The PURPLE N study: objective and perceived nutritional status in children and adolescents with cerebral palsy

Purpose: To obtain information on characteristics, management, current objective nutritional status and perception of nutritional status of children with cerebral palsy (CP) from healthcare professionals (HCPs) and caregivers. Materials and methods: A detailed survey of several items on eight main topics (general characteristics, motor function, comorbidities, therapies, anthropometry, feeding mode and problems and perceived nutritional status) was developed and tested for the study. Correlation between nutritional status and Gross Motor Function Classification System (GMFCS) levels was assessed using continuous variables (Z-scores for weight-for-age, height-for-age, weight-for-height, and body mass index-for-age), and categorical variables (being malnourished, stunted, or wasted). HCP and caregiver perceptions of the child’s nutritional status as well as agreement between perceived and objective nutritional status and agreement between perceived nutritional status and concerns about the nutritional status were analyzed. Results: Data were available for 497 participants from eight European countries. Poorer nutritional status was associated with higher (more severe) GMFCS levels. There was minimal agreement between perceived and objective nutritional status, both for HCPs and caregivers. Agreement between HCP and caregiver perceptions of the child’s nutritional status was weak (weighted kappa 0.56). However, the concerns about the nutritional status of the child were in line with the perceived nutritional status. Conclusions: The risk of poor nutritional status is associated with more severe disability in children and adolescents with CP. There is a mismatch between HCP and caregiver perceptions of participants’ nutritional status as well as between subjective and objective nutritional status. Our data warrant the use of a simple and objective screening tool in daily practice to determine nutritional status in children and adolescents with CP. Clinical trial registration: ClinicalTrials.gov Identifier: NCT03499288 (https://clinicaltrials.gov/ct2/show/NCT03499288).IMPLICATIONS FOR REHABILITATION Use of the ESPGHAN recommendations and simple screening tools in daily practice is needed to improve nutritional care for individuals with CP. Attention should be paid to the differences in the perception of nutritional status of individuals with CP between professionals and caregivers to improve appropriate referral for nutritional support. Objective measures rather than the professional’s perception need to be used to define the nutritional status of individuals with CP

Peptide Bond Distortions from Planarity: New Insights from Quantum Mechanical Calculations and Peptide/Protein Crystal Structures

By combining quantum-mechanical analysis and statistical survey of peptide/protein structure databases we here report a thorough investigation of the conformational dependence of the geometry of peptide bond, the basic element of protein structures. Different peptide model systems have been studied by an integrated quantum mechanical approach, employing DFT, MP2 and CCSD(T) calculations, both in aqueous solution and in the gas phase. Also in absence of inter-residue interactions, small distortions from the planarity are more a rule than an exception, and they are mainly determined by the backbone ψ dihedral angle. These indications are fully corroborated by a statistical survey of accurate protein/peptide structures. Orbital analysis shows that orbital interactions between the σ system of Cα substituents and the π system of the amide bond are crucial for the modulation of peptide bond distortions. Our study thus indicates that, although long-range inter-molecular interactions can obviously affect the peptide planarity, their influence is statistically averaged. Therefore, the variability of peptide bond geometry in proteins is remarkably reproduced by extremely simplified systems since local factors are the main driving force of these observed trends. The implications of the present findings for protein structure determination, validation and prediction are also discussed

EpiNet as a way of involving more physicians and patients in epilepsy research: Validation study and accreditation process

open185siObjective: EpiNet was established to encourage epilepsy research. EpiNet is used for multicenter cohort studies and investigator-led trials. Physicians must be accredited to recruit patients into trials. Here, we describe the accreditation process for the EpiNet-First trials. Methods: Physicians with an interest in epilepsy were invited to assess 30 case scenarios to determine the following: whether patients have epilepsy; the nature of the seizures (generalized, focal); and the etiology. Information was presented in two steps for 23 cases. The EpiNet steering committee determined that 21 cases had epilepsy. The steering committee determined by consensus which responses were acceptable for each case. We chose a subset of 18 cases to accredit investigators for the EpiNet-First trials. We initially focused on 12 cases; to be accredited, investigators could not diagnose epilepsy in any case that the steering committee determined did not have epilepsy. If investigators were not accredited after assessing 12 cases, 6 further cases were considered. When assessing the 18 cases, investigators could be accredited if they diagnosed one of six nonepilepsy patients as having possible epilepsy but could make no other false-positive errors and could make only one error regarding seizure classification. Results: Between December 2013 and December 2014, 189 physicians assessed the 30 cases. Agreement with the steering committee regarding the diagnosis at step 1 ranged from 47% to 100%, and improved when information regarding tests was provided at step 2. One hundred five of the 189 physicians (55%) were accredited for the EpiNet-First trials. The kappa value for diagnosis of epilepsy across all 30 cases for accredited physicians was 0.70. Significance: We have established criteria for accrediting physicians using EpiNet. New investigators can be accredited by assessing 18 case scenarios. We encourage physicians with an interest in epilepsy to become EpiNet-accredited and to participate in these investigator-led clinical trials.openBergin P.S.; Beghi E.; Sadleir L.G.; Brockington A.; Tripathi M.; Richardson M.P.; Bianchi E.; Srivastava K.; Jayabal J.; Legros B.; Ossemann M.; McGrath N.; Verrotti A.; Tan H.J.; Beretta S.; Frith R.; Iniesta I.; Whitham E.; Wanigasinghe J.; Ezeala-Adikaibe B.; Striano P.; Rosemergy I.; Walker E.B.; Alkhidze M.; Rodriguez-Leyva I.; Ramirez Gonzalez J.A.; D'Souza W.J.; Calle A.; Palacios C.; Cairns A.; Carney P.; Craig D.; Gill D.; Gupta S.; Lander C.; Laue-Gizzi H.; Hitchens N.; Kiley M.; Lawn N.; Reyneke E.; Riney K.; Tan M.; Tan M.; Thieban M.; Wong C.; van Rijckevorsel G.; Ferrari Strang A.G.; Gifoni A.; Helio L.; Monnerat B.; Brna P.; Donner E.; Jacques S.; Jette N.; McLachlan R.; Mohamed I.; Tran T.P.Y.; Bo X.; Fan S.; Guang Y.; Li M.; Wang K.; Zhang S.; Ladino L.; Christensen J.; Kӧlmel M.S.; Nikanorova M.; Uusitalo A.; Vieira P.; Auvin S.; Ediberidze T.; Gogatishvili N.; Jishkariani T.; Dennig D.; Grimmer A.; Michaelis R.; Schubert-Bast S.; Stephani C.; Stodieck S.; Vollbrandt M.; Zellner A.; Zafeiriou D.; Fogarasi A.; Halasz P.; Chaurasia R.N.; Jain S.; Nair R.; Passi P.; Rajadhyaksha S.; Sattaluri S.J.; Shah H.; Udani V.; Costello D.; Aguglia U.; Bartocci A.; Benna P.; Ferlazzo E.; Laino D.; Spalice A.; Zanchi C.; Ali A.; Lim K.S.; Ramirez A.; Anderson N.; Barber A.; Cariga P.; Cleland J.; Child N.; Davis S.; Dayal V.; Dickson C.; Doran J.; Duncan R.; Giri P.; Herd M.; Hutchinson D.; Jones B.; Kao J.; Kilfoyle D.; Mottershead J.; Muir C.; Nolan M.; Pereira J.; Ranta A.; Sadani S.; Simpson M.; Spooner C.; Timmings P.; Walker E.; Wei D.; Willoughby E.; Wong E.; Wu T.; Olusola T.; Mahmud H.; Mogul Z.; Espinoza J.; Vizarreta J.H.; Baeta E.M.; Teotonio R.; Jocic-Jakubi B.; Lukic S.; Korosec M.; Zgur T.; Eguilaz M.G.; Asztely F.; Sithinamsuwan P.; Anderson J.; Auce P.; Desurkar A.; Hamandi K.; Kelso A.; Sanchez V.; Sidra A.; Smith P.; Wehner T.; Winston G.; Andrade E.; Bensalem-Owen M.; Boudreau M.; Caller T.; Chapman K.; Chari G.; Davis K.; Droker B.; El-Hagrassy M.; Eliashiv D.; Eze C.; Heck C.; Kabir A.; Kolesnik D.; Lam A.; Lopez J.; Maamoon T.; Cohen J.M.; Maganti R.; Nwankwo C.; Park K.; Proteasa S.; Sandok E.; Seinfield S.; Toub J.; Wirrell E.; Arbildi M.; Thien T.T.Bergin, P. S.; Beghi, E.; Sadleir, L. G.; Brockington, A.; Tripathi, M.; Richardson, M. P.; Bianchi, E.; Srivastava, K.; Jayabal, J.; Legros, B.; Ossemann, M.; Mcgrath, N.; Verrotti, A.; Tan, H. J.; Beretta, S.; Frith, R.; Iniesta, I.; Whitham, E.; Wanigasinghe, J.; Ezeala-Adikaibe, B.; Striano, P.; Rosemergy, I.; Walker, E. B.; Alkhidze, M.; Rodriguez-Leyva, I.; Ramirez Gonzalez, J. A.; D'Souza, W. J.; Calle, A.; Palacios, C.; Cairns, A.; Carney, P.; Craig, D.; Gill, D.; Gupta, S.; Lander, C.; Laue-Gizzi, H.; Hitchens, N.; Kiley, M.; Lawn, N.; Reyneke, E.; Riney, K.; Tan, M.; Tan, M.; Thieban, M.; Wong, C.; van Rijckevorsel, G.; Ferrari Strang, A. G.; Gifoni, A.; Helio, L.; Monnerat, B.; Brna, P.; Donner, E.; Jacques, S.; Jette, N.; Mclachlan, R.; Mohamed, I.; Tran, T. P. Y.; Bo, X.; Fan, S.; Guang, Y.; Li, M.; Wang, K.; Zhang, S.; Ladino, L.; Christensen, J.; Kӧlmel, M. S.; Nikanorova, M.; Uusitalo, A.; Vieira, P.; Auvin, S.; Ediberidze, T.; Gogatishvili, N.; Jishkariani, T.; Dennig, D.; Grimmer, A.; Michaelis, R.; Schubert-Bast, S.; Stephani, C.; Stodieck, S.; Vollbrandt, M.; Zellner, A.; Zafeiriou, D.; Fogarasi, A.; Halasz, P.; Chaurasia, R. N.; Jain, S.; Nair, R.; Passi, P.; Rajadhyaksha, S.; Sattaluri, S. J.; Shah, H.; Udani, V.; Costello, D.; Aguglia, U.; Bartocci, A.; Benna, P.; Ferlazzo, E.; Laino, D.; Spalice, A.; Zanchi, C.; Ali, A.; Lim, K. S.; Ramirez, A.; Anderson, N.; Barber, A.; Cariga, P.; Cleland, J.; Child, N.; Davis, S.; Dayal, V.; Dickson, C.; Doran, J.; Duncan, R.; Giri, P.; Herd, M.; Hutchinson, D.; Jones, B.; Kao, J.; Kilfoyle, D.; Mottershead, J.; Muir, C.; Nolan, M.; Pereira, J.; Ranta, A.; Sadani, S.; Simpson, M.; Spooner, C.; Timmings, P.; Walker, E.; Wei, D.; Willoughby, E.; Wong, E.; Wu, T.; Olusola, T.; Mahmud, H.; Mogul, Z.; Espinoza, J.; Vizarreta, J. H.; Baeta, E. M.; Teotonio, R.; Jocic-Jakubi, B.; Lukic, S.; Korosec, M.; Zgur, T.; Eguilaz, M. G.; Asztely, F.; Sithinamsuwan, P.; Anderson, J.; Auce, P.; Desurkar, A.; Hamandi, K.; Kelso, A.; Sanchez, V.; Sidra, A.; Smith, P.; Wehner, T.; Winston, G.; Andrade, E.; Bensalem-Owen, M.; Boudreau, M.; Caller, T.; Chapman, K.; Chari, G.; Davis, K.; Droker, B.; El-Hagrassy, M.; Eliashiv, D.; Eze, C.; Heck, C.; Kabir, A.; Kolesnik, D.; Lam, A.; Lopez, J.; Maamoon, T.; Cohen, J. M.; Maganti, R.; Nwankwo, C.; Park, K.; Proteasa, S.; Sandok, E.; Seinfield, S.; Toub, J.; Wirrell, E.; Arbildi, M.; Thien, T. T

Toward a unified functional account of structural focus and negation in Hungarian

The goal of this paper is to provide a unified analysis of the function of various types of (structural) focus and the negative particle (used preverbally) in Hungarian. It is argued that the function of these elements (each inducing the inversion of verbal modifier and verb) is best understood with respect to the interpretation assigned to the verbal predicate in different contexts. By treating the verbal predicate as a schematic positive declarative clause (or “proto-statement”) in its default interpretation, it becomes possible to define the function of the elements concerned in terms of the kind of relation in which they stand with the proto-statement, the kind of relation in which the overall symbolic pattern (as a Gestalt) stands with the unmarked positive declarative clause type

The bear in Eurasian plant names: Motivations and models

Ethnolinguistic studies are important for understanding an ethnic group's ideas on the world, expressed in its language. Comparing corresponding aspects of such knowledge might help clarify problems of origin for certain concepts and words, e.g. whether they form common heritage, have an independent origin, are borrowings, or calques. The current study was conducted on the material in Slavonic, Baltic, Germanic, Romance, Finno-Ugrian, Turkic and Albanian languages. The bear was chosen as being a large, dangerous animal, important in traditional culture, whose name is widely reflected in folk plant names. The phytonyms for comparison were mostly obtained from dictionaries and other publications, and supplemented with data from databases, the co-authors' field data, and archival sources (dialect and folklore materials). More than 1200 phytonym use records (combinations of a local name and a meaning) for 364 plant and fungal taxa were recorded to help find out the reasoning behind bear-nomination in various languages, as well as differences and similarities between the patterns among them. Among the most common taxa with bear-related phytonyms were Arctostaphylos uva-ursi (L.) Spreng., Heracleum sphondylium L., Acanthus mollis L., and Allium ursinum L., with Latin loan translation contributing a high proportion of the phytonyms. Some plants have many and various bear-related phytonyms, while others have only one or two bear names. Features like form and/or surface generated the richest pool of names, while such features as colour seemed to provoke rather few associations with bears. The unevenness of bear phytonyms in the chosen languages was not related to the size of the language nor the present occurence of the Brown Bear in the region. However, this may, at least to certain extent, be related to the amount of the historical ethnolinguistic research done on the selected languages