379 research outputs found
UK Renal Registry 18th Annual Report:Chapter 4 Demography of Patients Receiving Renal Replacement Therapy in Paediatric Centres in the UK in 2014
Labels, instructions and features of convertible Child Restraint Systems (CRS): evaluating their effects on CRS installation errors
This report documents a study of how CRS features, labels, and instructions contribute to CRS installation errors.
Task 1A focused on assessing different physical features of 16 convertible CRS, while Task 1B evaluated baseline and
modified versions of labels and instructions for two CRS models. For each phase of testing, 32 subjects were recruited
based on their education level (high or low) and experience with installing CRS (none or experienced). Each subject was
asked to perform four child restraint installations in a 2006 Pontiac G6 sedan. An 18-month-old CRABI anthropometric test
device (ATD) weighing 25 lb was used for all installations. Each subject installed two CRS forward-facing (FF), one with
LATCH and one with seatbelt, and two CRS rear-facing (RF), one with LATCH and one with the seatbelt. For Task 1A,
each subject installed four of the sixteen convertible CRS. For Task 1B, each subject installed a Graco ComfortSport and
Evenflo Titan twice, where each CRS had one of eight alternate instruction manuals and one of eight alternate label
conditions. After each installation, the experimenter evaluated 42 factors for each installation, such as choice of belt routing
path, tightness of installation, and harness snugness.
Analyses used linear mixed models to identify CRS installation outcomes associated with CRS features or label/ instruction
type. LATCH connector type, LATCH belt adjustor type, and the presence of belt lockoffs are associated with the tightness
of the CRS installation. The type of harness shoulder height adjuster is associated with the rate of achieving a snug harness.
Correct tether use is associated with the tether storage method. In general, subject assessments of the ease of use of CRS
features are not highly correlated with the quality of their installation, suggesting a need for feedback with incorrect
installations.
The results of testing alternative labels and instructions indicate that no alternative condition significantly improved CRS
installation compared to baseline conditions across all potential installation errors that were evaluated. An unintended
consequence of using “combined” labels (incorporating all of the variations recommended by human factors experts that
were tested individually in other conditions) is that subjects were less likely to use the CRS manual. The most promising
alternative manual is a video version. Neither the labels nor manuals with improved graphics showed substantial benefit
compared to baseline, even though graphics-based manuals and labels score well using the ISO and NHTSA ease-of-use
rating system. The effects of varying labels and manuals on installation error are small compared to the effects of different
CRS designs.
The data from this study provide quantitative assessments of some CRS features that are associated with reductions in CRS
installation errors. This information can be used to update the NHTSA CRS ease-of-use rating system to account for
recently developed CRS features. Based on human factors recommendations, suggestions are made for assessing “clear”
labels and instructions and modifying FMVSS 213 requirements to facilitate clearer labels and instructions.VTTI, National Highway Traffic Safety Administrationhttp://deepblue.lib.umich.edu/bitstream/2027.42/89861/1/102795.pd
UK Renal Registry 18th Annual Report:Chapter 10 Clinical, Haematological and Biochemical Parameters in Patients Receiving Renal Replacement Therapy in Paediatric Centres in the UK in 2014: National and Centre-specific Analyses
Psychosocial Health and Lifestyle Behaviors in Young Adults Receiving Renal Replacement Therapy Compared to the General Population:Findings From the SPEAK Study
Continually improving standards of care:The UK Renal Registry as a translational public health tool
A Global lake ecological observatory network (GLEON) for synthesising high-frequency sensor data for validation of deterministic ecological models
A Global Lake Ecological Observatory Network (GLEON; www.gleon.org) has formed to provide a coordinated response to the need for scientific understanding of lake processes, utilising technological advances available from autonomous sensors. The organisation embraces a grassroots approach to engage researchers from varying disciplines, sites spanning geographic and ecological gradients, and novel sensor and cyberinfrastructure to synthesise high-frequency lake data at scales ranging from local to global. The high-frequency data provide a platform to rigorously validate processbased ecological models because model simulation time steps are better aligned with sensor measurements than with lower-frequency, manual samples. Two case studies from Trout Bog, Wisconsin, USA, and Lake Rotoehu, North Island, New Zealand, are presented to demonstrate that in the past, ecological model outputs (e.g., temperature, chlorophyll) have been relatively poorly validated based on a limited number of directly comparable measurements, both in time and space. The case studies demonstrate some of the difficulties of mapping sensor measurements directly to model state variable outputs as well as the opportunities to use deviations between sensor measurements and model simulations to better inform process understanding. Well-validated ecological models provide a mechanism to extrapolate high-frequency sensor data in space and time, thereby potentially creating a fully 3-dimensional simulation of key variables of interest
Immunolocalization of NLRP3 Inflammasome in Normal Murine Airway Epithelium and Changes following Induction of Ovalbumin-Induced Airway Inflammation
Little is known about innate immunity and components of inflammasomes in airway epithelium. This study evaluated immunohistological evidence for NLRP3 inflammasomes in normal and inflamed murine (Balb/c) airway epithelium in a model of ovalbumin (OVA) induced allergic airway inflammation. The airway epithelium of control mice exhibited strong cytoplasmic staining for total caspase-1, ASC, and NLRP3, whereas the OVA mice exhibited strong staining for active caspase-1, with redistribution of caspase-1, IL-1β and IL-18, indicating possible activation of the NLRP3 inflammasome. Active caspase-1, NLRP3, and other inflammasome components were also detected in tissue eosinophils from OVA mice, and may potentially contribute to IL-1β and IL-18 production. In whole lung, inRNA expression of NAIP and procaspase-1 was increased in OVA mice, whereas NLRP3, IL-1β and IL-18 decreased. Some OVA-treated mice also had significantly elevated and tightly correlated serum levels of IL-1β and TNFα. In cultured normal human bronchial epithelial cells, LPS priming resulted in a significant increase in NLRP3 and II-lp protein expression. This study is the first to demonstrate NLRP3 inflammasome components in normal airway epithelium and changes with inflammation. We propose activation and/or luminal release of the inflammasome is a feature of allergic airway inflammation which may contribute to disease pathogenesis
Negative Effects of Paternal Age on Children's Neurocognitive Outcomes Can Be Explained by Maternal Education and Number of Siblings
Background: Recent findings suggest advanced paternal age may be associated with impaired child outcomes, in particular, neurocognitive skills. Such patterns are worrisome given relatively universal trends in advanced countries toward delayed nuptiality and fertility. But nature and nurture are both important for child outcomes, and it is important to control for both when drawing inferences about either pathway. Methods and Findings: We examined cross-sectional patterns in six developmental outcome measures among children in the U.S. Collaborative Perinatal Project (n = 31,346). Many of these outcomes at 8 mo, 4 y, and 7 y of age (Bayley scales, Stanford Binet Intelligence Scale, Graham-Ernhart Block Sort Test, Wechsler Intelligence Scale for Children, Wide Range Achievement Test) are negatively correlated with paternal age when important family characteristics such as maternal education and number of siblings are not included as covariates. But controlling for family characteristics in general and mother’s education in particular renders the effect of paternal age statistically insignificant for most developmental measures. Conclusions: Assortative mating produces interesting relationships between maternal and paternal characteristics that can inject spurious correlation into observational studies via omitted variable bias. Controlling for both nature and nurture reveals little residual evidence of a link between child neurocognitive outcomes and paternal age in these data. Result
The HNF4A R76W mutation causes atypical dominant Fanconi syndrome in addition to a β cell phenotype
types: JOURNAL ARTICLEMutation specific effects in monogenic disorders are rare. We describe atypical Fanconi syndrome caused by a specific heterozygous mutation in HNF4A. Heterozygous HNF4A mutations cause a beta cell phenotype of neonatal hyperinsulinism with macrosomia and young onset diabetes. Autosomal dominant idiopathic Fanconi syndrome (a renal proximal tubulopathy) is described but no genetic cause has been defined.This article presents independent research supported by the National Institute for Health Research (NIHR) Exeter Clinical Research Facility. The research is funded by a Wellcome Trust Senior Investigator Award, (grant number 098395/Z/12/Z).Wellcome Trus
Potential Economic Viability of Two Proposed Rifapentine-Based Regimens for Treatment of Latent Tuberculosis Infection
Rationale: Rifapentine-based regimens for treating latent tuberculosis infection (LTBI) are being considered for future clinical trials, but even if they prove effective, high drug costs may limit their economic viability. Objectives: To inform clinical trial design by estimating the potential costs and effectiveness of rifapentine-based regimens for treatment of latent tuberculosis infection (LTBI). Methods: We used a Markov model to estimate cost and societal benefits for three regimens for treating LTBI: Isoniazid/ rifapentine daily for one month, isoniazid/rifapentine weekly for three months (self-administered and directly-observed), and isoniazid daily for nine months; a strategy of ‘‘no treatment’ ’ used for comparison. Costs, quality-adjusted life-years gained, and instances of active tuberculosis averted were calculated for all arms. Results: Both daily isoniazid/rifapentine for one month and weekly isoniazid/rifapentine for three months were less expensive and more effective than other strategies under a wide variety of clinically plausibly parameter estimates. Daily isoniazid/rifapentine for one month was the least expensive and most effective regimen. Conclusions: Daily isoniazid/rifapentine for one month and weekly isoniazid/rifapentine for three months should be studied in a large-scale clinical trial for efficacy. Because both regimens performed well even if their efficacy is somewhat reduced
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