Tuberculous meningitis in children: reducing the burden of death and disability

Tuberculous meningitis disproportionately affects young children. As the most devastating form of tuberculosis, it is associated with unacceptably high rates of mortality and morbidity even if treated. Challenging to diagnose and treat, tuberculous meningitis commonly causes long-term neurodisability in those who do survive. There remains an urgent need for strengthened surveillance, improved rapid diagnostics technology, optimised anti-tuberculosis drug therapy, investigation of new host-directed therapy, and further research on long-term functional and neurodevelopmental outcomes to allow targeted intervention. This review focuses on the neglected field of paediatric tuberculous meningitis and bridges current clinical gaps with research questions to improve outcomes from this crippling disease

Developmental regulation of Foxp3 expression during ontogeny

Thymectomy of neonatal mice can result in the development of autoimmune pathology. It has been proposed that thymic output of regulatory T (T reg) cells is delayed during ontogeny and that the development of autoimmune disease in neonatally thymectomized mice is caused by the escape of self-reactive T cells before thymectomy without accompanying T reg cells. However, the kinetics of T reg cell production within the thymus during ontogeny has not been assessed. We demonstrate that the development of Foxp3-expressing T reg cells is substantially delayed relative to nonregulatory thymocytes during ontogeny. Based on our data, we speculate that induction of Foxp3 in developing thymocytes and, thus, commitment to the T reg cell lineage is facilitated by a signal largely associated with the thymic medulla

Critical value factors in business intelligence systems implementations

Business Intelligence (BI) systems have been rated as a leading technology for the last several years. However, organizations have struggled to ensure that high quality information is provided to and from BI systems. This suggests that organizations have recognized the value of information and the potential opportunities available but are challenged by the lack of success in Business Intelligence Systems Implementation (BISI). Therefore, our research addresses the preponderance of failed BI system projects, promulgated by a lack of attention to Systems Quality (SQ) and Information Quality (IQ) in BISI. The main purpose of this study is to determine how an organization may gain benefits by uncovering the antecedents and critical value factors (CVFs) of SQ and IQ necessary to derive greater BISI success. We approached these issues through adopting ‘critical value factors’ (CVF) as a conceptual ‘lens’. Following an initial pilot study, we undertook an empirical analysis of 1,300 survey invitations to BI analysts. We used exploratory factor analysis (EFA) techniques to uncover the CVFs of SQ and IQ of BISI. Our study demonstrates that there is a significant effect in the relationships of perceived IQ of BISI to perceived user information satisfaction thereby confirming the importance BI system users place on information and the output produced. Our study also reported that there is a significant effect in the relationships of perceived IQ of BISI to perceived user system satisfaction thereby confirming the importance BI system users place on system output. We believe our research will be of benefit to both academics and practitioners in attempting to ensure BI systems implementation success

The effect of compression gloves in hand Osteoarthritis: A pre-post test trial

Background: Compression gloves are used in Hand Osteoarthritis (HOA) to reduce pain (day and/or night), stiffness and improve hand function. A systematic review identified only two trials (sample sizes n= 2 and 5), with inconclusive results [1]. The commonest compression gloves provided in the UK are Isotoner gloves. The aim was to evaluate effects of compression gloves on hand pain, stiffness and function. Methods: A pre-post-test study was conducted. Participants were recruited from 10 Rheumatology Occupational Therapy (OT) departments; had a doctor diagnosis of HOA and no steroid injections or new/changed medication within the previous 4 weeks. Assessments at 0 and 4 weeks included: hand pain on activity and at night, hand stiffness (all 0-10 numeric rating scales: none to very severe); Measure of Activity Performance of the Hand [MAP-HAND, 2]; Grip Ability Test [GAT, 3]; and composite finger flexion to distal wrist crease (CFF). OT assessors were trained in standardised hand assessment procedures. Assessor inter-rater reliability (ICC,10) was good : CFF (0.76-0.93); GAT (0.98) [4]. All participants received Isotoner ¾ finger gloves. Data were analysed using paired t-tests and effect sizes calculated using eta-squared (values of 0.14+ = large effect, 5). Results: 30 people with HOA participated: 28 women, 2 men); average age = 61.23(SD 8.35) years; time since diagnosis 4.71(SD 6.47) years. Conclusion: This study demonstrates, for the first time, that compression gloves used by people with HOA led to significant improvements in: pain during the day and night, stiffness, hand function and finger motion, with moderate to large effect sizes. A limitation was the lack of a control group meaning we cannot be certain benefits were due to compression gloves. A randomised controlled trial needs to be conducted, including longer follow-up

I=3/2 KπK \pi Scattering in the Nonrelativisitic Quark Potential Model

We study $I=3/2$ elastic $K\pi$ scattering to Born order using nonrelativistic quark wavefunctions in a constituent-exchange model. This channel is ideal for the study of nonresonant meson-meson scattering amplitudes since s-channel resonances do not contribute significantly. Standard quark model parameters yield good agreement with the measured S- and P-wave phase shifts and with PCAC calculations of the scattering length. The P-wave phase shift is especially interesting because it is nonzero solely due to $SU(3)_f$ symmetry breaking effects, and is found to be in good agreement with experiment given conventional values for the strange and nonstrange constituent quark masses.Comment: 12 pages + 2 postscript figures, Revtex, MIT-CTP-210

How do psychiatrists address delusions in first meetings in acute care? A qualitative study

Licensed under the Creative Commons Attribution Licens

Does splinting the upper limb improve the quality of life and functional independence of stroke survivors?

Introduction and Background: Up to 80% of stroke survivors have impairments of the upper limb, which considerably affects participation in everyday activities and quality of life (Langhorne et al., 2009). Improving upper limb function to maximise functional potential is an integral part of a stroke survivor’s rehabilitation programme (Lum et al., 2009). The use of splinting to improve functional outcomes has been a source of debate in the literature as its application in practice is diverse and warrants further research to guide practice (Basaran et al., 2012). Methods: An in-depth case study approach was used to evaluate eight stroke survivors’ sensorimotor and functional outcomes following a splinting regime using either dorsal or volar splints. The ICF framework was used to develop and structure the study. Data collection occurred biweekly for 2 months and then at 6 months to evaluate the impact of splinting. Descriptive and nonparametric data analysis of sensorimotor, functional and quality of life measures was done using SPSS. Results and conclusion: All participants showed some degree of improvement in majority of the study measures following an 8-week splinting programme. For younger participants, improvements of sensorimotor components were significantly associated with an improvement in functional ability and quality of life. Impact: The findings highlight areas of splinting practice that are potentially effective for the rehabilitation of the upper limb of stroke survivors but require research on a larger population using randomised controlled trials to confirm the findings. Implications for practice: A 6 month splinting programme has the potential to effect sensorimotor, functional and quality of life outcomes for individuals in the chronic phase of Stoke rehabilitation. There are many variables that need to be considered and the structure of the ICF model is well suited in guiding OTs when using splints for the rehabilitation of the upper limb for stroke survivors. References Basaran, A., E e, U., Karadavut, K.I., Balbaloglu, O., Bulmus, N. (2012) Hand splinting for poststroke spasticity: a randomized controlled trial. Topics In Stroke Rehabilitation. 19(4), 329#8211337. Langhorne, P., Coupar, F., Pollock, A. (2009) Motor recovery after stroke: a systematic review. The Lancet Neurology. 8(8), 741#8211754. Lum, P.S., Mulroy, S., Amdur, R.L., Requejo, P., Prilutsky, B.I., Dromerick, A.W. (2009) Gains in upper extremity function after stroke via recovery or compensation: Potential differential effects on amount of real-world limb use. Topics In Stroke Rehabilitation. 16(4), 237#8211253. Keywords Neurological practice, Research, Practice – present and future, Voluntary/third sector services Contact E-mail Addresses [email protected]

Towards Multi-Language Recipe Personalisation and Recommendation

Multi-language recipe personalisation and recommendation is an under-explored field of information retrieval in academic and production systems. The existing gaps in our current understanding are numerous, even on fundamental questions such as whether consistent and high-quality recipe recommendation can be delivered across languages. In this paper, we introduce the multi-language recipe recommendation setting and present grounding results that will help to establish the potential and absolute value of future work in this area. Our work draws on several billion events from millions of recipes and users from Arabic, English, Indonesian, Russian, and Spanish. We represent recipes using a combination of normalised ingredients, standardised skills and image embeddings obtained without human intervention. In modelling, we take a classical approach based on optimising an embedded bi-linear user-item metric space towards the interactions that most strongly elicit cooking intent. For users without interaction histories, a bespoke content-based cold-start model that predicts context and recipe affinity is introduced. We show that our approach to personalisation is stable and easily scales to new languages. A robust cross-validation campaign is employed and consistently rejects baseline models and representations, strongly favouring those we propose. Our results are presented in a language-oriented (as opposed to model-oriented) fashion to emphasise the language-based goals of this work. We believe that this is the first large-scale work that comprehensively considers the value and potential of multi-language recipe recommendation and personalisation as well as delivering scalable and reliable models.Comment: 5 table