3,031 research outputs found
Shallow-water spinal injuries â devastating but preventable
Background. Shallow-water diving injuries have devastating consequences for patients and their families, requiring intensive use of resources in both the acute and rehabilitative phases of injury. With the final clinical outcome often poor, the question is raised as to whether a target group can be identified for whom to implement a preventive programme. Objective. To evaluate the demographics, clinical features and outcomes of shallow-water diving injuries in an acute spinal cord injury (ASCI) unit. Materials and methods. All patients admitted to the ASCI unit with diving-related injuries were entered into the study. Data regarding demographics, injury profile and subsequent management were collated. All case notes and X-rays were reviewed. Ethical approval was obtained. Results. Forty-six patients were reviewed from 19 April 2003 to 8 February 2009. A steady annual increase in diving injuries was noted. A very specific patient profile was identified: 91% male incidence, average age 23 years, 37% admitted alcohol use, with a summer-time prevalence. Compression-flexion type injuries were most prevalent, with an orthopaedic level of C5 and neurological level of C4 being the most common injury sites. A third of diving injuries occurred in the sea, 20% in swimming pools, 20% in rivers, 11% in tidal pools and 4% in dams. Conclusion. A very specific patient profile was identified, and the severity of shallow-water diving injuries was confirmed. No current preventive programme exists except for a single television advertisement. These data will be used to motivate further educational and preventive programmes for reducing the incidence of diving-related injuries
Systematic review of sensory processing in preterm children reveals abnormal sensory modulation, somatosensory processing and sensory-based motor processing
Aim Preterm birth poses concerns in daily functioning and behaviour in childhood, possibly connected to sensory processing disorder. This review aimed to systematically identify assessments, incidence and nature of sensory processing disorder in preterm-born infants and children. Methods We searched literature through CINAHL-EBSCOhost, Cochrane, Ovid/PsychINFO, PubMed/Medline, Scopus and Google Scholar, published until November 2018. We included electronically available, peer-reviewed studies of preterm-born children that applied standardised sensory processing assessments. We excluded studies of preterm-born children with major neurodevelopmental impairments. Results We identified 27 studies of premature children, aged from birth to 9 years 7 months. The assessments represented three versions of Sensory Profile questionnaires and three clinical tests, Test of Sensory Functions in Infants, the Miller Assessment for Preschoolers, and the Sensory Integration and Praxis Test. The studies revealed wide variation of atypical sensory processing: 28%-87% in sensory modulation, 9%-70% in somatosensory processing and 20%-70% in sensory-based motor processing. Conclusion Preterm-born children exhibited elevated risk for sensory processing disorder from infancy into school age. Routine screening of sensory processing, intervention intervals and parental consultations should be considered in ameliorating sensory processing and neurocognitive development. Moreover, a larger body of intervention studies is needed.Peer reviewe
Jupiterâs equatorial X-ray emissions over two solar cycles
Jupiterâs disk is bright in X-rays as H2 molecules in the atmosphere are very effective at scattering solar X-rays. K-shell fluorescence from carbon atoms in atmospheric methane is thought to also provide a minor contribution. XMM-Newton has now observed Jupiter over a span of nearly two solar cycles from 2003 to 2021, offering the opportunity to determine whether Jupiterâs disk emissions are driven by solar activity or not. We compare the count rates of X-rays of energies 0.2â10.0Â keV, 0.2â2.0Â keV, 2.1â5.0Â keV, and 5.1â10.0Â keV from the planetâs equatorial region, with the sunspot number and F10.7 adjusted solar radio flux. The respective Pearsonâs Correlation Coefficients for both are 0.88/0.84, 0.86/0.83, 0.40/0.34 and 0.29/0.22 for each energy demonstrating that the low energy X-ray disk emissions are indeed controlled by the Sunâs activity. This relationship is less clear for the higher energy emissions, raising questions around the source of these emissions
Intraperitoneal injection of lipopolysaccharide prevents seizure-induced respiratory arrest in a DBA/1 mouse model of SUDEP
Objective
Sudden unexpected death in epilepsy (SUDEP) is the cause of premature death of 50% patients with chronic refractory epilepsy. Respiratory failure during seizures is regarded as an important mechanism of SUDEP. Previous studies have shown that abnormal serotonergic neurotransmission is involved in the pathogenesis of seizureâinduced respiratory failure, while enhancing serotonergic neurotransmission in the brainstem suppresses it. Because peripheral inflammation is known to enhance serotonergic neuron activation and 5âHT synthesis and release, we investigated the effect of intraperitoneal lipopolysaccharide (LPS)âinduced inflammation on the SâIRA susceptibility during audiogenic seizures in DBA/1 mice.
Methods
After DBA/1 mice were primed by exposing to sound stimulation for three consecutive days, they were tested for seizure severity and seizureâinduced respiratory arrest (SâIRA) induced by sound stimulation under different conditions. We determined the dose and time course of the effects of intraperitoneal administration of LPS on audiogenic seizures and SâIRA. The effects of blocking TLR4 or RAGE receptors and blocking 5âHT receptors on the LPSâinduced effect on SâIRA were investigated. Statistical significance was evaluated using the KruskalâWallis test.
Results
Intraperitoneal injection of LPS significantly had doseâdependent effects in reducing the incidence of SâIRA as well as seizure severity in DBA/1 mice. The protective effect of LPS on SâIRA peaked at 8â12 hours after LPS injection and was related to both reducing seizure severity and enhancing autoresuscitation. Blocking TLR4 or RAGE receptor with TAKâ242 or FPSâZM1, respectively, prior to LPS injection attenuated its effects on SâIRA and seizure severity. Injection of a nonselective 5âHT receptor antagonist, cyproheptadine, or a 5âHT3 receptor antagonist, ondansetron, was effective in blocking LPSâinduced effect on SâIRA. Immunostaining results showed a significant increase in câFosâpositive serotonergic neurons in the dorsal raphe.
Significance
This is the first study that demonstrates the effect of intraperitoneal LPS injectionâinduced inflammation on reducing SâIRA susceptibility and provides additional evidence supporting the serotonin hypothesis on SUDEP. Our study suggests that inflammation may enhance brainstem 5âHT neurotransmission to promote autoresuscitation during seizure and prevent SUDEP
Deep learning-based insights on T:R ratio behaviour during prolonged screening for S-ICD eligibility.
Peer reviewedPublisher PD
Superiority and non-inferiority: two sides of the same coin?
BACKGROUND: The classification of phase 3 trials as superiority or non-inferiority has become routine, and it is widely accepted that there are important differences between the two types of trial in their design, analysis and interpretation. MAIN TEXT: There is a clear rationale for the superiority/non-inferiority framework in the context of regulatory trials. The focus of our article is non-regulatory trials with a public health objective. First, using two examples from infectious disease research, we show that the classification of superiority or non-inferiority trials is not always straightforward. Second, we show that several arguments for different approaches to the design, analysis and interpretation of superiority and non-inferiority trials are unconvincing when examined in detail. We consider, in particular, the calculation of sample size (and the choice of delta or the non-inferiority margin), intention-to-treat versus per-protocol analyses, and one-sided versus two-sided confidence intervals. We argue that the superiority/non-inferiority framework is not just unnecessary but can have a detrimental effect, being a barrier to clear scientific thought and communication. In particular, it places undue emphasis on tests for significance or non-inferiority at the expense of estimation. We emphasise that these concerns apply to phase 3 non-regulatory trials in general, not just to those where the classification of the trial as superiority or non-inferiority is ambiguous. CONCLUSIONS: Guidelines and statistical practice should abandon the sharp division between superiority and non-inferiority phase 3 non-regulatory trials and be more closely aligned to the clinical and public health questions that motivate the trial
Perceived family functioning and friendship quality: cross-sectional associations with physical activity and sedentary behaviours.
This study examined the association of adolescent-reported family functioning and friendship quality with objectively-measured moderate to vigorous physical activity (MVPA), sedentary time, and self-reported sedentary behaviours.The work of Andrew J Atkin, Kirsten Corder, and Esther M F van Sluijs was supported, wholly or in part, by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence (RES-590-28-0002). Funding from the British Heart Foundation, Department of Health, Economic and Social Research Council, Medical Research Council, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The work of Esther M F van Sluijs, Kirsten Corder, Ulf Ekelund and Soren Brage was supported by the Medical Research Council (MC_UU_12015/7, MC_UU_12015/3). The ROOTS data collection was supported by a programme grant to Ian Goodyer (074296/Z/04/Z) from the Wellcome Trust and by the Medical Research Council Epidemiology Unit and Medical Research Council Human Nutrition Research.This is the final version of the article. It first appeared at http://www.ijbnpa.org/content/12/1/2
Role of deep learning methods in screening for subcutaneous implantable cardioverter defibrillator in heart failure.
Peer reviewedPublisher PD
Properties of plasmoids observed in Saturnâs dayside and nightside magnetodisc
Plasmoid is a key structure for transferring magnetic flux and plasma in planetary magnetospheres. At Earth, plasmoids are key media which transfer energy and mass in the "Dungey Cycle". For giant planets, plasmoids are primarily generated by the dynamic processes associated with âVasyliunas Cycleâ. It is generally believed that planetary magnetotails are favorable for producing plasmoids. Nevertheless, recent studies reveal that magnetic field lines could be sufficiently stretched to allow magnetic reconnection in Saturnâs dayside magnetodisc. In the study, we report direct observations of plasmoids in Saturnâs dayside magnetodisc for the first time. Moreover, we perform a statistical investigation on the global plasmoid electron density distribution. The results show an inverse correlation between the nightside plasmoid electron density and local time, and the maximum plasmoid electron density around prenoon local time on the dayside. These results are consistent with the magnetospheric circulation picture associated with the "Vasyliunas Cycle"
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