An Overview of the Adaptive Behaviour Profile in Young Children with Angelman Syndrome: Insights from the Global Angelman Syndrome Registry

Objectives: Angelman syndrome (AS) is a rare genetic disorder that affects the expression of the UBE3A gene within the central nervous system that profoundly impacts neurodevelopment. Individuals with AS experience significant challenges across multiple adaptive behaviour domains including communication, motor skills, and the ability to independently perform daily functions such as feeding, and toileting. Furthermore, persons with AS can demonstrate specific behaviours that limit their ability to participate within their social environment that vary with age. The aim of this paper is to explore the adaptive behaviour profile through parent report from the Global Angelman Syndrome Registry. Methods: Specific parent report data from the Global Angelman Syndrome Registry were analysed to explore the adaptive profile of 204 young children, under the age of 6 years old, with formal diagnoses of AS. Analysis of data focused on communication skills, gross and fine motor skills, daily self-care skills (feeding, toileting, and dressing), and behavioural characteristics. Several relationships were explored: (a) the age at which certain skills were first performed based on genotype; (b) abilities in motor and adaptive behaviours, according to age and genotype, and (c) the frequency at which children performed specific communication skills and the presence and frequency of challenging behaviours, across age and genotype. Results: We visually present the ages at which frequent speech, walking, and independent dressing and toileting were first mastered by children. Additionally, we provide in-depth descriptives of expressive and receptive communication skills (including the use of alternative communication forms), fine and gross motor skills, eating, dressing, toileting, anxiety, aggression, and other behavioural characteristics. Conclusions: This cross-sectional profile of adaptive skills in 204 young children with AS showcases that although many communication, motor and adaptive skills were determined by age, children with a non-deletion aetiology exhibited advantages in communication skills, which may have impacted upon subsequent adaptive skills. The use of parent report in the present study provides valuable insight into the adaptive behaviour profile of young children with AS

Variable density and viscosity, miscible displacements in horizontal Hele-Shaw cells. Part 2. Nonlinear simulations

Direct numerical simulations of the variable density and viscosity Navier-Stokes equations are employed, in order to explore three-dimensional effects within miscible displacements in horizontal Hele-Shaw cells. These simulations identify a number of mechanisms concerning the interaction of viscous fingering with a spanwise Rayleigh-Taylor instability. The dominant wavelength of the Rayleigh-Taylor instability along the upper, gravitationally unstable side of the interface generally is shorter than that of the fingering instability. This results in the formation of plumes of the more viscous resident fluid not only in between neighbouring viscous fingers, but also along the centre of fingers, thereby destroying their shoulders and splitting them longitudinally. The streamwise vorticity dipoles forming as a result of the spanwise Rayleigh-Taylor instability place viscous resident fluid in between regions of less viscous, injected fluid, thereby resulting in the formation of gapwise vorticity via the traditional, gap-averaged viscous fingering mechanism. This leads to a strong spatial correlation of both vorticity components. For stronger density contrasts, the streamwise vorticity component increases, while the gapwise component is reduced, thus indicating a transition from viscously dominated to gravitationally dominated displacements. Gap-averaged, time-dependent concentration profiles show that variable density displacement fronts propagate more slowly than their constant density counterparts. This indicates that the gravitational mixing results in a more complete expulsion of the resident fluid from the Hele-Shaw cell. This observation may be of interest in the context of enhanced oil recovery or carbon sequestration application

A DNA probe for the detection of Dicrocoelium dendriticum in ants of Formica spp. and Lasius spp

Repetitive DNA sequences present in the genome of Dicrocoelium dendriticum were identified by hybridization of genomic DNA that had been digested with different restriction enzymes with 32P-labeled genomic D. dendriticum DNA. DNA fragments containing repetitive sequences were isolated from PstI-digested D. dendriticum DNA and were subcloned into a plasmid vector. Plasmids containing repetitive sequences were identified by colony hybridization. One of these plasmids, designated Ddr-IV, was isolated and used as a probe in further studies. Ddr-IV is specific for D. dendriticum since it does not hybridize to DNA isolated from other trematodes. In addition, Ddr-IV was capable of detecting D. dendriticum metacercariae in ants (Formica cunicularia, F. rufibarbis, and Lasius sp.), which act as second intermediate hosts in the parasite's life cycle. Since metacercariae constitute the infectious stage of the parasite for grazing animals, Ddr-IV will provide a useful tool for epidemiology studies of dicrocoeliosis

Association between early and current gastro-intestinal symptoms and co-morbidities in children and adolescents with Angelman syndrome

Background Angelman syndrome (AS) is a neurogenetic disorder that causes severe intellectual disability, expressive language deficits, motor impairment, ataxia, sleep problems, epileptic seizures and a happy disposition. People with AS frequently experience gastrointestinal (GI) symptoms. Method This study used data from the Global Angelman Syndrome Registry to explore the relationship between early and current GI symptoms and co-morbidity in children and adolescents with AS (\u1d62f = 173). Two groups that experienced a high (\u1d62f = 91) and a low (\u1d62f = 82) frequency of GI symptoms were examined in relation to feeding and GI history in infancy, sleep and toileting problems, levels of language and communication and challenging behaviours. Predictors of GI symptoms were then investigated using a series of logistic regressions. Results This analysis found that constipation and gastroesophageal reflux affected 84% and 64%, of the sample, respectively. The high frequency of GI symptoms were significantly associated with: ‘refusal to nurse’, ‘vomiting’, ‘arching’, ‘difficulty gaining weight’, gastroesophageal reflux, ‘solid food transition’, frequency of night-time urinary continence and sleep hyperhidrosis during infancy. GI symptoms were not significantly associated with sleep, toileting, language or challenging behaviours. Significant predictors of high frequency GI symptoms were gastroesophageal reflux and sleep hyperhidrosis. Conclusions Future research needs to investigate the association between AS and GI co-morbidity in adults with AS

Wafer scale manufacturing of high precision micro-optical components through X-ray lithography yielding 1800 Gray Levels in a fingertip sized chip

We present a novel x-ray lithography based micromanufacturing methodology that offers scalable manufacturing of high precision optical components. It is accomplished through simultaneous usage of multiple stencil masks made moveable with respect to one another through custom made micromotion stages. The range of spectral flux reaching the sample surface at the LiMiNT micro/nanomanufacturing facility of Singapore Synchrotron Light Source (SSLS) is about 2 keV to 10 keV, offering substantial photon energy to carry out deep x-ray lithography. In this energy range, x-rays penetrate through resist materials with only little scattering. The highly collimated rectangular beam architecture of the x-ray source enables a full 4″ wafer scale fabrication. Precise control of dose deposited offers determined chain scission in the polymer to required depth enabling 1800 discrete gray levels in a chip of area 20 mm$^{2}$ and with more than 2000 within our reach. Due to its parallel processing capability, our methodology serves as a promising candidate to fabricate micro/nano components of optical quality on a large scale to cater for industrial requirements. Usage of these fine components in analytical devices such as spectrometers and multispectral imagers transforms their architecture and shrinks their size to pocket dimension. It also reduces their complexity and increases affordability while also expanding their application areas. Consequently, equipment based on these devices is made available and affordable for consumers and businesses expanding the horizon of analytical applications. Mass manufacturing is especially vital when these devices are to be sold in large quantities especially as components for original equipment manufacturers (OEM), which has also been demonstrated through our work. Furthermore, we also substantially improve the quality of the micro-components fabricated, 3D architecture generated, throughput, capability and availability for industrial application. Manufacturing 1800 Gray levels or more through other competing techniques is either limited due to multiple process steps involved or due to unacceptably long time required owing to their pencil beam architecture. Our manufacturing technique presented here overcomes both these shortcomings in terms of the maximum number of gray levels that can be generated, and the time required to generate the same

Melatonin in Youth: N-of-1 trials in a stimulant-treated ADHD Population (MYNAP): study protocol for a randomized controlled trial

Attention-deficit/hyperactivity disorder (ADHD) is a common neurological disorder affecting 5\ua0% of children worldwide. A prevalent problem for children with ADHD is initial insomnia. The gold standard treatment to manage ADHD symptoms is stimulant medications, which may exacerbate the severity of existing initial insomnia. Currently, no gold standard treatment option exists for initial insomnia for these children. Melatonin, a hormone and a popular natural health product, is commonly provided to children by parents and recommended by healthcare providers, but high quality pediatric evidence is lacking.This trial is a multicenter randomized triple-blind, placebo-controlled, parallel-group, randomized, controlled trial (RCT), in which each participant is offered an N-of-1 trial. An N-of-1 trial is a multiple-crossover, randomized, controlled trial conducted in a single individual. For the N-of-1 trial, each participant will undergo three pairs of treatment/placebo periods; each period is 1\ua0week in length. Half the participants will have melatonin in the first period, the other half will start with placebo, and this will make up the parallel-group RCT. The primary outcome will be mean difference in sleep onset latency as measured by sleep diaries. A comparison of treatment effects yielded by the RCT data versus the aggregated N-of-1 trial data will also be assessed.This trial will provide rigorous evidence for the effectiveness of melatonin in children with ADHD on stimulants who experience initial insomnia. Further, this study will provide the first prospectively planned head-to-head comparison of RCT data with pooled data from a series of N-of-1 trials. Aggregated N-of-1 trials may be a powerful tool to produce high quality clinical trial evidence.ClinicalTrials.gov, NCT02333149 . Registered on 16 December 2014. Australian New Zealand Clinical Trials Registry, ACTRN12614000542695 . Registered on 21 May 2014

Does a brief, behavioural intervention, delivered by paediatricians or psychologists improve sleep problems for children with ADHD? Protocol for a cluster-randomised, translational trial

INTRODUCTION: Up to 70% of children with attention-deficit/hyperactivity disorder (ADHD) experience sleep problems. We have demonstrated the efficacy of a brief behavioural intervention for children with ADHD in a large randomised controlled trial (RCT) and now aim to examine whether this intervention is effective in real-life clinical settings when delivered by paediatricians or psychologists. We will also assess the cost-effectiveness of the intervention. METHODS AND ANALYSIS: Children aged 5-12 years with ADHD (n=320) are being recruited for this translational cluster RCT through paediatrician practices in Victoria and Queensland, Australia. Children are eligible if they meet criteria for ADHD, have a moderate/severe sleep problem and meet American Academy of Sleep Medicine criteria for either chronic insomnia disorder or delayed sleep-wake phase disorder; or are experiencing sleep-related anxiety. Clinicians are randomly allocated at the level of the paediatrician to either receive the sleep training or not. The behavioural intervention comprises 2 consultations covering sleep hygiene and standardised behavioural strategies. The primary outcome is change in the proportion of children with moderate/severe sleep problems from moderate/severe to no/mild by parent report at 3 months postintervention. Secondary outcomes include a range of child (eg, sleep severity, ADHD symptoms, quality of life, behaviour, working memory, executive functioning, learning, academic achievement) and primary caregiver (mental health, parenting, work attendance) measures. Analyses will address clustering at the level of the paediatrician using linear mixed effect models adjusting for potential a priori confounding variables. ETHICS AND DISSEMINATION: Ethics approval has been granted. Findings will determine whether the benefits of an efficacy trial can be realised more broadly at the population level and will inform the development of clinical guidelines for managing sleep problems in this population. We will seek to publish in leading international paediatric journals, present at major conferences and through established clinician networks. TRIAL REGISTRATION NUMBER: ISRCTN50834814, Pre-results

A bovine lymphosarcoma cell line infected with theileria annulata exhibits an irreversible reconfiguration of host cell gene expression

Theileria annulata, an intracellular parasite of bovine lymphoid cells, induces substantial phenotypic alterations to its host cell including continuous proliferation, cytoskeletal changes and resistance to apoptosis. While parasite induced modulation of host cell signal transduction pathways and NFκB activation are established, there remains considerable speculation on the complexities of the parasite directed control mechanisms that govern these radical changes to the host cell. Our objectives in this study were to provide a comprehensive analysis of the global changes to host cell gene expression with emphasis on those that result from direct intervention by the parasite. By using comparative microarray analysis of an uninfected bovine cell line and its Theileria infected counterpart, in conjunction with use of the specific parasitacidal agent, buparvaquone, we have identified a large number of host cell gene expression changes that result from parasite infection. Our results indicate that the viable parasite can irreversibly modify the transformed phenotype of a bovine cell line. Fifty percent of genes with altered expression failed to show a reversible response to parasite death, a possible contributing factor to initiation of host cell apoptosis. The genes that did show an early predicted response to loss of parasite viability highlighted a sub-group of genes that are likely to be under direct control by parasite infection. Network and pathway analysis demonstrated that this sub-group is significantly enriched for genes involved in regulation of chromatin modification and gene expression. The results provide evidence that the Theileria parasite has the regulatory capacity to generate widespread change to host cell gene expression in a complex and largely irreversible manner