3,044 research outputs found

    Book Reviews

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    Reliability and Feasibility of the Four Square Step Test for Use in Children with Cerebral Palsy: A Pilot Study

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    Purpose: The ability to maintain standing balance with a moving base of support and while making rapid postural adjustments is important for independence in various functional activities. Clinical tests and measures have not addressed this ability in children with disability. This pilot study examined the feasibility and reliability of the Four Square Step Test (FSST) as a test of dynamic balance in children with cerebral palsy (CP). Method: Four children with CP (Gross Motor Function Classification Scale levels I-II) were tested on the FSST by 3 assessors on the first occasion (interrater reliability) and repeat-tested by 1 assessor after 2 weeks (test-retest reliability). Six children with typical development (TD) were tested on a separate occasion to explore any between-group difference in performance. Results: The FSST was easy to setup, required no specialized equipment, could be completed in 5 minutes, and might be carried out by clinicians with limited experience in pediatric therapy. It demonstrated excellent interrater reliability (ICC = 0.832) and test-retest reliability (ICC = 0.979) in children with CP. Compared with FSST times for children with TD (mean = 9.12 Ā± 2.67 seconds), times for children with CP (mean = 18.38 Ā± 9.02 seconds) were significantly slower (p = 0.019, Mann-Whitney U = -2.345). Conclusions and Recommendations: The pilot study provides initial evidence on the potential usefulness of the FSST as a test of dynamic standing balance in children with CP. This warrants further investigation of the clinimetric properties of the FSST using an adequate sample size

    Meeting report : Ocean ā€˜omics science, technology and cyberinfrastructure : current challenges and future requirements (August 20-23, 2013)

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    Ā© The Author(s), 2014. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Standards in Genomic Sciences 9 (2014): 1251-1258, doi:10.4056/sigs.5749944.The National Science Foundationā€™s EarthCube End User Workshop was held at USCā€™s Wrigley Marine Science Center on Catalina Island, California in August 2013. The workshop was designed to explore and characterise the needs and tools available to the community focusing on microbial and physical oceanography research with a particular focus on ā€˜omic research. The assembled researchers outlined the existing concerns regarding the vast data resources that are being generated, and how we will deal with these resources as their volume and diversity increases. Particular attention was focused on the tools for handling and analysing the existing data, and on the need for the construction and curation of diverse federated databases, as well as development of shared interoperable, ā€œbig-data capableā€ analytical tools. The key outputs from this workshop include (i) critical scientific challenges and cyberinfrastructure constraints, (ii) the current and future ocean ā€˜omics science grand challenges and questions, and (iii) data management, analytical and associated and cyber-infrastructure capabilities required to meet critical current and future scientific challenges. The main thrust of the meeting and the outcome of this report is a definition of the ā€˜omics tools, technologies and infrastructures that facilitate continued advance in ocean science biology, marine biogeochemistry, and biological oceanography.We gratefully acknowledge support for the Ocean ā€˜Omics EarthCube end-user workshop by the Geo-sciences Division of the U.S. National Science Foundation

    Leukotriene antagonists as first-line or add-on asthma controller therapy

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    Most randomized trials of treatment for asthma study highly selected patients under idealized conditions. METHODS: We conducted two parallel, multicenter, pragmatic trials to evaluate the real-world effectiveness of a leukotriene-receptor antagonist (LTRA) as compared with either an inhaled glucocorticoid for first-line asthma-controller therapy or a long-acting beta(2)-agonist (LABA) as add-on therapy in patients already receiving inhaled glucocorticoid therapy. Eligible primary care patients 12 to 80 years of age had impaired asthma-related quality of life (Mini Asthma Quality of Life Questionnaire [MiniAQLQ] score =6) or inadequate asthma control (Asthma Control Questionnaire [ACQ] score =1). We randomly assigned patients to 2 years of open-label therapy, under the care of their usual physician, with LTRA (148 patients) or an inhaled glucocorticoid (158 patients) in the first-line controller therapy trial and LTRA (170 patients) or LABA (182 patients) added to an inhaled glucocorticoid in the add-on therapy trial. RESULTS: Mean MiniAQLQ scores increased by 0.8 to 1.0 point over a period of 2 years in both trials. At 2 months, differences in the MiniAQLQ scores between the two treatment groups met our definition of equivalence (95% confidence interval [CI] for an adjusted mean difference, -0.3 to 0.3). At 2 years, mean MiniAQLQ scores approached equivalence, with an adjusted mean difference between treatment groups of -0.11 (95% CI, -0.35 to 0.13) in the first-line controller therapy trial and of -0.11 (95% CI, -0.32 to 0.11) in the add-on therapy trial. Exacerbation rates and ACQ scores did not differ significantly between the two groups. CONCLUSIONS: Study results at 2 months suggest that LTRA was equivalent to an inhaled glucocorticoid as first-line controller therapy and to LABA as add-on therapy for diverse primary care patients. Equivalence was not proved at 2 years. The interpretation of results of pragmatic research may be limited by the crossover between treatment groups and lack of a placebo group

    Photodissociation dynamics of the iodide-uracil (I-U) complex

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    Photofragment action spectroscopy and femtosecond time-resolved photoelectron imaging are utilized to probe the dissociation channels in iodide-uracil (Iāˆ’ ā‹… U) binary clusters upon photoexcitation. The photofragment action spectra show strong Iāˆ’ and weak [U- H]āˆ’ ion signal upon photoexcitation. The action spectra show two bands for Iāˆ’ and [U- H]āˆ’ production peaking around 4.0 and 4.8 eV. Time-resolved experiments measured the rate of Iāˆ’ production resulting from excitation of the two bands. At 4.03 eV and 4.72 eV, the photoelectron signal from Iāˆ’ exhibits rise times of 86 Ā± 7 ps and 36 Ā± 3 ps, respectively. Electronic structure calculations indicate that the lower energy band, which encompasses the vertical detachment energy (4.11 eV) of Iāˆ’U, corresponds to excitation of a dipole-bound state of the complex, while the higher energy band is primarily a Ļ€-Ļ€āˆ— excitation on the uracil moiety. Although the nature of the two excited states is very different, the long lifetimes for Iāˆ’ production suggest that this channel results from internal conversion to the Iāˆ’ ā‹… U ground state followed by evaporation of Iāˆ’. This hypothesis was tested by comparing the dissociation rates to Rice-Ramsperger-Kassel-Marcus calculations

    Child abuse inventory at emergency rooms: CHAIN-ER rationale and design

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    <p>Abstract</p> <p>Background</p> <p>Child abuse and neglect is an important international health problem with unacceptable levels of morbidity and mortality. Although maltreatment as a cause of injury is estimated to be only 1% or less of the injured children attending the emergency room, the consequences of both missed child abuse cases and wrong suspicions are substantial. Therefore, the accuracy of ongoing detection at emergency rooms by health care professionals is highly important. Internationally, several diagnostic instruments or strategies for child abuse detection are used at emergency rooms, but their diagnostic value is still unknown. The aim of the study 'Child Abuse Inventory at Emergency Rooms' (CHAIN-ER) is to assess if active structured inquiry by emergency room staff can accurately detect physical maltreatment in children presenting at emergency rooms with physical injury.</p> <p>Methods/design</p> <p>CHAIN-ER is a multi-centre, cross-sectional study with 6 months diagnostic follow-up. Five thousand children aged 0-7 presenting with injury at an emergency room will be included. The index test - the SPUTOVAMO-R questionnaire- is to be tested for its diagnostic value against the decision of an expert panel. All SPUTOVAMO-R positives and a 15% random sample of the SPUTOVAMO-R negatives will undergo the same systematic diagnostic work up, which consists of an adequate history being taken by a pediatrician, inquiry with other health care providers by structured questionnaires in order to obtain child abuse predictors, and by additional follow-up information. Eventually, an expert panel (reference test) determines the <it>true </it>presence or absence of child abuse.</p> <p>Discussion</p> <p>CHAIN-ER will determine both positive and negative predictive value of a child abuse detection instrument used in the emergency room. We mention a benefit of the use of an expert panel and of the use of complete data. Conducting a diagnostic accuracy study on a child abuse detection instrument is also accompanied by scientific hurdles, such as the lack of an accepted reference standard and potential (non-) response. Notwithstanding these scientific challenges, CHAIN-ER will provide accurate data on the predictive value of SPUTOVAMO-R.</p

    Kepler-16: A Transiting Circumbinary Planet

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    We report the detection of a planet whose orbit surrounds a pair of low-mass stars. Data from the Kepler spacecraft reveal transits of the planet across both stars, in addition to the mutual eclipses of the stars, giving precise constraints on the absolute dimensions of all three bodies. The planet is comparable to Saturn in mass and size, and is on a nearly circular 229-day orbit around its two parent stars. The eclipsing stars are 20% and 69% as massive as the sun, and have an eccentric 41-day orbit. The motions of all three bodies are confined to within 0.5 degree of a single plane, suggesting that the planet formed within a circumbinary disk.Comment: Science, in press; for supplemental material see http://www.sciencemag.org/content/suppl/2011/09/14/333.6049.1602.DC1/1210923.Doyle.SOM.pd
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