Neural correlates of visualizations of concrete and abstract words in preschool children: A developmental embodied approach

The neural correlates of visualization underlying word comprehension were examined in preschool children. On each trial, a concrete or abstract word was delivered binaurally (part 1: post-auditory visualization), followed by a four-picture array (a target plus three distractors; part 2: matching visualization). Children were to select the picture matching the word they heard in part 1. Event-related potentials (ERPs) locked to each stimulus presentation and task interval were averaged over sets of trials of increasing word abstractness. ERP time-course during both parts of the task showed that early activity (i.e., <300 ms) was predominant in response to concrete words, while activity in response to abstract words became evident only at intermediate (i.e., 300-699 ms) and late (i.e., 700-1000 ms) ERP intervals. Specifically, ERP topography showed that while early activity during post-auditory visualization was linked to left temporo-parietal areas for concrete words, early activity during matching visualization occurred mostly in occipito-parietal areas for concrete words, but more anteriorly in centro-parietal areas for abstract words. In intermediate ERPs, post-auditory visualization coincided with parieto- occipital and parieto-frontal activity in response to both concrete and abstract words, while in matching visualization a parieto-central activity was common to both types of words. In the late ERPs for both types of words, the post-auditory visualization involved right-hemispheric activity following a "post-anterior" pathway sequence: occipital, parietal, and temporal areas; conversely, matching visualization involved left-hemispheric activity following an "ant-posterior" pathway sequence: frontal, temporal, parietal, and occipital areas. These results suggest that, similarly, for concrete and abstract words, meaning in young children depends on variably complex visualization processes integrating visuo-auditory experiences and supramodal embodying representations

Factors related to medical students’ and doctors’ attitudes towards older patients: A systematic review

Background:Studies have sought to identify the possible determinants of medical students’ and doctors’ attitudes towards older patients by examining relationships with a variety of factors: demographic; educational/training; exposure to older people; personality/cognitive; and job/career factors. This review collates and synthesises these findings. Methods: An electronic search of ten databases was performed (ABI/Inform, ASSIA, British Nursing Index, CINAHL, Informa Health, Medline, PsycINFO, Science Direct, Scopus, and Web of Science) through to 7 February 2017. Results: The main search identified 2332 articles; 37 studies met the eligibility criteria set. All included studies analysed self-reported attitudes based on correlational analyses or difference testing, therefore causation could not be determined. However, self-reported positive attitudes towards older patients were related to: (i) intrinsic motivation for studying medicine; (ii) increased preference for working with older patients; and (iii) good previous relationships with older people. Additionally, more positive attitudes were also reported in those with higher knowledge scores but these may relate to the use of a knowledge assessment which is an indirect measure of attitudes (i.e. Palmore’s Facts on Aging Quizzes). Four out of the five high quality studies included in this review reported more positive attitudes in females compared to males. Conclusion:This paper identifies factors associated with medical students’ and doctors’ positive attitudes towards older patients. Future research could bring greater clarity to the relationship between knowledge and attitudes by using a knowledge measure which is distinct from attitudes and also measures knowledge that is relevant to clinical care

Nonthermal X-Rays from Supernova Remnant G330.2+1.0 and the Characteristics of its Central Compact Object

We present results from our X-ray data analysis of the SNR G330.2+1.0 and its CCO, CXOU J160103.1--513353 (J1601). Using our XMM-Newton and Chandra observations, we find that the X-ray spectrum of J1601 can be described by neutron star atmosphere models (T ~ 2.5--3.7 MK). Assuming the distance of d ~ 5 kpc for J1601 as estimated for SNR G330.2+1.0, a small emission region of R ~ 1--2 km is implied. X-ray pulsations previously suggested by Chandra are not confirmed by the XMM-Newton data, and are likely not real. However, our timing analysis of the XMM-Newton data is limited by poor photon statistics, and thus pulsations with a relatively low amplitude (i.e., an intrinsic pulsed-fraction < 40%) cannot be ruled out. Our results indicate that J1601 is a CCO similar to that in the Cassiopeia A SNR.X-ray emission from SNR G330.2+1.0 is dominated by power law continuum (Gamma ~ 2.1--2.5) which primarily originates from thin filaments along the boundary shell. This X-ray spectrum implies synchrotron radiation from shock-accelerated electrons with an exponential roll-off frequency ~ 2--3 x 10^17 Hz. For the measured widths of the X-ray filaments (D ~ 0.3 pc) and the estimated shock velocity (v_s ~ a few x 10^3 km s^-1), a downstream magnetic field B ~ 10--50 $\mu$G is derived. The estimated maximum electron energy E_max ~ 27--38 TeV suggests that G330.2+1.0 is a candidate TeV gamma-ray source. We detect faint thermal X-ray emission in G330.2+1.0. We estimate a low preshock density n_0 ~ 0.1 cm^-3, which suggests a dominant contribution from an inverse Compton mechanism (than the proton-proton collision) to the prospective gamma-ray emission. Follow-up deep radio, X-ray, and gamma-ray observations will be essential to reveal the details of the shock parameters and the nature of particle accelerations in this SNR.Comment: 26 pages, 3 tables, 7 figures (4 color figures), Accepted by Ap

Shot Noise through a Quantum Dot in the Kondo Regime

The shot noise in the current through a quantum dot is calculated as a function of voltage from the high-voltage, Coulomb blockaded regime to the low-voltage, Kondo regime. Using several complementary approaches, it is shown that the zero-frequency shot noise (scaled by the voltage) exhibits a non-monotonic dependence on voltage, with a peak around the Kondo temperature. Beyond giving a good estimate of the Kondo temperature, it is shown that the shot noise yields additional information on the effects of electronic correlations on the local density of states in the Kondo regime, unaccessible in traditional transport measurements.Comment: 4 pages, 1 figur

Second-line agents in myositis: 1-year factorial trial of additional immunosuppression in patients who have partially responded to steroids.

Ciclosporin and MTX are used in idiopathic inflammatory myopathies (DM and PM) when patients incompletely respond to glucocorticoids. Their effectiveness is unproved in randomized controlled trials (RCTs). We evaluated their benefits in a placebo-controlled factorial RCT

Discovery of a Candidate Central Compact Object in the Galactic Nonthermal SNR G330.2+1.0

We report on the discovery of a pointlike source (CXOU J160103.1$-$513353) at the center of a Galactic supernova remnant (SNR) G330.2+1.0 with {\it Chandra X-Ray Observatory}. The X-ray spectrum fits a black-body (BB) model with $kT$ $\sim$ 0.49 keV, implying a small emission region of $R$ $\sim$ 0.4 km at the distance of 5 kpc. The estimated X-ray luminosity is $L_X$ $\sim$ 1 $\times$ 10$^{33}$ ergs s$^{-1}$ in the 1 $-$ 10 keV band. A power law model may also fit the observed spectrum, but the fit results in a very large photon index, $\Gamma$ $\sim$ 5. We find no counterparts at other wavelengths. The X-ray emission was steady over the $\sim$13 hr observation period, showing no variability. While we find marginal evidence for X-ray pulsations ($P$ $\approx$ 7.5 s), the presence of a pulsar at the position of this object is not conclusive with the current data, requiring an independent confirmation. These results are generally consistent with an interpretation of this object as a Central Compact Object associated with SNR G330.2+1.0.Comment: 9 pages (AASTex preprint style) including 1 Table and 4 Figures. Accepted by ApJ Letter

Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock. The VANISH Randomized Clinical Trial

IMPORTANCE: Norepinephrine is currently recommended as the first-line vasopressor in septic shock; however, early vasopressin use has been proposed as an alternative. OBJECTIVE: To compare the effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock. DESIGN, SETTING, AND PARTICIPANTS: A factorial (2×2), double-blind, randomized clinical trial conducted in 18 general adult intensive care units in the United Kingdom between February 2013 and May 2015, enrolling adult patients who had septic shock requiring vasopressors despite fluid resuscitation within a maximum of 6 hours after the onset of shock. INTERVENTIONS: Patients were randomly allocated to vasopressin (titrated up to 0.06 U/min) and hydrocortisone (n = 101), vasopressin and placebo (n = 104), norepinephrine and hydrocortisone (n = 101), or norepinephrine and placebo (n = 103). MAIN OUTCOMES AND MEASURES: The primary outcome was kidney failure-free days during the 28-day period after randomization, measured as (1) the proportion of patients who never developed kidney failure and (2) median number of days alive and free of kidney failure for patients who did not survive, who experienced kidney failure, or both. Rates of renal replacement therapy, mortality, and serious adverse events were secondary outcomes. RESULTS: A total of 409 patients (median age, 66 years; men, 58.2%) were included in the study, with a median time to study drug administration of 3.5 hours after diagnosis of shock. The number of survivors who never developed kidney failure was 94 of 165 patients (57.0%) in the vasopressin group and 93 of 157 patients (59.2%) in the norepinephrine group (difference, -2.3% [95% CI, -13.0% to 8.5%]). The median number of kidney failure-free days for patients who did not survive, who experienced kidney failure, or both was 9 days (interquartile range [IQR], 1 to -24) in the vasopressin group and 13 days (IQR, 1 to -25) in the norepinephrine group (difference, -4 days [95% CI, -11 to 5]). There was less use of renal replacement therapy in the vasopressin group than in the norepinephrine group (25.4% for vasopressin vs 35.3% for norepinephrine; difference, -9.9% [95% CI, -19.3% to -0.6%]). There was no significant difference in mortality rates between groups. In total, 22 of 205 patients (10.7%) had a serious adverse event in the vasopressin group vs 17 of 204 patients (8.3%) in the norepinephrine group (difference, 2.5% [95% CI, -3.3% to 8.2%]). CONCLUSIONS AND RELEVANCE: Among adults with septic shock, the early use of vasopressin compared with norepinephrine did not improve the number of kidney failure-free days. Although these findings do not support the use of vasopressin to replace norepinephrine as initial treatment in this situation, the confidence interval included a potential clinically important benefit for vasopressin, and larger trials may be warranted to assess this further. TRIAL REGISTRATION: clinicaltrials.gov Identifier: ISRCTN 20769191

Multiplex PCR and Next Generation Sequencing for the Non-Invasive Detection of Bladder Cancer

Highly sensitive and specific urine-based tests to detect either primary or recurrent bladder cancer have proved elusive to date. Our ever increasing knowledge of the genomic aberrations in bladder cancer should enable the development of such tests based on urinary DNA