A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence

Non-Alcoholic Fatty Liver Disease (NAFLD) is now the most prevalent form of chronic liver disease, affecting 10%–20% of the general paediatric population. Within the next 10 years it is expected to become the leading cause of liver pathology, liver failure and indication for liver transplantation in childhood and adolescence in the Western world. While our understanding of the pathophysiological mechanisms underlying this disease remains limited, it is thought to be the hepatic manifestation of more widespread metabolic dysfunction and is strongly associated with a number of metabolic risk factors, including insulin resistance, dyslipidaemia, cardiovascular disease and, most significantly, obesity. Despite this, ”paediatric” NAFLD remains under-studied, under-recognised and, potentially, undermanaged. This article will explore and evaluate our current understanding of NAFLD in childhood and adolescence and how it differs from adult NAFLD, in terms of its epidemiology, pathophysiology, natural history, diagnosis and clinical management. Given the current absence of definitive radiological and histopathological diagnostic tests, maintenance of a high clinical suspicion by all members of the multidisciplinary team in primary and specialist care settings remains the most potent of diagnostic tools, enabling early diagnosis and appropriate therapeutic intervention

Numerical Calculation of Diffraction Coefficients in Anisotropic Media

Ultrasonic inspection is used to detect and size crack-like defects in pressure vessels and pipework used in the nuclear industry. Reliable inspection can only be achieved if the inspection technique is understood, is optimised and subsequently applied correctly. Austenitic steels are used because of their corrosion resistance and toughness. Welds and centrifugally cast materials tend to crystallise with grains larger than the ultrasonic wavelength required to achieve the desired resolution in the inspection and thus appear anisotropic. Since the grains in a weld grow along the, varying, directions of maximum heat flux during cooling, the welds are inhomogeneous as well as anisotropic. We wish to understand the ultrasonic signals scattered by cracks in such inhomogeneous anisotropic materials. To calculate large numbers of cases we would like to use a relatively efficient tool: (ray tracing) and wish to incorporate the diffraction and reflection which occurs at the defect through the use of diffraction or scattering coefficients.</p

Elastic Wave Diffraction at Cracks in Anisotropic Materials

Ultrasonic inspection is used to confirm that there are no defects of concern in various regions of a nuclear reactor primary circuit. All materials are naturally anisotropic, but if the grains are small relative to the ultrasonic wavelength and are also randomly oriented, then the material will appear as homogeneous and isotropic as in ferritic steel. The ultrasonic wavelength is chosen as a compromise between resolution of defect size and acoustic noise from grain boundaries. In austenitic steel, the wavelength chosen will typically be smaller than the grain size, at least in one direction. The grains are not randomly oriented but exhibit macroscopic patterns which depend on the welding process, and the material is neither homogeneous nor isotropic

Surface Waves for Anisotropic Material Characterization-A Computer Aided Evaluation System

Along with a wide application of nondestructive evaluation methods by ultrasonic techniques, Rayleigh surface waves are being studied for their applications in material characterization. Because surface waves can offer some sensitive measurement features of wave propagation, it is suggested that surface waves be conveniently used as an experimental technique for the solution of the inverse problem of determining elastic constants and/or other characteristics in materials [1–3]. The most common direct problem is to obtain wave propagation features by theoretical analysis, experimental measurement, or numerical calculation. A desired problem in material evaluation however, is to solve an inverse problem to find material characteristics from a set of field measurement data. In surface wave problems, the closed form solutions may not even exist for some direct problems. Moreover, often material constants collectively influence the ultrasonic wave propagation in anisotropic medium, and we can not decouple them and evaluate them individually by each single ultrasonic measurement. Therefore, a numerical computational procedure is proposed.</p

The politics of protest in newspaper campaigns: dissent, populism and the rhetoric of authenticity

Newspaper campaigns embody newspaper’ most emphatic claims to speak for ‘the people’, and as such are generally regarded as populist. However, they can be oppositional, engaging in dissent of one sort or another, and often assume a certain amount of political engagement with that dissent on the part of the audience. This article examines the potential of newspaper camapigns to facilitate the political engagement of citizens through the politics of protest. It draws on qualitative analysis of seven campaigns that ran in the Scottish press between 2000 and 2005, and semi-structured interviews with relevant journalists. The distinction between legitimate protest and manipulative populism is made in terms of: (a) the rhetoric and strategies of political representation, participation and influence and (b) the construction of political legitimacy in terms of the public interest and the moral authority of the ‘victim’. It is argued that populist impulses dominate, driving a tendency to use discourses of emotional authenticity and offence to legitimise demands for a plebiscitary response to popular of ‘victim’ preference and to close down controversy and debate, with the principal objective marketing the newspaper as an influential community champion

The Eastern Origins of the Rise of the West and the “Return” of Asia

With the current interest in China (and India) proliferating within the Western Academy, this article claims that what we are witnessing today is not the rise but the “return” of China (and India). Many academics assume that the West has been the dominant civilization in the world economy in the last 500 years and that the current “rise” of China threatens to knock the West off its perch. However, this article provides an alternative take to this cherished axiom of Eurocentric world history by inverting the standard belief that the West pioneered modernity and then expanded outwards to remake the world. Thus, I argue not only that globalization preceded the rise of the West but that it was Eastern-led on the one hand and that it enabled the Western breakthrough into modernity on the other. This, in turn, rests on my claim that Chinese development stems back not to 1978 but to 960 ce as the Sung Dynasty emerged and subsequently undertook a quasi-industrial miracle. Moreover, between 1450/1492 and ca. 1830 China lay at the centre of the nascent global economy, fanning the integration process alongside other key non-Western regions such as India and West Asia/North Africa. And, while the West was the dominant player after ca. 1830 down to the turn of the third millennium, nevertheless, what we witness today is the return of China to the centre of the global economy whence it came

Young pregnant women's views on the acceptability of screening for chlamydia as part of routine antenatal care

<p>Abstract</p> <p>Background</p> <p>In pregnancy, untreated chlamydia infection has been associated with adverse outcomes for both mother and infant. Like most women, pregnant women infected with chlamydia do not report genital symptoms, and are therefore unlikely to be aware of their infection. The aim of this study was to determine the acceptability of screening pregnant women aged 16-25 years for chlamydia as part of routine antenatal care.</p> <p>Methods</p> <p>As part of a larger prospective, cross-sectional study of pregnant women aged 16-25 years attending antenatal services across Melbourne, Australia, 100 women were invited to participate in a face-to-face, semi structured interview on the acceptability of screening for chlamydia during pregnancy. Women infected with chlamydia were oversampled (n = 31).</p> <p>Results</p> <p>Women had low levels of awareness of chlamydia before the test, retained relatively little knowledge after the test and commonly had misconceptions around chlamydia transmission, testing and sequelae. Women indicated a high level of acceptance and support for chlamydia screening, expressing their willingness to undertake whatever care was necessary to ensure the health of their baby. There was a strong preference for urine testing over other methods of specimen collection. Women questioned why testing was not already conducted alongside other antenatal STI screening tests, particularly in view of the risks chlamydia poses to the baby. Women who tested positive for chlamydia had mixed reactions, however, most felt relief and gratitude at having had chlamydia detected and reported high levels of partner support.</p> <p>Conclusions</p> <p>Chlamydia screening as part of routine antenatal care was considered highly acceptable among young pregnant women who recognized the benefits of screening and strongly supported its implementation as part of routine antenatal care. The acceptability of screening is important to the uptake of chlamydia screening in future antenatal screening strategies.</p

The influence of caffeine on energy content of sugar-sweetened beverages : the caffeine–calorie effect

Background/Objectives: Caffeine is a mildly addictive psychoactive chemical and controversial additive to sugar-sweetened beverages (SSBs). The objective of this study is to assess if removal of caffeine from SSBs allows co-removal of sucrose (energy) without affecting flavour of SSBs, and if removal of caffeine could potentially affect population weight gain. Subjects/Methods: The research comprised of three studies; study 1 used three-alternate forced choice and paired comparison tests to establish detection thresholds for caffeine in water and sucrose solution (subjects, n ¼ 63), and to determine if caffeine suppressed sweetness. Study 2 (subjects, n ¼ 30) examined the proportion of sucrose that could be co-removed with caffeine from SSBs without affecting the flavour of the SSBs. Study 3 applied validated coefficients to estimate the impact on the weight of the United States population if there was no caffeine in SSBs. Results: Detection threshold for caffeine in water was higher (1.09±0.08 mM) than the detection threshold for caffeine in sucrose solution (0.49 ± 0.04 mM), and a paired comparison test revealed caffeine significantly reduced the sweetness of sucrose (Po0.001). Removing caffeine from SSBs allowed co-removal of 10.3% sucrose without affecting flavour of the SSBs, equating to 116 kJ per 500 ml serving. The effect of this on body weight in adults and children would be 0.600 and 0.142 kg, which are equivalent to 2.08 and 1.10 years of observed existing trends in weight gain, respectively. Conclusion: These data suggest the extra energy in SSBs as a result of caffeine&apos;s effect on sweetness may be associated with adult and child weight gain

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO