Neurobiological abnormalities in the first few years of life in individuals later diagnosed with Autistic Spectrum Disorder : A review of recent data

Peer reviewedPublisher PD

Northward field excursions in Saturn’s magnetotail and their relationship to magnetospheric periodicities

We present results from an investigation of Cassini encounters with Saturn’s magnetotail current sheet, using magnetic field and plasma data. In the first of two intervals shown, small periodic changes in the north-south component of the magnetic field are matched by periodic density enhancements associated with the plasma sheet center. In the second interval, a large plasmoid signature is observed set against a background of small-scale current sheet motions. We interpret the quasi-periodic small field deflections and density enhancements as large-scale wave-like motion of the current sheet. We stress that plasmoid signatures are of a clearly different character and occur much less frequently

The persistence of the Turkish nation in the mausoleum of Mustafa Kemal Atatürk

[No abstract available

Attitudes and training of research fellows in surgery: national questionnaire survey

We examined the views of research fellows towards research and investigated whether the recommendations of the Calman report on research and surgical training had been adhered to

Radio Source Heating in the ICM: The Example of Cygnus A

One of the most promising solutions for the cooling flow problem involves energy injection from the central AGN. However it is still not clear how collimated jets can heat the ICM at large scale, and very little is known concerning the effect of radio lobe expansion as they enter into pressure equilibrium with the surrounding cluster gas. Cygnus A is one of the best examples of a nearby powerful radio galaxy for which the synchrotron emitting plasma and thermal emitting intra-cluster medium can be mapped in fine detail, and previous observations have inferred possible shock structure at the location of the cocoon. We use new XMM-Newton observations of Cygnus A, in combination with deep Chandra observations, to measure the temperature of the intra-cluster medium around the expanding radio cavities. We investigate how inflation of the cavities may relate to shock heating of the intra-cluster gas, and whether such a mechanism is sufficient to provide enough energy to offset cooling to the extent observed.Comment: To appear in the Proceedings of "Heating vs. Cooling in Galaxies and Clusters of Galaxies", August 2006, Garching (Germany), Eds. H. Boehringer, G.W. Pratt, A. Finoguenov, P. Schuecker, Springer-Verlag series "ESO Astrophysics Symposia", p.101, in press. 8 pages, 3 multiple figure

Impact of chloride on uranium(VI) speciation in acidic sulfate ion exchange systems: Towards seawater-tolerant mineral processing circuits

Using X-ray absorption spectroscopy, we have identified the mechanism by which chloride impacts the extraction of U(VI) by a weak base anion exchange resin from acidic sulfate solutions. The amount of chloride present affects U(VI) speciation both in the feed solutions and adsorbed by the resin, and we find three distinct U(VI) species taken up by the resin across the salinity gradient, directly corresponding to changes in levels of U(VI) extraction. These findings are integral to the effective design of mineral processing circuits incorporating seawater—a cheaper and more sustainable water source than fresh water

Assessment of knowledge on self-care practices by Diabetes Mellitus Type II attending Diabetes clinic at Kakamega County Referral Hospital

Introduction: In 2012, more than 371 million people presented with Diabetes Mellitus Type II worldwide. Approximately 4.8 million people died in 2012 due to the complications of Diabetes Mellitus Type II (American Diabetes Association 2013). In 2012, in sub-Saharan Africa, Diabetes Mellitus Type II was estimated at 6 percent of total mortality, this reflects an increase from 2.5 percent in 2000. Rapid urbanization leading to sedentary lifestyle and diet changes is a big contributing factor to the rapid increase of Diabetes Mellitus Type II in Sub-Saharan Africa.Kenya presents with heavy disease burden with life expectancy averaging 56 years. Despite the commendable successes to curb CDs (Communicable Diseases), health problem status has stagnated as a result of increase in NCDs causing 28% of all patients deaths in 2010; Diabetes Mellitus Type II accounting for 2% of the total death.Study area: Kakamega County Referral Hospital is approximately 400 kilometers from Nairobi the capital city of Kenya. It is the main referral hospital in western Kenya and receives referrals from neighboring counties e.g. Vihiga County, Bungoma County and various hospitals within the County. Target Population: Diabetes Mellitus Type II patients attending Kakamega County Referral HospitalAim: To assess adequate self-care practice by Diabetes Mellitus Type II patients attending the Diabetes clinic at Kakamega County Referral Hospital.Methods and Materials: This was a descriptive cross-sectional study. Researcher administered questionnaires based on W.H.O Diabetes Mellitus Type II self-care guidelines were used to collect data. Questionnaires that were filled were screened and carefully scrutinized for completeness, relevance and correctness before storage. Qualitative data was analyzed manually and Quantitative data was organized, coded, and standardized then descriptive statistics were used to analyze aided by statistical package for social scientists (SPSS) version 22. Descriptive analysis was carried out to provide simple summaries about the sample and the measures. Tables were used to present the data. Models of statistical analysis were done to validate the findings of the study.Results: The study found out that, only 22.02% of the participants gave correct signs and symptoms of high blood sugars. Only 13% of the participants demonstrated knowledge of signs and symptoms of low blood sugar. On low blood sugar management 84.52% gave correct responses. Frequency of feet checking was poor with only 16.67% of the participants giving correct responses. Majority (93.45%) of the participants were well versed with the complications of Diabetes Mellitus Type II. Frequency of eye examination had 90.48% of the participants giving the correct responses.Conclusion: The spoken knowledge in low literacy patient with Diabetes Mellitus Type II (SKILLD) scale was poorly scored with majority of the participants demonstrating low knowledge regarding common complications of Diabetes Mellitus Type II. Keywords: Diabetes Mellitus Type II, Self-care and Patient

Angiogenesis in the synovium and at the osteochondral junction in osteoarthritis

SummaryObjectivesWe hypothesised that osteochondral and synovial angiogenesis in osteoarthritis (OA) are independent processes. We investigated whether indices of osteochondral and synovial angiogenesis display different relationships with synovitis, disease severity and chondrocalcinosis in patients with OA.DesignSynovium and medial tibial plateaux were obtained from 62 patients undergoing total knee joint replacement for OA (18 [29%] had chondrocalcinosis) and from 31 recently deceased people with no evidence of joint pathology post-mortem (PM). Vascular endothelium, proliferating endothelial cells (ECs) and macrophages were quantified by immunohistochemistry for CD34, CD31/Ki67 and CD14, respectively. Grades were assigned for radiographic and histological OA disease severity, clinical disease activity and histological synovitis (based on cellular content of the synovium).ResultsBlood vessels breached the tidemark in 60% of patients with OA and 20% of PM controls. Osteochondral vascular density increased with increasing cartilage severity and clinical disease activity scores, but not with synovitis. Synovial EC proliferation, inflammation and macrophage infiltration were higher in OA than in PM controls. Synovial angiogenesis indices increased with increasing histological synovitis, but were not related to osteochondral vascular density or other indices of OA disease severity. OA changes were more severe in patients with concurrent chondrocalcinosis. Chondrocalcinosis was not associated with increased angiogenesis or histological synovitis beyond that seen in OA alone.ConclusionOsteochondral and synovial angiogenesis appear to be independent processes. Osteochondral vascularity is associated with the severity of OA cartilage changes and clinical disease activity, whereas synovial angiogenesis is associated with histological synovitis. Modulation of osteochondral and synovial angiogenesis may differentially affect OA disease

Effect of intraoperative fluid optimisation on renal function in patients undergoing emergency abdominal surgery; a randomised controlled pilot study (ISRCTN 11799696) Fluid optimisation for emergency surgery

<b>Background:</b> Emergency abdominal surgery carries a high risk of postoperative morbidity and mortality. Goal directed therapy has been advocated to improve outcome in high-risk surgery. The aim of the present pilot study was to examine the effect of goal directed therapy using fluid alone on postoperative renal function and organ failure score in patients undergoing emergency abdominal surgery. <b>Methods:</b> This prospective randomised pilot study included patients over the age of 50 undergoing emergency abdominal surgery. In the intervention group pulse pressure variation measurements were used to guide fluid boluses of 6% Hydroxyethylstarch 130/0.4. The control group received standard care. Serum urea, creatinine and cystatin C levels were measured prior to and at the end of surgery and postoperatively on day 1, day 3 and day 5. <b>Results:</b> Thirty patients were recruited. One patient died prior to surgery and was excluded from the analysis. The intervention group received a median of 750ml of hydroxyethylstarch. The peak values of postoperative urea were 6.9 (2.7–31.8) vs. 6.4 (3.5–11.5)mmol/l (p=0.425), creatinine 100 (60–300) vs. 85 (65–150) μmol/l (p=0.085) and cystatin C 1.09 (0.66–4.94) vs. 1.01 (0.33–2.29)mg/dl (p=0.352) in the control and intervention group, respectively. <b>Conclusions:</b> In the present pilot study replacing the identified fluid deficit was not associated with a change in renal function. These results do not preclude that goal directed therapy using fluid alone may have an effect on renal function but they would suggest that the effect size of fluid optimisation alone on renal function is small

The incidence of all-cause, cardiovascular and respiratory disease admission among 20,252 users of lisinopril vs. perindopril: a cohort study

Background: Major international guidelines do not offer explicit recommendations on any specific angiotensin-converting enzyme inhibitor (ACEI) agent over another within the same drug group. This study compared the effectiveness of lisinopril vs. perindopril in reducing the incidence of hospital admission due to all-cause, cardiovascular disease and respiratory disease. Methods: Adult patients who received new prescriptions of lisinopril or perindopril from 2001 to 2005 in all public hospitals and clinics in Hong Kong were included, and followed up for ≥2 years. The incidence of admissions due to all-cause, cardiovascular disease and respiratory disease were evaluated, respectively, by using Cox proportional hazard regression models. The regression models were constructed with propensity score matching to minimize indication biases. Results: A total of 20,252 eligible patients with an average age of 64.5 years (standard deviation 15.0) were included. The admission rate at 24 months within the date of index prescription due to any cause, cardiovascular disease and respiratory disease among lisinopril vs. perindopril users was 24.8% vs. 24.8%, 13.7% vs. 14.0% and 6.9% vs. 6.3%, respectively. Lisinopril users were significantly more likely to be admitted due to respiratory diseases (adjusted hazard ratios [AHR] = 1.25, 95% CI 1.08 to 1.43, p = 0.002 at 12 months; AHR = 1.17, 95% CI 1.04 to 1.31, p = 0.009 at 24 months) and all causes (AHR = 1.12, 95% CI 1.05 to 1.19, p < 0.001 at 24 months) than perindopril users. Conclusions: These findings support intra-class differences in the effectiveness of ACEIs, which could be considered by clinical guidelines when the preferred first-line antihypertensive drugs are recommended