Maternal methadone use in pregnancy : factors associated with the development of neonatal abstinence syndrome and implications for healthcare resources

The objectives of this study were to investigate factors associated with the development of neonatal abstinence syndrome (NAS) and to assess the implications for healthcare resources of infants born to drug-misusing women. Design. Retrospective cohort study from 1 January 2004 to 31 December 2006. Setting. Inner-city maternity hospital providing dedicated multidisciplinary care to drug-misusing women. Four hundred and fifty singleton pregnancies of drugmisusing women prescribed substitute methadone in pregnancy. Development of NAS and duration of infant hospital stay. 45.5% of infants developed NAS requiring pharmacological treatment. The odds ratio of the infant developing NAS was independently related to prescribed maternal methadone dose rather than associated polydrug misuse. Breastfeeding was associated with reduced odds of requiring treatment for NAS (OR 0.55, 95% CI 0.34-0.88). Preterm birth did not influence the odds of the infant receiving treatment for NAS. 48.4% infants were admitted to the neonatal unit (NNU) 40% of these primarily for treatment of NAS. The median total hospital stay for all infants was 10 days (interquartile range 7-17 days). Infants born to methadone-prescribed drug-misusing mothers represented 2.9% of hospital births, but used 18.2% of NNU cot days. Higher maternal methadone dose is associated with a higher incidence of NAS. Pregnant drug-misusing women should be encouraged and supported to breastfeed. Their infants are extremely vulnerable and draw heavily on healthcare resources

Isospectrality and heat content

We present examples of isospectral operators that do not have the same heat content. Several of these examples are planar polygons that are isospectral for the Laplace operator with Dirichlet boundary conditions. These include examples with infinitely many components. Other planar examples have mixed Dirichlet and Neumann boundary conditions. We also consider Schr\"{o}dinger operators acting in $L^2[0,1]$ with Dirichlet boundary conditions, and show that an abundance of isospectral deformations do not preserve the heat content.Comment: 18 page

Efficacy of imidacloprid + moxidectin and selamectin topical solutions against the KS1 Ctenocephalides felis flea strain infesting cats

<p>Abstract</p> <p>Background</p> <p>Two studies were conducted to evaluate and compare the efficacy of imidacloprid + moxidectin and selamectin topical solutions against the KS1 flea strain infesting cats. In both studies the treatment groups were comprised of non-treated controls, 6% w/v selamectin (Revolution^®; Pfizer Animal Health) topical solution and 10% w/v imidacloprid + 1% w/v moxidectin (Advantage <it>Multi</it>^®for Cats, Bayer Animal Health) topical solution. All cats were infested with 100 fleas on Days -2, 7, 14, 21, and 28. The difference in the studies was that in study #1 efficacy evaluations were conducted at 24 and 48 hours post-treatment or post-infestation, and in study #2 evaluations were conducted at 12 and 24 hours.</p> <p>Results</p> <p>In study #1 imidacloprid + moxidectin and the selamectin formulation provided 99.8% and 99.0% efficacy at 24 hours post-treatment. On day 28, the 24 hour efficacy of the selamectin formulation dropped to 87.1%, whereas the imidacloprid + moxidectin formulation provided 98.9% efficacy. At the 48 hour assessments following the 28 day infestations, efficacy of the imidacloprid + moxidectin and selamectin formulations was 96.8% and 98.3% respectively. In study # 2 the efficacy of the imidacloprid + moxidectin and selamectin formulations 12 hours after treatment was 100% and 69.4%, respectively. On day 28, efficacy of the imidacloprid + moxidectin and selamectin formulations 12 hours after infestation was 90.2% and 57.3%, respectively. In study #2 both formulations provided high levels of efficacy at the 24 hour post-infestation assessments, with selamectin and imidacloprid + moxidectin providing 95.3% and 97.5% efficacy, following infestations on day 28.</p> <p>Conclusions</p> <p>At the 24 and 48 hour residual efficacy assessments, the imidacloprid + moxidectin and selamectin formulations were similarly highly efficacious. However, the imidacloprid + moxidectin formulation provided a significantly higher rate of flea kill against the KS1 flea strain infesting cats at every 12 hour post-infestation residual efficacy assessment. Both formulations should provide excellent flea control for an entire month on cats.</p

A Metaphysical “Passage” to India ： E. M. Forster’s Perspectives on Dostoevsky and Dante

In this article we investigate and explain similarities in selected works of British writer Edward Morgan Forster and Russian novelist Fyodor Mikhailovich Dostoevsky from perspectives both sacred and profane. We consider why the two authors incorporated music into their works. In addition, we examine various influences on both authors, including the “trinitarian” structure of Dante’s Divine Comedy. Finally, we explore possible explanations for Forster’s interest in Dostoevsky works in relation to gay themes

Fourth Grade Writing Instruction: A Case Study of Three Teachers in Title I Schools

The purpose of this study was to explore writing instruction provided to students in fourth grade classrooms of two Title I schools. The researchers observed the writing instruction and classroom procedures of three fourth grade teachers at these two Title I campuses. The following three research questions guided this study: (1) How do fourth grade writing teachers in two Title I schools in Texas approach the teaching of writing? (2) How does the challenge of standardized testing impact writing instruction? (3) How do these fourth grade teachers perceive their effectiveness as teachers of writing? Analysis of data led to the following conclusions: for these three teachers, district mandates and a centralized curriculum established the agenda for classroom writing instruction for the most part. However, even within these constraints, researchers observed that efforts were made by each teacher to adapt some of the curriculum needs of their students and to incorporate their own teaching styles and strategies as much as possible

Effect of Turbulence in Wind-Tunnel Measurements

This paper gives some quantitative measurements of wind tunnel turbulence and its effect on the air resistance of spheres and airship models, measurements made possible by the hot wire anemometer and associated apparatus in its original form was described in Technical Report no. 320 and some modifications are presented in an appendix to the present paper. One important result of the investigation is a curve by means of which measurements of the air resistance of spheres can be interpreted to give the turbulence quantitatively. Another is the definite proof that the discrepancies in the results on the N. P. L. Standard airship models are due mainly to differences in the turbulences of the wind tunnels in which the tests were made. An attempt is made to interpret the observed results in terms of the boundary layer theory and for this purpose a brief account is given of the physical bases of this theory and of conceptions that have been obtained by analogy with the laws of flow in pipes