Comorbidities and quality of life in children with intellectual disability

Background: Many children with intellectual disability live with medical comorbidities. This study examined the impacts of comorbidities on quality of life (QOL) of children with intellectual disabilities and whether impacts varied with caregiver perceptions that medical needs had been met. Methods: Primary caregivers of 447 children (aged 5–19 years) with an intellectual disability reported on their child's medical comorbidities and the extent to which they perceived their child's medical needs had been met in a cross-sectional observational study. The Quality of Life Inventory-Disability was used to measure QOL on a 100-point scale. Linear regression models including interaction terms were used to evaluate their associations. Results: Parent-reported recurrent child pain (−4.97, 95% CI −8.21, −1.72), night-time sleep disturbances (−4.98, 95% CI −7.23, −2.73), daytime somnolence (−8.71, 95% CI −11.30, −2.73), seizures that occurred at least weekly (−7.59, 95% CI −13.50, −1.68) and conservatively managed severe scoliosis (−7.39, 95% CI −12.97, −1.81) were negatively associated with child QOL. Despite the majority of parents (~70%) perceiving that their child's medical needs had been met to a great extent, this did not significantly moderate the association between any comorbidities and QOL. Conclusions: Comorbidities were common and had marked associations with QOL. Evaluation and management of pain and sleep disturbance continue to be high priorities in improving QOL of young people with intellectual disabilities. Further research on the optimal methods of managing these comorbidities is warranted

The Parallax, Mass and Age of the PSR J2145-0750 binary system

We present results of timing measurements of the binary millisecond pulsar PSR J2145-0750. Combining timing data obtained with the Effelsberg and Lovell radio telescopes we measure a significant timing parallax of 2.0(6) mas placing the system at 500 pc distance to the solar system. The detected secular change of the projected semi-major axis of the orbit $\dot x=1.8(6)\times 10^{-14}$ lt-s s$^{-1}$, where $x=(a_{\rm p}\sin i)/c$, is caused by the proper motion of the system. With this measurement we can constrain the orbital inclination angle to i<61\degr, with a median likelihood value of 46\degr which is consistent with results from polarimetric studies of the pulsar magnetosphere. This constraint together with the non-detection of Shapiro delay rules out certain combinations of the companion mass, $m_2$, and the inclination, $i$. For typical neutron star masses and using optical observations of the carbon/oxygen-core white dwarf we derive a mass range for the companion of $0.7 M_\odot\leq m_2\leq 1.0 M_\odot$. We apply evolutionary white dwarf cooling models to revisit the cooling age of the companion. Our analysis reveals that the companion has an effective temperature of $T_{\rm eff}=5750\pm600$ K and a cooling age of $\tau_{\rm cool}=3.6(2)$ Gyr, which is roughly a factor of three lower than the pulsar's characteristic age of 10.4 Gyr. The cooling age implies an initial spin period of $P_0=13.0(5)$ ms, which is very close to the current period.Comment: 11 pages, 5 figures, accepted for publication in A&

Eight urgent, fundamental and simultaneous steps needed to restore ocean health, and the consequences for humanity and the planet of inaction or delay

The ocean crisis is urgent and central to human wellbeing and life on Earth; past and current activities are damaging the planet's main life support system for future generations. We are witnessing an increase in ocean heat, disturbance, acidification, bio‐invasions and nutrients, and reducing oxygen levels. Several of these act like ratchets: once detrimental or negative changes have occurred, they may lock in place and may not be reversible, especially at gross ecological and ocean process scales. Each change may represent a loss to humanity of resources, ecosystem function, oxygen production and species. The longer we pursue unsuitable actions, the more we close the path to recovery and better ocean health and greater benefits for humanity in the future. We stand at a critical juncture and have identified eight priority issues that need to be addressed in unison to help avert a potential ecological disaster in the global ocean. They form a purposely ambitious agenda for global governance and are aimed at informing decision‐makers at a high level. They should also be of interest to the general public. Of all the themes, the highest priority is to rigorously address global warming and limit surface temperature rise to 1.5°C by 2100, as warming is the pre‐eminent factor driving change in the ocean. The other themes are establishing a robust and comprehensive High Seas Treaty, enforcing existing standards for Marine Protected Areas and expanding their coverage, especially in terms of high levels of protection, adopting a precautionary pause on deep‐sea mining, ending overfishing and destructive fishing practices, radically reducing marine pollution, putting in place a financing mechanism for ocean management and protection, and lastly, scaling up science/data gathering and facilitating data sharing. By implementing all eight measures in unison, as a coordinated strategy, we can build resilience to climate change, help sustain fisheries productivity, particularly for low‐income countries dependent on fisheries, protect coasts (e.g. via soft‐engineering/habitat‐based approaches), promote mitigation (e.g. carbon storage) and enable improved adaptation to rapid global change.The attached document is the author(’s’) final accepted/submitted version of the journal article. You are advised to consult the publisher’s version if you wish to cite from it

Antiretroviral Therapy, Renal Function among HIV-Infected Tanzanian, Adults, HIV/AIDS, .

Data regarding the outcomes of HIV-infected adults with baseline renal dysfunction who start antiretroviral therapy are conflicting. We followed up a previously-published cohort of HIV-infected adult outpatients in northwest Tanzania who had high prevalence of renal dysfunction at the time of starting antiretroviral therapy (between November 2009 and February 2010). Patients had serum creatinine, proteinuria, microalbuminuria, and CD4(+) T-cell count measured at the time of antiretroviral therapy initiation and at follow-up. We used the adjusted Cockroft-Gault equation to calculate estimated glomerular filtration rates (eGFRs). In this cohort of 171 adults who had taken antiretroviral therapy for a median of two years, the prevalence of renal dysfunction (eGFR <90 mL/min/1.73 m(2)) decreased from 131/171 (76.6%) at the time of ART initiation to 50/171 (29.2%) at the time of follow-up (p<0.001). Moderate dysfunction (eGFR<60 mL/min/1.73 m(2)) decreased from 21.1% at antiretroviral therapy initiation to 1.1% at follow-up (p<0.001), as did the prevalence of microalbuminuria (72% to 44%, p<0.001). Use of tenofovir was not associated with renal dysfunction at follow-up. Mild and moderate renal dysfunction were common in this cohort of HIV-infected adults initiating antiretroviral therapy, and both significantly improved after a median follow-up time of 2 years. Our work supports the renal safety of antiretroviral therapy in African adults with mild-moderate renal dysfunction, suggesting that these regimens do not lead to renal damage in the majority of patients and that they may even improve renal function in patients with mild to moderate renal dysfunction

Communications Biophysics

Contains reports on seven research projects split into three sections.National Institutes of Health (Grant 5 PO1 NS13126)National Institutes of Health (Grant 1 RO1 NS18682)National Institutes of Health (Training Grant 5 T32 NS07047)National Science Foundation (Grant BNS77-16861)National Institutes of Health (Grant 1 F33 NS07202-01)National Institutes of Health (Grant 5 RO1 NS10916)National Institutes of Health (Grant 5 RO1 NS12846)National Institutes of Health (Grant 1 RO1 NS16917)National Institutes of Health (Grant 1 RO1 NS14092-05)National Science Foundation (Grant BNS 77 21751)National Institutes of Health (Grant 5 R01 NS11080)National Institutes of Health (Grant GM-21189

State Mandates, Housing Elements, and Low-income Housing Production

In order to create low-income housing opportunities and mitigate exclusionary zoning, in 1968 Congress mandated that municipalities receiving comprehensive planning funds must create a housing element. In tandem, many states mandated that municipal housing elements must accommodate low-income housing needs. After examining empirical research for California, Florida, Illinois, and Minnesota, this review found aspirational success because those states rewarded the municipal planning process. In order to increase low-income housing, this review argues for state housing policy reform. Under US Department of Housing and Urban Development’s revised fair housing rule, which requires an assessment of local data, states can no longer ignore the exclusionary behavior of municipalities

Bats in the anthropogenic matrix: Challenges and opportunities for the conservation of chiroptera and their ecosystem services in agricultural landscapes

Intensification in land-use and farming practices has had largely negative effects on bats, leading to population declines and concomitant losses of ecosystem services. Current trends in land-use change suggest that agricultural areas will further expand, while production systems may either experience further intensification (particularly in developing nations) or become more environmentally friendly (especially in Europe). In this chapter, we review the existing literature on how agricultural management affects the bat assemblages and the behavior of individual bat species, as well as the literature on provision of ecosystem services by bats (pest insect suppression and pollination) in agricultural systems. Bats show highly variable responses to habitat conversion, with no significant change in species richness or measures of activity or abundance. In contrast, intensification within agricultural systems (i.e., increased agrochemical inputs, reduction of natural structuring elements such as hedges, woods, and marshes) had more consistently negative effects on abundance and species richness. Agroforestry systems appear to mitigate negative consequences of habitat conversion and intensification, often having higher abundances and activity levels than natural areas. Across biomes, bats play key roles in limiting populations of arthropods by consuming various agricultural pests. In tropical areas, bats are key pollinators of several commercial fruit species. However, these substantial benefits may go unrecognized by farmers, who sometimes associate bats with ecosystem disservices such as crop raiding. Given the importance of bats for global food production, future agricultural management should focus on “wildlife-friendly” farming practices that allow more bats to exploit and persist in the anthropogenic matrix so as to enhance provision of ecosystem services. Pressing research topics include (1) a better understanding of how local-level versus landscape-level management practices interact to structure bat assemblages, (2) the effects of new pesticide classes and GM crops on bat populations, and (3) how increased documentation and valuation of the ecosystem services provided by bats could improve attitudes of producers toward their conservation

Mutational analysis of the C-terminal FATC domain of Saccharomyces cerevisiae Tra1

Tra1 is a component of the Saccharomyces cerevisiae SAGA and NuA4 complexes and a member of the PIKK family, which contain a C-terminal phosphatidylinositol 3-kinase-like (PI3K) domain followed by a 35-residue FATC domain. Single residue changes of L3733A and F3744A, within the FATC domain, resulted in transcriptional changes and phenotypes that were similar but not identical to those caused by mutations in the PI3K domain or deletions of other SAGA or NuA4 components. The distinct nature of the FATC mutations was also apparent from the additive effect of tra1-L3733A with SAGA, NuA4, and tra1 PI3K domain mutations. Tra1-L3733A associates with SAGA and NuA4 components and with the Gal4 activation domain, to the same extent as wild-type Tra1; however, steady-state levels of Tra1-L3733A were reduced. We suggest that decreased stability of Tra1-L3733A accounts for the phenotypes since intragenic suppressors of tra1-L3733A restored Tra1 levels, and reducing wild-type Tra1 led to comparable growth defects. Also supporting a key role for the FATC domain in the structure/function of Tra1, addition of a C-terminal glycine residue resulted in decreased association with Spt7 and Esa1, and loss of cellular viability. These findings demonstrate the regulatory potential of mechanisms targeting the FATC domains of PIKK proteins