abnormality need to start therapy early, and because of this they should be detected as soon as possible. Currently, no widely accepted method of early evaluation exists.Objectives_ To assess and compare, in terms of predicting neurodevelopmental outcome at 1 year of age: (i) a perinatal risk rating (PRR); (ii) the DubQwitz Neurological Assessment. (DNA); and (iii) the Infant Neuromotor Assessment (INA). Design and setting. A prospective neurodevelopmental followup study on graduates from the Groote Schuur Hospital (GSH) neonatal intensive care unit (NICU). Subjects. A cohort of 130 consecutive NICD graduates were selected according to high-risk criteria_Outcome measures. Each infant was examined at term gestational age on the DNAbefore discharge, and a PRR was allocated_ Study infants were seen again at 18 weeks of age when an INA was done, and at 1 year of age a Griffiths Developmental Assessment and full neurological examination was carried out.Results. All of the 130 infants assessed at term were seen at 18 weeks. Thereafter 5 were lost to follow-up and 2 died. The outcome for the remaining 123 is known.Conclusions. Prediction of a normal outcome at 1 year of age was 96% on the DNA and 98% for the PRR, but for an abnormal outcome they predicted only 56% and 42%, respectively. The INA done at 18 weeks predicted a normal outcome at 1 year in 99% of cases if 3 or less abnormal signs were present and an abnormal outcome in 82% of cases with 4 or more abnormal signs. Based on these findings a protocol for follow-up of these high-risk infants is suggested

Ghost of invasion past: legacy effects on community disassembly following eradication of an invasive ecosystem engineer

By changing ecosystem processes and altering the physical landscape, invasive ecosystem engineers can have substantial impacts on ecosystem functions and human economies and may facilitate other non-native species. Eradication programs in terrestrial and aquatic systems aim to reverse the impacts of invasive species and return the system to its pre-invasion conditions. Despite an extensive focus on the impacts of both native and non-native ecosystem engineers, the consequences of removing invasive ecosystem engineers, particularly in coastal ecosystems, are largely unknown. In this study, we quantified changes in a benthic community following the eradication of the invasive ecosystem engineer, hybrid cordgrass Spartina, in San Francisco Bay, California. We used field experimental manipulations to test for persistent effects of both aboveground and belowground structural modifications of the invasive plant on the benthic community. We found significant effects of the invasive plant more than four years following eradication. Experimental modification of the above- vs. belowground structure of this ecosystem engineer revealed taxonomic specific effects resulting in hysteresis in the recovery of the benthic food webs. We found that these legacy effects resulted from two specific mechanisms: (1) delayed breakdown of belowground structures (stems, roots) and (2) persistence of other invasive species whose invasion was facilitated by the ecosystem engineer. Both of these mechanisms are likely to occur in similar systems where belowground structures breakdown more slowly or where other associated long-lived invaders persist. Our work is among the first to quantify the slow rate of change in food web and community processes and the persistent legacy effects of an invasive ecosystem engineer in a coastal ecosystem. We suggest that this delayed transition to pre-invasion conditions could resemble an alternate state that would be misidentified without a sufficient monitoring interval or recovery duration, with consequences for future management and restoration activity planning

HCI as a means to prosociality in the economy

HCI research often involves intervening in the economic lives of people, but researchers only rarely give explicit consideration to what actually constitutes prosociality in the economy. Much has been said previously regarding sustainability but this has largely focused on environmental rather than interpersonal relations. This paper provides an analysis of how prosocial HCI has been discussed and continues to be defined as a research field. Based on a corpus of published works, we describe a variety of genres of work relating to prosocial HCI. Key intellectual differences are explored, including the epistemological and ethical positions involved in designing for prosocial outcomes as well as how HCI researchers posit economic decision-making. Finally, emerging issues and opportunities for further debate and collaboration are discussed in turn

Repurposing tofacitinib as an anti-myeloma therapeutic to reverse growth-promoting effects of the bone marrow microenvironment.

The myeloma bone marrow microenvironment promotes proliferation of malignant plasma cells and resistance to therapy. Activation of JAK/STAT signaling is thought to be a central component of these microenvironment-induced phenotypes. In a prior drug repurposing screen, we identified tofacitinib, a pan-JAK inhibitor Food and Drug Administration (FDA) approved for rheumatoid arthritis, as an agent that may reverse the tumor-stimulating effects of bone marrow mesenchymal stromal cells. Herein, we validated in vitro, in stromal-responsive human myeloma cell lines, and in vivo, in orthotopic disseminated xenograft models of myeloma, that tofacitinib showed efficacy in myeloma models. Furthermore, tofacitinib strongly synergized with venetoclax in coculture with bone marrow stromal cells but not in monoculture. Surprisingly, we found that ruxolitinib, an FDA approved agent targeting JAK1 and JAK2, did not lead to the same anti-myeloma effects. Combination with a novel irreversible JAK3-selective inhibitor also did not enhance ruxolitinib effects. Transcriptome analysis and unbiased phosphoproteomics revealed that bone marrow stromal cells stimulate a JAK/STAT-mediated proliferative program in myeloma cells, and tofacitinib reversed the large majority of these pro-growth signals. Taken together, our results suggest that tofacitinib reverses the growth-promoting effects of the tumor microenvironment. As tofacitinib is already FDA approved, these results can be rapidly translated into potential clinical benefits for myeloma patients

Development of a model-based clinical sepsis biomarker for critically ill patients

Invited. online 15 May 2010.Sepsis occurs frequently in the intensive care unit (ICU) and is a leading cause of admission, mortality, and cost. Treatment guidelines recommend early intervention, however positive blood culture results may take up to 48 h. Insulin sensitivity (SI) is known to decrease with worsening condition and could thus be used to aid diagnosis. Some glycemic control protocols are able to accurately identify insulin sensitivity in real-time. Hourly model-based insulin sensitivity SI values were calculated from glycemic control data of 36 patients with sepsis. The hourly SI is compared to the hourly sepsis score (ss) for these patients (ss = 0–4 for increasing severity). A multivariate clinical biomarker was also developed to maximize the discrimination between different ss groups. Receiver operator characteristic (ROC) curves for severe sepsis (ss=2) are created for both SI and the multivariate clinical biomarker. Insulin sensitivity as a sepsis biomarker for diagnosis of severe sepsis achieves a 50% sensitivity, 76% specificity, 4.8% positive predictive value (PPV), and 98.3% negative predictive value (NPV) at an SI cut-off value of 0.00013 L/mU/min. Multivariate clinical biomarker combining SI, temperature, heart rate, respiratory rate, blood pressure, and their respective hourly rates of change achieves 73% sensitivity, 80% specificity, 8.4% PPV, and 99.2% NPV. Thus, themultivariate clinical biomarker provides an effective real-time negative predictive diagnostic for severe sepsis. Examination of both inter- and intra-patient statistical distribution of this biomarker and sepsis score shows potential avenues to improve the positive predictive value

Schools and civil society : corporate or community governance

School improvement depends upon mediating the cultural conditions of learning as young people journey between their parochial worlds and the public world of cosmopolitan society. Governing bodies have a crucial role in including or diminishing the representation of different cultural traditions and in enabling or frustrating the expression of voice and deliberation of differences whose resolution is central to the mediation of and responsiveness to learning needs. A recent study of governing bodies in England and Wales argues that the trend to corporatising school governance will diminish the capacity of schools to learn how they can understand cultural traditions and accommodate them in their curricula and teaching strategies. A democratic, stakeholder model remains crucial to the effective practice of governing schools. By deliberating and reconciling social and cultural differences, governance constitutes the practices for mediating particular and cosmopolitan worlds and thus the conditions for engaging young people in their learning, as well as in the preparation for citizenship in civil society

Enhancement of mercury control in flue-gas cleanup systems

This paper summarizes research at Argonne National Laboratory which is focused on techniques to enhance the capture of elemental mercury and integrate its control into existing flue-gas cleanup (FGC) systems. Both laboratory and field tests have shown that very little elemental mercury is captured in a wet scrubber system due to the low solubility of that species. To enhance the ability of wet scrubbers to capture mercury, Argonne has studied improved mass transfer through both mechanical and chemical means, as well as the conversion of elemental mercury into a more soluble species that can be easily absorbed. Current research is investigating the roles of several halogen species either alone or in combination with typical flue-gas components such as sulfur dioxide and nitric oxide in the oxidation of mercury to form compounds that are easily scrubbed from the flue gas